论文标题
MRI引导的HIFU方法用于消融肝脏和肾癌
MRI-guided HIFU Methods for the Ablation of Liver and Renal Cancers
论文作者
论文摘要
MRI引导的高强度聚焦超声(MRI-HIFU)是许多器官(包括肝脏和肾脏)的许多器官中病理组织非侵入性消融的有前途方法。以非侵入性的方式将热能局部沉积的可能性为新的治疗策略开辟了道路,具有提高的可靠性和减少相关的创伤,从而提高了疗效,降低住院和成本。肝脏和肾脏肿瘤代表了一个主要的健康问题,因为并非所有患者都适合手术治疗。当前,射频是经皮消融的最常用方法。基于MR指导高强度的超声(HIFU)治疗的完全非侵入性方法的发展特别令人感兴趣,这是由于患者的负担减轻了,与治疗相关的患者发病率和并发症率相关。尽管这些器官的生理运动,但MR引导的目的是在靶向病理区域内控制HIFU的热量沉积,以便提供有效的治疗,并减少持续时间和患者安全的水平提高。关于这一点,必须解决一些技术挑战:首先,两个器官在胸笼中的解剖位置需要骨间消融策略,这可以保留治疗效率,但可以防止对肋骨和肋间肌肉的不良组织损害。其次,必须将治疗指导和能量沉积与腹部的连续生理运动兼容。
MRI-guided High Intensity Focused Ultrasound (MRI-HIFU) is a promising method for the non-invasive ablation of pathological tissue in many organs, including mobile organs such as liver and kidney. The possibility to locally deposit thermal energy in a non-invasive way opens a path towards new therapeutic strategies with improved reliability and reduced associated trauma, leading to improved efficacy, reduced hospitalization and costs. Liver and kidney tumors represent a major health problem because not all patients are suitable for curative treatment with surgery. Currently, radio-frequency is the most used method for percutaneous ablation. The development of a completely non-invasive method based on MR guided high intensity focused ultrasound (HIFU) treatments is of particular interest due to the associated reduced burden for the patient, treatment related patient morbidity and complication rate. The objective of MR-guidance is hereby to control heat deposition with HIFU within the targeted pathological area, despite the physiological motion of these organs, in order to provide an effective treatment with a reduced duration and an increased level of patient safety. Regarding this, several technological challenges have to be addressed: Firstly, the anatomical location of both organs within the thoracic cage requires inter-costal ablation strategies, which preserve the therapeutic efficiency, but prevent undesired tissue damage to the ribs and the intercostal muscle. Secondly, both therapy guidance and energy deposition have to be rendered compatible with the continuous physiological motion of the abdomen.