Morphologic alterations in normal and neoplastic tissues following hyperthermia treatment

International Nuclear Information System (INIS)

Badylak, S.F.; Babbs, C.F.

1984-01-01

The sequential morphologic alterations in normal skeletal muscle in rats, Walker 256 tumors in rats, and transmissible venereal tumors (TVT) in dogs following microwave-induced hyperthermia (43 0 C and 45 0 for 20 minutes) were studied by light and electron microscopy. Normal muscle and Walker 256 tumors showed vascular damage at 5 minutes post-heating (PH), followed by suppuration and thrombosis at 6 and 48 hours PH, and by regeneration and repair at 7 days PH. Endothelial damage and parenchymal degeneration were present 5 minutes PH. Progressive ischemic injury occurred for at least 48 hours PH. Two hyperthermia treatments, separated by a 30 or 60 minute cooling interval, were applied to rats implanted with Walker 256 tumors. Increased selective heating of tumor tissue versus surrounding normal tissue, and increased intratumoral temperatures were found during the second hyperthermia treatment. Canine TVTs were resistant to hyperthermia damage. These results characterized the sequential morphologic alterations following hyperthermia treatment and showed that: 1) vascular damage contributed to the immediate and latent cytotoxic effects of hyperthermia, 2) selective heating occurred in the neoplastic tissue disrupted by prior heat treatment, and 3) not all neoplasms are responsive to hyperthermia treatment

The effect of hyperthermia in the preoperative combined treatment of radiation, hyperthermia and chemotherapy for rectal carcinoma

Energy Technology Data Exchange (ETDEWEB)

Konishi, Fumio; Furuta, Kazuhiro; Saito, Yukio; Kataoka, Takashi; Kashiwagi, Hiroshi; Okada, Masaki; Kanazawa, Kyotaro; Sugahara, Tadashi; Shinohara, Naohiro (Jichi Medical School, Minamikawachi, Tochigi (Japan))

1994-03-01

To investigate the effectiveness of hyperthermia in the preoperative combined treatment of radiation, chemotherapy and hyperthermia for rectal carcinoma, two groups were compared. Group A consisted of 18 patients in whom hyperthermia, radiation and chemotherapy were performed. Group B consisted of 18 patients in whom only chemotherapy and radiation were performed. The total dose of radiation in both of the two groups was 40.5 Gy, and a radiation field covering the whole pelvis was used. Hyperthermia was performed using 8 MHz radiofrequency waves (Thermotron RF8, Yamamoto Vinyter, Japan), and tumors were heated at about 42 degrees C for 50 minutes. Hyperthermia was repeated five times during the preoperative treatment. Chemotherapy was performed by giving 5-fluorouracil suppositories to a total dose of 3400 mg. Mean tumor reduction rates on barium enema were 31.8% in group A and 18.2% in group B. The difference was statistically significant. The result of the histological assessment of tumor necrosis showed that there was a significantly higher degree of necrosis in group A than in group B. These results showed that the addition of hyperthermia enhanced tumor necrosis. It was concluded that the addition of hyperthermia would be an effective preoperative treatment of rectal carcinoma. (author).

The effect of hyperthermia in the preoperative combined treatment of radiation, hyperthermia and chemotherapy for rectal carcinoma

International Nuclear Information System (INIS)

Konishi, Fumio; Furuta, Kazuhiro; Saito, Yukio; Kataoka, Takashi; Kashiwagi, Hiroshi; Okada, Masaki; Kanazawa, Kyotaro; Sugahara, Tadashi; Shinohara, Naohiro

1994-01-01

To investigate the effectiveness of hyperthermia in the preoperative combined treatment of radiation, chemotherapy and hyperthermia for rectal carcinoma, two groups were compared. Group A consisted of 18 patients in whom hyperthermia, radiation and chemotherapy were performed. Group B consisted of 18 patients in whom only chemotherapy and radiation were performed. The total dose of radiation in both of the two groups was 40.5 Gy, and a radiation field covering the whole pelvis was used. Hyperthermia was performed using 8 MHz radiofrequency waves (Thermotron RF8, Yamamoto Vinyter, Japan), and tumors were heated at about 42 degrees C for 50 minutes. Hyperthermia was repeated five times during the preoperative treatment. Chemotherapy was performed by giving 5-fluorouracil suppositories to a total dose of 3400 mg. Mean tumor reduction rates on barium enema were 31.8% in group A and 18.2% in group B. The difference was statistically significant. The result of the histological assessment of tumor necrosis showed that there was a significantly higher degree of necrosis in group A than in group B. These results showed that the addition of hyperthermia enhanced tumor necrosis. It was concluded that the addition of hyperthermia would be an effective preoperative treatment of rectal carcinoma. (author)

Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis

Energy Technology Data Exchange (ETDEWEB)

Fan, Tien-Ying [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Zhang, Lian; Chen, Wenzhi [Clinical Center of Tumor Therapy of 2nd Affiliated Hospital of Chongqing Medical University, Chongqing 400010 (China); Liu, Yinjiang; He, Min; Huang, Xiu [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Orsi, Franco [Interventional Radiology Unit, European Institute of Oncology, 435 Via Ripamonti, 20141 Milan (Italy); Wang, Zhibiao, E-mail: wangzhibiao@haifu.com.cn [State Key Laboratory of Ultrasound Engineering in Medicine, Department of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Clinical Center of Tumor Therapy of 2nd Affiliated Hospital of Chongqing Medical University, Chongqing 400010 (China)

2012-11-15

Highlights: Black-Right-Pointing-Pointer We tested the feasibility of MRIgHIFU ablation for adenomyosis. Black-Right-Pointing-Pointer Patients were treated with MRIgHIFU under conscious sedation. Black-Right-Pointing-Pointer Patient symptoms were assessed using SSS and UFS-QOL. Black-Right-Pointing-Pointer The mean SSS and UFS-QOL showed significant improvements at follow up. Black-Right-Pointing-Pointer No serious complications were observed 62.5 {+-} 21.6. -- Abstract: Purpose: To test the feasibility of MRI-guided high intensity focused ultrasound ablation for adenomyosis. Materials and methods: Patients with symptomatic adenomyosis were treated with MRI-guided high intensity focused ultrasound (MRIgHIFU). Under conscious sedation, MRIgHIFU was performed by a clinical MRI-compatible focused ultrasound tumour therapeutic system (JM15100, Haifu{sup Registered-Sign} Technology Co. Ltd., Chongqing, China) which is combined with a 1.5 T MRI system (Magnetom Symphony, Siemens Healthcare, Erlangen, Germany). MRI was used to calculate the volume of the uterus and lesion. Non-perfused volume of the targeted lesions was evaluated immediately after MRIgHIFU. Patient symptoms were assessed using symptom severity score (SSS) and uterine fibroids symptoms and quality of life questionnaire (UFS-QOL). Results: Ten patients with mean age of 40.3 {+-} 4 years with an average lesion size of 56.9 {+-} 12.7 mm in diameter were treated. Non-perfused volume and the percentage of non-perfused volume obtained from contrast-enhanced T1 Magnetic resonance images immediately post-treatment were 66.6 {+-} 49.4 cm{sup 3} and 62.5 {+-} 21.6%, respectively. The mean SSS and UFS-QOL showed significant improvements of 25%, 16% and 25% at 3, 6 and 12 months follow up, respectively, to pre-treatment scores. No serious complications were observed. Conclusion: Based on the results from this study, MRIgHIFU treatment appears to be a safe and feasible modality to ablate adenomyosis lesion and

Gold nanorod-mediated hyperthermia enhances the efficacy of HPMA copolymer-90Y conjugates in treatment of prostate tumors

International Nuclear Information System (INIS)

Buckway, Brandon; Frazier, Nick; Gormley, Adam J.; Ray, Abhijit; Ghandehari, Hamidreza

2014-01-01

Introduction: The treatment of prostate cancer using a radiotherapeutic 90 Y labeled N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer can be enhanced with localized tumor hyperthermia. An 111 In labeled HPMA copolymer system for single photon emission computerized tomography (SPECT) was developed to observe the biodistribution changes associated with hyperthermia. Efficacy studies were conducted in prostate tumor bearing mice using the 90 Y HPMA copolymer with hyperthermia. Methods: HPMA copolymers containing 1, 4, 7, 10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) were synthesized by reversible addition-fragmentation transfer (RAFT) copolymerization and subsequently labeled with either 111 In for imaging or 90 Y for efficacy studies. Radiolabel stability was characterized in vitro with mouse serum. Imaging and efficacy studies were conducted in DU145 prostate tumor bearing mice. Imaging was performed using single photon emission computerized tomography (SPECT). Localized mild tumor hyperthermia was achieved by plasmonic photothermal therapy using gold nanorods. Results: HPMA copolymer-DOTA conjugates demonstrated efficient labeling and stability for both radionuclides. Imaging analysis showed a marked increase of radiolabeled copolymer within the hyperthermia treated prostate tumors, with no significant accumulation in non-targeted tissues. The greatest reduction in tumor growth was observed in the hyperthermia treated tumors with 90 Y HPMA copolymer conjugates. Histological analysis confirmed treatment efficacy and safety. Conclusion: HPMA copolymer-DOTA conjugates radiolabeled with both the imaging and treatment radioisotopes, when combined with hyperthermia can serve as an image guided approach for efficacious treatment of prostate tumors

Deep RF-hyperthermia: an effective treatment of advanced gliomas

International Nuclear Information System (INIS)

Sahinbas, H.; Groenemeyer, D.H.W.

2005-01-01

Full text: Contrary to the enormous efforts, results of conventional treatments of high-grade malignant gliomas are unsatisfactory. The prognosis of that tumor type is poor, its overall median survival time (MST) less than a year. Most of the cases are inoperable or only partially resectable, and their response to the various chemotherapies and/or radiotherapy is poor. The chemo-therapies which are successful for other locations often fail due to the effective brain-blood barrier (BBB). Probably the modification of the BBB by electromagnetic fields together with the direct electromagnetic-field heating are the main factors for the success of electro-hyperthermia. Primary aim of this study was to present the therapy tolerance for patients of electro-hyperthermia (EHY) for advanced malignant gliomas and as main intention to show the increase of the median survival time (MST). Our study was performed between 2000 - 2004; for patients with inoperable, partially resected or recurrent gliomas (WHO grade III and IV) with progression after radio- and/or chemotherapy and a Karnofsky Performance Score ≤30-40 %. 105 pts were involved in this study: 38 astrocytoma pts, 56 glioblastoma pts and 12 pts with other brain malignancies. All patients were heavily and unsatisfactory pretreated. EHY was applied over 4 weeks, 3 times a week over 1 hour in average by 100 Watt, as mono- or combined therapy (chemotherapy, irradiation therapy). The set of patients as well as the frequency of EHY was well documented for future evaluations. The historic reference of the MST from the first diagnosis for gliomas grade III and IV in our institute is 11.42 months (range 1-62), which is in good agreement with the relevant literature. The median survival time (MST) in our institute with EHY increases to 44.2 m, 23.2 m and 61.0 m for astrocytoma, glioblastoma and other brain malignancies, respectively. The therapy results were controlled by MRI images. EHY is a feasible treatment for advanced

TU-B-210-00: MR-Guided Focused Ultrasound Therapy in Oncology

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

Energy Technology Data Exchange (ETDEWEB)

Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

2014-06-15

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

International Nuclear Information System (INIS)

Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

2014-01-01

Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

Energy Technology Data Exchange (ETDEWEB)

Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

2014-01-15

To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

Hyperthermia for the Treatment of Locally Advanced Cervix Cancer

NARCIS (Netherlands)

M. Franckena (Martine)

2010-01-01

textabstract(English): There is a strong biological rationale for the use of hyperthermia as an oncological treatment modality. Fifteen randomized trials have shown significant improvement in clinical outcome when hyperthermia was added to radiotherapy, chemotherapy or both. At temperatures ≥ 40

Multicentre treatment planning study of MRI-guided brachytherapy for cervical cancer: Comparison between tandem-ovoid applicator users

International Nuclear Information System (INIS)

Nomden, Christel N.; Leeuw, Astrid A.C. de; Van Limbergen, Erik; Brabandere, Marisol de; Nulens, An; Nout, Remi A.; Laman, Mirjam; Ketelaars, Martijn; Lutgens, Ludovicus; Reniers, Brigitte; Jürgenliemk-Schulz, Ina Maria

2013-01-01

Background and purpose: To compare MRI-guided treatment planning approaches between four centres that use tandem-ovoid applicators. Material and methods: Four centres generated three treatment plans for four patients: standard, optimised intracavitary, and optimised intracavitary/interstitial. Prescribed D90 High-Risk CTV (HR-CTV) was 85 Gy EQD2 (external-beam radiotherapy and brachytherapy), while the D 2cc OAR limit was 90 Gy EQD2 for bladder and 75 Gy EQD2 for rectum, sigmoid, and bowel, respectively. DVH-parameters, source loading patterns and spatial dose distributions of the three treatment plans were compared. Results: The standard plans of the different centres were comparable with respect to the D90 HR-CTV, but differed in OAR doses. MRI-guided intracavitary optimisation resulted in organ sparing and smaller variation in DVH parameters between the centres. Adding interstitial needles led to target dose escalation while respecting the OAR constraints. However, substantial differences in relative weights of the applicator parts resulted in an increased variation in DVH parameters and locations of high dose regions. Conclusions: MRI-guided brachytherapy treatment planning optimisation provides the possibility to increase the dose to the HR-CTV and spare the OARs. Depending on the degree of conformity the centres make different choices in relative weighting of applicator parts, leading to different dose distributions

A support system in virtual reality for effective hyperthermia treatments. Heating properties of needle applicator for brain tumors

International Nuclear Information System (INIS)

Shindo, Yasuhiro; Iseki, Yuya; Nakane, Kazuya; Mimoto, Naoki; Kubo, Mitsunori; Kato, Kazuo; Takahashi, Hideaki; Uzuka, Takeo; Fujii, Yukihiko

2011-01-01

This paper describes the effectiveness of the developed simulator system for performing an effective hyperthermia treatment with a needle applicator in virtual reality (VR). The human brain is protected by the skull, which makes it difficult to non-invasively heat deep brain tumors with electromagnetic energy. Generally, needle applicators were used in clinical practice to heat brain tumors. However, some problems exist. One is that this heating method has a small heating area around the needle. In order to expand the heating area of a needle applicator, we developed a new type of needle applicator made from a shape memory alloy (SMA). The thermal properties of the SMA were checked experimentally using the developed heating system. As a result, the proposed needle applicator made of SMA is useful to create a wider heating area inside a tumor. Another problem is that medical doctors find it difficult to put a needle applicator into a target point inside of tumors. Therefore, a support system for performing an effective hyperthermia treatment is required in the clinic. In this paper, first, we constructed an anatomical 3-D model from magnetic resonance imaging (MRI) and X-ray computed tomography (CT) images by using 3-D computer aided design (CAD) software. Second, we presented the finite element method (FEM) model which is divided into non-linear elements on 3-D computer graphics (CG). Finally, we calculated temperature distributions using the 3-D FEM model with blood perfusion during hyperthermia treatments. From these results, it was found that the proposed VR system is effective for performing hyperthermia treatments. (author)

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

International Nuclear Information System (INIS)

Fortunati, Valerio; Niessen, Wiro J; Veenland, Jifke F; Van Walsum, Theo; Verhaart, René F; Paulides, Margarethus M

2015-01-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck.Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available.The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used.Using the proposed approach we improved the performance of the approach previously presented for H and N hyperthermia treatment planning, making the method suitable for clinical application. (paper)

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

Science.gov (United States)

Fortunati, Valerio; Verhaart, René F.; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; van Walsum, Theo

2015-08-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck. Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available. The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used. Using the proposed approach we improved the performance of the approach previously presented for H&N hyperthermia treatment planning, making the method suitable for clinical application.

