Development of a Magnetic Resonance guided High Intensity Focused Ultrasound Therapy Platform for Perinatal Applications

先天性畸形是妊娠并发症，可导致婴儿心力衰竭和流产。这些都是通过超声诊断，可以治疗，如果胎儿死亡的风险超过手术的风险。目前的治疗方法都涉及微创进入子宫，并伴有早产的风险。磁共振引导的 高强度聚焦超声（MRgHIFU）是一种非侵入性疗法，在加拿大临床上被批准用于子宫肌瘤和骨转移的热消融。MRgHIFU从位于患者下方的专用MRI台内的换能器传输超声能量，并将该能量聚焦到体内，产生像米粒一样小的热损伤。该焦点被引导以覆盖大的治疗体积，而无需重新定位患者。由于吸收的能量是非电离的，无切口，感染和长期副作用的风险很小，使其成为胎儿干预的理想方式。然而，在已批准的器械中，能量源位于不 适合于怀孕的母亲，并且这不适合于安全和人体工程学上可行的治疗。该项目的目标是开发一种新的模块化MRgHIFU机器人平台，该平台将HIFU换能器带到MRI扫描仪内的患者，该配置为我们的一些最重要的疾病提供新颖，安全和无创的治疗技术。 脆弱的儿科病人

Congenital abnormalities are complications of pregnancy that can lead to heart failure of the baby and loss of pregnancy. These are diagnosed by ultrasound and can be treated if the risk of fetal death outweighs the risk of surgery. Current therapies all involve minimally invasive access into the uterus and comes with a risk of preterm birth. Magnetic resonance guided high intensity focused ultrasound (MRgHIFU) is a noninvasive therapy that is clinically approved in Canada for thermal ablation of uterine fibroids, and bone metastasis. MRgHIFU transmits ultrasound energy from a transducer located inside a dedicated MRI table that is below the patient, and focuses that energy into the body, producing a thermal lesion as small as a rice kernel. This focus is steered to cover a large treatment volume without repositioning the patient. Since the absorbed energy is nonionizing and incisionless, the risk of infection and long-term side effects are minimal, making it an ideal modality for fetal interventions. However, in the approved devices the energy source is located in configurations that are not adapted for a pregnant mother, and this is not amenable to a safe and ergonomically feasible treatment. The objective of this project is to develop a new modular MRgHIFU robotic platform that brings a HIFU transducer to a patient inside an MRI scanner in a configuration that provides a novel, safe and noninvasive therapy technology for some of our most vulnerable pediatric patients.