Optimising patient specific treatment plans for ultrasound ablative therapies in the abdomen (OptimUS)

手术和消融技术是治疗实体肿瘤最有效的局部治疗方法。与手术干预相关的显著副作用导致了对更安全、更有效和耐受性更好的替代方案的持续追求。近年来，已经从开放手术向微创手术（如腹腔镜和机器人手术）以及从那里向原位肿瘤破坏的其他方法（通常涉及基于能量的破坏）发生了显著的转变。这些包括栓塞、射频、微波和激光消融、冷冻消融和HIFU。HIFU是一种使用高振幅超声来热消融组织局部区域的手术。对于腹部应用，超声通常由位于体外的聚焦换能器产生。当超声波在组织中传播时，在高声强下，能量的吸收可以在明确定义的体积内诱导靶组织坏死，而不会损坏覆盖的组织。OptimUS的目的是为使用HIFU消融的腹部肿瘤开发一种新的数学和治疗规划框架。这个新框架将专门为获得CE认证的市售MR引导和监测HIFU系统而构建，该系统包括一个多元件传感器。它将利用高性能计算能力，准确快速地提供最佳治疗计划。这一框架将极大地扩展和加强HIFU作为一种完全非侵入性消融方式的作用，并从根本上改善肾脏、胰腺和肝脏肿瘤、子宫肌瘤和肾交感神经去支配（RSD）的治疗。世界领先的研究人员和合作伙伴已经聚集在这个项目上，来自伦敦大学学院、剑桥大学、英国癌症研究所和牛津大学HIFU单位。所有这些都带来了数学，工程，物理，肿瘤学和计算领域的独特而互补的专业知识，以解决一系列复杂的挑战，这将导致患者的生活质量和预期寿命显着提高。此外，HIFU治疗计划方法的发展将导致更具成本效益的癌症治疗方案，节省NHS的时间，资源和金钱。

Surgical and ablative technologies are the most effective local therapies for solid malignancies. The significant side effects associated with surgical interventions have led to an ongoing quest for safer, more efficient, and better tolerated alternatives. In recent years, there has been a notable shift away from open surgery towards less invasive procedures such as laparoscopic and robotic surgery, and from there to other methods for in situ tumour destruction, often involving energy based destruction. These include embolisation, radiofrequency, microwave and laser ablation, cryoablation and HIFU. HIFU is a procedure which uses high-amplitude ultrasound to thermally ablate a localised region of tissue. For abdominal applications, the ultrasound is typically generated by a focused transducer located extracorporealy. As the ultrasound propagates through tissue and at high acoustic intensities, absorption of the energy can induce targeted tissue necrosis within a well-defined volume without damaging the overlying tissue.The aim of OptimUS is to develop a novel mathematical and treatment planning framework for tumours of the abdomen which are to be ablated using HIFU. This new framework will be purpose built for a CE marked commercially available MR-guided & monitored HIFU system, which includes a multi-element transducer. It will make use of high-performance computing capabilities which will deliver optimal treatment plans both accurately and fast. This framework will greatly extend and reinforce the role of HIFU as a completely non-invasive ablative modality, and radically improve the treatment of kidney, pancreas and liver tumours, of uterine fibroids and renal sympathetic denervation (RSD).World-leading investigators and partners have been assembled to collaborate on this project, from University College London, University of Cambridge, the Institute of Cancer Research UK and Oxford HIFU Unit. All bring unique yet complementary expertise in the fields of mathematics, engineering, physics, oncology and computing to solve a series of complex challenges, which will lead to a significant increase in the quality of life and life expectancy of patients. In addition, the development of HIFU treatment planning methods will lead to more cost-effective cancer treatment protocols, saving the NHS time, resources and money.