WE-EF-BRD-01: Past, Present and Future: MRI-Guided Radiotherapy From 2005 to 2025

Energy Technology Data Exchange (ETDEWEB)

Lagendijk, J. [University Medical Center Utrecht (Netherlands)

2015-06-15

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

Online Adaptive Hyperthermia Treatment Planning During Locoregional Heating to Suppress Treatment-Limiting Hot Spots

NARCIS (Netherlands)

Kok, H. Petra; Korshuize-van Straten, Linda; Bakker, Akke; de Kroon-Oldenhof, Rianne; Geijsen, Elisabeth D.; Stalpers, Lukas J. A.; Crezee, Johannes

2017-01-01

Adequate tumor temperatures during hyperthermia are essential for good clinical response, but excessive heating of normal tissue should be avoided. This makes locoregional heating using phased array systems technically challenging. Online application of hyperthermia treatment planning could help to

Folic acid-conjugated Fe3O4 magnetic nanoparticles for hyperthermia and MRI in vitro and in vivo

International Nuclear Information System (INIS)

Jiang, Q.L.; Zheng, S.W.; Hong, R.Y.; Deng, S.M.; Guo, L.; Hu, R.L.; Gao, B.; Huang, M.; Cheng, L.F.; Liu, G.H.; Wang, Y.Q.

2014-01-01

The folic acid (FA)-conjugated Fe 3 O 4 magnetic nanoparticles (MNPs) were synthesized by co-precipitation of Fe 3+ and Fe 2+ solution followed by surface modification with carboxymethyl dextran (CMD) to form carboxymethyl group terminated MNPs, then FA was conjugated with the carboxyl group functionalized MNPs. The morphology and properties of obtained nanoparticles were characterized by X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), UV–visible spectra (UV–vis), transmission electron microscopy (TEM), dynamic light scattering (DLS), vibrating sample magnetometer (VSM) and thermogravimetric analysis (TGA). The FA-conjugated MNPs exhibited relatively high saturation magnetization and fast magneto-temperature response which could be applied to hyperthermia therapy. To determine the accurate targeting effect of FA, we chose FA-conjugated MNPs as MRI contrast enhancement agent for detection of KB cells with folate receptor over-expression in vitro and in vivo. The results show that these magnetic nanoparticles appear to be the promising materials for local hyperthermia and MRI.

Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation

International Nuclear Information System (INIS)

Chu, William; Staruch, Robert M.; Pichardo, Samuel; Tillander, Matti; Köhler, Max O.; Huang, Yuexi; Ylihautala, Mika; McGuffin, Merrylee; Czarnota, Gregory; Hynynen, Kullervo

2016-01-01

Purpose: To evaluate the feasibility of magnetic resonance–guided high-intensity focused ultrasound (MR-HIFU) mild hyperthermia in deep tissue targets for enhancing radiation therapy and chemotherapy in the context of recurrent rectal cancer. A preclinical study was performed to evaluate the safety and performance of MR-HIFU mild hyperthermia. A prospective imaging study was performed in volunteers with rectal cancer to evaluate MR thermometry quality near the rectum and accessibility of rectal tumors using MR-HIFU. Methods and Materials: Mild hyperthermia was performed in pig thigh (9 sonications, 6 pigs) using a clinical MR-HIFU system. Targets near the rectal wall and deep thigh were evaluated. Thermal maps obtained in 6 planes every 3.2 seconds were used to control sonications in 18-mm diameter treatment regions at temperatures of 42°C to 42.5°C for 10 to 60 minutes. Volunteer imaging-only studies to assess the quality of MR thermometry (without heating) were approved by the institutional research ethics board. Anatomic and MR thermometry images were acquired in consenting volunteers with rectal cancer. In 3 of 6 study participants, rectal filling with saline was used to reduce motion-related MR thermometry artifacts near the tumor. Results: In pigs, mean target temperature matched the desired hyperthermia temperature within 0.2°C; temporal standard deviation ≤0.5°C. With optimized control thresholds, no undesired tissue damage was observed. In human volunteers, MR temperature measurements had adequate precision and stability, especially when rectal filling was used to reduce bowel motion. Conclusions: In pigs, MR-HIFU can safely deliver mild hyperthermia (41°C-43°C) to a targeted volume for 30 minutes. In humans, careful patient selection and preparation will enable adequate targeting for recurrent rectal cancers and sufficient MR temperature mapping stability to control mild hyperthermia. These results enable human trials of MR-HIFU hyperthermia.

Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation

Energy Technology Data Exchange (ETDEWEB)

Chu, William, E-mail: William.Chu@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario (Canada); Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario (Canada); Staruch, Robert M. [Clinical Sites Research Program, Philips Research, Cambridge, Massachusetts (United States); Pichardo, Samuel [Thunder Bay Regional Research Institute, Thunder Bay, Ontario (Canada); Physics and Electrical Engineering, Lakehead University, Thunder Bay, Ontario (Canada); Tillander, Matti; Köhler, Max O. [MR Therapy, Philips Healthcare, Vantaa (Finland); Huang, Yuexi [Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario (Canada); Ylihautala, Mika [MR Therapy, Philips Healthcare, Vantaa (Finland); McGuffin, Merrylee [Department of Radiation Oncology, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario (Canada); Czarnota, Gregory [Department of Radiation Oncology, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario (Canada); Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario (Canada); Hynynen, Kullervo [Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario (Canada)

2016-07-15

Purpose: To evaluate the feasibility of magnetic resonance–guided high-intensity focused ultrasound (MR-HIFU) mild hyperthermia in deep tissue targets for enhancing radiation therapy and chemotherapy in the context of recurrent rectal cancer. A preclinical study was performed to evaluate the safety and performance of MR-HIFU mild hyperthermia. A prospective imaging study was performed in volunteers with rectal cancer to evaluate MR thermometry quality near the rectum and accessibility of rectal tumors using MR-HIFU. Methods and Materials: Mild hyperthermia was performed in pig thigh (9 sonications, 6 pigs) using a clinical MR-HIFU system. Targets near the rectal wall and deep thigh were evaluated. Thermal maps obtained in 6 planes every 3.2 seconds were used to control sonications in 18-mm diameter treatment regions at temperatures of 42°C to 42.5°C for 10 to 60 minutes. Volunteer imaging-only studies to assess the quality of MR thermometry (without heating) were approved by the institutional research ethics board. Anatomic and MR thermometry images were acquired in consenting volunteers with rectal cancer. In 3 of 6 study participants, rectal filling with saline was used to reduce motion-related MR thermometry artifacts near the tumor. Results: In pigs, mean target temperature matched the desired hyperthermia temperature within 0.2°C; temporal standard deviation ≤0.5°C. With optimized control thresholds, no undesired tissue damage was observed. In human volunteers, MR temperature measurements had adequate precision and stability, especially when rectal filling was used to reduce bowel motion. Conclusions: In pigs, MR-HIFU can safely deliver mild hyperthermia (41°C-43°C) to a targeted volume for 30 minutes. In humans, careful patient selection and preparation will enable adequate targeting for recurrent rectal cancers and sufficient MR temperature mapping stability to control mild hyperthermia. These results enable human trials of MR-HIFU hyperthermia.

Iron oxide nanoparticle hyperthermia and chemotherapy cancer treatment

Science.gov (United States)

Petryk, A. A.; Giustini, A. J.; Ryan, P.; Strawbridge, R. R.; Hoopes, P. J.

2009-02-01

The benefit of combining hyperthermia and chemotherapy to treat cancer is well established. However, combined therapy has not yet achieved standard of care status. The reasons are numerous and varied, however the lack of significantly greater tumor cell sensitivity to heat (as compared to normal cells) and the inability to deliver heat to the tumor in a precise manner have been major factors. Iron oxide nanoparticle (IONP) hyperthermia, alone and combined with other modalities, offers a new direction in hyperthermia cancer therapy via improved tumor targeting and an improved therapeutic ratio. Our preliminary studies have demonstrated tumor cell cytotoxicity (in vitro and in vivo) with IONP heat and cisplatinum (CDDP) doses lower than those necessary when using conventional heating techniques or cisplatinum alone. Ongoing studies suggest such treatment could be further improved through the use of targeted nanoparticles.

Potential use of SERS-assisted theranostic strategy based on Fe{sub 3}O{sub 4}/Au cluster/shell nanocomposites for bio-detection, MRI, and magnetic hyperthermia

Energy Technology Data Exchange (ETDEWEB)

Han, Yu; Lei, Sheng-lan [Department of Biomaterials, College of Materials, Xiamen University, Xiamen 361005 (China); Lu, Jian-hua [Department of Electronic Science, College of Physical Science and Technology, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen 361005 (China); He, Yuan [Department of Biomaterials, College of Materials, Xiamen University, Xiamen 361005 (China); Chen, Zhi-wei, E-mail: chenzhiwei@xmu.edu.cn [Department of Electronic Science, College of Physical Science and Technology, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance Research, Xiamen University, Xiamen 361005 (China); Ren, Lei, E-mail: renlei@xmu.edu.cn [Department of Biomaterials, College of Materials, Xiamen University, Xiamen 361005 (China); State Key Laboratory for Physical Chemistry of Solid Surfaces, Xiamen University, Xiamen 361005 (China); Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Xiamen 361005 (China); Zhou, Xi [Department of Biomaterials, College of Materials, Xiamen University, Xiamen 361005 (China); Fujian Provincial Key Laboratory of Fire Retardant Materials, Xiamen University, Xiamen 361005 (China); Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Xiamen 361005 (China)

2016-07-01

A surface-enhanced Raman scattering (SERS)-assisted theranostic strategy was designed based on a synthesized multifunctional Fe{sub 3}O{sub 4}/Au cluster/shell nanocomposite. This theranostic strategy was used for free prostate specific antigen (free-PSA) detection, magnetic resonance imaging (MRI), and magnetic hyperthermia. The lowest protein concentration detected was 1 ng mL{sup −1}, and the limit of detection (LOD) of the calculated PSA was 0.75 ng mL{sup −1}. Then, MRI was carried out to visualize the tumor cell. Lastly, magnetic hyperthermia was employed and revealed a favorable killing effect for the tumor cells. Thus, this SERS-assisted strategy based on a Fe{sub 3}O{sub 4}/Au cluster/shell nanocomposite showed great advantages in theranostic treatment. - Graphical abstract: Fe{sub 3}O{sub 4}/Au cluster/shell composite can be used for specific protein detection, magnetic resonance imaging and magnetic hyperthermia therapy. - Highlights: • We designed a SERS-assisted theranostic strategy based on the mutifunctional nanocomposites using gold shelled Fe{sub 3}O{sub 4} clusters. • Fe{sub 3}O{sub 4}/Au nanoparticles with theranostics and SERS for early diagnosis of PSA were reported for the first time. • The LOD of detection for PSA was lowed as 0.75 ng mL{sup −1}, and the total detection time was shorten to less than 1 h. • Fe{sub 3}O{sub 4} clusters had spin-spin (T{sub 2}) contrast enhancement and increased magnetic response. • Gold nanoshells supplied excellent chemical stability, biocompatibility, better heating property for magnetic hyperthermia.

Hyperthermia and radiotherapy

International Nuclear Information System (INIS)

Fitspatrick, C.

1990-01-01

Hyperthermia and radiotherapy have for long been used to assist in the control of tumours, either as separate entities, or, in a combined treatment scheme. This paper outlines why hyperthermia works, thermal dose and the considerations required in the timing when hyperthermia is combined with radiotherapy. Previously reported results for hyperthermia and radiotherapy used together are also presented. 8 refs., 8 tabs

Online Adaptive Hyperthermia Treatment Planning During Locoregional Heating to Suppress Treatment-Limiting Hot Spots.

Science.gov (United States)

Kok, H Petra; Korshuize-van Straten, Linda; Bakker, Akke; de Kroon-Oldenhof, Rianne; Geijsen, Elisabeth D; Stalpers, Lukas J A; Crezee, Johannes

2017-11-15

Adequate tumor temperatures during hyperthermia are essential for good clinical response, but excessive heating of normal tissue should be avoided. This makes locoregional heating using phased array systems technically challenging. Online application of hyperthermia treatment planning could help to improve the heating quality. The aim of this study was to evaluate the clinical benefit of online treatment planning during treatment of pelvic tumors heated with the AMC-8 locoregional hyperthermia system. For online adaptive hyperthermia treatment planning, a graphical user interface was developed. Electric fields were calculated in a preprocessing step using our in-house-developed finite-difference-based treatment planning system. This allows instant calculation of the temperature distribution for user-selected phase-amplitude settings during treatment and projection onto the patient's computed tomographic scan for online visualization. Online treatment planning was used for 14 treatment sessions in 8 patients to reduce the patients' reports of hot spots while maintaining the same level of tumor heating. The predicted decrease in hot spot temperature should be at least 0.5°C, and the tumor temperature should decrease less than 0.2°C. These predictions were compared with clinical data: patient feedback about the hot spot and temperature measurements in the tumor region. In total, 17 hot spot reports occurred during the 14 sessions, and the alternative settings predicted the hot spot temperature to decrease by at least 0.5°C, which was confirmed by the disappearance of all 17 hot spot reports. At the same time, the average tumor temperature was predicted to change on average -0.01°C (range, -0.19°C to 0.34°C). The measured tumor temperature change was on average only -0.02°C (range, -0.26°C to 0.31°C). In only 2 cases the temperature decrease was slightly larger than 0.2°C, but at most it was 0.26°C. Online application of hyperthermia treatment planning is

Folic acid-conjugated Fe{sub 3}O{sub 4} magnetic nanoparticles for hyperthermia and MRI in vitro and in vivo

Energy Technology Data Exchange (ETDEWEB)

Jiang, Q.L.; Zheng, S.W. [College of Chemistry, Chemical Engineering and Materials Science and Key Laboratory of Organic Synthesis of Jiangsu Province, Soochow University, SIP, Suzhou 215123 (China); Hong, R.Y., E-mail: rhong@suda.edu.cn [College of Chemistry, Chemical Engineering and Materials Science and Key Laboratory of Organic Synthesis of Jiangsu Province, Soochow University, SIP, Suzhou 215123 (China); College of Chemistry and Chemical Engineering, Fuzhou University, Fuzhou 350002 (China); Deng, S.M.; Guo, L. [The First Affiliated Hospital of Soochow University, Suzhou 215011 (China); Hu, R.L. [Department of Thoracic Surgery, Hangzhou First People' s Hospital, Hangzhou 310006 (China); Gao, B.; Huang, M.; Cheng, L.F. [College of Medicine, Soochow University, SIP, Suzhou 215123 (China); Liu, G.H. [Respiration Department, Suzhou Municipal Hospital (East-Section), Suzhou 215001 (China); Wang, Y.Q. [Key Laboratory of Environmental Materials and Engineering of Jiangsu Province, Yangzhou University, Yangzhou 225002 (China)

2014-07-01

The folic acid (FA)-conjugated Fe{sub 3}O{sub 4} magnetic nanoparticles (MNPs) were synthesized by co-precipitation of Fe{sup 3+} and Fe{sup 2+} solution followed by surface modification with carboxymethyl dextran (CMD) to form carboxymethyl group terminated MNPs, then FA was conjugated with the carboxyl group functionalized MNPs. The morphology and properties of obtained nanoparticles were characterized by X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), UV–visible spectra (UV–vis), transmission electron microscopy (TEM), dynamic light scattering (DLS), vibrating sample magnetometer (VSM) and thermogravimetric analysis (TGA). The FA-conjugated MNPs exhibited relatively high saturation magnetization and fast magneto-temperature response which could be applied to hyperthermia therapy. To determine the accurate targeting effect of FA, we chose FA-conjugated MNPs as MRI contrast enhancement agent for detection of KB cells with folate receptor over-expression in vitro and in vivo. The results show that these magnetic nanoparticles appear to be the promising materials for local hyperthermia and MRI.

