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In vivo evaluation of focused ultrasound ablation surgery (FUAS)-induced coagulation using echo amplitudes of the therapeutic focused ultrasound transducer. 利用治疗性聚焦超声换能器的回波振幅,对聚焦超声消融手术(FUAS)诱导的凝血过程进行体内评估。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-04 DOI: 10.1080/02656736.2024.2325477
Yufeng Zhou, Xiaobo Gong, Yaqing You

Objective: Monitoring sensitivity of sonography in focused ultrasound ablation surgery (FUAS) is limited (no hyperechoes in ∼50% of successful coagulation in uterine fibroids). A more accurate and sensitive approach is required.

Method: The echo amplitudes of the focused ultrasound (FUS) transducer in a testing mode (short pulse duration and low power) were found to correlate with the ex vivo coagulation. To further evaluate its coagulation prediction capabilities, in vivo experiments were carried out. The liver, kidney, and leg muscles of three adult goats were treated using clinical FUAS settings, and the echo amplitude of the FUS transducer and grayscale in sonography before and after FUAS were collected. On day 7, animals were sacrificed humanely, and the treated tissues were dissected to expose the lesion. Echo amplitude changes and lesion areas were analyzed statistically, as were the coagulation prediction metrics.

Results: The echo amplitude changes of the FUS transducer correlate well with the lesion areas in the liver (R = 0.682). Its prediction in accuracy (94.4% vs. 50%), sensitivity (92.9% vs. 35.7%), and negative prediction (80% vs. 30.8%) is better than sonography, but similar in specificity (80% vs. 100%) and positive prediction (100% vs. 100%). In addition, the correlation between tissue depth and the lesion area is not good (|R| < 0.2). Prediction performances in kidney and leg muscles are similar.

Conclusion: The FUS echo amplitudes are sensitive to the tissue properties and their changes after FUAS. They are sensitive and reliable in evaluating and predicting FUAS outcomes.

目的:在聚焦超声消融手术(FUAS)中,超声波检查的监测灵敏度有限(子宫肌瘤成功凝固的 50% 以上无高回声)。需要一种更准确、更灵敏的方法:方法:研究发现,聚焦超声(FUS)换能器在测试模式(短脉冲持续时间和低功率)下的回声振幅与体内凝固相关。为进一步评估其凝血预测能力,进行了体内实验。使用临床 FUAS 设置对三只成年山羊的肝脏、肾脏和腿部肌肉进行治疗,并收集 FUAS 前后 FUS 传感器的回波振幅和声像图的灰度。第 7 天,对动物进行人道处死,解剖处理过的组织以暴露病变。对回波振幅变化和病变面积以及凝血预测指标进行统计分析:结果:FUS 换能器的回声振幅变化与肝脏病变区域有很好的相关性(R = 0.682)。其预测准确性(94.4% 对 50%)、敏感性(92.9% 对 35.7%)和阴性预测(80% 对 30.8%)均优于超声波检查,但特异性(80% 对 100%)和阳性预测(100% 对 100%)相似。此外,组织深度与病变面积之间的相关性并不好(|R| < 0.2)。肾脏和腿部肌肉的预测性能相似:结论:FUS回波振幅对组织特性及其在FUAS后的变化很敏感。结论:FUS 回波振幅对组织特性及其在 FUAS 后的变化很敏感,在评估和预测 FUAS 结果方面灵敏可靠。
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引用次数: 0
Feasibility and acceptability of an integrated mind-body intervention for depression: whole-body hyperthermia (WBH) and cognitive behavioral therapy (CBT). 身心综合干预抑郁症的可行性和可接受性:全身热疗(WBH)和认知行为疗法(CBT)。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-05-14 DOI: 10.1080/02656736.2024.2351459
Ashley E Mason, Anoushka Chowdhary, Wendy Hartogensis, Chelsea J Siwik, Osnat Lupesko-Persky, Leena S Pandya, Stefanie Roberts, Claudine Anglo, Patricia J Moran, J Craig Nelson, Christopher A Lowry, Rhonda P Patrick, Charles L Raison, Frederick M Hecht

Objective: To examine the feasibility of an integrated mind-body MDD treatment combining cognitive behavioral therapy (CBT) and whole-body hyperthermia (WBH).

