MR Guided Focused Ultrasound Surgery

在本研究的当前资助期间，我们成功地实施了基于MRI的 用于监测聚焦超声治疗的温度计。我们已经使用了基于MRI的测温技术来 在短时间内确定组织损伤的阈值热剂量，我们有 在临床环境中证明了其在治疗乳腺纤维腺瘤、乳腺癌和 子宫肌瘤。我们还开发了治疗计划的方法，并展示了波前的影响 由覆盖的组织造成的变形。基于这些结果，我们建议通过测试 以下假设：腔内超声相控阵可以有效地凝固前列腺 当使用MRI体温监测时，肿瘤。为了检验这一假设，我们首先要探索其可行性。 用腔内聚焦超声相控阵研制线阵进行磁共振监测 早期前列腺癌微创超声手术及临床前应用系统 在动物模型上进行了试验。其次，我们将探索利用核磁共振获取的温度信息的方法 控制治疗，以完成完全靶体积的凝固。最后， 我们将开发全尺寸二维经直肠阵列，充分发挥相控阵的潜力 超声技术用于治疗前列腺疾病。在这项研究结束时，我们将有 开发了一种用于临床可行性测试的必要方法 电凝法治疗前列腺癌，既可缩短治疗时间，又可减少阳萎发生率。这 手术可能会用一种可能在门诊患者身上进行的方法来取代目前的开放手术 而且侵入性要小得多。拟议治疗的医疗益处是显著的， 包括更快的恢复、更低的成本以及更低的感染和出血风险

During the current funded period of this research, we have successfully implemented MRI-based thermometry for the monitoring of focused ultrasound treatments. We have used MRI-based thermometry to determine the threshold thermal dose for tissue damage during short sonications, and we have demonstrated its usefulness in a clinical setting in treatments of breast fibroadenomas, breast cancer, and uterine fibroids. We have also developed methods for treatment planning and shown the impact of wavefront distortion by overlying tissues. Based on these results, we propose to further this research by testing the following hypothesis: Intracavitary ultrasound phased arrays can be used to effectively coagulate prostate tumors when MRI temperature monitoring is used. To test this hypothesis we will first, explore the feasibility of using intracavitary focused ultrasound phased arrays with MRI monitoring by developing a linear array system for minimally invasive ultrasound surgery of early stage prostate cancer and performing pre-clinical tests of it in an animal model. Second, we will explore methods to use MRI derived temperature information to control the treatment so that the coagulation of the complete target volume can be accomplished. Finally, we will develop full-scale two-dimensional transrectal arrays that will exploit the full potential of phased array ultrasound technology for the treatment of prostate disease. At the close of this research we will have developed the necessary methods for clinical feasibility testing of a precise and monitored thermal coagulation method for prostate cancer that can reduce both the treatment time and the impotency rate. This procedure may replace current open surgery with a method that could potentially be performed on outpatient basis and is much less invasive. The healthcare benefits of the proposed treatments are significant and include faster recovery, reduced cost, and a lowered risk of infection and bleeding