Hyperthermia treatment of tumors by mesenchymal stem cell-delivered superparamagnetic iron oxide nanoparticles

Directory of Open Access Journals (Sweden)

Kalber TL

2016-05-01

Full Text Available Tammy L Kalber,1,2,* Katherine L Ordidge,1,2,* Paul Southern,3 Michael R Loebinger,1 Panagiotis G Kyrtatos,2,3 Quentin A Pankhurst,3,* Mark F Lythgoe,2,* Sam M Janes1,* 1Lungs for Living Research Centre, UCL Respiratory, University College London, 2UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, 3Healthcare Biomagnetics Laboratory, University College London, London, UK *These authors contributed equally to this work Abstract: Magnetic hyperthermia – a potential cancer treatment in which superparamagnetic iron oxide nanoparticles (SPIONs are made to resonantly respond to an alternating magnetic field (AMF and thereby produce heat – is of significant current interest. We have previously shown that mesenchymal stem cells (MSCs can be labeled with SPIONs with no effect on cell proliferation or survival and that within an hour of systemic administration, they migrate to and integrate into tumors in vivo. Here, we report on some longer term (up to 3 weeks post-integration characteristics of magnetically labeled human MSCs in an immunocompromized mouse model. We initially assessed how the size and coating of SPIONs dictated the loading capacity and cellular heating of MSCs. Ferucarbotran® was the best of those tested, having the best like-for-like heating capability and being the only one to retain that capability after cell internalization. A mouse model was created by subcutaneous flank injection of a combination of 0.5 million Ferucarbotran-loaded MSCs and 1.0 million OVCAR-3 ovarian tumor cells. After 2 weeks, the tumors reached ~100 µL in volume and then entered a rapid growth phase over the third week to reach ~300 µL. In the control mice that received no AMF treatment, magnetic resonance imaging (MRI data showed that the labeled MSCs were both incorporated into and retained within the tumors over the entire 3-week period. In the AMF-treated mice, heat increases of ~4°C were observed

MRI-guided biopsies and minimally invasive therapy for prostate cancer

Directory of Open Access Journals (Sweden)

Sangeet Ghai

2015-01-01

Full Text Available Recent advances in multiparametric magnetic resonance imaging (mp-MRI have led to a paradigm shift in the diagnosis and management of prostate cancer (PCa. Its sensitivity in detecting clinically significant cancer and the ability to localize the tumor within the prostate gland has opened up discussion on targeted diagnosis and therapy in PCa. Use of mp-MRI in conjunction with prostate-specific antigen followed by targeted biopsy allows for a better diagnostic pathway than transrectal ultrasound (TRUS biopsy and improves the diagnosis of PCa. Improved detection of PCa by mp-MRI has also opened up opportunities for focal therapy within the organ while reducing the incidence of side-effects associated with the radical treatment methods for PCa. This review discusses the evidence and techniques for in-bore MRI-guided prostate biopsy and provides an update on the status of MRI-guided targeted focal therapy in PCa.

Future of medical physics: Real-time MRI-guided proton therapy.

Science.gov (United States)

Oborn, Bradley M; Dowdell, Stephen; Metcalfe, Peter E; Crozier, Stuart; Mohan, Radhe; Keall, Paul J

2017-08-01

With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), attention is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidance for proton beam therapy is expected to offer a compelling improvement to the current treatment workflow which is warranted arguably more than for x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomes are similar to that of the most advanced IMRT treatments, despite being a fundamentally superior particle for cancer treatment. In this Future of Medical Physics article, we describe the various software and hardware aspects of potential MRPT systems and the corresponding treatment workflow. Significant software developments, particularly focused around adaptive MRI-based planning will be required. The magnetic interaction between the MRI and the proton beamline components will be a key area of focus. For example, the modeling and potential redesign of a magnetically compatible gantry to allow for beam delivery from multiple angles towards a patient located within the bore of an MRI scanner. Further to this, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringe field will require modeling, testing, and potential further development to ensure that the highly targeted radiotherapy is maintained. Looking forward we envisage a clear and accelerated path for hardware development, leveraging from lessons learnt from MRXT development. Within few years, simple prototype systems will likely exist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestones will be key in the development of a more efficient, more accurate, and more successful form of proton beam therapy for many common cancer sites. © 2017 American Association of Physicists in Medicine.

WE-FG-202-08: Assessment of Treatment Response Via Longitudinal Diffusion MRI On A MRI-Guided System: Initial Experience of Quantitative Analysis

Energy Technology Data Exchange (ETDEWEB)

Qi, X; Yang, Y; Yang, L; Low, D; Sheng, K [UCLA, Los Angeles, CA (United States)

2016-06-15

Purpose: To report our initial experience of systematic monitoring treatment response using longitudinal diffusion MR images on a Co-60 MRI-guided radiotherapy system. Methods: Four patients, including 2 head-and-necks, 1 sarcoma and 1 GBM treated on a 0.35 Tesla MRI-guided treatment system, were analyzed. For each patient, 3D TrueFISP MRIs were acquired during CT simulation and before each treatment for treatment planning and patient setup purposes respectively. Additionally, 2D diffusion-weighted MR images (DWI) were acquired weekly throughout the treatment course. The gross target volume (GTV) and brainstem (as a reference structure) were delineated on weekly 3D TrueFISP MRIs to monitor anatomy changes, the contours were then transferred onto the corresponding DWI images after fusing with the weekly TrueFISP images. The patient-specific temporal and spatial variations during the entire treatment course, such as anatomic changes, target apparent diffusion coefficient (ADC) distribution were evaluated in a longitudinal pattern. Results: Routine MRI revealed progressive soft-tissue GTV volume changes (up to 53%) for the H&N cases during the treatment course of 5–7 weeks. Within the GTV, the mean ADC values varied from −44% (ADC decrease) to +26% (ADC increase) in a week. The gradual increase of ADC value was inversely associated with target volume variation for one H&N case. The maximal changes of mean ADC values within the brainstem were 5.3% for the H&N cases. For the large size sarcoma and GBM tumors, spatial heterogeneity and temporal variations were observed through longitudinal ADC analysis. Conclusion: In addition to the superior soft-tissue visualization, the 0.35T MR system on ViewRay showed the potential to quantitatively measure the ADC values for both tumor and normal tissues. For normal tissue that is minimally affected by radiation, its ADC values are reproducible. Tumor ADC values show temporal and spatial fluctuation that can be exploited for

Findings in young pigs following combined treatment by hyperthermia and irradiation

International Nuclear Information System (INIS)

Schorcht, J.; Herrmann, T.; Barke, R.; Johannsen, U.

1985-01-01

In a pilot study, 8 store pigs were submitted to a combined treatment with hyperthermia (5 x 60 min; 42 0 C in the thoracic region) followed by telecobalt irradiation of the right lung (5 x 4 Gy). Radiologic checks of the thoracic organs and laboratory diagnostics provided useful data as to the temporal course of the radiogenic pulmonary affections and the tolerability of fractionated whole-body hyperthermia including superimposed local heating on store pigs. Histologic examinations of sections of heated and irradiated (right) as compared to exclusively heated (left) lung lobes of 4 animals suggested that hyperthermia exerted a radiosensitizing effect on the right lungs. Histologically confirmed irreversible lung fibrosis occurred there after exposure to even lower total doses following hyperthermia as compared to sole irradiation. (author)

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

Energy Technology Data Exchange (ETDEWEB)

Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Lakovaara, Martti [Oulu Deaconess Institute, Department of Surgery, Oulu (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery, Oulu (Finland)

2011-06-15

The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

International Nuclear Information System (INIS)

Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto; Lakovaara, Martti; Hyvoenen, Pekka; Lehenkari, Petri

2011-01-01

The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

The case for SAR as the major component of a hyperthermia treatment unit

International Nuclear Information System (INIS)

Scott, R.S.

1985-01-01

A major problem facing clinical hyperthermia is the lack of a useful unit of treatment. Most attempts at a treatment unit have utilized some function of temperature and time. Having accepted the validity of such a hypothetical units, one is faced with the formidable problem of obtaining a three dimensional temperature profile so that thermal dose can be determined. A corollary is the desirability of obtaining uniform temperature in the treatment volume. Various studies suggest that a uniform SAR is a more desirable goal when radiotherapy is to be used in combination with hyperthermia. The synergy between radiation and hyperthermia is maximized in low pH regions of tumor which are presumably also hypoxic. These regions are poorly perfused, likely to heat readily, and are resistant to the cytotoxic effects of radiation alone. On the other hand, well perfused regions of tumor are likely sensitive to radiation, and benefit less from the combination treatment. Other studies have definitely shown that tissue temperatures in the range normally associated with desirable hyperthermia treatment result in severe vascular damage. This damage could be expected to unnecessarily compromise the effectiveness of radiotherapy. Models in the literature can be combined to verify these observations

MRI-Guided Focused Ultrasound as a New Method of Drug Delivery

Directory of Open Access Journals (Sweden)

M. Thanou

2013-01-01

Full Text Available Ultrasound-mediated drug delivery under the guidance of an imaging modality can improve drug disposition and achieve site-specific drug delivery. The term focal drug delivery has been introduced to describe the focal targeting of drugs in tissues with the help of imaging and focused ultrasound. Focal drug delivery aims to improve the therapeutic profile of drugs by improving their specificity and their permeation in defined areas. Focused-ultrasound- (FUS- mediated drug delivery has been applied with various molecules to improve their local distribution in tissues. FUS is applied with the aid of microbubbles to enhance the permeability of bioactive molecules across BBB and improve drug distribution in the brain. Recently, FUS has been utilised in combination with MRI-labelled liposomes that respond to temperature increase. This strategy aims to “activate” nanoparticles to release their cargo locally when triggered by hyperthermia induced by FUS. MRI-guided FUS drug delivery provides the opportunity to improve drug bioavailability locally and therefore improve the therapeutic profiles of drugs. This drug delivery strategy can be directly translated to clinic as MRg FUS is a promising clinically therapeutic approach. However, more basic research is required to understand the physiological mechanism of FUS-enhanced drug delivery.

500 kHZ intracavitary hyperthermia in the treatment of patients with cervical and endometrial cancer - preliminary results and treatment description

International Nuclear Information System (INIS)

Piotrowicz, N.; Lyczek, J.; Zielinski, J.; Debicki, P.

2002-01-01

The effectiveness of elevated temperature (hyperthermia) in cancer treatment is a well-known issue. However, due to technical problems with generating hyperthermia within the tumour and, at the same time, sparing the healthy tissues, in practice this modality is not widely used. Local hyperthermia was induced by a computer-controlled generator (500 kHz) with three amplifiers transmitting energy to the lesion via a modified uterine brachytherapy applicator. Temperature was measured with 3 thermocouples.Total treatment time was 60-90 minutes. 10 patients with cervical and endometrial cancer were enrolled into this study and 11 procedures were performed. Prior to hyperthermia all patients were treated with external field irradiation to the pelvis to the dose of 45-46 Gy. Intracavitary LDR/HDR brachytherapy (dose of 45 Gy/point Ai n two fractions) with colpostat used for the hyperthermia procedure was than performed. In all cases, except one, caused by equipment failure, biologically stable temperature was observed. No severe side effects of treatment were observed. There was no need to terminate treatment due to high temperature intolerance. (author)

Interstitial hyperthermia using 8 MHz radiofrequency and stereotaxic brachytherapy for brain tumors

International Nuclear Information System (INIS)

Nishimura, Satoshi

1990-01-01

As a preliminary study of the interstitial hyperthermia combined with interstitial irradiation (brachytherapy) for the treatment of malignant brain tumors, we performed an experiment of interstitial hyperthermia of brain tissue of dogs. Nine afterloading tubes, four for needle electrodes and five for thermisters, were inserted in the brain tissue of dogs. Rise and stability of temperature were ascertained, and clinical safety was confirmed. Thereafter this combined therapy was applied on seven cases, in which three were malignant gliomas and four were metastatic tumors. Through the guide tubes, 192 Ir thin wires were implanted stereotaxically, and interstitial irradiation was carried out. After removal of 192 Ir wires, needle electrodes were inserted through the same tubes, and also a thermister was guided at the center of electrodes. And interstitial hyperthermia using 8 MHz radiofrequency was carried out. The results of the treatment were evaluated with CT scan based on criteria of the Japan Neurological Society. In cases of malignant gliomas, 2 PRs (partial remission), and 1 NC (no change) were obtained. In cases of metastatic tumors, 1 CR (complete remission), 2 PRs, 1 NC were obtaind. In cases of NCs, progression of tumors have been suppressed for 10 and 17 months, and still alive. As complication, transient worsening of neurological symptoms were observed in four cases (increased paresis: two cases, nausea and vomiting: two cases). The author have had an impression that interstitial hyperthermia combined with interstitial irradiation might become an effective means of treatment of brain tumors. (author)

Local hyperthermia and artificial hyperglycemia in combined treatment of patients with rectum cancer

International Nuclear Information System (INIS)

Bezmen, V.A.; Illarionov, A.A.; Novokhrost, V.I.; Shilov, N.I.; Ospishchev, A.A.; Kejs, G.D.

1990-01-01

To study prospects of application of local hyperthermia, artificial hyperglycemia and radiotherapy in a preoperative period, 31 patients with rectum cancer were studied. The treatment included 3-hour artificial hyperglycemia first, then local SHF hyperthermia and telegamma irradiation using large-fractioned doses (ROD is 5 Gy, COD is 20 Gy). No serious side-effects were observed during the preoperative treatment period. The immediate and early results of combined treatment promise to improve the effectiveness of treatment of patients with rectum cancer. 3 refs

CT-based patient modeling for head and neck hyperthermia treatment planning: manual versus automatic normal-tissue-segmentation.

Science.gov (United States)

Verhaart, René F; Fortunati, Valerio; Verduijn, Gerda M; van Walsum, Theo; Veenland, Jifke F; Paulides, Margarethus M

2014-04-01

Clinical trials have shown that hyperthermia, as adjuvant to radiotherapy and/or chemotherapy, improves treatment of patients with locally advanced or recurrent head and neck (H&N) carcinoma. Hyperthermia treatment planning (HTP) guided H&N hyperthermia is being investigated, which requires patient specific 3D patient models derived from Computed Tomography (CT)-images. To decide whether a recently developed automatic-segmentation algorithm can be introduced in the clinic, we compared the impact of manual- and automatic normal-tissue-segmentation variations on HTP quality. CT images of seven patients were segmented automatically and manually by four observers, to study inter-observer and intra-observer geometrical variation. To determine the impact of this variation on HTP quality, HTP was performed using the automatic and manual segmentation of each observer, for each patient. This impact was compared to other sources of patient model uncertainties, i.e. varying gridsizes and dielectric tissue properties. Despite geometrical variations, manual and automatic generated 3D patient models resulted in an equal, i.e. 1%, variation in HTP quality. This variation was minor with respect to the total of other sources of patient model uncertainties, i.e. 11.7%. Automatically generated 3D patient models can be introduced in the clinic for H&N HTP. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

CT-based patient modeling for head and neck hyperthermia treatment planning: Manual versus automatic normal-tissue-segmentation

International Nuclear Information System (INIS)

Verhaart, René F.; Fortunati, Valerio; Verduijn, Gerda M.; Walsum, Theo van; Veenland, Jifke F.; Paulides, Margarethus M.

2014-01-01

Background and purpose: Clinical trials have shown that hyperthermia, as adjuvant to radiotherapy and/or chemotherapy, improves treatment of patients with locally advanced or recurrent head and neck (H and N) carcinoma. Hyperthermia treatment planning (HTP) guided H and N hyperthermia is being investigated, which requires patient specific 3D patient models derived from Computed Tomography (CT)-images. To decide whether a recently developed automatic-segmentation algorithm can be introduced in the clinic, we compared the impact of manual- and automatic normal-tissue-segmentation variations on HTP quality. Material and methods: CT images of seven patients were segmented automatically and manually by four observers, to study inter-observer and intra-observer geometrical variation. To determine the impact of this variation on HTP quality, HTP was performed using the automatic and manual segmentation of each observer, for each patient. This impact was compared to other sources of patient model uncertainties, i.e. varying gridsizes and dielectric tissue properties. Results: Despite geometrical variations, manual and automatic generated 3D patient models resulted in an equal, i.e. 1%, variation in HTP quality. This variation was minor with respect to the total of other sources of patient model uncertainties, i.e. 11.7%. Conclusions: Automatically generated 3D patient models can be introduced in the clinic for H and N HTP

Fully automated MRI-guided robotics for prostate brachytherapy

International Nuclear Information System (INIS)

Stoianovici, D.; Vigaru, B.; Petrisor, D.; Muntener, M.; Patriciu, A.; Song, D.

