PDF(Pubmed)
Abstract：
Focused ultrasound (FUS) is a minimally invasive treatment that utilizes high-energy ultrasound waves to thermally ablate tissue. Magnetic resonance imaging (MRI) guidance may be combined with FUS (MRgFUS) to increase its accuracy and has been proposed for lung tumor ablation/debulking. However, the lungs are predominantly filled with air, which attenuates the strength of the FUS beam. This investigation aimed to test the feasibility of a new approach using an intentional lung collapse to reduce the amount of air inside the lung and a controlled hydrothorax to create an acoustic window for transcutaneous MRgFUS lung ablation. Eleven pigs had one lung mechanically ventilated while the other lung underwent a controlled collapse and subsequent hydrothorax of that hemisphere. The MRgFUS lung ablations were then conducted via the intercostal space. All the animals recovered well and remained healthy in the week following the FUS treatment. The location and size of the ablations were confirmed one week post-treatment via MRI, necropsy, and histological analysis. The animals had almost no side effects and the skin burns were completely eliminated after the first two animal studies, following technique refinement. This study introduces a novel methodology of MRgFUS that can be used to treat deep lung parenchyma in a safe and viable manner.
摘要：
聚焦超声（FUS）是一种微创治疗，利用高能超声波热消融组织。磁共振成像（MRI）指导可以与FUS（MRgFUS）结合使用以提高其准确性，并已被提议用于肺肿瘤消融/减瘤。然而,肺部主要充满空气，这削弱了FUS梁的强度。这项研究旨在测试一种新方法的可行性，该方法使用有意的肺塌陷来减少肺内的空气量，并使用受控的胸腔积液来创建经皮MRgFUS肺消融的声窗。11头猪的一个肺进行了机械通气，而另一个肺进行了受控的塌陷，随后出现了该半球的胸腔积液。然后通过肋间空间进行MRgFUS肺消融。在FUS处理后的一周内,所有动物恢复良好并保持健康。消融的位置和大小在治疗后一周通过MRI确认，尸检,和组织学分析。在前两次动物研究后，动物几乎没有副作用，皮肤灼伤完全消除，遵循技术改进。这项研究介绍了一种新的MRgFUS方法，可用于以安全可行的方式治疗深部肺实质。
