Ultrasound-Guided HIFU for Tumor Treatment

描述（由申请人提供）： 热疗法在癌症治疗中具有重要的应用;即，治愈性或姑息性肿瘤消融。高强度聚焦超声（HIFU）对于这种应用是一种有吸引力的模态，因为它具有非侵入性地应用的潜力（即，transmitting）。有几个因素限制了HIFU治疗的有效性;即，能够：（1）基于对物理学和生物学的牢固理解开发有效的治疗方案，（2）真实的实时监测治疗进展以提供指导和控制，（3）准确有效地输送适当的热剂量，以及（4）配准目标并补偿组织运动。该项目的长期目标是开发一个集成的热治疗研究系统，该系统使用经皮HIFU作为热源，并将作为未来治疗平台的原型。具体目标是满足上述需求，开发研究治疗系统，并在体内对系统进行初步测试。目的1是发展定量的方法，高强度聚焦超声暴露量和热剂量，并验证和完善他们的治疗计划。目标2是改进我们处理射频超声（US）反向散射数据的算法，以实现对使用HIFU或其他热疗法产生的治疗进展的真实的实时监测和控制。目标3是开发新的HIFU协议，使用连续移动的聚焦区，以产生所需的体积组织温度分布和病变的几何形状，从而实现准确和有效的治疗。尽管气穴现象通常与高强度聚焦超声有关，并且可以机械地消融组织，但我们将尝试设计最大限度地减少其作用的方案。目的4是改进用于预处理多模式图像配准的算法（例如，MR和3-D US）和使用治疗时间2-D US图像进行运动补偿，并将这些算法与HIFU治疗计划、US温度传感和简单的机器人系统集成，以构建研究US引导治疗系统。目的5是在体内病变放置的急性研究中测试系统，并迭代地改进系统组件。采用多学科团队方法，涉及声学，生物学，医学，应用数学，工程和软件开发，并将建立在与HIFU技术的大型集体经验。体外和体内实验，数值建模，图像处理方法和其他工程方面将有助于实现总体目标，元件之间的密切沟通，以实现快速反馈和改进。

DESCRIPTION (provided by applicant): Thermal therapies have important applications in cancer treatment; viz., curative or palliative tumor ablation. High intensity focused ultrasound (HIFU) is an attractive modality for such applications because of its potential to be applied non-invasively (i.e., transcutaneously). Several factors limit the effectiveness of HIFU therapy; viz., the abilities to:(1) develop effective treatment protocols based on a firm understanding of the physics and biology, (2) monitor treatment progression in real time to provide guidance and control, (3) deliver the appropriate thermal dose accurately and efficiently, and (4) register the target and compensate for tissue motion. The project's long term objective is to develop an integrated thermal therapy research system that uses transcutaneous HIFU as the heat source and which would serve as a prototype for future therapy platforms. Specific aims address the needs identified above, development of a research therapy system, and preliminary testing of the system in vivo. Aim 1 is to develop quantitative approaches to HIFU exposimetry and thermal dosimetry, and to validate and refine them for treatment planning. Aim 2 is to refine our algorithms for processing radio frequency ultrasound (US) backscatter data to enable real time monitoring and control of treatment progression produced using HIFU or other thermal therapies. Aim 3 is to develop new HIFU protocols using continuously moving focal zones to produce desired volumetric tissue temperature profiles and lesion geometries, and thus enable accurate and efficient treatment. Although cavitation is often associated with HIFU and can ablate tissues mechanically, we will attempt to devise protocols that minimize its role. Aim 4 is to refine algorithms for pre-treatment multimode image registration (e.g., MR and 3-D US) and for motion compensation using time-of-treatment 2-D US images, and to integrate these algorithms with the HIFU therapy plan, US temperature sensing, and a simple robotic system to build a research US-guided therapy system. Aim 5 is to test the system in acute studies of lesion placement in vivo, and to iteratively refine the system components. A multidisciplinary team approach is taken, involving acoustics, biology, medicine, applied mathematics, engineering, and software development, and will build on a large collective experience with HIFU technology. In vitro and in vivo experimentation, numerical modeling, image processing methods and other engineering aspects will contribute to the overall goal, with close communication between elements to enable rapid feedback and refinements.