Mapping and Monitoring of Ablative Thermal Therapy for Improved Results

摘要

We demonstrate a method which incorporates state-of-the-art x-ray imaging with novel thermal therapy monitoring to enable improved minimally invasive thermal-therapy delivery for benign or malignant tumors. Thermal ablative techniques including RFA, microwave, and laser ablation are gaining acceptance. Incomplete treatments are common since there is no reliable method to monitor treatment zones during ablation. Treatment that doesn't encompass the entire tumor results in recurrence usually within one year. We describe a method to monitor tumor ablation zones during ablations performed under CT image guidance. This method allows the operator to predict necrosis while avoiding injury to critical structures. We validated the model using tissue and animal experiments. We also report on initial clinical results from patients receiving RFA treatments for primary or metastatic lesions. Following CT image-guidance to position RFA devices in a patient's tumor, intraprocedural CT data was acquired and processed offline. In this paper we describe the methods to monitor and provide feedback on the ablation during the study. By demonstrating the creation of accurate thermal maps in tissue and animal models, and extending this in preliminary treatment of tumors in patients, we hope to encourage the broader adoption of these methods by improving both safety and efficacy.