MR-Guided HIFU of Soft Tissue Tumors

MR 引导的软组织肿瘤 HIFU

• 批准号: 8728144
• 负责人: Raffi S. Avedian
• 金额: $ 28.48万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8728144
• 关键词: Ablation; Adipose tissue; Adopted; Affect; Age; Anatomic structures; Anatomy; Animal Model; Animals; Area; Benign; Blood Vessels; Breast; Cadaver; Cancer Intervention; Chemotherapy-Oncologic Procedure; Clinical; Clinical Treatment; Coupling; Effectiveness; Equipment; Excision; Extremity Part; FDA approved; Family suidae; Fatty acid glycerol esters; Femoral vein; Focused Ultrasound Therapy; Foundations; Frequencies; Gel; Geometry; Goals; Gold; Heating; Histocompatibility Testing; Human; Imaging Techniques; Imaging technology; In Vitro; Incidence; Individual; Injury; Knee; Leg; Life; Limb structure; Lipomatous neoplasm; Location; Magnetic Resonance; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Metastatic Neoplasm to the Bone; Methods; Modality; Modeling; Monitor; Morbidity - disease rate; Muscle; Nerve; Operative Surgical Procedures; Outcome; Patients; Peripheral Nerves; Positioning Attribute; Prostate; Protocols documentation; Radiation; Radiation therapy; Relative (related person); Risk Factors; Safety; Series; Skin; Soft Tissue Neoplasms; Specimen; Structure; Surface; System; Techniques; Technology; Temperature; Tendon structure; Testing; Thermometry; Thick; Thigh structure; Tissues; Transducers; Treatment Effectiveness; Treatment Protocols; Ultrasonic Therapy; Ultrasonic Transducer; Ultrasonography; Uterine Fibroids; Veins; absorption; aging population; base; bone; cancer type; chemotherapy; high risk; human subject; improved; in vivo; injured; innovation; malignant breast neoplasm; novel; novel therapeutic intervention; research study; sarcoma; sciatic nerve; standard care; standard of care; tumor

Soft tissue tumors of the extremity, benign and malignant, occur in people of all ages. The incidence of these tumors will likely increase in the coming years due both to an aging population and to the longer survival of patients with a previous cancer treated with radiation and/or chemotherapy, both known to be risk factors for sarcoma. The gold standard for treatment of soft tissue tumors is complete surgical resection of the tumor and in the case of malignant tumors an additional margin of healthy tissue. Despite advances in surgical techniques, imaging technologies, chemotherapy regimens, and radiotherapy neither the morbidity associated with treating these tumors nor the survival for patients with malignant tumors has significantly improved over the past 20 years. Accordingly, there is a need for novel treatment modalities to improve the outcomes for patients who have soft tissue tumors both in terms of survival and of treatment-related morbidity. Magnetic Resonance guided High Intensity Focused Ultrasound (MRgHIFU) ablation is a noninvasive treatment modality that is currently in clinical use for treating uterine fibroids and in investigational use to treat prostate, breast, and other types of cancer. We will adapt MRgHIFU techniques to the treatment of benign and malignant soft tissue tumors of the extremities with the goal of safely and effectively performing HIFU ablation on human subjects. A series of cadaver experiments will define the best methods to couple the ultrasound transducer to the extremity, determine the accuracy of MRgHIFU treatment in different tissues such as tendon, fat, muscle and near bone, and characterize the effect of using different ultrasound frequencies on the ablation of target tissue and the surrounding healthy tissue. In an animal model, we will determine how closely MRgHIFU ablation can be performed relative to important anatomic structures such as major peripheral nerves without causing injury. We will test the accuracy and effectiveness of the HIFU treatment in patients prior to standard of care surgical removal of the tumors. Also, we will optimize the post ablation imaging techniques to assess effectiveness of treatment.

各个年龄段的人都发生了末端和恶性的软组织肿瘤。这些发生率 由于人口老龄化和较长的生存率，肿瘤可能会在未来几年增加 先前接受放射线和/或化学疗法治疗的癌症的患者，这两者都被称为危险因素 肉瘤。软组织肿瘤治疗的金标准是肿瘤的完整手术切除 在恶性肿瘤的情况下，健康组织的额外缘。尽管手术进展 技术，成像技术，化学疗法方案和放射疗法都不发病 与治疗这些肿瘤或恶性肿瘤患者的生存有关 在过去的20年中有所改善。因此，需要新颖的治疗方式来改善 在生存和治疗相关的患者中，患有软组织肿瘤的患者的结局 发病率。磁共振引导的高强度聚焦超声（MRGHIFU）消融是 目前正在用于治疗子宫肌瘤的非侵入性治疗方式 用于治疗前列腺，乳房和其他类型的癌症的研究用途。我们将改编Mrghifu技术 末端的良性和恶性软组织肿瘤的治疗，以安全和 有效地对人类受试者进行HIFU消融。一系列尸体实验将定义最好的 将超声传感器搭配到末端的方法，确定mrghifu的准确性 在不同组织中的治疗，例如肌腱，脂肪，肌肉和近骨，并表征了使用的影响 目标组织和周围健康组织的消融上的不同超声频率。在 动物模型，我们将确定如何相对于重要的MRGHIFU消融 解剖结构，例如主要的周围神经而不会引起损伤。我们将测试准确性和 HIFU治疗在护理标准的手术清除肿瘤之前的有效性。还， 我们将优化后消融成像技术来评估治疗的有效性。