Methods: In this single-arm trial, 16 adults with MDD initially received 8 weekly CBT sessions and 8 weekly WBH sessions. Outcomes included WBH sessions completed (primary), self-report depression assessments completed (secondary), and pre-post intervention changes in depression symptoms (secondary). We also explored changes in mood and cognitive processes and assessed changes in mood as predictors of overall treatment response.

Results: Thirteen participants (81.3%) completed 4 WBH sessions (primary outcome); midway through the trial, we reduced from 8 weekly to 4 bi-weekly WBH sessions to increase feasibility. The n = 12 participants who attended the final assessment visit completed 100% of administered self-report depression assessments; all enrolled participants (n = 16) completed 89% of these assessments. Among the n = 12 who attended the final assessment visit, the average pre-post-intervention BDI-II reduction was 15.8 points (95% CI: -22.0, -9.70), p = 0.0001, with 11 no longer meeting MDD criteria (secondary outcomes). Pre-post intervention improvements in negative automatic thinking, but not cognitive flexibility, achieved statistical significance. Improved mood from pre-post the initial WBH session predicted pre-post treatment BDI-II change (36.2%; rho = 0.60, p = 0.038); mood changes pre-post the first CBT session did not.

Limitations: Small sample size and single-arm design limit generalizability.

Conclusion: An integrated mind-body intervention comprising weekly CBT sessions and bi-weekly WBH sessions was feasible. Results warrant future larger controlled clinical trials.Clinivaltrials.gov Registration: NCT05708976.

目的研究结合认知行为疗法(CBT)和全身热疗(WBH)的身心MDD综合疗法的可行性:在这项单臂试验中,16 名患有 MDD 的成人最初接受了每周 8 次的 CBT 治疗和每周 8 次的全身热疗治疗。结果包括完成的 WBH 课程(主要)、完成的自我报告抑郁评估(次要)以及干预前抑郁症状的变化(次要)。我们还探讨了情绪和认知过程的变化,并将情绪变化作为整体治疗反应的预测因素进行了评估:13名参与者(81.3%)完成了≥4次WBH疗程(主要结果);在试验中途,我们将每周8次的WBH疗程减少为每两周4次,以提高可行性。参加最终评估访问的 12 名参与者 100%完成了自我报告抑郁评估;所有注册参与者(16 人)完成了 89% 的评估。在参加最终评估的 n = 12 名参与者中,干预前 BDI-II 平均降低了 15.8 分(95% CI:-22.0,-9.70),p = 0.0001,其中 11 人不再符合 MDD 标准(次要结果)。干预前-干预后,消极自动思维的改善达到了统计学意义,但认知灵活性的改善没有达到统计学意义。首次WBH治疗前后的情绪改善可预测治疗前BDI-II的变化(36.2%;rho = 0.60,p = 0.038);而首次CBT治疗前后的情绪变化则无法预测:局限性:样本量小和单臂设计限制了推广性:结论:由每周一次的CBT课程和每两周一次的WBH课程组成的综合身心干预是可行的。结果值得在未来进行更大规模的临床对照试验:NCT05708976。
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引用次数: 0
Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study. 经皮微波消融与硬化剂注射治疗大肝脏血管瘤:一项多中心队列研究。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.1080/02656736.2023.2285705
Qian Cai, Tong-Gang Qian, Qi-Yu Zhao, Shun-You Feng, Qiao Yang, Yan-Chun Luo, Yu-Qing Dai, Ping Liang, Xiao-Ling Yu, Fang-Yi Liu, Zhi-Yu Han, Qiao-Wei Du, Xin Li, Jie Yu

Objective: The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH).

Methods: This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR.

Results: During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006).

Conclusions: Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.

