肿瘤热疗超声无创监测技术研究进展

Recent Advances in Noninvasive Ultrasound Monitoring of Thermal Therapy for Tumors

肿瘤热疗是用加热方式杀死癌细胞,已成为肿瘤治疗的一种重要手段。肿瘤热疗分为传统热疗（41-45Ⅱ）和热消融治疗（〉60Ⅱ）。在肿瘤热疗中,对治疗区组织温度及热凝固区进行无创测控是保证热疗安全和提高疗效的关键,本文综述肿瘤热疗超声无创测温及热凝固区检测技术的研究进展。超声无创测温主要基于声速和热膨胀、超声衰减系数、背向散射能量、B超图像纹理等参数的温度相关性。热凝固区超声检测主要基于超声组织定征技术,包括Nakagami统计模型、超声衰减、超声背向散射积分、超声弹性成像、组织散射子平均间距、次谐波低频声发射等。提出了肿瘤热疗超声无创监测技术的未来发展方向,包括监测精度验证方法的研究、针对组织个体差异自适应调整参数的研究、减少组织运动干扰的方法研究、多维多参数监测方法研究、实时计算技术的研究及肿瘤热疗实验数据共享中心的建立。

Thermal therapy is a technique to kill tumor cells with heat and has become an important means for tumor treatment. It can be divided into conventional hyperthermia （41-45%） and thermal ablation （〉60℃）. For thermal therapy, noninvasive monitoring of tissue temperature distribution and thermal lesion （coagulation zone） formation in the treatment area is the key to guaranteeing treatment safety and efficacy. In this review, recent advances in noninvasive ultrasound-based temperature estimation and thermal lesion detection techniques are presented. Noninvasive ultrasound temperature estimation is based on temperature dependence of such parameters as speed of sound and thermal expansion, ultrasound attenuation coefficient, backscattered energy, and B-mode ultrasound image texture feature. Noninvasive ultrasonic thermal lesion detection is based on ultrasound tissue characterization techniques. These techniques include the Nakagami statistical model, ultrasound attenuation, integrated backscatter, ultrasound elasticity imaging, mean scatterer spacing, and low-frequency acoustic emission. Future developments of noninvasive ultrasound monitoring techniques for thermal therapy are discussed. Future work may include the study of monitoring precision validation, adaptive parameter adjustment for tissue interindividual difference, reducing tissue movement interference, multi-dimensional and multi-parameter monitoring, realtime computing, and the establishment of the thermal therapy experimental data center.