2008-01-01

The uncertainties encountered in the deployment of brachytherapy seeds are related to the commonly used ultrasound imager and the basic instrumentation used for the implant. An alternative solution is under development in which a fully automated robot is used to place the seeds according to the dosimetry plan under direct MRI-guidance. Incorporation of MRI-guidance creates potential for physiological and molecular image-guided therapies. Moreover, MRI-guided brachytherapy is also enabling for re-estimating dosimetry during the procedure, because with the MRI the seeds already implanted can be localised. An MRI compatible robot (MrBot) was developed. The robot is designed for transperineal percutaneous prostate interventions, and customised for fully automated MRI-guided brachytherapy. With different end-effectors, the robot applies to other image-guided interventions of the prostate. The robot is constructed of non-magnetic and dielectric materials and is electricity free using pneumatic actuation and optic sensing. A new motor (PneuStep) was purposely developed to set this robot in motion. The robot fits alongside the patient in closed-bore MRI scanners. It is able to stay fully operational during MR imaging without deteriorating the quality of the scan. In vitro, cadaver, and animal tests showed millimetre needle targeting accuracy, and very precise seed placement. The robot tested without any interference up to 7T. The robot is the first fully automated robot to function in MRI scanners. Its first application is MRI-guided seed brachytherapy. It is capable of automated, highly accurate needle placement. Extensive testing is in progress prior to clinical trials. Preliminary results show that the robot may become a useful image-guided intervention instrument. (author)

Feasibility study on 3D image reconstruction from 2D orthogonal cine-MRI for MRI-guided radiotherapy.

Science.gov (United States)

Paganelli, Chiara; Lee, Danny; Kipritidis, John; Whelan, Brendan; Greer, Peter B; Baroni, Guido; Riboldi, Marco; Keall, Paul

2018-02-11

In-room MRI is a promising image guidance strategy in external beam radiotherapy to acquire volumetric information for moving targets. However, limitations in spatio-temporal resolution led several authors to use 2D orthogonal images for guidance. The aim of this work is to present a method to concurrently compensate for non-rigid tumour motion and provide an approach for 3D reconstruction from 2D orthogonal cine-MRI slices for MRI-guided treatments. Free-breathing sagittal/coronal interleaved 2D cine-MRI were acquired in addition to a pre-treatment 3D volume in two patients. We performed deformable image registration (DIR) between cine-MRI slices and corresponding slices in the pre-treatment 3D volume. Based on an extrapolation of the interleaved 2D motion fields, the 3D motion field was estimated and used to warp the pre-treatment volume. Due to the lack of a ground truth for patients, the method was validated on a digital 4D lung phantom. On the phantom, the 3D reconstruction method was able to compensate for tumour motion and compared favourably to the results of previously adopted strategies. The difference in the 3D motion fields between the phantom and the extrapolated motion was 0.4 ± 0.3 mm for tumour and 0.8 ± 1.5 mm for whole anatomy, demonstrating feasibility of performing a 3D volumetric reconstruction directly from 2D orthogonal cine-MRI slices. Application of the method to patient data confirmed the feasibility of utilizing this method in real world scenarios. Preliminary results on phantom and patient cases confirm the feasibility of the proposed approach in an MRI-guided scenario, especially for non-rigid tumour motion compensation. © 2018 The Royal Australian and New Zealand College of Radiologists.

Development of a spherically focused phased array transducer for ultrasonic image-guided hyperthermia

OpenAIRE

Liu, Jingfei; Foiret, Josquin; Stephens, Douglas N.; Le Baron, Olivier; Ferrara, Katherine W.

2016-01-01

A 1.5 MHz prolate spheroidal therapeutic array with 128 circular elements was designed to accommodate standard imaging arrays for ultrasonic image-guided hyperthermia. The implementation of this dual-array system integrates real-time therapeutic and imaging functions with a single ultrasound system (Vantage 256, Verasonics). To facilitate applications involving small animal imaging and therapy the array was designed to have a beam depth of field smaller than 3.5 mm and to electronically steer...

First patients treated with a 1.5 T MRI-Linac: clinical proof of concept of a high-precision, high-field MRI guided radiotherapy treatment

Science.gov (United States)

Raaymakers, B. W.; Jürgenliemk-Schulz, I. M.; Bol, G. H.; Glitzner, M.; Kotte, A. N. T. J.; van Asselen, B.; de Boer, J. C. J.; Bluemink, J. J.; Hackett, S. L.; Moerland, M. A.; Woodings, S. J.; Wolthaus, J. W. H.; van Zijp, H. M.; Philippens, M. E. P.; Tijssen, R.; Kok, J. G. M.; de Groot-van Breugel, E. N.; Kiekebosch, I.; Meijers, L. T. C.; Nomden, C. N.; Sikkes, G. G.; Doornaert, P. A. H.; Eppinga, W. S. C.; Kasperts, N.; Kerkmeijer, L. G. W.; Tersteeg, J. H. A.; Brown, K. J.; Pais, B.; Woodhead, P.; Lagendijk, J. J. W.

2017-12-01

The integration of 1.5 T MRI functionality with a radiotherapy linear accelerator (linac) has been pursued since 1999 by the UMC Utrecht in close collaboration with Elekta and Philips. The idea behind this integrated device is to offer unrivalled, online and real-time, soft-tissue visualization of the tumour and the surroundings for more precise radiation delivery. The proof of concept of this device was given in 2009 by demonstrating simultaneous irradiation and MR imaging on phantoms, since then the device has been further developed and commercialized by Elekta. The aim of this work is to demonstrate the clinical feasibility of online, high-precision, high-field MRI guidance of radiotherapy using the first clinical prototype MRI-Linac. Four patients with lumbar spine bone metastases were treated with a 3 or 5 beam step-and-shoot IMRT plan. The IMRT plan was created while the patient was on the treatment table and based on the online 1.5 T MR images; pre-treatment CT was deformably registered to the online MRI to obtain Hounsfield values. Bone metastases were chosen as the first site as these tumors can be clearly visualized on MRI and the surrounding spine bone can be detected on the integrated portal imager. This way the portal images served as an independent verification of the MRI based guidance to quantify the geometric precision of radiation delivery. Dosimetric accuracy was assessed post-treatment from phantom measurements with an ionization chamber and film. Absolute doses were found to be highly accurate, with deviations ranging from 0.0% to 1.7% in the isocenter. The geometrical, MRI based targeting as confirmed using portal images was better than 0.5 mm, ranging from 0.2 mm to 0.4 mm. In conclusion, high precision, high-field, 1.5 T MRI guided radiotherapy is clinically feasible.

Implementing MRI-based target delineation for cervical cancer treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI.

Science.gov (United States)

Trifiletti, Daniel M; Libby, Bruce; Feuerlein, Sebastian; Kim, Taeho; Garda, Allison; Watkins, W Tyler; Erickson, Sarah; Ornan, Afshan; Showalter, Timothy N

2015-01-01

Magnetic resonance imaging (MRI)-based intracavitary brachytherapy offers several advantages over computed tomography (CT)-based brachytherapy, but many centers are unable to offer it at the time of brachytherapy because of logistic and/or financial considerations. We have implemented a method of integrating MRI into a CT-guided, high-dose-rate intracavitary brachytherapy workflow in clinics that do not have immediately available MRI capability. At our institution, patients receiving high-dose-rate intracavitary brachytherapy as a component of the definitive treatment of cervical cancer have a Smit sleeve placed during the first brachytherapy fraction in a dedicated suite with in-room CT-on-rails. After the first fraction of brachytherapy, an MRI is obtained with the Smit sleeve, but no applicator, in place. For each subsequent fraction, CT scans are coregistered to the MRI scan by the Smit sleeve. The gross target volume is defined by MRI and overlaid on the CT images for each brachytherapy treatment for dose optimization. This MRI-integrated workflow adds workflow is a feasible compromise to preserve an efficient workflow while integrating MRI target delineation, and it provides many of the advantages of both MRI- and CT-based brachytherapy. The future collection and analysis of clinical data will serve to compare the proposed approach to non-MRI containing techniques. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Robotic System for MRI-Guided Stereotactic Neurosurgery

Science.gov (United States)

Li, Gang; Cole, Gregory A.; Shang, Weijian; Harrington, Kevin; Camilo, Alex; Pilitsis, Julie G.; Fischer, Gregory S.

2015-01-01

Stereotaxy is a neurosurgical technique that can take several hours to reach a specific target, typically utilizing a mechanical frame and guided by preoperative imaging. An error in any one of the numerous steps or deviations of the target anatomy from the preoperative plan such as brain shift (up to 20 mm), may affect the targeting accuracy and thus the treatment effectiveness. Moreover, because the procedure is typically performed through a small burr hole opening in the skull that prevents tissue visualization, the intervention is basically “blind” for the operator with limited means of intraoperative confirmation that may result in reduced accuracy and safety. The presented system is intended to address the clinical needs for enhanced efficiency, accuracy, and safety of image-guided stereotactic neurosurgery for Deep Brain Stimulation (DBS) lead placement. The work describes a magnetic resonance imaging (MRI)-guided, robotically actuated stereotactic neural intervention system for deep brain stimulation procedure, which offers the potential of reducing procedure duration while improving targeting accuracy and enhancing safety. This is achieved through simultaneous robotic manipulation of the instrument and interactively updated in situ MRI guidance that enables visualization of the anatomy and interventional instrument. During simultaneous actuation and imaging, the system has demonstrated less than 15% signal-to-noise ratio (SNR) variation and less than 0.20% geometric distortion artifact without affecting the imaging usability to visualize and guide the procedure. Optical tracking and MRI phantom experiments streamline the clinical workflow of the prototype system, corroborating targeting accuracy with 3-axis root mean square error 1.38 ± 0.45 mm in tip position and 2.03 ± 0.58° in insertion angle. PMID:25376035

Longitudinal diffusion MRI for treatment response assessment: Preliminary experience using an MRI-guided tri-cobalt 60 radiotherapy system.

Science.gov (United States)

Yang, Yingli; Cao, Minsong; Sheng, Ke; Gao, Yu; Chen, Allen; Kamrava, Mitch; Lee, Percy; Agazaryan, Nzhde; Lamb, James; Thomas, David; Low, Daniel; Hu, Peng

2016-03-01

To demonstrate the preliminary feasibility of a longitudinal diffusion magnetic resonance imaging (MRI) strategy for assessing patient response to radiotherapy at 0.35 T using an MRI-guided radiotherapy system (ViewRay). Six patients (three head and neck cancer, three sarcoma) who underwent fractionated radiotherapy were enrolled in this study. A 2D multislice spin echo single-shot echo planar imaging diffusion pulse sequence was implemented on the ViewRay system and tested in phantom studies. The same pulse sequence was used to acquire longitudinal diffusion data (every 2-5 fractions) on the six patients throughout the entire course of radiotherapy. The reproducibility of the apparent diffusion coefficient (ADC) measurements was assessed using reference regions and the temporal variations of the tumor ADC values were evaluated. In diffusion phantom studies, the ADC values measured on the ViewRay system matched well with reference ADC values with ViewRay MRI. Larger patient cohort studies are warranted to correlate the longitudinal diffusion measurements to patient outcomes. Such an approach may enable response-guided adaptive radiotherapy.

Radionuclide investigations of the hormonal reflection of warm stress in cancer patients under whole body guided hyperthermia. Radionuklidnye issledovaniya gormonal'nykh proyavlenij teplovogo stressa u onkologicheskikh bol'nykh pri obshchej upravlyaemoj gipertermii

Energy Technology Data Exchange (ETDEWEB)

Prokhorova, V I; Zhavrid, Eh A; Fradkin, S Z; Tsyrus' , T P; Shitikov, B D; Kosheleva, M I

1991-01-01

The results of the radioimmunoassay of ACTH, ST, hydrocortisone, glucagon, C-peptide, insulin and cyclic nucleotides in 180 patients with advanced and metastatic melanomas, soft tissue sarcomas, lung cancers and renal cell carcinomas testify to the development of the syndrome of endocrine hyperfunction in patients under whole-body guided hyperthermia and artificial hyperglycemia as well as of functional pancreas insufficiency. The data presented form a biochemical basis for working out measures to optimally carry out whole-body hyperthermia and artificial hyperglycemia treatment, aimed at increasing the range of indications for its use in clinical oncology.

Multimodal 18F-Fluciclovine PET/MRI and Ultrasound-Guided Neurosurgery of an Anaplastic Oligodendroglioma.

Science.gov (United States)

Karlberg, Anna; Berntsen, Erik Magnus; Johansen, Håkon; Myrthue, Mariane; Skjulsvik, Anne Jarstein; Reinertsen, Ingerid; Esmaeili, Morteza; Dai, Hong Yan; Xiao, Yiming; Rivaz, Hassan; Borghammer, Per; Solheim, Ole; Eikenes, Live

2017-12-01

Structural magnetic resonance imaging (MRI) and histopathologic tissue sampling are routinely performed as part of the diagnostic workup for patients with glioma. Because of the heterogeneous nature of gliomas, there is a risk of undergrading caused by histopathologic sampling errors. MRI has limitations in identifying tumor grade and type, detecting diffuse invasive growth, and separating recurrences from treatment induced changes. Positron emission tomography (PET) can provide quantitative information of cellular activity and metabolism, and may therefore complement MRI. In this report, we present the first patient with brain glioma examined with simultaneous PET/MRI using the amino acid tracer 18 F-fluciclovine ( 18 F-FACBC) for intraoperative image-guided surgery. A previously healthy 60-year old woman was admitted to the emergency care with speech difficulties and a mild left-sided hemiparesis. MRI revealed a tumor that was suggestive of glioma. Before surgery, the patient underwent a simultaneous PET/MRI examination. Fused PET/MRI, T1, FLAIR, and intraoperative three-dimensional ultrasound images were used to guide histopathologic tissue sampling and surgical resection. Navigated, image-guided histopathologic samples were compared with PET/MRI image data to assess the additional value of the PET acquisition. Histopathologic analysis showed anaplastic oligodendroglioma in the most malignant parts of the tumor, while several regions were World Health Organization (WHO) grade II. 18 F-Fluciclovine uptake was found in parts of the tumor where regional WHO grade, cell proliferation, and cell densities were highest. This finding suggests that PET/MRI with this tracer could be used to improve accuracy in histopathologic tissue sampling and grading, and possibly for guiding treatments targeting the most malignant part of extensive and eloquent gliomas. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Hyperthermia quality assurance

International Nuclear Information System (INIS)

Shrivastava, P.N.; Paliwal, B.R.

1984-01-01

Hyperthermia Physics Center (HPC) operating under contract with the National Cancer Institute is developing a Quality Assurance program for local and regional hyperthermia. The major clinical problem in hyperthermia treatments is that they are extremely difficult to plan, execute, monitor and reproduce. A scientific basis for treatment planning can be established only after ensuring that the performance of heat generating and temperature monitoring systems are reliable. The HPC is presently concentrating on providing uniform NBS traceable calibration of thermometers and evaluation of reproducibility for power generator operation, applicator performance, phanta compositions, system calibrations and personnel shielding. The organizational plan together with recommended evaluation measurements, procedures and criteria are presented

Hyperthermia and PARP1-inhibition for sensitization of radiation and cisplatin treatment of cervical carcinoma cells

International Nuclear Information System (INIS)

Franken, Nicolaas; Oei, Arlene; Leeuwen, Caspar van; Stalpers, Lukas; Rodermond, Hans; Bel, Arjan; Kok, Petra; Crezee, Hans

2014-01-01

Ionizing radiation causes single and double strand breaks (SSBs and DSBs). DSBs are among the most critical DNA lesions and can be repaired via either non-homologous end joining (NHEJ) in which PARP1, Ku70 and DNA-PKcs are important, or homologous recombination (HR), where BRCA2 and Rad51 are essential. Hyperthermia disturbs HR by temporary inactivation of BRCA2. Cisplatin disrupts NHEJ and PARP1-inhibitor blocks Poly-(ADP-ribose)polymerase- 1, which is important in SSB repair, NHEJ and backup-NHEJ. Our goal was to investigate the additional effectiveness of hyperthermia and PARP1-inhibition on radiation and/or cisplatin treatment. Cervical carcinoma cells (SiHa) were treated at different temperature levels levels (41.0-43.0℃, PARP1-inhibitor (100 μM; NU1025), gamma-irradiation doses (0-8 Gy) or cisplatin (1'R for 1 h). Clonogenic assays were carried out to measure survival and γH2AX staining was used to visualize DSBs. To elucidate mechanisms of action expression levels of DNA repair proteins BRCA2 and DNA-PKcs were investigated after 42.0℃ (1 h) using western blot. Combined hyperthermia and radiation resulted in an increased number of γH2AX foci as compared to radiation alone. Hyperthermia treatment in combination with cisplatin and PARP1 inhibitor and with radiation and PARP1 inhibitor significantly decreased cell survival. Western blot demonstrated a decreased expression of BRCA2 protein at 30 min after hyperthermia treatment. Adding PARP1-inhibitor significantly improves the effectiveness of combined hyperthermia radiotherapy and combined hyperthermia-cisplatin treatment on cervical carcinoma cells. Hyperthermia affects DNA-DSB repair as is indicated by increased γH2AX foci numbers and decreased BRCA2 expression. (author)

A numerical study on dual-phase-lag model of bio-heat transfer during hyperthermia treatment.

