DS04 - Vie, santé et bien-être

Design of a transesophageal HIFU probe for the treatment of cardiac arrhythmias – CHORUS

Design of a transesophageal HIFU probe for the treatment of cardiac arrhythmias

Cardiac arrhythmias are related to a dysfunction of the electrical conduction pathway in the cardiac tissue. When drugs become inefficient, thermal ablation by catheterization is commonly applied. Current treatments lack of motion compensation and real-time imaging and result in incomplete lesions.

The CHORUS project aims at developing a transesophageal ultrasonic probe for image guided thermal ablation.

Technological developments <br />- Improve the HIFU transducer technology in order to deliver more surface energy faster and ensure MR-compatibility<br />- Reduce the probe dimensions to facilitate clinical transfer <br />- Allow multiplane ultrasound imaging from the esophagus<br />- Design a 2D matrix for multiplane imaging and 3D beam steering in HIFU mode<br />Methodological developments<br />- Design a treatment gated with heart beat that limit heat diffusion and reduces risks of inducting fatal arrhythmia.<br />- Develop dynamic focusing to follow heart motion and enhance treatment accuracy and efficacy, including 3D motion of the target. <br />- Develop algorithms for elastography (active and passive) for assessing stiffness change in real time and mapping electromechanical cardiac activity<br />- Develop a registration procedure for placing adjacent lesions and perform a complete treatment

Preliminary in vivo data allowed demonstrating the feasibility of the concept but, before a clinical evaluation, some work remains to be done for facilitating the procedure, compensating cardiac motion and improving image guidance. More specifically, the project will result in the design a MR compatible dual mode (imaging and therapy) matrix of ultrasonic transducers, high speed ultrasound imaging for characterizing stiffer thermally ablated zone and electro mechanical coupling and tracking solutions for treatment planning.

Development of a real-time 3D MRI thermometry method with a spatial resolution of 1.4 mm in the plane of section and a thickness of 3 mm (Liryc). This method is applicable to patients.
Development of an accelerated 3D post-treatment imaging method based on longitudinal relaxation time of proton (T1) of inversion-recovery type in 3D with compensation of movements (cardiac and respiratory) (Liryc).
Development and use of ultrafast ultrasound for the detection of foci of arrhythmia (LabTAU)

The project aims at developing and commercializing (in the future) an ultrasound-based tool for image-guided cardiac surgery.

Sandoval Z, Castro M, Alirezaie J, Bessière F, Lafon C, Dillenseger JL. Transesophageal 2D Ultrasound to 3D Computed Tomography registration for the guidance of a cardiac arrhythmia therapy. Phys Med Biol. 2018 Jul 27;63(15):155007.

Greillier G, Ankou B, Bour P, Zorgani A, Lacoste R, Bessière F, Pernot M, Catheline S, Quesson B, Chevalier P, Lafon C. Myocardial thermal ablation with a transesophageal HIFU probe: experiments on beating heart models. Ultrasound Med Biol. 2018 Dec;44(12):2625-2636.

Ozenne V, Bour P, Denis de Senneville B, Toupin S, Vaussy A, Lepetit-Coiffé M, Jaïs P, H Cochet H, Quesson B. Assessment of left ventricle MR temperature stability in patients in the presence of arrhythmias. Assessment of left ventricle magnetic resonance temperature stability in patients in the presence of arrhythmias, NMR Biomed, in press.

Cardiac arrhythmias are related to a dysfunction of the electrical conduction pathway in the cardiac tissue. When drugs become inefficient, thermal ablation by catheterization is commonly applied. In an attempt to respond to the limitations of these treatments (incomplete lesions, lack of motion compensation and real-time imaging), the CHORUS project aims at developing a transesophageal ultrasonic probe for image-guided thermal ablation. Preliminary in vivo data allowed demonstrating the feasibility of the concept but, before a clinical evaluation, major technological and methodological improvements remains to be done for facilitating the procedure, compensating cardiac motion and improving image guidance for online prediction of lesion assessment. More specifically, the project will result in the design a MR compatible dual mode (imaging and therapy) matrix of ultrasonic transducers, high speed ultrasound imaging for characterizing stiffer thermally ablated zone and electro mechanical coupling and tracking solutions for treatment planning. CHORUS gathers a very complementary consortium. Academic laboratories have expertise in ultrasound technologies for imaging and therapy (LabTAU), cardiology/real-time MRI technology (Liryc) and image processing for treatment planning (LTSI) while the company Vermon is a world leader in ultrasound device for diagnosis and therapy. CHORUS is a three-year project that will be coordinated by Cyril Lafon, built on results of the CardioUSgHIFU and TACIT former ANR 2011 projects. It is organized around 3 technical work packages (WP): 1- Iterative development of a trans esophageal HIFU probe for multi planar sonography, 2 – Methodological developments for treatment planning and monitoring and 3 – Ex vivo and in vivo assessment of the technological and methodological developments.

Project coordination

Cyril LAFON (APPLICATIONS DES ULTRASONS A LA THERAPIE)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

CRCTB CENTRE DE RECHERCHE CARDIO-THORACIQUE DE BORDEAUX et IHU LIRYC
VERMON SA VERMON
LTSI LABORATOIRE TRAITEMENT DU SIGNAL ET DE L'IMAGE
LabTAU APPLICATIONS DES ULTRASONS A LA THERAPIE

Help of the ANR 621,175 euros
Beginning and duration of the scientific project: - 36 Months

Useful links

Explorez notre base de projets financés

 

 

ANR makes available its datasets on funded projects, click here to find more.

Sign up for the latest news:
Subscribe to our newsletter