V. Khokhlova, P. Rosnitskiy, S. Tsysar, M. Karzova, S. Buravkov, Natalya V. Danilova, Pavel G. Malkov, E. Ponomarchuk, O. Sapozhnikov, Tatiana Khokhlova, A. Maxwell, Yak-Nam Wang, A. Kadrev, A. Chernyaev, G. Schade
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引用次数: 0
摘要
本研究评估了沸腾组织切削术(BH)使良性增生(BPH)和腺癌(PCa)的体外人体前列腺组织机械液化的可行性。在 B 模式引导下,使用 1.5 兆赫聚焦换能器、10 和 1 毫秒占空比为 1%的脉冲,在新鲜组织样本中产生体积 BH 病变。在曝露 BH 之前,使用剪切波弹性成像(SWE)对样本进行分析,以确定其机械性能是否具有临床代表性。对 BH 病变的消融完整性和效率进行了大体、组织学和 B 型超声评估。经 SWE 测量,样本的杨氏模量在临床观察到的典型范围内。在暴露过程中,BH 诱导的高回声气泡在 B 型超声中清晰可见,治疗后的低回声区域表明组织分馏成功。对暴露的良性前列腺增生样本进行的大体分析表明,良性前列腺增生僵硬结节内的目标组织已被消融。使用 1 毫秒脉冲(每个焦点 150 个脉冲)进行超声治疗的速度是使用 10 毫秒脉冲(每个焦点 30 个脉冲)的两倍。组织学分析表明,所有良性前列腺增生症样本中的液化病灶都含有均质化的细胞碎片。将人类 PCa 肿瘤分馏成亚细胞碎片的试验性实验在组织学上得到了证实。[工作得到 R01CA258581、R01DK119310 和 RSF 20-12-00145 的支持]。
Mechanical disintegration of benign and malignant tumors in ex vivo human prostate tissues using boiling histotripsy
The feasibility of boiling histotripsy (BH) to mechanically liquefy ex vivo human prostate tissue with benign hyperplasia (BPH) and adenocarcinoma (PCa) was assessed. Volumetric BH lesions were generated in fresh tissue samples under B-mode guidance using a 1.5-MHz focused transducer, 10- and 1-ms pulses with 1% duty cycle. Prior to BH exposures, the samples were analyzed using shear wave elastography (SWE) to determine whether their mechanical properties were clinically representative. Completeness and efficiency of ablation for BH lesions were evaluated grossly, histologically, and using B-mode ultrasound. The SWE measured Young’s modulus of the samples was shown to be within the typical range observed clinically. During the exposures, BH-induced hyperechogenic bubbles were visible using B-mode, and post-treatment hypoechoic regions indicated successful tissue fractionation. Gross analysis of the exposed samples with BPH revealed ablation of the targeted tissue inside stiff BPH nodules. The sonications using 1-ms pulses (with 150 pulses-per-focus) were twofold faster comparing to 10-ms (with 30 pulses-per-focus). Histological analysis revealed liquefied lesions containing homogenized cell debris in all BPH samples. A pilot experiment of human PCa tumor fractionation into subcellular fragments was confirmed histologically. [Work supported by R01CA258581, R01DK119310, and RSF 20-12-00145.]