Science.gov (United States)

Kumar, P; Kumar, Dinesh; Rai, K N

2015-01-01

The success of hyperthermia in the treatment of cancer depends on the precise prediction and control of temperature. It was absolutely a necessity for hyperthermia treatment planning to understand the temperature distribution within living biological tissues. In this paper, dual-phase-lag model of bio-heat transfer has been studied using Gaussian distribution source term under most generalized boundary condition during hyperthermia treatment. An approximate analytical solution of the present problem has been done by Finite element wavelet Galerkin method which uses Legendre wavelet as a basis function. Multi-resolution analysis of Legendre wavelet in the present case localizes small scale variations of solution and fast switching of functional bases. The whole analysis is presented in dimensionless form. The dual-phase-lag model of bio-heat transfer has compared with Pennes and Thermal wave model of bio-heat transfer and it has been found that large differences in the temperature at the hyperthermia position and time to achieve the hyperthermia temperature exist, when we increase the value of τT. Particular cases when surface subjected to boundary condition of 1st, 2nd and 3rd kind are discussed in detail. The use of dual-phase-lag model of bio-heat transfer and finite element wavelet Galerkin method as a solution method helps in precise prediction of temperature. Gaussian distribution source term helps in control of temperature during hyperthermia treatment. So, it makes this study more useful for clinical applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Delineation of potential hot spots for hyperthermia treatment planning optimisation

NARCIS (Netherlands)

Wiersma, J.; van Wieringen, N.; Crezee, H.; van Dijk, J. D. P.

2007-01-01

The optimal feed parameters of the generators for a complex-phased hyperthermia array system consisting of 4, 8 or even more applicators cannot be found using only the expertise of the treatment staff or using the limited amount of field and temperature data obtained during treatment. A number of

Verification of hyperthermia treatment planning in cervix carcinoma patients using invasive thermometry

International Nuclear Information System (INIS)

Haaren Van, P.M.A.; Kok, H.P.; Zum Voerde Sive Voerding, P.J.; Oldenborg, S.; Stalpers, L.J.A.; Crezee, J.; Berg Van den, C.A.T; Leeuw De, A.A.C.

2005-01-01

Full text: Hyperthermia treatment planning (HTP) is a useful tool for improvement of clinical hyperthermia treatments. Aim of this study was to determine the correlation between HTP and measurements during hyperthermia treatments. We compared the calculated specific absorption rate (SAR) with clinically measured SAR-values, from ΔT-measurements, in cervix carcinoma patients. General difficulties for such clinical verifications are changes in the anatomy during the different steps and possible movement of the catheters. We used one fixed invasive catheter in the tumor additional to the usual non-invasive catheters in the vagina, bladder and rectum, for insertion of multisensor thermocouple probes. A special CT-scan with the patient in treatment position and the catheters in situ was made for the HTP. We performed these verifications in a total of 11 treatments in 7 patients. The main difficulties for accurate verification were of clinical nature: difficulties arising from the use of gynaecological tampon and the limited number of measurements in tissue. Remaining air in the vagina and sub-optimal tissue contact of the catheters resulted in bad thermal contact between thermocouples and tissue, causing measurement artefacts that are difficult to correlate with calculations. These artefacts are probably not specific for thermocouple measurements, but more general for intraluminal temperature and SAR measurements. (author)

MRI-only treatment planning: benefits and challenges

Science.gov (United States)

Owrangi, Amir M.; Greer, Peter B.; Glide-Hurst, Carri K.

2018-03-01

Over the past decade, the application of magnetic resonance imaging (MRI) has increased, and there is growing evidence to suggest that improvements in the accuracy of target delineation in MRI-guided radiation therapy may improve clinical outcomes in a variety of cancer types. However, some considerations should be recognized including patient motion during image acquisition and geometric accuracy of images. Moreover, MR-compatible immobilization devices need to be used when acquiring images in the treatment position while minimizing patient motion during the scan time. Finally, synthetic CT images (i.e. electron density maps) and digitally reconstructed radiograph images should be generated from MRI images for dose calculation and image guidance prior to treatment. A short review of the concepts and techniques that have been developed for implementation of MRI-only workflows in radiation therapy is provided in this document.

Non-Invasive Radiofrequency Field Treatment to Produce Hepatic Hyperthermia: Efficacy and Safety in Swine

OpenAIRE

,; ,; ,; ,; ,; ,; ,; ,; ,

2017-01-01

The Kanzius non-invasive radio-frequency hyperthermia system (KNiRFH) has been investigated as a treatment option for hepatic hyperthermia cancer therapy. The treatment involves exposing the patient to an external high-power RF (13.56 MHz) electric field, whereby the propagating waves penetrate deep into the tumor causing targeted heating based on differential tissue dielectric properties. However, a comprehensive examination of the Kanzius system alongside any associated toxicities and its a...

Description and characterization of the novel hyperthermia- and thermoablation-system MFHregistered300F for clinical magnetic fluid hyperthermia

International Nuclear Information System (INIS)

Gneveckow, Uwe; Jordan, Andreas; Scholz, Regina; Bruess, Volker; Waldoefner, Norbert; Ricke, Jens; Feussner, Annelie; Hildebrandt, Bert; Rau, Beate; Wust, Peter

2004-01-01

Magnetic fluid hyperthermia (MFH) is a new approach to deposit heat power in deep tissues by overcoming limitations of conventional heat treatments. After infiltration of the target tissue with nanosized magnetic particles, the power of an alternating magnetic field is transformed into heat. The combination of the 100 kHz magnetic field applicator MFH registered 300F and the magnetofluid (MF), which both are designed for medical use, is investigated with respect to its dosage recommendations and clinical applicability. We found a magnetic field strength of up to 18 kA/m in a cylindrical treatment area of 20 cm diameter and aperture height up to 300 mm. The specific absorption rate (SAR) can be controlled directly by the magnetic field strength during the treatment. The relationship between magnetic field strength and the iron normalized SAR (SAR Fe ) is only slightly depending on the concentration of the MF and can be used for planning the target SAR. The achievable energy absorption rates of the MF distributed in the tissue is sufficient for either hyperthermia or thermoablation. The fluid has a visible contrast in therapeutic concentrations on a CT scanner and can be detected down to 0.01 g/l Fe in the MRI. The system has proved its capability and practicability for heat treatment in deep regions of the human body

Thermal dosimetry for bladder hyperthermia treatment. An overview.

Science.gov (United States)

Schooneveldt, Gerben; Bakker, Akke; Balidemaj, Edmond; Chopra, Rajiv; Crezee, Johannes; Geijsen, Elisabeth D; Hartmann, Josefin; Hulshof, Maarten C C M; Kok, H Petra; Paulides, Margarethus M; Sousa-Escandon, Alejandro; Stauffer, Paul R; Maccarini, Paolo F

2016-06-01

The urinary bladder is a fluid-filled organ. This makes, on the one hand, the internal surface of the bladder wall relatively easy to heat and ensures in most cases a relatively homogeneous temperature distribution; on the other hand the variable volume, organ motion, and moving fluid cause artefacts for most non-invasive thermometry methods, and require additional efforts in planning accurate thermal treatment of bladder cancer. We give an overview of the thermometry methods currently used and investigated for hyperthermia treatments of bladder cancer, and discuss their advantages and disadvantages within the context of the specific disease (muscle-invasive or non-muscle-invasive bladder cancer) and the heating technique used. The role of treatment simulation to determine the thermal dose delivered is also discussed. Generally speaking, invasive measurement methods are more accurate than non-invasive methods, but provide more limited spatial information; therefore, a combination of both is desirable, preferably supplemented by simulations. Current efforts at research and clinical centres continue to improve non-invasive thermometry methods and the reliability of treatment planning and control software. Due to the challenges in measuring temperature across the non-stationary bladder wall and surrounding tissues, more research is needed to increase our knowledge about the penetration depth and typical heating pattern of the various hyperthermia devices, in order to further improve treatments. The ability to better determine the delivered thermal dose will enable clinicians to investigate the optimal treatment parameters, and consequentially, to give better controlled, thus even more reliable and effective, thermal treatments.

MR image-guided portal verification for brain treatment field

International Nuclear Information System (INIS)

Yin Fangfang; Gao Qinghuai; Xie Huchen; Nelson, Diana F.; Yu Yan; Kwok, W. Edmund; Totterman, Saara; Schell, Michael C.; Rubin, Philip

1998-01-01

Purpose: To investigate a method for the generation of digitally reconstructed radiographs directly from MR images (DRR-MRI) to guide a computerized portal verification procedure. Methods and Materials: Several major steps were developed to perform an MR image-guided portal verification procedure. Initially, a wavelet-based multiresolution adaptive thresholding method was used to segment the skin slice-by-slice in MR brain axial images. Some selected anatomical structures, such as target volume and critical organs, were then manually identified and were reassigned to relatively higher intensities. Interslice information was interpolated with a directional method to achieve comparable display resolution in three dimensions. Next, a ray-tracing method was used to generate a DRR-MRI image at the planned treatment position, and the ray tracing was simply performed on summation of voxels along the ray. The skin and its relative positions were also projected to the DRR-MRI and were used to guide the search of similar features in the portal image. A Canny edge detector was used to enhance the brain contour in both portal and simulation images. The skin in the brain portal image was then extracted using a knowledge-based searching technique. Finally, a Chamfer matching technique was used to correlate features between DRR-MRI and portal image. Results: The MR image-guided portal verification method was evaluated using a brain phantom case and a clinical patient case. Both DRR-CT and DRR-MRI were generated using CT and MR phantom images with the same beam orientation and then compared. The matching result indicated that the maximum deviation of internal structures was less than 1 mm. The segmented results for brain MR slice images indicated that a wavelet-based image segmentation technique provided a reasonable estimation for the brain skin. For the clinical patient case with a given portal field, the MR image-guided verification method provided an excellent match between

Mechanisms of hyperthermia induced radiatiosensitization for treatment of human papillomavirus positive tumors

International Nuclear Information System (INIS)

Oei, Arlene; Leeuwen, Caspar van; Stalpers, Lukas; Rodermond, Hans; Kok, Petra; Crezee, Hans; Franken, Nicolaas

2016-01-01

HPV is associated with cervical cancer, the third most common cancer in women. In over 70% of cervical cancers, the high-risk HPV-types 16 and 18 are found. In these tumors, functionality of p53 is suppressed by the presence of protein E6. Hyperthermia is a clinical application of heat in which tumour temperatures are raised to 40-43°C and combined hyperthermia with radiation is very effective in the treatment of cervical cancer

Magnetic hyperthermia dosimetry by biomechanical properties revealed in magnetomotive optical coherence elastography (MM-OCE) (Conference Presentation)

Science.gov (United States)

Huang, Pin-Chieh; Marjanovic, Marina; Spillman, Darold R.; Odintsov, Boris M.; Boppart, Stephen A.

2016-03-01

Magnetic nanoparticles (MNPs) have been utilized in magnetic hyperthermia to treat solid tumors. Under an appropriate AC magnetic field, energy can be transferred to the MNPs to heat up the intended tissue target while sparing non-targeted healthy tissue. However, a sensitive monitoring technique for the dose of MNP thermal therapy is desirable in order to prevent over-treatment and collateral injury. Typical hyperthermia dosimetry often relies on changes in imaging properties or temperature measurements based on the thermal distribution. Alternative dosimetric indicators can include the biomechanical properties of the tissue, reflecting the changes due to protein denaturation, coagulation, and tissue dehydration during hyperthermia treatments. Tissue stiffness can be probed by elastography modalities including MRI, ultrasound imaging, and optical coherence elastography (OCE), with OCE showing the highest displacement sensitivity (tens of nanometers). Magnetomotive optical coherence elastography (MM-OCE) is one type of OCE that utilizes MNPs as internal force transducers to probe the tissue stiffness. Therefore, we examined the feasibility of evaluating the hyperthermia dose based on the elasticity changes revealed by MM-OCE. Superparamagnetic MNPs were applied to ex vivo tissue specimens for both magnetic hyperthermia and MM-OCE experiments, where temperature and elastic modulus were obtained. A correlation between temperature rise and measured stiffness was observed. In addition, we found that with repetitive sequential treatments, tissue stiffness increased, while temperature rise remained relatively constant. These results potentially suggest that MM-OCE could indicate the irreversible changes the tissue undergoes during thermal therapy, which supports the idea for MM-OCE-based hyperthermia dosage control in future applications.

MRI-guided laser-induced thermotherapy (LITT) of liver metastases: clinical evaluation

International Nuclear Information System (INIS)

Vogl, T.J.; Weinhold, N.; Mueller, P.; Mack, M.; Scholz, W.; Philipp, C.; Roggan, A.; Felix, R.

1996-01-01

The goal was to perform an evaluation of MRI-guided laser-induced thermotherapy (LITT) of liver metastases as a clinical method. In a prospective study, 50 patients with liver metastases of colorectal carcinoma (35 patients), or other primary tumors (15 patients) were treated with LITT. For preparation and intermittent controls of therapy, standardized MRI examinations were made. Online monitoring during the the LITT was done with temperature-sensitive T1-weighted sequences (FLASH-2D, TurboFLASH). All in all, 83 metastases of a volume between 1 and 282 cubic centimeters (median = ± 10 cm 3 ) were treated.During performance of the LITT, a decrease of signal intensity in the thermosensitive sequences was measured for the application area, and was correlated with fluorine-optical temperature measurements. The MRI-guided LITT is a novel, potential modality for treatment of liver metastases, and poses only minimal clinical risks. (orig./VHE) [de

Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI.

Science.gov (United States)

Song, Sung Eun; Cho, Nariya; Han, Wonshik

2017-12-01

To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. • Post-clip MRI is useful for confirming adequate sampling of US-guided biopsy. • Post-clip MRI following US-guided biopsy revealed a 96.6 % technical success rate. • One technical failure case was a benign, 1.1-cm non-mass enhancement. • The technical success rate of US-guided biopsy for non-mass enhancements was 83.3 %.

In vivo noninvasive thermometry for hyperthermia applications using the MRI-based proton-resonance-frequency method

Energy Technology Data Exchange (ETDEWEB)

De Poorter, J; De Deene, Y; Achten, E [Ghent University (Belgium). Dept. of Magnetic Resonance; De Wagter, C [Ghent Rijksuniversiteit (Belgium). Kliniek voor Radiotherapie en Kerngeneeskunde; Thomsen, C [Hvidovre Univ. (Denmark); Staahlberg, F [Lund Univ. (Sweden). Dept. of Radiation Physics

1995-12-01

The lack of noninvasive temperature monitoring is seriously limiting hyperthermia treatment of deep-seated tumors. MRI methods exploit the temperature dependence of a physical property whose spatial distribution can be visualized. The Proton Resonance Frequency (PRF) as physical property was examined because phantom studies prove the high accuracy that can be obtained using this parameter. Thermal experiments were performed in human lower legs. The results show that in muscle tissue the three-dimensional temperature distribution can be evaluated with a mean spatial distribution of 2 millimetres, a temporal resolution of 2 minutes and an accuracy of about 1 degree Celsius. However, it is not possible to retrieve the temperature distribution in fat tissue using the PRF-method due to the predominance of susceptibility effects in fat. The susceptibility effects are a consequence of the temperature dependence of the susceptibility constants. Experimental data on these dependencies were obtained and the magnitude of these effects was modelled for some specific configurations. The susceptibility effects in muscle tissue can be neglected when precautions are made. The PRF method is an attractive tool to study time-varying temperature changes in muscle tissue.

