PROSTATE CANCER AND BPH ABLATION USING HIFU WAVEGUIDE

描述（改编自申请人摘要）：申请人提出 设计和制造一种经尿道声波导系统 良性前列腺病变组织切除术 前列腺肥大（BPH）和前列腺癌。的一般方法 将采用声波导和经尿道方法 将高强度聚焦超声（HIFU）应用于前列腺。 申请人提出开始通过开发原型波导 使用大型外部换能器来产生高水平声波的系统 能量将通过前列腺传输到前列腺。 波导，并使其在前列腺内形成足够尖锐的焦点 造成热消融该波导系统可能是 能够使治疗焦点沿着3个自由度移动， 以便将超声波能量转换通过 以受控方式切除前列腺。申请人将 通过声场标测评估体外波导系统， 一个纹影摄影过程，并在研究幻影和切除 组织，并将确定一个最佳的治疗方案， 应用于系统的电力，最有效的 移动波导焦点的技术，以及最佳方法 以冷却和保护附近的敏感正常结构， 前列腺使用循环水浴。犬的后续评价 将使用确定为 体外工作中最佳的，以评估能力 在体内产生受控的前列腺消融， 评估邻近前列腺周围组织的损伤程度。所有 将使用新的MR热成像进行体模和动物研究 用于监测组织加热的标测技术。这些技术将 包括快速T1加权和相敏MR成像，优化用于 这个应用程序。完成这项工作后，申请人预计 开发并测试了声波导系统， 通过MRI热标测引导的超声输送， BPH的高效微创治疗的潜力 和前列腺癌的局部控制。

DESCRIPTION (Adapted from Applicant's Abstract): The applicants proposed to design and fabricate a transurethral acoustic waveguide system for the ablation of abnormal human prostatic tissue involved with benign prostatic hypertrophy (BPH) and prostate cancer. The general approach would be to employ an acoustic waveguide and a transurethral approach to apply high-intensity focused ultrasound (HIFU) to the prostate gland. The applicants proposed to begin by developing a prototype waveguide system using a large external transducer to create high levels of sonic energy which would be transmitted to the prostate gland by the waveguide, and brought to a sufficiently sharp focus within the prostate to cause thermal ablation. The waveguide system would potentially be capable of moving the treating focal spot along 3 degrees of freedom so as to translate the ultrasonic energy through the regions of the prostate to be ablated in a controlled manner. The applicants would evaluate the waveguide system in vitro by acoustic field mapping using a Schlieren photographic process, and in studies of phantoms and excised tissues, and would determine an optimal treatment protocol in terms of the electrical power applied to the system, the most effective techniques for moving the focal spot of the waveguide, and the best way in which to cool and protect sensitive normal structures near the prostate using a circulating water bath. Subsequent evaluations in dogs would be performed with the insonification protocol determined to be most optimal from the in vitro work, in order to evaluate the ability of the device to produce controlled prostatic ablation in vivo, and to assess the degree of damage to adjacent periprostatic tissues. All phantom and animal studies would be performed with new MR thermal mapping techniques for monitoring tissue heating. These techniques would include rapid T1-weighted and phase-sensitive MR imaging optimized for this application. Upon completion of this work, the applicants expect to have developed and tested an acoustic waveguide system, with ultrasonic delivery guided by thermal mapping with MRI, that has the potential for highly effective and minimally invasive treatment of BPH and local control of prostate cancer.