高强度聚焦超声的剂量学研究进展

 高强度聚焦超声（HIFU）技术是一种新型的物理治疗方法，它的诞生符合医学治疗从有创到微创甚至无创的发展理念。剂量-生物学效应关系是HIFU技术的重点和难点，也是该技术临床应用推广的关键之一。针对这一事实，本文介绍了HIFU技术的治疗原理，HIFU治疗系统的基本构成、核心技术，以及HIFU技术的特点，特别指出了热效应、机械效应和空化效应等损伤机制。在此背景下，评估了国内外在HIFU剂量学方面的研究态势，重点讨论HIFU量效关系和治疗头频率、声功率、辐照时间、治疗方式、治疗深度及组织生物学特性和声学环境之间的联系。阐述了目前剂量学研究的三大问题：HIFU的监控系统、声通道、HIFU量效关系的“双重标准”，提出推动HIFU剂量学甚至整个技术发展的建议。随着HIFU技术的不断完善和发展，其治疗效率高、安全性强、无创性切除、实时监控等特点将更加突出，必将在未来的医学领域占据越来越重要的地位。

Research Progress on the Therapeutic Dosimetry of High Intensity Focused Ultrasound

High Intensity Focused Ultrasound (HIFU) is a new type of physical therapy, consistent with the concept from invasive to noninvasive or minimally invasive treatment. The relationship between HIFU dose and biological effects is important and is difficult to determine, but also is one of the keys for the clinical application of HIFU technology. This paper presents a review of HIFU, including the therapy principle, system's basic structure, core technology and characteristics, especially the damages from thermal heat, mechanical and cavitations effect. Based on the assessment of HIFU technology, domestic and international research trends on therapeutic dosimetry are discussed and the key links between the dose-effect relationship and frequency, sound power, radiation time, treatment methods, treatment depth, biological characteristics and acoustic environment of the organization are highlighted. Three major issues are stressed: monitoring system, sound channels and the "double standards" of dose- effect relationship, and proposals are given about developing dose study and HIFU technology. With the development and improvement of HIFU technology, the features of high efficiency, safety, noninvasive, and real-time monitoring will become more prominent, and it will play a more and more important role in the field of medicine.