In vivo noninvasive thermometry for hyperthermia applications using the MRI-based proton-resonance-frequency method

International Nuclear Information System (INIS)

De Poorter, J.; De Deene, Y.; Achten, E.; Staahlberg, F.

1995-01-01

The lack of noninvasive temperature monitoring is seriously limiting hyperthermia treatment of deep-seated tumors. MRI methods exploit the temperature dependence of a physical property whose spatial distribution can be visualized. The Proton Resonance Frequency (PRF) as physical property was examined because phantom studies prove the high accuracy that can be obtained using this parameter. Thermal experiments were performed in human lower legs. The results show that in muscle tissue the three-dimensional temperature distribution can be evaluated with a mean spatial distribution of 2 millimetres, a temporal resolution of 2 minutes and an accuracy of about 1 degree Celsius. However, it is not possible to retrieve the temperature distribution in fat tissue using the PRF-method due to the predominance of susceptibility effects in fat. The susceptibility effects are a consequence of the temperature dependence of the susceptibility constants. Experimental data on these dependencies were obtained and the magnitude of these effects was modelled for some specific configurations. The susceptibility effects in muscle tissue can be neglected when precautions are made. The PRF method is an attractive tool to study time-varying temperature changes in muscle tissue

Towards MRI-guided linear accelerator control: gating on an MRI accelerator.

Science.gov (United States)

Crijns, S P M; Kok, J G M; Lagendijk, J J W; Raaymakers, B W

2011-08-07

To boost the possibilities of image guidance in radiotherapy by providing images with superior soft-tissue contrast during treatment, we pursue diagnostic quality MRI functionality integrated with a linear accelerator. Large respiration-induced semi-periodic target excursions hamper treatment of cancer of the abdominal organs. Methods to compensate in real time for such motion are gating and tracking. These strategies are most effective in cases where anatomic motion can be visualized directly, which supports the use of an integrated MRI accelerator. We establish here an infrastructure needed to realize gated radiation delivery based on MR feedback and demonstrate its potential as a first step towards more advanced image guidance techniques. The position of a phantom subjected to one-dimensional periodic translation is tracked with the MR scanner. Real-time communication with the MR scanner and control of the radiation beam are established. Based on the time-resolved position of the phantom, gated radiation delivery to the phantom is realized. Dose distributions for dynamic delivery conditions with varying gating windows are recorded on gafchromic film. The similarity between dynamically and statically obtained dose profiles gradually increases as the gating window is decreased. With gating windows of 5 mm, we obtain sharp dose profiles. We validate our gating implementation by comparing measured dose profiles to theoretical profiles calculated using the knowledge of the imposed motion pattern. Excellent correspondence is observed. At the same time, we show that real-time on-line reconstruction of the accumulated dose can be performed using time-resolved target position information. This facilitates plan adaptation not only on a fraction-to-fraction scale but also during one fraction, which is especially valuable in highly accelerated treatment strategies. With the currently established framework and upcoming improvements to our prototype-integrated MRI accelerator

Development of a new apparatus for MRI guided stereotactic surgery

International Nuclear Information System (INIS)

Iwata, Yukiya; Amano, Keiichi; Kawamura, Hirotsune; Tanikawa, Tatsuya; Kawabatake, Hiroko; Iseki, Hiroshi; Kobayashi, Naotoshi; Ono, Yuko

1990-01-01

Since Leksell et al. reported the application of NMR imaging to stereotactic surgery, MRI has been used for determination of the coordinates of target in the brain. The image of the MRI, however, is significantly distorted due to non-uniformity of the magnetic field. The authors have devised a new marker system (the imaginary inner marker system) and have also modified the Iseki CT guided stereotactic frame for utilizing MRI. In this system, the imaginary markers were set up inside the brain. The image of the grid phantom, obtained immediately before the operation, is superimposed on the image of a patient's brain. The nearest image of grid phantom is used for MRI localization as an imaginary inner marker. To prevent distortion and resolution degradation on MRI, the localizing system is composed of acrylic resin and titanium. The head ring can be fixed on both the MRI localizing system and the Iseki CT guided stereotactic frame which allows the transformation of target coordinates from the MRI localizing system to the CT guided frame. MRI guided stereotactic surgery, therefore, can be performed while monitoring with the CT scan. The system was tested using a phantom and taking T 1 -weighted images before clinical application. Coordinates of target points were determined accurately to a 2 mm cube. A 47-year-old, right-handed woman underwent a MRI guided biopsy of the right thalamic mass lesion that was more accurately detected by MRI than CT scan. The histological diagnosis was a malignant lymphoma. No complications have occurred. MRI stereotaxy, at the present time, is expected to be most useful in the biopsy of deep-seated brain lesions which are not easily detected by CT scan. In the near future, It will take the place of other imaging techniques during functional neurosurgery, with sufficient accuracy. (author)

The effect of hypofractionated radiation and magnetic nanoparticle hyperthermia on tumor immunogenicity and overall treatment response

Science.gov (United States)

Hoopes, P. Jack; Wagner, Robert J.; Song, Ailin; Osterberg, Bjorn; Gladstone, David J.; Bursey, Alicea A.; Fiering, Steven N.; Giustini, Andrew J.

2017-02-01

It is now known that many tumors develop molecular signals (immune checkpoint modulators) that inhibit an effective tumor immune response. New information also suggest that even well-known cancer treatment modalities such as radiation and hyperthermia generate potentially beneficial immune responses that have been blocked or mitigated by such immune checkpoints, or similar molecules. The cancer therapy challenge is to; a) identify these treatment-based immune signals (proteins, antigens, etc.); b) the treatment doses or regimens that produce them; and c) the mechanisms that block or have the potential to promote them. The goal of this preliminary study, using the B6 mouse - B16 tumor model, clinically relevant radiation doses and fractionation schemes (including those used clinically in hypofractionated radiation therapy), magnetic nanoparticle hyperthermia (mNPH) and sophisticated protein, immune and tumor growth analysis techniques and modulators, is to determine the effect of specific radiation or hyperthermia alone and combined on overall treatment efficacy and immunologic response mechanisms. Preliminary analysis suggests that radiation dose (10 Gy vs. 2 Gy) significantly alters the mechanism of cell death (apoptosis vs. mitosis vs. necrosis) and the resulting immunogenicity. Our hypothesis and data suggest this difference is protein/antigen and immune recognition-based. Similarly, our evidence suggest that radiation doses larger than the conventional 2 Gy dose and specific hyperthermia doses and techniques (including mNP hyperthermia treatment) can be immunologically different, and potentially superior to, the radiation and heat therapy regimens that are typically used in research and clinical practice.

MRI-guided prostate focal laser ablation therapy using a mechatronic needle guidance system

Science.gov (United States)

Cepek, Jeremy; Lindner, Uri; Ghai, Sangeet; Davidson, Sean R. H.; Trachtenberg, John; Fenster, Aaron

2014-03-01

Focal therapy of localized prostate cancer is receiving increased attention due to its potential for providing effective cancer control in select patients with minimal treatment-related side effects. Magnetic resonance imaging (MRI)-guided focal laser ablation (FLA) therapy is an attractive modality for such an approach. In FLA therapy, accurate placement of laser fibers is critical to ensuring that the full target volume is ablated. In practice, error in needle placement is invariably present due to pre- to intra-procedure image registration error, needle deflection, prostate motion, and variability in interventionalist skill. In addition, some of these sources of error are difficult to control, since the available workspace and patient positions are restricted within a clinical MRI bore. In an attempt to take full advantage of the utility of intraprocedure MRI, while minimizing error in needle placement, we developed an MRI-compatible mechatronic system for guiding needles to the prostate for FLA therapy. The system has been used to place interstitial catheters for MRI-guided FLA therapy in eight subjects in an ongoing Phase I/II clinical trial. Data from these cases has provided quantification of the level of uncertainty in needle placement error. To relate needle placement error to clinical outcome, we developed a model for predicting the probability of achieving complete focal target ablation for a family of parameterized treatment plans. Results from this work have enabled the specification of evidence-based selection criteria for the maximum target size that can be confidently ablated using this technique, and quantify the benefit that may be gained with improvements in needle placement accuracy.

Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation

Energy Technology Data Exchange (ETDEWEB)

Lin, Zheng-Yu, E-mail: linsinlan@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Chen, Jin, E-mail: snow8968851@163.com [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Deng, Xiu-Fen, E-mail: dxf197286@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China)

2012-11-15

Objective: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation. Methods: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35 {+-} 1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels ({>=}3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels. Results: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1 {+-} 6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased. Conclusion: The 1.5T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.

Improved operative efficiency using a real-time MRI-guided stereotactic platform for laser amygdalohippocampotomy.

Science.gov (United States)

Ho, Allen L; Sussman, Eric S; Pendharkar, Arjun V; Le, Scheherazade; Mantovani, Alessandra; Keebaugh, Alaine C; Drover, David R; Grant, Gerald A; Wintermark, Max; Halpern, Casey H

2018-04-01

OBJECTIVE MR-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive method for thermal destruction of benign or malignant tissue that has been used for selective amygdalohippocampal ablation for the treatment of temporal lobe epilepsy. The authors report their initial experience adopting a real-time MRI-guided stereotactic platform that allows for completion of the entire procedure in the MRI suite. METHODS Between October 2014 and May 2016, 17 patients with mesial temporal sclerosis were selected by a multidisciplinary epilepsy board to undergo a selective amygdalohippocampal ablation for temporal lobe epilepsy using MRgLITT. The first 9 patients underwent standard laser ablation in 2 phases (operating room [OR] and MRI suite), whereas the next 8 patients underwent laser ablation entirely in the MRI suite with the ClearPoint platform. A checklist specific to the real-time MRI-guided laser amydalohippocampal ablation was developed and used for each case. For both cohorts, clinical and operative information, including average case times and accuracy data, was collected and analyzed. RESULTS There was a learning curve associated with using this real-time MRI-guided system. However, operative times decreased in a linear fashion, as did total anesthesia time. In fact, the total mean patient procedure time was less in the MRI cohort (362.8 ± 86.6 minutes) than in the OR cohort (456.9 ± 80.7 minutes). The mean anesthesia time was significantly shorter in the MRI cohort (327.2 ± 79.9 minutes) than in the OR cohort (435.8 ± 78.4 minutes, p = 0.02). CONCLUSIONS The real-time MRI platform for MRgLITT can be adopted in an expedient manner. Completion of MRgLITT entirely in the MRI suite may lead to significant advantages in procedural times.

Feasibility study of local ultrasound hyperthermia in cancer therapy

International Nuclear Information System (INIS)

Jones, K.G.; Straube, W.; Emami, B.; Perez, C.A.

1987-01-01

This paper describes a retrospective analysis of patients treated at Washington University for recurrent or persistent cancer with Ultrasound Hyperthermia between October 1984 and June 1986. Fifteen of 102 lesions were treated during this time period with Ultrasound Hyperthermia instead of microwave hyperthermia due to the size of the lesion needing heat at depths greater than 4 cm. Also, the patients' lesion could not be implanted for interstitial microwave hyperthermia. Fourteen of the treated patients received concomitant radiotherapy, while one received concomitant Bleomycin. There were 79 total hyperthermia treatments delivered, of which 67 achieved a therapeutic temperature of 43 0 C for 60 minutes. During 15/79 treatments, patients experienced pain; of which 11/15 lead to poor heating. Only one treatment of the twelve poor treatments was secondary to technical difficulties. Complete local control was accomplished in seven patients, a partial response in four patients. The results of therapeutic heating and its relationship to the site of treatment and local control are presented, along with phantom studies of Ultrasound microwave hyperthermia reemphasizing the feasibility of using Ultrasound Hyperthermia

Adaptation of antenna profiles for control of MR guided hyperthermia (HT) in a hybrid MR-HT system

International Nuclear Information System (INIS)

Weihrauch, Mirko; Wust, Peter; Weiser, Martin; Nadobny, Jacek; Eisenhardt, Steffen; Budach, Volker; Gellermann, Johanna

2007-01-01

A combined numerical-experimental iterative procedure, based on the Gauss-Newton algorithm, has been developed for control of magnetic resonance (MR)-guided hyperthermia (HT) applications in a hybrid MR-HT system BSD 2000 3D-MRI. In this MR-HT system, composed of a 3-D HT applicator Sigma-Eye placed inside a tunnel-type MR tomograph Siemens MAGNETOM Symphony (1.5 T), the temperature rise due to the HT radiation can be measured on-line in three dimensions by use of the proton resonance frequency shift (PRFS) method. The basic idea of our iterative procedure is the improvement of the system's characterization by a step-by-step modification of the theoretical HT antenna profiles (electric fields radiated by single antennas). The adaptation of antenna profiles is efficient if the initial estimates are radiation fields calculated from a good a priori electromagnetic model. Throughout the iterative procedure, the calculated antenna fields (FDTD) are step-by-step modified by comparing the calculated and experimental data, the latter obtained using the PRFS method. The procedure has been experimentally tested on homogeneous and inhomogeneous phantoms. It is shown that only few comparison steps are necessary for obtaining a dramatic improvement of the general predictability and quality of the specific absorption rate (SAR) inside the MR-HT hybrid system

Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI

Energy Technology Data Exchange (ETDEWEB)

Song, Sung Eun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Cho, Nariya [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Centre, Institute of Radiation Medicine, Seoul (Korea, Republic of); Han, Wonshik [Seoul National University Hospital, Department of Surgery, Seoul (Korea, Republic of)

2017-12-15

To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. (orig.)

Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI

International Nuclear Information System (INIS)

Song, Sung Eun; Cho, Nariya; Han, Wonshik

2017-01-01

To evaluate whether the post-clip placement MRI following second-look ultrasound (US)-guided core biopsy is useful to confirm the adequate sampling of suspicious lesions identified on breast MRI. Between 2014 and 2016, 31 consecutive women with 34 suspicious lesions that had not been identified on previous mammography or US were detected using MRI. Among them, 26 women with 29 lesions (mean size 1.5 cm, range 0.5-5.8 cm) found by second-look US underwent US-guided biopsy, subsequent clip insertion and post-clip placement MRI. Five women with five lesions that were not found by second-look US underwent MRI-guided biopsy. The technical success rate and lesion characteristics were described. The technical success rate was 96.6% (28/29). One failure case was a benign, 1.1-cm non-mass enhancement. Of the 28 success cases, 23 (82.1%) were masses and 5 (17.9%) were non-mass enhancements; 17 (60.7%) were benign, 4 (14.3%) were high-risk and 7 (25.0%) were malignant lesions. The technical success rate was 100% (28/28) for masses and 83.3% (5/6) for non-mass enhancements. Post-clip placement MRI following US-guided biopsy is useful in confirming the adequate sampling of lesions identified on MRI. This method could be an alternative to MRI-guided biopsy for lesions visible on US. (orig.)

The significance of accurate dielectric tissue data for hyperthermia treatment planning

NARCIS (Netherlands)

van de Kamer, J. B.; van Wieringen, N.; de Leeuw, A. A.; Lagendijk, J. J.

2001-01-01

For hyperthermia treatment planning, dielectric properties of several tissue types are required. Since it is difficult to perform patient specific dielectric imaging, default values based on literature data are used. However, these show a large spread (approximately 50%). Consequently, it is

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

Science.gov (United States)

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Formula to estimate the thermal enhancement ratio of a single simultaneous hyperthermia and radiation treatment

International Nuclear Information System (INIS)

Overgaard, J.

1984-01-01

An experimental model composed of a C 3 H mammary carcinoma and its surrounding skin has been exposed to simultaneous radiation and hyperthermia given with different combinations of the heating time and temperature. Based on the thermal enhancement ratio (TER) values obtained in the temperature range 41.5 to 43.5 0 C, a linear relationship between TER and the heating time was achieved at each temperature. The slopes of the curves drawn at each temperature were found to have a log-linear relationship with the treatment temperature. With these relationships it was possible to make a formula expressing the TER as a function of treatment temperature and time. This formula gives a crude but probably acceptable estimate of the TER following a single simultaneous radiation and heat treatment. Although subject to several limitations, the formula represents an attempt to describe a heat dose concept for the radiosensitizing effect of hyperthermia. This may be useful to establish the tolerance level of a given radiation treatment when combined with hyperthermia. (Auth.)

