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CardioVascular and Interventional Radiology

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16.07.2020 | Laboratory Investigation

Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape

verfasst von: Katherine C. Longo, Annie M. Zlevor, Paul F. Laeseke, John F. Swietlik, Emily A. Knott, Allison C. Rodgers, Lu Mao, Xiaofei Zhang, Zhen Xu, Martin G. Wagner, Sarvesh Periyasamy, Fred T. Lee Jr., Timothy J. Ziemlewicz

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 11/2020

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Abstract

Background

Previous human-scale porcine liver model studies of histotripsy have resulted in ablation zones elongated in the cranial-caudal (CC) dimension due to uninterrupted respiratory motion during the ablation procedure.

Purpose

The purpose of this study is to compensate for elongation of hepatic histotripsy ablation zones in the cranial-caudal (CC) dimension caused by respiratory motion by prescribing ellipsoid-shaped ablations.

Methods

Six female swine underwent 12 hepatic histotripsy ablations using a prototype clinical histotripsy system under general anesthesia. Each animal received two ablation zones prescribed as either an ellipsoid (2.5 cm (AP) × 2.5 cm (ML) × 1.7 cm (CC), prescribed volume = 5.8 cc) or a sphere (2.5 cm all dimensions, prescribed volume 8.2 cc). Ventilatory tidal volume was held constant at 400 cc for all ablations. Post-procedure MRI was followed by sacrifice and gross and microscopic histology.

Results

Ablations on MRI were slightly larger than prescribed in all dimensions. Ellipsoid plan ablations (2.8 × 3.0 × 3.1 cm, volume 13.2 cc, sphericity index 0.987) were closer to prescribed volume than spherical plan ablations (2.9 × 3.1 × 3.7 cm, volume 17.1 cc, sphericity index 0.953). Ellipsoid plan ablations were more spherical than sphere plan ablations, but the difference did not reach statistical significance (p = .0.06). Pathologic analysis confirmed complete necrosis within the center of each ablation zone with no widening of the zone of partial ablation on the superior and inferior as compared to the lateral borders (p = .0.22).

Conclusion

Altering ablation zone prescription shape when performing hepatic histotripsy ablations can partially mitigate respiratory motion effects to achieve the desired ablation shape and volume.

Vlaisavljevich E, Maxwell A, Mancia L, Johnsen E, Cain CA, Xu Z. Visualizing the histotripsy process: bubble cloud-cancer cell interactions in a tissue-mimicking environment. Ultrasound Med Biol. 2016;42(10):2466–77. https://doi.org/10.1016/j.ultrasmedbio.2016.05.018.CrossRefPubMedPubMedCentral

Vlaisavljevich E, Kim Y, Allen S, et al. Feasibility study in an in vivo porcine model. Ultrasound Med Biol. 2013;39(8):1398–409. https://doi.org/10.1016/j.ultrasmedbio.2013.02.005.CrossRefPubMedPubMedCentral

Smolock AR, Cristescu MM, Vlaisavljevich E, et al. Robotically assisted sonic therapy as a noninvasive nonthermal ablation modality: proof of concept in a porcine liver model. Radiology. 2018;287(2):485–93. https://doi.org/10.1148/radiol.2018171544.CrossRefPubMed

Longo KC, Knott EA, Watson RF, et al. Robotically assisted sonic therapy (RAST) for noninvasive hepatic ablation in a porcine model: mitigation of body wall damage with a modified pulse sequence. Cardiovasc Interv Radiol. 2019;42:1016–23. https://doi.org/10.1007/s00270-019-02215-8.CrossRef

Knott EA, Swietlik JF, Longo KC, et al. Robotically-assisted sonic therapy for renal ablation in a live porcine model: initial preclinical results. J Vasc Interv Radiol. 2019;30:1293–302. https://doi.org/10.1016/j.jvir.2019.01.023.CrossRefPubMedPubMedCentral

Ziemlewicz TJ, Vidal-Jove J, Serres X, et al. THERESA Study: Final Reporting of Phase I Study of Safety and Efficacy of Hepatic Histotripsy, SIO 2020.

Vlaisavljevich E, Kim Y, Owens G, Roberts W, Cain CA, Xu Z. Effects of tissue mechanical properties on susceptibility to histotripsy-induced tissue damage. Phys Med Biol. 2014;59:253–70. https://doi.org/10.1088/0031-9155/59/2/253.CrossRefPubMed

Parsons JE, Cain CA, Abrams GD, Fowlkes JB. Pulsed cavitational ultrasound therapy for controlled tissue homogenization. Ultrasound Med Biol. 2006;32(1):115–29. https://doi.org/10.1016/j.ultrasmedbio.2005.09.005.CrossRefPubMed

Lake AM, Xu Z, Wilkinson JE, Cain CA, Roberts WW. Renal ablation by histotripsy-does it spare the collecting system? J Urol. 2008;179(3):853–6. https://doi.org/10.1016/j.juro.2007.10.033.CrossRef

10.

