Liver Cancer Ablation Guidance BY ARFI Imaging

描述（由申请人提供）： 肝脏和其他器官的癌症消融过程的图像引导将理想地利用能够使正常解剖结构、消融电极、癌性损伤和生长的热损伤可视化的模态。当超声方法被证明不足以观察肿瘤时，通常会使用CT（有或没有荧光镜成像），并且在极少数机构中，MRI通常用于引导消融电极的放置。这些方法中没有一种在消融过程期间准确显示消融组织方面既实用又成功，结果是，目前肝脏消融在很大程度上以“盲”方式进行。MR或CT成像，特别是在导管放置尝试期间，增加了消融手术的长度和成本，并且限制了实际上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局和潜在肿瘤再生长成像的金标准。 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，这显示了很大的希望，在实时可视化的不断增长的消融病变，我们假设，将允许改善成像的肝癌病变。在开发ARFI成像作为消融引导方法以及优化和评估其临床相关性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.