研究目的该研究旨在比较超声引导下微波消融术(MWA)和经皮硬化剂注射术(PS)治疗肝大血管瘤(LHH)的有效性和安全性:这项回顾性研究纳入了2016年1月至2021年12月期间在三家三级医院接受微波消融术(54例)和经皮硬化剂注射术(42例)作为LHH一线治疗的96例患者。主要结果为技术有效率(12个月时体积缩小率[VRR] >50%)、12个月时症状缓解率和局部肿瘤进展(LTP)。次要结果包括手术时间、主要并发症、治疗次数、费用以及一年、两年、三年的体积缩小率:结果:在中位随访 36 个月期间,MWA 组的技术有效率(100% 对 90.4%,p = .018)和症状缓解率(100% 对 80%,p = .123)均高于 PS 组。与 PS 相比,MWA 组的治疗次数更少,一年、两年和三年的 VRR 更高,LTP 率更低(所有 p p = .432)。经过多变量分析,病变的异质性和最大直径大于 8.1 厘米是 LTP 的独立危险因素(所有 p 0.115 mg/cm3 的 LTP 风险较低(p = .006):结论:MWA和PS治疗巨大肝血管瘤均安全有效,其中MWA在疗效方面更胜一筹。
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引用次数: 0
Impacts of hyperthermic chemotherapeutic agent on cytotoxicity, chemoresistance-related proteins and PD-L1 expression in human gastric cancer cells. 热化疗药物对人胃癌细胞毒性、化疗耐药相关蛋白和 PD-L1 表达的影响
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-13 DOI: 10.1080/02656736.2024.2310017
Bor-Chyuan Su, Guan-Yu Chen, Chun-Ming Yang, Wei-Ting Chuang, Meng-Chieh Lin, Pei-Ling Hsu, Chu-Wan Lee, Chih-Cheng Cheng, Shih-Ying Wu, Bo-Syong Pan, Hsin-Hsien Yu

Objective: Gastric cancer with peritoneal metastasis is considered to be final stage gastric cancer. One current treatment approach for this condition is combined cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). However, the therapeutic mechanisms of HIPEC remain largely undescribed. Method: In order to assess the cellular effects of HIPEC in vitro, we treated AGS human gastric adenocarcinoma cells with or without 5-fluorouracil (5-Fu) at 37 °C or at 43 °C (hyperthermic temperature) for 1 h followed by incubation at 37 °C for 23 h. The impacts of hyperthermia/5-Fu on apoptosis, cell survival signals, oxidative stress, chemoresistance-related proteins and programmed death-ligand 1 (PD-L1) expression were measured. Results: Our results showed that hyperthermia potentiates 5-Fu-mediated cytotoxicity in AGS cells. Furthermore, the combination of 5-Fu and hyperthermia reduces levels of both phosphorylated STAT3 and STAT3, while increasing the levels of phosphorylated Akt and ERK. In addition, 5-Fu/hyperthermia enhances reactive oxygen species and suppresses superoxide dismutase 1. Chemoresistance-related proteins, such as multidrug resistance 1 and thymidylate synthase, are also suppressed by 5-Fu/hyperthermia. Interestingly, hyperthermia enhances 5-Fu-mediated induction of glycosylated PD-L1, but 5-Fu-mediated upregulation of PD-L1 surface expression is prevented by hyperthermia. Conclusion: Taken together, our findings provide insights that may aid in the development of novel therapeutic strategies and enhanced therapeutic efficacy of HIPEC.

目的:伴有腹膜转移的胃癌被认为是晚期胃癌。目前治疗这种情况的一种方法是联合细胞还原手术和腹腔热化疗(HIPEC)。然而,HIPEC 的治疗机制在很大程度上仍未得到阐明。方法:为了评估HIPEC在体外对细胞的影响,我们在37 °C或43 °C(高热温度)下用或不用5-氟尿嘧啶(5-Fu)处理AGS人胃腺癌细胞1小时,然后在37 °C下培养23小时,测量高热/5-Fu对细胞凋亡、细胞存活信号、氧化应激、化疗耐药相关蛋白和程序性死亡配体1(PD-L1)表达的影响。结果显示结果表明,热疗能增强 5-Fu 介导的 AGS 细胞毒性。此外,5-Fu 和热疗联合使用可降低磷酸化 STAT3 和 STAT3 的水平,同时提高磷酸化 Akt 和 ERK 的水平。此外,5-Fu/热疗还会增强活性氧并抑制超氧化物歧化酶1。化疗耐药性相关蛋白,如多药耐药性 1 和胸苷酸合成酶,也受到 5-Fu/hyperthermia 的抑制。有趣的是,热疗可增强 5-Fu 介导的糖基化 PD-L1 诱导,但热疗可阻止 5-Fu 介导的 PD-L1 表面表达上调。结论综上所述,我们的研究结果有助于开发新型治疗策略和提高 HIPEC 的疗效。
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引用次数: 0
High-intensity focused ultrasound ablation in the treatment of fumarate hydratase-deficient uterine leiomyoma. 高强度聚焦超声消融治疗富马酸氢化酶缺陷型子宫肌瘤。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-29 DOI: 10.1080/02656736.2024.2384459
Luyao Zhang, Zhouzhou Liao, Jianfa Jiang

Objective: This study aimed to explore the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation for treating fumarate hydratase (FH)-deficient uterine leiomyomas.

