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Title: CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

Journal Article · · AIP Conference Proceedings
DOI:https://doi.org/10.1063/1.2205450· OSTI ID:20800253
; ; ; ; ; ;  [1]; ;  [2];  [3];  [4]
  1. National Institutes of Health, Dept. Diagnostic Radiology, Clinical Center, Bethesda, MD (United States)
  2. Philips Medical Systems, Computed Tomography Clinical Science Dept., Cleveland, OH (United States)
  3. Philips Research, Clinical Research Program, Briarcliff Manor, NY (United States)
  4. Focus Surgery, Indianapolis, IN (United States)

To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large animals and humans for HIFU-induced ablation and drug delivery. Integrated CT-guided focused ultrasound holds promise for tissue ablation, enhancing local drug delivery, and CT thermometry for monitoring ablation in near real-time.

OSTI ID:
20800253
Journal Information:
AIP Conference Proceedings, Vol. 829, Issue 1; Conference: 5. international symposium on therapeutic ultrasound, Boston, MA (United States), 27-29 Oct 2005; Other Information: DOI: 10.1063/1.2205450; (c) 2006 American Institute of Physics; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-243X
Country of Publication:
United States
Language:
English

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