Bronchoscope-guided microwave ablation of early-stage lung tumors

项目摘要 在这个产学合作R 01研究计划中，我们提出了开发，优化， 以及对支气管镜引导微波消融（MWA）系统进行的首次人体试验性评价， 早期肺肿瘤的快速适形热消融。微创，影像- 引导的MWA是用于肝脏中不可切除的肿瘤的热破坏的成本有效的治疗， 肺肾和其他器官目前用于肺肿瘤的MWA技术仅限于 经皮入路，这排除了中央肿瘤的治疗，并具有较高的相关风险， 气胸此外，术中反馈有限，缺乏指导和治疗 规划工具给医生带来了很大的负担 目标的充分消融，同时限制对非目标的损害。虚拟支气管镜检查和 导航，率先由Broncus医疗（工业合作伙伴），提供准确，微创 进入早期肺部肿瘤，气胸的风险最小，相比之下， 经皮入路堪萨斯州立大学（学术合作伙伴）的团队将开发 用于对肺肿瘤进行局部热消融的优化的柔性微波施加器 通过支气管镜的方法所提出的MWA设备包括具有方向控制的天线， 微波功率沉积，用于精确烧蚀小目标，并将广泛评估， 计算模型和实验，在实验台上，和在体内动物模型。瞬态 天线阻抗匹配的变化将被用作评估的反馈参数 消融进展。基于机器学习的治疗计划和指导平台将在 开发并与Broncus的阿基米德计划和虚拟支气管镜检查平台集成， 指导最佳治疗参数的选择。集成系统将被翻译为先进的， 评价支气管镜输送MWA靶向的可行性和安全性的人体研究 肺肿瘤（通过Broncus Medical获得不列颠哥伦比亚省大学的子奖项）。的 本研究的中心假设是支气管镜MWA系统集成：（1）施用器， 消融轮廓的方向控制;（2）基于阻抗的术中反馈;以及（3） 支气管镜引导和治疗计划工具，将提供安全有效的治疗， 局部早期肺部肿瘤拟议的研究将导致开发一种 用于肺肿瘤的支气管镜消融的集成系统及其初步可行性评估 在人类病人身上。如果成功，这项工作将大大扩大肺结核患者的范围。 可以用具有成本效益的微创方法治疗的肿瘤。

PROJECT SUMMARY In this Industry-Academic partnership R01 research plan, we propose the development, optimization, and pilot first-in-human evaluation of a bronchoscope-guided microwave ablation (MWA) system for rapid and conformal thermal ablation of early stage pulmonary tumors. Minimally-invasive, image- guided MWA is a cost-effective treatment for thermal destruction of unresectable tumors in the liver, lung, kidney, and other organs. Current MWA technology for pulmonary tumors is limited to a percutaneous approach, which precludes treatment of central tumors and has a high associated risk of pneumothorax. Furthermore, limited intra-procedural feedback and lack of guidance and treatment planning tools places a substantial burden on the physician to precisely position applicators and ensure adequate ablation of the target, while limiting damage to non-targets. Virtual bronchoscopy and navigation, pioneered by Broncus Medical (industrial partner), affords accurate, minimally-invasive access to early-stage pulmonary tumors, with minimal risk of pneumothorax, compared to a percutaneous approach. The team at Kansas State University (academic partner) will develop optimized flexible microwave applicators for delivering localized thermal ablation to pulmonary tumors via a bronchoscopic approach. The proposed MWA devices include antennas with directional control of microwave power deposition for precise ablation of small targets, and will be extensively evaluated with computational models and experimentally, on the benchtop, and in an in vivo animal model. Transient changes in antenna impedance matching will be exploited as a feedback parameter for assessing ablation progress. A machine-learning based treatment planning and guidance platform will be developed and integrated with Broncus’ Archimedes planning and virtual bronchoscopy platform to guide the selection of optimal treatment parameters. The integrated system will be translated for first-in- human studies to evaluate the feasibility and safety of bronchoscopically delivering MWA for targeting pulmonary tumors (subaward with University of British Columbia, through Broncus Medical). The central hypothesis of this research is that a bronchoscopic MWA system integrating: (1) applicators with directional control of ablation profiles; (2) impedance-based intra-procedural feedback; and (3) bronchoscopic guidance and treatment planning tools, will afford the safe and effective treatment of localized early-stage pulmonary tumors. The proposed research will lead to the development of an integrated system for bronchoscopic ablation of pulmonary tumors, and its pilot feasibility assessment in human patients. If successful, this work will considerably expand the range of patients with lung tumors that can be treated with a cost-effective, minimally-invasive approach.