The significance of accurate dielectric tissue data for hyperthermia treatment planning

NARCIS (Netherlands)

van de Kamer, JB; van Wieringen, N; de Leeuw, AAC; Lagendijk, JJW

2001-01-01

For hyperthermia treatment planning, dielectric properties of several tissue types are required. Since it is difficult to perform patient specific dielectric imaging, default values based on literature data are used. However, these show a large spread (approximate to 50%). Consequently, it is

A novel hyperthermia treatment for bone metastases using magnetic materials

International Nuclear Information System (INIS)

Matsumine, Akihiko; Asanuma, Kunihiro; Matsubara, Takao; Nakamura, Tomoki; Uchida, Atsumasa; Sudo, Akihiro; Takegami, Kenji

2011-01-01

Patients with bone metastases in the extremities sometimes require surgical intervention to prevent deterioration of quality of life due to a pathological fracture. The use of localized radiotherapy combined with surgical reinforcement has been a gold standard for the treatment of bone metastases. However, radiotherapy sometimes induces soft tissue damage, including muscle induration and joint contracture. Moreover, cancer cells are not always radiosensitive. Hyperthermia has been studied since the 1940s using an experimental animal model to treat various types of advanced cancer, and studies have now reached the stage of clinical application, especially in conjunction with radiotherapy or chemotherapy. Nevertheless, bone metastases have several special properties which discourage oncologists from developing hyperthermic therapeutic strategies. First, the bone is located deep in the body, and has low thermal conductivity due to the thickness of cortical bone and the highly vascularized medulla. To address these issues, we developed new hyperthermic strategies which generate heat using magnetic materials under an alternating electromagnetic field, and started clinical application of this treatment modality. The purpose of this review is to summarize the latest studies on hyperthermic treatment in the field of musculoskeletal tumors, and to introduce the treatment strategy employing our novel hyperthermia approach. (author)

Study on the usefulness of high-frequency analysis of the combined treatment of cancer with hyperthermia

International Nuclear Information System (INIS)

Ji, Youn Sang; Dong, Kyung Rae; Yeo, Hwa Yeon

2016-01-01

In order to understand the usefulness to the high-frequency thermal therapy of cancer staging according to the TNM classification treatment, was to evaluate the effect of high frequency hyperthermia treatment approach through other means and whether other organs, according to the combined presence of transition. Targeted to receive more than a total of 1 cycle high frequency heat treatment at C hospital that performed the high-frequency hyperthermia cancer patients 92 people out stage, depending on the presence or absence of metastasis, combined hyperthermia patients for statistics before and after treatment the therapeutic effect of the therapeutic classification. Out of a total of 92 patients decrease 11 patients, stable 71 patients, with increase 10 patients, the rate of increase is the result of about 11% patients showed a decrease of about 89% is occupied by patients and a stable rate. There is strong evidence for the usefulness as a secondary therapy to maintain the quality of life, while slowing the progression of cancer by a high-frequency heat treatment

Study on the usefulness of high-frequency analysis of the combined treatment of cancer with hyperthermia

Energy Technology Data Exchange (ETDEWEB)

Ji, Youn Sang; Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Yeo, Hwa Yeon [Dept. of of Radiology, Nambu University, Gwangju (Korea, Republic of)

2016-11-15

In order to understand the usefulness to the high-frequency thermal therapy of cancer staging according to the TNM classification treatment, was to evaluate the effect of high frequency hyperthermia treatment approach through other means and whether other organs, according to the combined presence of transition. Targeted to receive more than a total of 1 cycle high frequency heat treatment at C hospital that performed the high-frequency hyperthermia cancer patients 92 people out stage, depending on the presence or absence of metastasis, combined hyperthermia patients for statistics before and after treatment the therapeutic effect of the therapeutic classification. Out of a total of 92 patients decrease 11 patients, stable 71 patients, with increase 10 patients, the rate of increase is the result of about 11% patients showed a decrease of about 89% is occupied by patients and a stable rate. There is strong evidence for the usefulness as a secondary therapy to maintain the quality of life, while slowing the progression of cancer by a high-frequency heat treatment.

Preparation and characterization of composite microspheres for brachytherapy and hyperthermia treatment of cancer

International Nuclear Information System (INIS)

Zhao Di; Huang Wenhai; Rahaman, Mohamed N.; Day, Delbert E.; Wang Deping; Gu Yifei

2012-01-01

Composite microspheres were prepared by coating yttrium–aluminum–silicate (YAS) glass microspheres (20–30 μm) with a layer of Fe 3 O 4 nanoparticles and evaluated for potential use in brachytherapy and hyperthermia treatment of cancer. After neutron activation to form the β-emitting 90 Y radionuclide, the composite microspheres can be injected into a patient to destroy cancerous tumors; at the same time, the composite microspheres can generate heat upon application of a magnetic field to also destroy the tumors. The results showed that the composite microspheres were chemically durable when immersed in a simulated body fluid (SBF), with ∼ 0.25% weight loss and ∼ 3.2% yttrium dissolved into the SBF after 30 days at 37 °C. The composite microspheres also showed ferromagnetic properties as a result of the Fe 3 O 4 coating; when immersed in water at 20 °C (20 mg in 1 mL of water), the application of an alternating magnetic field produced a temperature increase from 20 °C to 38−46 °C depending on the thickness of the Fe 3 O 4 coating. The results indicate that these composite microspheres have promising potential in combined brachytherapy and hyperthermia treatment of cancerous tumors. - Highlights: ► Composite microspheres for brachytherapy and hyperthermia treatment of cancer. ► Fe 3 O 4 nanoparticles coated on the yttrium–aluminum–silicate glass microspheres. ► Microspheres are chemically stable in SBF. ► Microspheres can generate heat for hyperthermia under an alternating magnetic field. ► Microspheres can emit β-rays for brachytherapy after neutron activation.

Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies

International Nuclear Information System (INIS)

Thompson, Scott M.; Callstrom, Matthew R.; McKusick, Michael A.; Woodrum, David A.

2015-01-01

PurposeThe purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).Materials and MethodsAn IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.ResultsEight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma–thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5–11.1 cm) and 2.5 cm (2.3–5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2–62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma–thrombocytopenia syndrome. There were two minor complications and no major complications.ConclusionImage-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA

Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies

Energy Technology Data Exchange (ETDEWEB)

Thompson, Scott M., E-mail: Thompson.scott@mayo.edu [Mayo Clinic, Mayo Graduate School, Mayo Medical School and the Mayo Clinic Medical Scientist Training Program, College of Medicine (United States); Callstrom, Matthew R., E-mail: callstrom.matthew@mayo.edu; McKusick, Michael A., E-mail: mckusick.michael@mayo.edu; Woodrum, David A., E-mail: woodrum.david@mayo.edu [Mayo Clinic, Department of Radiology, College of Medicine (United States)

2015-10-15

PurposeThe purpose of this study was to determine the feasibility, safety, and early effectiveness of percutaneous image-guided ablation as second-line treatment for symptomatic soft-tissue vascular anomalies (VA).Materials and MethodsAn IRB-approved retrospective review was undertaken of all patients who underwent percutaneous image-guided ablation as second-line therapy for treatment of symptomatic soft-tissue VA during the period from 1/1/2008 to 5/20/2014. US/CT- or MRI-guided and monitored cryoablation or MRI-guided and monitored laser ablation was performed. Clinical follow-up began at one-month post-ablation.ResultsEight patients with nine torso or lower extremity VA were treated with US/CT (N = 4) or MRI-guided (N = 2) cryoablation or MRI-guided laser ablation (N = 5) for moderate to severe pain (N = 7) or diffuse bleeding secondary to hemangioma–thrombocytopenia syndrome (N = 1). The median maximal diameter was 9.0 cm (6.5–11.1 cm) and 2.5 cm (2.3–5.3 cm) for VA undergoing cryoablation and laser ablation, respectively. Seven VA were ablated in one session, one VA initially treated with MRI-guided cryoablation for severe pain was re-treated with MRI-guided laser ablation due to persistent moderate pain, and one VA was treated in a planned two-stage session due to large VA size. At an average follow-up of 19.8 months (range 2–62 months), 7 of 7 patients with painful VA reported symptomatic pain relief. There was no recurrence of bleeding at five-year post-ablation in the patient with hemangioma–thrombocytopenia syndrome. There were two minor complications and no major complications.ConclusionImage-guided percutaneous ablation is a feasible, safe, and effective second-line treatment option for symptomatic VA.

Multimodal treatment combining chemotherapy, hyperthermia and radiotherapy for ovarian cancer

International Nuclear Information System (INIS)

Nagashima, Kei

1992-01-01

There has been increasing interest in the use of heat in the treatment of cancer. Theoretically cells are the most sensitive to ionizing radiation at mitosis, whereas the cycle phase that is the most resistant to ionizing radiation namely late in the DNA. Synthetic phase (late S) is the most sensitive to hyperthermia. Hyperthermia has been reported to enhance the cytocidal effects of several active chemotherapeutic agents. When thermal potentiation of chemotherapeutic agents against malignant cells is contemplated, normal tissues have a relatively high ambient blood flow which increases in response to thermal stress, thereby dissipating heat, compared to tumors. Tumors, with relatively poor blood flow and a responsive neovasculature, are in capable of augmenting flow and acting as a heat reservoir. This is the phenomenon of a heat reservoir which is one factor to enhance the cytocidal effects of several active anticancer agents for enhancing the uptake in tumor. The importance is in the adjuvant chemotherapy treated for post operative, advanced and recurrent ovarian cancer. Heating enhances the effects of radiotherapy and chemotherapy. Thirty patients with ovarian cancer were subjected to the multidisciplinary treatment with combination of hyperthermochemotherapy and radiation. The 30 patients consisted of 18 with endometrioid adenocarcinoma and 7 with serious post operative or recurrent status. Two types of equipments with rediofrequencies of 70 MHz (BSD-1000) or 434 MHZ (TAG MED·HS 434) were used for hyperthermia. Chemotherapeutic agents such as adriamycin, cis DDP, cyclophosphamide and etoposide were injected intravenously. Arterial infusion with reservoir was very effective in advanced stage of ovarian cancer. No severe or fatal side effects were observed. Hyperthermochemotherapy is useful and effective for the postoperative management or the treatment of recurrent cancer of the ovary. (J.P.N.)

Infrared fibers for radiometer thermometry in hypothermia and hyperthermia treatment

International Nuclear Information System (INIS)

Katzir, A.; Bowman, H.F.; Asfour, Y.; Zur, A.; Valeri, C.R.

1989-01-01

Hypothermia is a condition which results from prolonged exposure to a cold environment. Rapid and efficient heating is needed to rewarm the patient from 32-35 degrees C to normal body temperature. Hyperthermia in cancer treatment involves heating malignant tumors to 42.5-43.0 degrees C for an extended period (e.g., 30 min) in an attempt to obtain remission. Microwave or radio frequency heating is often used for rewarming in hypothermia or for temperature elevation in hyperthermia treatment. One severe problem with such heating is the accurate measurement and control of temperature in the presence of a strong electromagnetic field. For this purpose, we have developed a fiberoptic radiometer system which is based on a nonmetallic, infrared fiber probe, which can operate either in contact or noncontact mode. In preliminary investigations, the radiometer worked well in a strong microwave or radiofrequency field, with an accuracy of +/- 0.5 degrees C. This fiberoptic thermometer was used to control the surface temperature of objects within +/- 2 degrees C

Chemotherapy and Radiofrequency-Induced Mild Hyperthermia Combined Treatment of Orthotopic Pancreatic Ductal Adenocarcinoma Xenografts.

Science.gov (United States)

Krzykawska-Serda, Martyna; Agha, Mahdi S; Ho, Jason Chak-Shing; Ware, Matthew J; Law, Justin J; Newton, Jared M; Nguyen, Lam; Curley, Steven A; Corr, Stuart J

2018-04-02

Patients with pancreatic ductal adenocarcinomas (PDAC) have one of the poorest survival rates of all cancers. The main reason for this is related to the unique tumor stroma and poor vascularization of PDAC. As a consequence, chemotherapeutic drugs, such as nab-paclitaxel and gemcitabine, cannot efficiently penetrate into the tumor tissue. Non-invasive radiofrequency (RF) mild hyperthermia treatment was proposed as a synergistic therapy to enhance drug uptake into the tumor by increasing tumor vascular inflow and perfusion, thus, increasing the effect of chemotherapy. RF-induced hyperthermia is a safer and non-invasive technique of tumor heating compared to conventional contact heating procedures. In this study, we investigated the short- and long-term effects (~20 days and 65 days, respectively) of combination chemotherapy and RF hyperthermia in an orthotopic PDAC model in mice. The benefit of nab-paclitaxel and gemcitabine treatment was confirmed in mice; however, the effect of treatment was statistically insignificant in comparison to saline treated mice during long-term observation. The benefit of RF was minimal in the short-term and completely insignificant during long-term observation. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Hyperthermia: Clinical promise and current challenges

International Nuclear Information System (INIS)

Kapp, D.S.

1987-01-01

Local-regional hyperthermia (HT) when used in conjunction with radiation therapy (XRT), has been shown in numerous clinical trials to result in considerable improvement in response rates and local tumor control rates when compared with treatment by XRT alone. Although considerable progress has been made in understanding the biological basis for hyperthermia induced cytotoxicity and radiosensitization, additional research remains in establishing the optimal treatment schedules for the clinical utilization of HT-XRT. The number of HT treatments; the sequencing of HT and XRT; the frequency of administration of HT; and the ideal temperature-time parameters all remain to be better defined for the clinical setting. The role of tumor blood flow on the thermal distributions also warrants further investigation. In addition, considerable effort is needed to improve hyperthermia equipment in order to provide more uniform therapeutic temperature distributions (temperatures ≥42.5%C). Better heating equipment is particularly needed for the treatment of deep seeted tumors. Pertinent clinical literature will be presented summarizing the clinical promise of hyperthermia and the above mentioned clinical challenges

Real-time MRI-guided percutaneous sclerotherapy of low-flow head and neck lymphatic malformations in the pediatric population - a stepwise approach

Energy Technology Data Exchange (ETDEWEB)

Partovi, Sasan; Vidal, Lorenna; Lu, Ziang; Nakamoto, Dean A.; Buethe, Ji; Clampitt, Mark; Coffey, Michael; Patel, Indravadan J. [University Hospitals Cleveland Medical Center, Case Western Reserve University, Department of Radiology, Section of Vascular and Interventional Radiology, Cleveland, OH (United States)

2017-05-15

Real-time MRI-guided percutaneous sclerotherapy is a novel and evolving treatment for congenital lymphatic malformations in the head and neck. We elaborate on the specific steps necessary to perform an MRI-guided percutaneous sclerotherapy of lymphatic malformations including pre-procedure patient work-up and preparation, stepwise intraprocedural interventional techniques and post-procedure management. Based on our institutional experience, MRI-guided sclerotherapy with a doxycycline-gadolinium-based mixture as a sclerosant for lymphatic malformations of the head and neck region in children is well tolerated and effective. (orig.)

Fast MRI-guided vacuum-assisted breast biopsy: initial experience.

Science.gov (United States)

Liberman, Laura; Morris, Elizabeth A; Dershaw, D David; Thornton, Cynthia M; Van Zee, Kimberly J; Tan, Lee K

2003-11-01

The purpose of this study was to evaluate a new method for performing MRI-guided vacuum-assisted breast biopsy in a study of lesions that had subsequent surgical excision. SUBJECTS AND METHODS. Twenty women scheduled for MRI-guided needle localization and surgical biopsy were prospectively entered in the study. MRI-guided biopsy was performed with a vacuum-assisted probe, followed by placement of a localizing clip, and then needle localization for surgical excision. Vacuum-assisted biopsy and surgical histology were correlated. Vacuum-assisted biopsy was successfully performed in 19 (95%) of the 20 women. The median size of 27 MRI-detected lesions that had biopsy was 1.0 cm (range, 0.4-6.4 cm). Cancer was present in eight (30%) of 27 lesions and in six (32%) of 19 women; among these eight cancers, five were infiltrating and three were ductal carcinoma in situ (DCIS). Among these 27 lesions, histology was benign at vacuum-assisted biopsy and at surgery in 19 (70%), cancer at vacuum-assisted biopsy in six (22%), atypical ductal hyperplasia at vacuum-assisted biopsy and DCIS at surgery in one (4%), and benign at vacuum-assisted biopsy with surgery showing microscopic DCIS that was occult at MRI in one (4%). The median time to perform vacuum-assisted biopsy of a single lesion was 35 min (mean, 35 min; range, 24-48 min). Placement of a localizing clip, attempted in 26 lesions, was successful in 25 (96%) of 26, and the clip was retrieved on specimen radiography in 22 (96%) of 23. One complication occurred: a hematoma that resolved with compression. MRI-guided vacuum-assisted biopsy is a fast, safe, and accurate alternative to surgical biopsy for breast lesions detected on MRI.