Ozhasoglu C, Murphy MJ. Issues in respiratory motion compensation during external-beam radiotherapy. Int J Radiat Oncol Biol Phys. 2002;52(5):1389–99. https://doi.org/10.1016/S0360-3016(01)02789-4.CrossRefPubMed

11.

Muller A, Petrusca L, Auboiroux V, Valette PJ, Salomir R, Cotton F. Management of respiratory motion in extracorporeal high-intensity focused ultrasound treatment in upper abdominal organs: current status and perspectives. Cardiovasc Interv Radiol. 2013;36:1464–76. https://doi.org/10.1007/s00270-013-0713-0.CrossRef

12.

Heinz C, Gerum S, Freislederer P, et al. Feasibility study on image guided patient positioning for stereotactic body radiation therapy of liver malignancies guided by liver motion. Radiat Oncol. 2016. https://doi.org/10.1186/s13014-016-0662-2.CrossRefPubMedPubMedCentral

13.

Dawson LA, Eccles C, Bissonnette JP, Brock KK. Accuracy of daily image guidance for hypofractionated liver radiotherapy with active breathing control. Int J Radiat Oncol Biol Phys. 2005;62(4):1247–52. https://doi.org/10.1016/j.ijrobp.2005.03.072.CrossRefPubMed

14.

Ritchie CJ, Hsieh J, Gard MF, Godwin JD, Kim YK, Crawford CR. Predictive respiratory gating: a new method to reduce motion artifacts on CT scans. Radiology. 1994;190(3):847–58.CrossRefPubMed

15.

Denys A, Lachenal Y, Duran R, Chollet-Rivier M, Bize P. Use of high-frequency jet ventilation for percutaneous tumor ablation. Cardiothorac Surg. 2014. https://doi.org/10.1007/s00270-013-0620-4.CrossRef

16.

Galmen K, Harbut P, Freedman J, Jakobsson JG. High frequency jet ventilation for motion management during ablation procedures, a narrative review. Acta Anaesthesiol Scand. 2017;61:1066–74. https://doi.org/10.1111/aas.12950.CrossRefPubMed

17.

Wadell H. Volume, shape, and roundness of quartz particles. J Geol. 1935;43(3):250–80. https://doi.org/10.1086/624298.CrossRef

18.

McDannold NJ, Jolesz FA, Hynynen KH. Determination of the optimal delay between sonications during focused ultrasound surgery in rabbits by using MR imaging to monitor thermal buildup in vivo. Radiology. 1999;211(2):419–26. https://doi.org/10.1148/radiology.211.2.r99ma41419.CrossRefPubMed

19.

Paganelli C, Seregni M, Fattori G, et al. Magnetic resonance imaging-guided versus surrogate-based motion tracking in liver radiation therapy: a prospective comparative study. Int J Radiat Oncol Biol Phys. 2015;91(4):840–8. https://doi.org/10.1016/j.ijrobp.2014.12.013.CrossRefPubMed

20.

Kishan AU, Lee P. MRI-guided radiotherapy: opening our eyes to the future. Integr Cancer Sci Ther. 2016;3(2):420–7. https://doi.org/10.15761/icst.1000181.CrossRef

21.

Poels K, Depuydt T, Verellen D, et al. A complementary dual-modality verification for tumor tracking on a gimbaled linac system. Radiother Oncol. 2013;109(3):469–74. https://doi.org/10.1016/j.radonc.2013.10.005.CrossRefPubMed

22.

Keall PJ, Sawant A, Cho B, et al. Electromagnetic-guided dynamic multileaf collimator tracking enables motion management for intensity-modulated arc therapy. Int J Radiat Oncol Biol Phys. 2011;79(1):312–20. https://doi.org/10.1016/j.ijrobp.2010.03.011.CrossRefPubMed

23.

Xu Q, Hanna G, Grimm J, et al. Quantifying rigid and nonrigid motion of liver tumors during stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2014;90(1):94–101. https://doi.org/10.1016/j.ijrobp.2014.05.007.CrossRefPubMed

24.

Rohlfing T, Maurer CR, O’Dell WG, Zhong J. Modeling liver motion and deformation during the respiratory cycle using intensity-based nonrigid registration of gated MR images. Med Phys. 2004;31(3):427–32. https://doi.org/10.1118/1.1644513.CrossRefPubMed

Titel: Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape
verfasst von: Katherine C. Longo
Annie M. Zlevor
Paul F. Laeseke
John F. Swietlik
Emily A. Knott
Allison C. Rodgers
Lu Mao
Xiaofei Zhang
Zhen Xu
Martin G. Wagner
Sarvesh Periyasamy
Fred T. Lee Jr.
Timothy J. Ziemlewicz
Publikationsdatum: 16.07.2020
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 11/2020
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-020-02582-7

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Histotripsy Ablations in a Porcine Liver Model: Feasibility of Respiratory Motion Compensation by Alteration of the Ablation Zone Prescription Shape