Percutaneous Vertebroplasty w/MR-Guided Laser Ablation

描述（由申请人提供）：大约30-70%的所有癌症患者最终将经历肿瘤转移到脊柱。这类肿瘤通常会给患者带来极度的疼痛和虚弱。转移性脊柱病变的治疗策略本质上是姑息性的，目标是减少肿瘤质量、缓解疼痛、保护神经功能和稳定脊柱。经皮椎体成形术，即将液体骨水泥注入受影响的椎体体内，已成为治疗脊柱转移瘤的常用方法。目前，椎体成形术与肿瘤缩小术联合进行，最常见的是通过放疗或化疗。这种双重治疗方法增加了管理成本，并可能使患者持续疼痛，直到两种治疗方案都完成。 最近，有人建议使用激光和射频加热进行脊柱肿瘤的椎体内消融。将肿瘤的靶向热消融与经皮椎体成形术相结合可能会产生一种单一的治疗技术，这种技术可以有效地同时实现当前治疗的所有目标。BioTex之前开发了一种磁共振图像引导激光治疗系统，该系统可以可视化组织结构中的激光加热。该系统可能是理想的指导安全激光消融脊柱肿瘤结合椎体成形术。 在这个提议中，我们研究了在犬模型中辅助经皮椎体成形术的MR引导激光消融治疗的技术可行性。将开发适当的激光治疗导管和成像序列，并由医学博士的介入放射科医生进行手术。德克萨斯州休斯顿的安德森癌症中心。犬研究将允许对MR引导下激光消融/椎体成形术的安全性和有效性进行关键评价。如果成功的话，这种技术可能会为某些椎管内脊柱病变提供更好的治疗选择。

DESCRIPTION (provided by applicant): Approximately 30-70% of all cancer patients will eventually experience tumor metastasis to the spine. Such tumors are often excruciatingly painful and debilitating to the patient. Treatment strategies for metastatic spinal lesions are palliative in nature and are targeted toward reduction of tumor mass, alleviation of pain, preservation of neurological function, and stabilization of the spinal column. Percutaneous vertebroplasty, whereby liquid cement is injected into the body of the affected vertebra has become a popular method for managing spinal metastases. Currently, vertebroplasty is performed in conjunction with tumor reduction most often through radiation or chemotherapy. This dual treatment approach increases the cost of management and may leave patients with continuing pain until both treatment regimens have been completed. Recently, intravertebral ablation of spinal tumors using both laser and RF heating has been suggested. Coupling targeted thermal ablation of tumors with percutaneous vertebroplasty may result in a single treatment technique, which is effective at accomplishing all the goals of current therapies at once. BioTex has previously developed a magnetic resonance image guided laser therapy system, which allows visualization of laser heating in tissue structures. This system may be ideal for guidance of safe laser ablation of spinal tumors in conjunction with vertebroplasty. In this proposal, we investigate the technical feasibility of MR-guided laser ablation therapy adjuvant to percutaneous vertebropasty in a canine model. Appropriate laser treatment catheters and imaging sequences will be developed, and procedures will be carried out by interventional radiologists at the M.D. Anderson Cancer Center in Houston, Texas. Canine studies will allow for a critical evaluation of the safety and effectiveness of MR-guided laser ablation/vertebroplasty. If successful, this technique could lead to an improved treatment option for certain intravertebral spinal lesions.