MR-Guided HIFU of Soft Tissue Tumors

四肢软组织肿瘤，良性和恶性，发生在所有年龄段的人。这些事件的发生率 肿瘤在未来几年可能会增加，这既是因为人口老龄化，也是因为人类生存时间更长 既往癌症患者接受过放射和/或化疗，这两者都是已知的致癌危险因素 肉瘤。治疗软组织肿瘤的金标准是完全手术切除肿瘤 在恶性肿瘤的情况下，增加健康组织的边缘。尽管外科技术取得了进步 技术、成像技术、化疗方案和放疗都不会降低发病率 与这些肿瘤的治疗相关的恶性肿瘤患者的存活率也有显著差异 在过去的20年里得到了改善。因此，需要新的治疗方式来改善 软组织肿瘤患者的生存和治疗相关预后 发病率。磁共振引导高强度聚焦超声(MRgHIFU)消融是一种 目前临床上用于治疗子宫肌瘤和子宫肌瘤的无创治疗方式 用于治疗前列腺癌、乳腺癌和其他类型癌症的研究用药。我们将调整MRgHIFU技术以 四肢软组织良恶性肿瘤的治疗 在人体受试者身上有效地进行HIFU消融。一系列身体实验将确定最好的 方法将超声换能器连接到四肢，确定磁共振高强度聚焦超声检查的准确性 在肌腱、脂肪、肌肉和近骨等不同组织中进行治疗，并表征其效果。 不同超声频率对靶区组织及周围健康组织的消融效果。在一个 动物模型，我们将确定MRgHIFU消融相对于重要的 不会造成损伤的主要周围神经等解剖结构。我们将测试精确度和 HIFU治疗患者在标准护理标准手术切除肿瘤前的疗效。另外， 我们将优化消融后成像技术以评估治疗效果。

Soft tissue tumors of the extremity, benign and malignant, occur in people of all ages. The incidence of these tumors will likely increase in the coming years due both to an aging population and to the longer survival of patients with a previous cancer treated with radiation and/or chemotherapy, both known to be risk factors for sarcoma. The gold standard for treatment of soft tissue tumors is complete surgical resection of the tumor and in the case of malignant tumors an additional margin of healthy tissue. Despite advances in surgical techniques, imaging technologies, chemotherapy regimens, and radiotherapy neither the morbidity associated with treating these tumors nor the survival for patients with malignant tumors has significantly improved over the past 20 years. Accordingly, there is a need for novel treatment modalities to improve the outcomes for patients who have soft tissue tumors both in terms of survival and of treatment-related morbidity. Magnetic Resonance guided High Intensity Focused Ultrasound (MRgHIFU) ablation is a noninvasive treatment modality that is currently in clinical use for treating uterine fibroids and in investigational use to treat prostate, breast, and other types of cancer. We will adapt MRgHIFU techniques to the treatment of benign and malignant soft tissue tumors of the extremities with the goal of safely and effectively performing HIFU ablation on human subjects. A series of cadaver experiments will define the best methods to couple the ultrasound transducer to the extremity, determine the accuracy of MRgHIFU treatment in different tissues such as tendon, fat, muscle and near bone, and characterize the effect of using different ultrasound frequencies on the ablation of target tissue and the surrounding healthy tissue. In an animal model, we will determine how closely MRgHIFU ablation can be performed relative to important anatomic structures such as major peripheral nerves without causing injury. We will test the accuracy and effectiveness of the HIFU treatment in patients prior to standard of care surgical removal of the tumors. Also, we will optimize the post ablation imaging techniques to assess effectiveness of treatment.