Method: Ten patients with FH-deficient uterine leiomyomas treated with HIFU ablation at the Third Xiangya Hospital from July 2017 to January 2023 were enrolled in this study. The effectiveness and adverse effects of HIFU were analyzed.

Results: The median age of the patients who received HIFU was 32.0 years (range: 28-41 years). Only 2 patients had solitary uterine leiomyomas, whereas the remaining 8 patients had multiple uterine leiomyomas. The median diameter of the largest myoma was 56 mm (range: 41-99 mm). Magnetic resonance imaging showed that the FH-deficient uterine leiomyomas of 8 patients presented as mixed intensity on T2WI, that of one patient was hypointense, and that of another patient was hyperintense on T2WI. All patients successfully underwent HIFU ablation in one session without severe adverse effects. The median nonperfusion volume ratio (NPVR) was 40% (30.0%-78.0%) after HIFU treatment. Four patients had NPVR ≥70%. At 3-month follow-up after HIFU ablation, the clinical symptoms of 5 of the 8 patients with symptoms before treatment were relieved. Six months after treatment, 4 of the 8 patients with symptoms were still in remission. All patients received reintervention by March 2024. The reintervention rates were 20%, 70%, and 90% at 12, 24, and 36 months, respectively, after HIFU ablation.

Conclusion: HIFU is a safe and feasible treatment for FH-deficient uterine leiomyomas, and most patients show effective results in the short term after treatment. However, the reintervention rates are high, and the long-term effects are limited.

研究目的本研究旨在探讨高强度聚焦超声(HIFU)消融术治疗富马酸氢化酶(FH)缺陷型子宫白肌瘤的有效性和安全性:本研究入选了2017年7月至2023年1月在湘雅三医院接受HIFU消融治疗的10例FH缺陷型子宫白肌瘤患者。对HIFU的疗效和不良反应进行分析:接受HIFU治疗的患者中位年龄为32.0岁(范围:28-41岁)。只有 2 例患者为单发子宫肌瘤,其余 8 例患者为多发性子宫肌瘤。最大肌瘤的中位直径为 56 毫米(范围:41-99 毫米)。磁共振成像显示,8 名患者的 FH 缺失型子宫肌瘤在 T2WI 上呈混合强度,一名患者的肌瘤呈低密度,另一名患者的肌瘤在 T2WI 上呈高密度。所有患者均在一次治疗中成功接受了 HIFU 消融术,未出现严重不良反应。HIFU 治疗后,非灌注容积比(NPVR)的中位数为 40%(30.0%-78.0%)。四名患者的 NPVR ≥70%。在 HIFU 消融术后 3 个月的随访中,8 位治疗前有症状的患者中有 5 位的临床症状得到缓解。治疗 6 个月后,8 名有症状的患者中仍有 4 人的症状得到缓解。所有患者均在 2024 年 3 月前接受了再次介入治疗。HIFU消融术后12个月、24个月和36个月的再介入率分别为20%、70%和90%:结论:HIFU 是治疗 FH 缺失型子宫肌瘤的一种安全可行的方法,大多数患者在治疗后短期内就能显示出有效的疗效。结论:HIFU 是治疗 FH 缺失型子宫肌瘤的一种安全、可行的方法,大多数患者在治疗后短期内都能获得有效的效果,但再次干预率较高,长期效果有限。
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引用次数: 0
Announcement of leadership transition. 宣布领导层交接。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-15 DOI: 10.1080/02656736.2024.2302707
Mark W Dewhirst, Nancy J Dewhirst
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引用次数: 0
Comparison of the efficacy and safety of ultrasound-guided radiofrequency ablation and microwave ablation for the treatment of unifocal papillary thyroid microcarcinoma: a retrospective study. 超声引导下射频消融和微波消融治疗单灶甲状腺乳头状微癌的疗效和安全性比较:一项回顾性研究。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-15 DOI: 10.1080/02656736.2023.2287964
Ning Li, YiJie Dong, Yunchuan Ding, Guihua Cui, Qing Hua, Shujun Xia, JianQiao Zhou

Purpose: This study aimed to compare the efficacy and safety of ultrasound-guided RFA and MWA in the treatment of unifocal PTMC.

