Liver Cancer Ablation Guidance BY ARFI Imaging

描述(由申请人提供)： 理想情况下，肝脏和其他器官的癌症消融手术的图像引导将利用一种能够可视化正常解剖结构、消融电极、癌变病变和不断增长的热损伤的方法。当超声方法证明不足以观察肿瘤时，如经常发生的情况，使用和不使用透视成像的CT，在极少数机构，MRI经常被用来指导消融电极的放置。这些方法都不是既实用又成功地在消融过程中准确地显示被消融的组织，结果是，目前的肝脏消融在很大程度上是“盲目的”进行的。MR或CT成像，特别是在导管放置尝试期间，增加了消融过程的长度和成本，并限制了实际可以消融的部位的数量。然而，MR、CT和PET成像仍然是评估消融结果和潜在肿瘤再生长的金标准。 我们已经开发了一种新的超声成像方法，声辐射力脉冲(ARFI)成像，它在实时显示不断增长的消融病变方面显示出巨大的前景，我们假设，将能够改进对肝脏癌症病变的成像。在发展ARFI成像作为消融指导方法以及优化和评估其临床意义方面仍然存在重大挑战。

DESCRIPTION (provided by applicant): Image guidance of cancer ablation procedures of the liver and other organs would ideally utilize a modality capable of visualizing normal anatomic structures, the ablation electrode, the cancerous lesion, and the growing thermal lesion. When, as frequently occurs, ultrasonic methods prove inadequate in viewing the tumor, CT with and without fluoroscopic imaging, and, in very few institutions, MRI are often used to guide placement of the ablation electrode. None of these methods are both practical and successful in accurately displaying the ablated tissue during the ablation procedure with the result that, currently, liver ablations are performed in a largely "blinded" fashion. MR or CT imaging, especially during the catheter placement attempts, increases the length and cost of ablation procedures and limits the number of sites than can be practically ablated. However, MR, CT, and PET imaging remain the gold standard for assessment of ablation outcomes and imaging of potential tumor regrowth. We have developed a novel ultrasonic imaging method, Acoustic Radiation Force Impulse (ARFI) imaging, which shows great promise in real-time visualization of growing ablation lesions and, we hypothesize, will allow improved imaging of cancerous lesions in the liver. Significant challenges remain in developing ARFI imaging as an ablation guidance method and in optimizing and assessing its clinical relevance.