Development of a Magnetic Resonance guided High Intensity Focused Ultrasound Therapy Platform for Perinatal Applications

先天异常是妊娠并发症，可能导致婴儿心力衰竭和妊娠丢失。这些都是通过超声波诊断的，如果胎儿死亡的风险超过了手术的风险，就可以进行治疗。目前的治疗方法都涉及到微创进入子宫，并伴随着早产的风险。磁共振引导高强度聚焦超声(MRgHIFU)是加拿大临床批准的一种非侵入性治疗方法，用于子宫肌瘤和骨转移瘤的热消融。MRgHIFU从位于患者下方的专用MRI工作台内的换能器传输超声波能量，并将这些能量集中到体内，产生小至米粒的热损伤。这一焦点被引导到覆盖大的治疗体积，而不需要重新定位患者。由于吸收的能量是非电离和非切开的，感染的风险和长期副作用最小，使其成为胎儿干预的理想方式。然而，在批准的装置中，能源的配置不适合怀孕的母亲，这不符合安全和符合人体工程学的治疗方案。该项目的目标是开发一种新的模块化MRgHIFU机器人平台，它将HIFU换能器带给MRI扫描仪内的患者，其配置为我们最脆弱的一些儿科患者提供了一种新颖、安全和非侵入性的治疗技术。

Congenital abnormalities are complications of pregnancy that can lead to heart failure of the baby and loss of pregnancy. These are diagnosed by ultrasound and can be treated if the risk of fetal death outweighs the risk of surgery. Current therapies all involve minimally invasive access into the uterus and comes with a risk of preterm birth. Magnetic resonance guidedhigh intensity focused ultrasound (MRgHIFU) is a noninvasive therapy that is clinically approved in Canada for thermal ablation of uterine fibroids, and bone metastasis. MRgHIFU transmits ultrasound energy from a transducer located inside a dedicated MRI table that is below the patient, and focuses that energy into the body, producing a thermal lesion as small as a rice kernel. This focus is steered to cover a large treatment volume without repositioning the patient. Since the absorbed energy is nonionizing and incisionless, the risk of infection and long-term side effects are minimal, making it an ideal modality for fetal interventions. However, in the approved devices the energy source is located in configurations that are notadapted for a pregnant mother, and this is not amenable to a safe and ergonomically feasible treatment. The objective of this project is to develop a new modular MRgHIFU robotic platform that brings a HIFU transducer to a patient inside an MRI scanner in a configuration that provides a novel, safe and noninvasive therapy technology for some of our mostvulnerable pediatric patients.