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用于改善磁共振引导聚焦超声消融中热损伤空间控制的实验方法。

Experimental methods for improved spatial control of thermal lesions in magnetic resonance-guided focused ultrasound ablation.

机构信息

Department of Radiology, University Hospitals of Geneva, Geneva, Switzerland.

出版信息

Ultrasound Med Biol. 2013 Sep;39(9):1580-95. doi: 10.1016/j.ultrasmedbio.2013.03.018. Epub 2013 Jun 29.

Abstract

Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU, or MRgFUS) is a hybrid technology that was developed to provide efficient and tolerable thermal ablation of targeted tumors or other pathologic tissues, while preserving the normal surrounding structures. Fast 3-D ablation strategies are feasible with the newly available phased-array HIFU transducers. However, unlike fixed heating sources for interstitial ablation (radiofrequency electrode, microwave applicator, infra-red laser applicator), HIFU uses propagating waves. Therefore, the main challenge is to avoid thermo-acoustical adverse effects, such as energy deposition at reflecting interfaces and thermal drift of the focal lesion toward the near field. We report here our investigations on some novel experimental solutions to solve, or at least to alleviate, these generally known tolerability problems in HIFU-based therapy. Online multiplanar MR thermometry was the main investigational tool extensively used in this study to identify the problems and to assess the efficacy of the tested solutions. We present an improved method to cancel the beam reflection at the exit window (i.e., tissue-to-air interface) by creating a multilayer protection, to dissipate the residual HIFU beam by bulk scattering. This study evaluates selective de-activation of transducer elements to reduce the collateral heating at bone surfaces in the far field, mainly during automatically controlled volumetric ablation. We also explore, using hybrid US/MR simultaneous imaging, the feasibility of using disruptive boiling at the focus, both as a far-field self-shielding technique and as an enhanced ablation strategy (i.e., boiling core controlled HIFU ablation).

摘要

磁共振引导高强度聚焦超声(MRgHIFU,或 MRgFUS)是一种混合技术,旨在提供高效且可耐受的靶向肿瘤或其他病理组织的热消融,同时保护正常的周围结构。新型相控阵 HIFU 换能器可实现快速 3D 消融策略。然而,与用于间质消融的固定加热源(射频电极、微波治疗器、红外激光治疗器)不同,HIFU 使用传播波。因此,主要的挑战是避免热声副作用,例如在反射界面处的能量沉积和焦点病变向近场的热漂移。我们在此报告了我们对一些解决这些普遍存在的基于 HIFU 的治疗耐受性问题的新型实验解决方案的研究。在线多平面磁共振测温是本研究中广泛使用的主要研究工具,用于识别问题并评估测试解决方案的效果。我们提出了一种改进的方法,通过创建多层保护来消除出口窗(即组织-空气界面)处的波束反射,通过体散射来耗散残余的 HIFU 波束。这项研究评估了选择性停用换能器元件以减少远场骨表面的附带加热,主要是在自动控制的容积消融期间。我们还使用超声/磁共振混合实时成像来探索在焦点处产生空化的可行性,作为远场自屏蔽技术和增强消融策略(即沸腾核控制的 HIFU 消融)。

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