Liquid Cooling Cycle for Ablation Using Integrated Thermal and Imaging Feedback

描述(由申请人提供)： 介入肿瘤学和肿瘤消融术是一个快速增长的癌症治疗领域，甚至可能对门诊提供图像引导的局部肿瘤治疗以实现潜在的治愈或姑息治疗具有成本效益。冷冻治疗比基于热疗的消融有一个明显的好处，那就是通过CT、US和MRI可以很好地显示冰缘。然而，0Co可见边缘并不反映完全覆盖肿瘤体积所需的细胞毒性组织温度(例如-20Co)。目前和新兴的冷冻技术无法测量组织对冷冻的反应，因为冷冻剂在加热过程中的反应过于复杂。此外，每个冷冻探头周围的可变散热片阻碍了对冰处理区域内温度的准确预测，使得目前的冷冻治疗操作员依赖于，特别是在主要血管附近。我们将展示一种新的冷冻技术的性能，它使用单相液体冷却循环，可以结合CT-可视化提供来自低温探头的集成热反馈。消融反应的组织反馈将允许确定任何可能改变冰形成和消融的邻近血管热。液体冷却循环将有助于准确测量这种相邻的加热响应，从而表征局部组织状况，这些状况将被用于通过计算机断层扫描(CT)快速预测周围温度分布和可见的冰缘。因此，冷冻治疗可以在手术中更快、更客观地纠正，以获得更好的结果，并在所有从事介入肿瘤学的医生中使用更统一的技术。与公共健康相关：该提案的目标是通过将来自新的冷冻技术的热反馈与手术的计算机断层扫描(CT)可视化相结合，来提高癌症消融结果的易用性和重复性。新的冷冻技术可以在消融过程中立即反馈目标组织的热反应，这在心脏和肿瘤学应用中都有很大的前景。计划和提供准确的治疗概况以彻底摧毁癌症肿瘤，同时保留邻近的关键结构是这项提案的主要重点，这一点更加复杂。平行的业务活动还将探索初步结果部分强调的新完成的单探头原型的许可选择，因为它可能立即应用于心律失常和更简单的商业途径。目前的提案定义了冷冻治疗癌症的潜在重大进展的背景研究。

DESCRIPTION (provided by applicant): Interventional oncology and tumor ablation is a rapidly growing field of cancer therapy that may even be cost-effective for outpatient delivery of image-guided treatments of local tumors for potential cure or paliative management. A distinct benefit of cryotherapy over heat-based ablations is the excellent visualization of ice margins by CT, US and MRI. However, the 0Co visible margin is not reflective of cytotoxic tissue temperatures (e.g., <-20Co) that are needed to thoroughly cover a tumor volume. Current and emerging cryotechnologies can not measure tissue responses to freezing due to exceedingly complex responses of the cryogens during heating. In addition, variable heat-sinks around each cryoprobe prohibit accurate temperature prediction within the ice treatment zone, making current cryotherapy operator dependent, especially near major vasculature. We will demonstrate the performance of a new cryotechnology, using a single-phase liquid cooling cycle that can provide integrated thermal feedback from the cryoprobes in combination with CT-visualization. Tissue feedback of ablation response will allow determination of any adjacent vascular heat that may alter ice formation and ablation. A liquid cooling cycle will facilitate accurate measurements of this adjacent heating response, thereby characterizing local tissue conditions which will be used to quickly predict surrounding temperature distributions in conjunction with visible ice margins by computed tomography (CT). Cryotherapy can thereby be more rapidly and objectively corrected during the procedure for better outcomes and more uniform techniques use b all physicians practicing interventional oncology. PUBLIC HEALTH RELEVANCE: The goals of the proposal are to improve the ease-of use and reproducibility of cancer ablation outcomes by integrating thermal feedback from a new cryotechnology with computed tomography (CT) visualization of the procedure. New cryotechnology that allows immediate feedback of thermal responses by the target tissue during ablation holds great promise for both cardiac and oncologic applications. The greater complexity of planning and delivering accurate treatment profiles for thorough destruction of cancerous tumors while preserving adjacent crucial structures is the primary focus of this proposal. Parallel business activities will also explore licensing options for the newly completed single probe prototype highlighted in the Preliminary Results section since it may have immediate applications for cardiac arrhythmias and a simpler commercial path. The current proposal defines background research for potential major advances in cryotherapy treatments for cancer.