Methods: This retrospective study included 512 patients with 512 unifocal papillary thyroid microcarcinomas (PTMCs) who underwent RFA (n = 346) and MWA (n = 166) between January 2021 and December 2021. The volumes of the ablation areas were measured during follow-up, and the volume reduction rates were evaluated. The ablation duration, volume of hydrodissection, and ablation-related complications were also compared between the groups.

Results: All lesions received complete ablation and no local or distant recurrences were observed in the two groups. A larger volume of isolation liquid was used for RFA than for MWA (p = 0.000). Hoarseness occurred in seven patients who underwent RFA (p = 0.102). At the 1-week follow-up, the mean volume of the areas ablated by RFA was smaller than that of the areas ablated by MWA (p = 0.049). During follow-ups at months 3, 9, 12, 15, and 18, the mean volumes of the ablated areas were larger in the RFA group than in the MWA group (all, p < 0.05). The mean volume of the ablated lesions increased slightly at the 1-week follow-up and then decreased at 1 month after ablation in both groups. The absorption curve of the ablated lesions in the RFA group was similar to that in the MWA group.

Conclusions: RFA and MWA are both efficient and safe methods for treating unifocal PTMC. They may be alternative techniques for patients who are not eligible or are unwilling to undergo surgery.

目的:本研究旨在比较超声引导下RFA和MWA治疗单灶PTMC的有效性和安全性:这项回顾性研究纳入了2021年1月至2021年12月期间接受RFA(n = 346)和MWA(n = 166)治疗的512例单灶甲状腺乳头状微癌(PTMC)患者。随访期间测量了消融区域的体积,并评估了体积缩小率。此外,还比较了两组的消融持续时间、水切割体积和消融相关并发症:结果:所有病灶均完全消融,两组患者均未观察到局部或远处复发。与 MWA 相比,RFA 使用的隔离液量更大(p = 0.000)。7 名接受 RFA 的患者出现了声音嘶哑(p = 0.102)。随访 1 周时,RFA 消融区域的平均体积小于 MWA 消融区域的平均体积(p = 0.049)。在第 3、9、12、15 和 18 个月的随访中,RFA 组消融区域的平均体积大于 MWA 组(均为 p):RFA 和 MWA 都是治疗单灶 PTMC 的高效、安全的方法。对于不符合手术条件或不愿接受手术的患者,这两种方法可作为替代技术。
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引用次数: 0
Correction. 更正。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.1080/02656736.2024.2307677
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引用次数: 0
Efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation for synovial hyperplasia. 超声引导下经皮射频消融治疗滑膜增生的有效性和安全性。
IF 3 3区 医学 Q2 ONCOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-04 DOI: 10.1080/02656736.2024.2328113
Qi Xu, Xiao-Hui Xu, Ze-Zheng Liu, Jian-Bi Zhu, Huan-Huan Ding, Chun-Chun Jin, Zhi-Han Yan

Purpose: This study aimed to investigate the efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) for the treatment of synovial hyperplasia in the knee joints of antigen-induced arthritis (AIA) model rabbits.

Methods: Forty Japanese large-eared white rabbits were divided into AIA and control groups. After successful induction of the AIA model, the knee joints were randomly assigned to RFA and non-RFA groups. The RFA group underwent ultrasound-guided RFA to treat synovial hyperplasia in the knee joint. Dynamic observation of various detection indices was conducted to evaluate the safety and effectiveness of the RFA procedure.

Results: Successful synovial ablation was achieved in the RFA group, with no intraoperative or perioperative mortality. Postoperative the circumference of the knee joint reached a peak before decreasing in the third week after surgery. The incidence and diameter of postoperative skin ulcers were not significantly different compared to the non-RFA group (p > .05). Anatomical examination revealed an intact intermuscular fascia around the ablated area in the RFA group. The ablated synovial tissue initially presented as a white mass, which subsequently liquefied into a milky white viscous fluid. Gross articular cartilage was observed, along with liquefied necrosis of the synovium on pathological histology and infiltration of inflammatory cells in the surrounding soft tissue.

Conclusion: The experimental results demonstrated that ultrasound-guided RFA of the knee in the treatment of synovial hyperplasia in AIA model animals was both effective and safe.

