MR Guided Focused Ultrasound for High Risk and Recurrent Breast Cancer

摘要

In this work we investigate the feasibility of MR guided focused ultrasound (MRgFUS) as an alternative treatment modality for high risk and recurrent breast cancers to replace surgery and/or RT. Preliminary in vitro and in vivo experiments have demonstrated the ability of MRgFUS to ablate various tissues in well defined treatment volumes with an array of sonications under real-time image guidance. Our MRgFUS system consists of an Insightec ExAblate 2000 high-intensity focused ultrasound (HIFU) system and a l.ST GE MR scanner. This system has been FDA approved for the treatment of uterine fibroids clinically and is being investigated under local IRB approval for treating bone metastases, prostate and breast cancers and the enhancement of drug delivery for gene therapy and chemotherapy. A comprehensive quality assurance (QA) program has been developed for the safe and effective operation of the MRgFUS system including system commissioning, monthly and annual QA procedures and pre-treatment calibration. Optimal parameters have been derived for breast treatment. For high-risk patients MRgFUS is used to ablate small (< 2cm) tumor volumes in combination with radiotherapy and chemotherapy. Larger treatment volumes (plus a margin) are designed for recurrent breast cancers.