目的:本研究旨在探讨超声引导下经皮射频消融术(RFA)治疗抗原诱发关节炎(AIA)模型兔膝关节滑膜增生的有效性和安全性:方法:将 40 只日本大耳白兔分为 AIA 组和对照组。成功诱导 AIA 模型后,将膝关节随机分配到 RFA 组和非 RFA 组。RFA组在超声引导下进行RFA治疗膝关节滑膜增生。对各种检测指标进行动态观察,以评估RFA手术的安全性和有效性:结果:RFA组成功实现了滑膜消融,术中和围术期无死亡病例。术后膝关节周径达到峰值,然后在术后第三周下降。术后皮肤溃疡的发生率和直径与非RFA组相比没有明显差异(P > .05)。解剖检查显示,RFA 组消融区域周围的肌间筋膜完好无损。消融的滑膜组织最初呈白色块状,随后液化成乳白色粘稠液体。病理组织学观察到关节软骨毛糙,滑膜液化坏死,周围软组织有炎性细胞浸润:实验结果表明,超声引导下膝关节 RFA 治疗 AIA 模型动物滑膜增生既有效又安全。
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引用次数: 0
Volumetric hyperthermia delivery using the ExAblate Body MR-guided focused ultrasound system. 使用ExAblate体磁共振引导聚焦超声系统进行容积热疗。
IF 3.1 3区 医学 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-05-05 DOI: 10.1080/02656736.2024.2349080
Kisoo Kim, Pragya Gupta, Kazim Narsinh, Chris J Diederich, Eugene Ozhinsky

Objectives: To investigate image-guided volumetric hyperthermia strategies using the ExAblate Body MR-guided focused ultrasound ablation system, involving mechanical transducer movement and sector-vortex beamforming.

Materials and methods: Acoustic and thermal simulations were performed to investigate volumetric hyperthermia using mechanical transducer movement combined with sector-vortex beamforming, specifically for the ExAblate Body transducer. The system control in the ExAblate Body system was modified to achieve fast transducer movement and MR thermometry-based hyperthermia control, mechanical transducer movements and electronic sector-vortex beamforming were combined to optimize hyperthermia delivery. The experimental validation was performed using a tissue-mimicking phantom.

Results: The developed simulation framework allowed for a parametric study with varying numbers of heating spots, sonication durations, and transducer movement times to evaluate the hyperthermia characteristics for mechanical transducer movement and sector-vortex beamforming. Hyperthermic patterns involving 2-4 sequential focal spots were analyzed. To demonstrate the feasibility of volumetric hyperthermia in the system, a tissue-mimicking phantom was sonicated with two distinct spots through mechanical transducer movement and sector-vortex beamforming. During hyperthermia, the average values of Tmax, T10, Tavg, T90, and Tmin over 200 s were measured within a circular ROI with a diameter of 10 pixels. These values were found to be 8.6, 7.9, 6.6, 5.2, and 4.5 °C, respectively, compared to the baseline temperature.

Conclusions: This study demonstrated the volumetric hyperthermia capabilities of the ExAblate Body system. The simulation framework developed in this study allowed for the evaluation of hyperthermia characteristics that could be implemented with the ExAblate MRgFUS system.

目的研究使用ExAblate Body磁共振引导聚焦超声消融系统的图像引导体积热疗策略,包括机械换能器移动和扇形涡流波束成形:对 ExAblate Body 传感器进行了声学和热学模拟,以研究使用机械换能器运动结合扇形涡流波束成形的容积热疗。对 ExAblate Body 系统中的系统控制进行了修改,以实现传感器的快速移动,并将基于磁共振测温的热疗控制、机械传感器移动和电子扇形涡流波束成形相结合,优化热疗输送。实验验证使用组织模拟模型进行:结果:所开发的模拟框架允许在不同加热点数量、超声持续时间和换能器移动时间下进行参数研究,以评估机械换能器移动和扇形涡流波束成形的热疗特性。对涉及 2-4 个连续焦点的热疗模式进行了分析。为了证明该系统进行容积热疗的可行性,通过机械换能器移动和扇形涡流波束成形,用两个不同的病灶对一个组织模拟模型进行了超声处理。在热疗过程中,在直径为 10 像素的圆形 ROI 内测量了 200 秒内的 Tmax、T10、Tavg、T90 和 Tmin 平均值。与基线温度相比,这些值分别为 8.6、7.9、6.6、5.2 和 4.5 °C:本研究证明了 ExAblate Body 系统的容积热疗功能。本研究中开发的模拟框架允许对ExAblate MRgFUS系统可实施的热疗特性进行评估。
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International Journal of Hyperthermia
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