Hyperthermia and hyperglycemia in oncology

International Nuclear Information System (INIS)

Zhavrid, Eh.A.; Osinskij, S.P.; Fradkin, S.Z.

1987-01-01

Consideration is being given to publication data and results of author's investigations into the effect of hyperthermia and hyperglycemia on physico-chemical characteristics and growth of various experimental tumors. Factors, modifying thermosensitivity, mechanisms of hyperthermia effect, various aspects of thermochimio- and thermoradiotherapy have been analyzed. Effect of artificial hyperglycemia on metabolism and kinetics of tumor and some normal cells is considered in detail. Many data, testifying to sufficient growth of efficiency of oncologic patient treatment under conditions of multimodality therapy including hyperthermia and hyperglycemia are presented

Plantar fascia: imaging diagnosis and guided treatment.

Science.gov (United States)

McNally, Eugene G; Shetty, Shilpa

2010-09-01

Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described. Thieme Medical Publishers.

SU-F-J-05: The Effect of Air Pockets in the Urinary Bladder During Bladder Hyperthermia Treatment

Energy Technology Data Exchange (ETDEWEB)

Schooneveldt, G.; Kok, H.P.; Bakker, A.; Geijsen, E.D.; Reijke, T.M. de; Crezee, J. [Academisch Medisch Centrum / Universiteit van Amsterdam, Amsterdam (Netherlands)

2016-06-15

Purpose: Hyperthermia combined with Mitomycin C is used for the treatment of non-muscle invasive bladder cancer (NMIBC), using a phased array system of microwave antennas for bladder heating. Often some air is present in the bladder, which effectively blocks the microwave radiation, potentially preventing proper treatment of that part of the bladder. Air can be a relevant fraction of the bladder content and large air pockets are expected to have a noticeable influence on achieved temperatures. Methods: We analysed 14 NMIBC patients treated at our institute with our AMC-4 hyperthermia device with four 70MHz antennas around the pelvis. A CT scan was made after treatment and a physician delineated the bladder on the CT scan. On the same scan, the amount of air present in the bladder was delineated. Using our in-house developed hyperthermia treatment planning system, we simulated the treatment using the clinically applied device settings. We did this once with the air pocket delineated on the CT scan, and once with the same volume filled with bladder tissue. Results: The patients had on average 4.2ml (range 0.8–10.1ml) air in the bladder. The bladder volume was delineated by the physician, that is including air pocket and bladder wall, was on average 253ml (range 93–452ml). The average volume in which changes exceeded 0.25°C was 22ml (range 0–108 ml), with the bladder being up to 2°C cooler when an air pocket was present. Except for extreme cases, there was no evident relation between the quantity of air and the difference in temperature. Conclusion: The effect of an air pocket in the bladder during bladder hyperthermia treatment varies strongly between patients. Generally, this leads to lower temperatures in the bladder, potentially affecting treatment quality, and suggesting that care need be taken to minimise the size of air pockets during hyperthermia treatments. The KWF Dutch Cancer Society financially supported this work, grant UVA 2012-5539.

MR-guided discography using an open 1 Tesla MRI system

International Nuclear Information System (INIS)

Streitparth, Florian; Bucourt, M. de; Hamm, B.; Teichgraeber, U.; Hartwig, T.; Strube, P.; Putzier, M.; Schnackenburg, B.; Chopra, S.

2011-01-01

To evaluate the feasibility of MR-guided discography using an open 1 Tesla MRI system. 48 disc segments of 41 patients scheduled for intradiscal thermal treatment, total disc replacement or spondylodesis were examined. A 1.0-T open MRI was used for instrument guidance and imaging. After primary disc puncture under guidance of interactive PDw TSE imaging, 1-2 ml of gadolinium contrast saline mixture was injected into the disc. The occurrence of memory pain during injection was recorded. Axial and sagittal T1w TSE images with and without fat saturation were obtained. All MRI discograms were analysed by two readers, who were blinded to the clinical findings. Overall, the placement of the puncture needle in the targeted disc was accurate under real-time MR guidance. Injections were technically successful in all cases. No major complications occurred. The mean procedure time was 17 min (range 13-34 min). Image quality of contrast-enhanced MR discograms was excellent when using an optimized gadolinium contrast saline mixture of 1:600. Memory pain was detected in 16 out of 48 affected segments. MR-guided discography is accurate and safe. Multiplanar dynamic imaging facilitates the puncture of discs and provides high-quality MR discograms. (orig.)

Interstitial microwave hyperthermia treatment investigations

International Nuclear Information System (INIS)

Siauve, N; Lormel, C

2012-01-01

Microwave ablation also called interstitial hyperthermia is a medical procedure used in the treatment of many cancers, cardiac arrhythmias and other medical conditions. With this medical therapy, an electromagnetic source (antenna) is directly positioned in the target tissue and a sufficient power is injected to necrosis the tissue. The aim of this study is to propose a design procedure and develop the associated tools, for determining the optimal shape, dimensions, type and operating frequency of antenna according to the target volume. In this context, a 3D numerical predictive model of temperature elevation induced by the electric fields and two benches for thermal and electrical tissues properties characterization have been developed. To validate the procedure and the different tools, an experimental bench test which includes interstitial antenna, external microwave generator, phantom that represents the target tissue and measurement system of temperature and electric field has been elaborated.

An FDTD code for hyperthermia treatment planning

Energy Technology Data Exchange (ETDEWEB)

Marrocco, G.; Bardati, F. [Rome Univ. Tor Vergata (Italy). Dipt. di Informatica, sistemi e produzione; Tognolatti, P. [L' Aquila Univ. (Italy). Dipt. di Ingegneria Elettrica

1999-08-01

Radio-frequency hyperthermia is an anticancer modality based on the heating of tumours by radiating sources. A set of antennas is frequently used to enhance power depositions in tissues. Treatments planning needs electromagnetic field computation within realistic body models. Since several simulation may be required the optimize the antenna-body configuration, the electromagnetic solver should be designed in such a way that new configuration of the antenna set-up can be solved without heavy changes of the basic numerical code. In this paper a numerical investigation on the effects of a segmentation technique will be presented, with reference to an FDTD computation and the heating of a paediatric tumour.

MRI guided needle localization in a patient with recurrence pleomorphic sarcoma and post-operative scarring

Energy Technology Data Exchange (ETDEWEB)

Chang, Ching-Di [Chang Gung University College of Medicine, Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung (China); Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Wei, Jesse; Wu, Jim S. [Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Goldsmith, Jeffrey D. [Harvard Medical School, Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA (United States); Gebhardt, Mark C. [Harvard Medical School, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA (United States)

2017-07-15

MRI-guided wire localization is commonly used for surgical localization of breast lesions. Here we introduce an alternative use of this technique to help with surgical resection of a recurrent pleomorphic sarcoma embedded in extensive post-treatment scar tissue. We describe a case of recurrent pleomorphic soft tissue sarcoma in the thigh after treatment with neoadjuvant therapy, surgery, and radiation. Due to the distortion of the normal tissue architecture and formation of extensive scar tissue from prior treatment, wire localization under MRI was successfully used to assist the surgeon in identifying the recurrent tumor for removal. (orig.)

SU-F-J-110: MRI-Guided Single-Session Simulation, Online Adaptation, and Treatment

International Nuclear Information System (INIS)

Hill, P; Geurts, M; Mittauer, K; Bayouth, J

2016-01-01

Purpose: To develop a combined simulation and treatment workflow for MRI-guided radiation therapy using the ViewRay treatment planning and delivery system. Methods: Several features of the ViewRay MRIdian planning and treatment workflows are used to simulate and treat patients that require emergent radiotherapy. A simple “pre-plan” is created on diagnostic imaging retrieved from radiology PACS, where conformal fields are created to target a volume defined by a physician based on review of the diagnostic images and chart notes. After initial consult in radiation oncology, the patient is brought to the treatment room, immobilized, and imaged in treatment position with a volumetric MR. While the patient rests on the table, the pre-plan is applied to the treatment planning MR and dose is calculated in the treatment geometry. After physician review, modification of the plan may include updating the target definition, redefining fields, or re-balancing beam weights. Once an acceptable treatment plan is finalized and approved, the patient is treated. Results: Careful preparation and judicious choices in the online planning process allow conformal treatment plans to be created and delivered in a single, thirty-minute session. Several advantages have been identified using this process as compared to conventional urgent CT simulation and delivery. Efficiency gains are notable, as physicians appreciate the predictable time commitment and patient waiting time for treatment is decreased. MR guidance in a treatment position offers both enhanced contrast for target delineation and reduction of setup uncertainties. The MRIdian system tools designed for adaptive radiotherapy are particularly useful, enabling plan changes to be made in minutes. Finally, the resulting plans, typically 6 conformal beams, are delivered as quickly as more conventional AP/PA beam arrangements with comparatively superior dose distributions. Conclusion: The ViewRay treatment planning software and

An overview of interstitial brachytherapy and hyperthermia

International Nuclear Information System (INIS)

Brandt, B.B.; Harney, J.

1989-01-01

Interstitial thermoradiotherapy, an experimental cancer treatment that combines interstitial radiation implants (brachytherapy) and interstitial hyperthermia, is in the early stages of investigation. In accordance with the procedure used in a current national trial protocol, a 60-minute hyperthermia treatment is administered after catheters are placed into the tumor area while the patient is under general anesthesia. This is immediately followed by loading of radioactive Iridium-192 seeds into the catheters for a defined period of time. Once the prescribed radiation dose is delivered, the radioactive sources are removed and a second, 60-minute hyperthermia treatment is administered. Clinical trials with hyperthermia in combination with radiation have increased in recent years. Nurses caring for these patients need to become more knowledgeable about this investigational therapy. This paper provides an overview of the biologic rationale for this therapy, as well as a description of the delivery method and clinical application. Specific related nursing interventions are defined in a nursing protocol.23 references

MRI guided stereotactic ventrointermediate thalamotomy for writer's cramp: two cases report and literature review

Directory of Open Access Journals (Sweden)

Chao-shi NIU

2015-10-01

Full Text Available Objective To explore the methods and curative effect of stereotactic surgery for treating writer's cramp (WC. Methods and Results Two patients with writer's cramp (tremor type underwent MRI guided stereotactic ventrointermediate (Vim thalamotomy on the left side. The symptoms of one patient disappeared immediately after operation, and the patient could write legibly. The tremor of right upper extremity in another patient was improved significantly. Two patients did not present obvious complications, and the previous symptoms were not found to recur during follow-up period respectively. Conclusions Stereotactic surgery for treatment of writer's cramp has definite therapeutic effect. MRI guided stereotactic technique can effectively avoid the complications of Vim thalamotomy. However, the indications of two methods in surgical treatment [thalamotomy and deep brain stimulation (DBS] and the respective merits still need further study. DOI: 10.3969/j.issn.1672-6731.2015.10.009

Analysis of clinical data to determine the minimum number of sensors required for adequate skin temperature monitoring of superficial hyperthermia treatments.

Science.gov (United States)

Bakker, Akke; Holman, Rebecca; Rodrigues, Dario B; Dobšíček Trefná, Hana; Stauffer, Paul R; van Tienhoven, Geertjan; Rasch, Coen R N; Crezee, Hans

2018-04-27

Tumor response and treatment toxicity are related to minimum and maximum tissue temperatures during hyperthermia, respectively. Using a large set of clinical data, we analyzed the number of sensors required to adequately monitor skin temperature during superficial hyperthermia treatment of breast cancer patients. Hyperthermia treatments monitored with >60 stationary temperature sensors were selected from a database of patients with recurrent breast cancer treated with re-irradiation (23 × 2 Gy) and hyperthermia using single 434 MHz applicators (effective field size 351-396 cm 2 ). Reduced temperature monitoring schemes involved randomly selected subsets of stationary skin sensors, and another subset simulating continuous thermal mapping of the skin. Temperature differences (ΔT) between subsets and complete sets of sensors were evaluated in terms of overall minimum (T min ) and maximum (T max ) temperature, as well as T90 and T10. Eighty patients were included yielding a total of 400 hyperthermia sessions. Median ΔT was 50 sensors were used. Subsets of sensors result in underestimation of T max up to -2.1 °C (ΔT 95%CI), which decreased to -0.5 °C when >50 sensors were used. Thermal profiles (8-21 probes) yielded a median ΔT 50 stationary sensors or thermal profiles. Adequate coverage of the skin temperature distribution during superficial hyperthermia treatment requires the use of >50 stationary sensors per 400 cm 2 applicator. Thermal mapping is a valid alternative.

MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

Energy Technology Data Exchange (ETDEWEB)

Choi, Hye Young [Department of Radiology, Gyeongsang National University Hospital, Jinju 660-702 (Korea, Republic of); Kim, Sun Mi; Jang, Mijung; Yun, Bo La [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Kim, Sung-Won; Kang, Eunyoung [Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Park, So Yeon [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Ko, Eun Sook [Department of Radiology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of)

2013-07-01

To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

International Nuclear Information System (INIS)

Choi, Hye Young; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Kim, Sung-Won; Kang, Eunyoung; Park, So Yeon; Moon, Woo Kyung; Ko, Eun Sook

2013-01-01

To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions

Ultrasound- and MRI-Guided Prostate Biopsy

Science.gov (United States)

... assistance of a nurse and an MR imaging technologist. As with the ultrasound procedure, you may receive antibiotics, sedatives and pain medication before the biopsy. The MRI-guided procedure may use contrast ... A nurse or technologist will insert an intravenous (IV) catheter into a ...

Non-Invasive Radiofrequency-Induced Targeted Hyperthermia for the Treatment of Hepatocellular Carcinoma

Directory of Open Access Journals (Sweden)

Mustafa Raoof

2011-01-01

Full Text Available Targeted biological therapies for hepatocellular cancer have shown minimal improvements in median survival. Multiple pathways to oncogenesis leading to rapid development of resistance to such therapies is a concern. Non-invasive radiofrequency field-induced targeted hyperthermia using nanoparticles is a radical departure from conventional modalities. In this paper we underscore the need for innovative strategies for the treatment of hepatocellular cancer, describe the central paradigm of targeted hyperthermia using non-invasive electromagnetic energy, review the process of characterization and modification of nanoparticles for the task, and summarize data from cell-based and animal-based models of hepatocellular cancer treated with non-invasive RF energy. Finally, future strategies and challenges in bringing this modality from bench to clinic are discussed.

Optimizing deep hyperthermia treatments: are locations of patient pain complaints correlated with modelled SAR peak locations?

Energy Technology Data Exchange (ETDEWEB)

Canters, R A M; Franckena, M; Van der Zee, J; Van Rhoon, G C, E-mail: r.canters@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC Daniel den Hoed Cancer Centre, Rotterdam, PO Box 5201, 3008 AE Rotterdam (Netherlands)

2011-01-21

During deep hyperthermia treatment, patient pain complaints due to heating are common when maximizing power. Hence, there exists a good rationale to investigate whether the locations of predicted SAR peaks by hyperthermia treatment planning (HTP) are correlated with the locations of patient pain during treatment. A retrospective analysis was performed, using the treatment reports of 35 patients treated with deep hyperthermia controlled by extensive treatment planning. For various SAR indicators, the average distance from a SAR peak to a patient discomfort location was calculated, for each complaint. The investigated V{sub 0.1closest} (i.e. the part of the 0.1th SAR percentile closest to the patient complaint) performed the best, and leads to an average distance between the SAR peak and the complaint location of 3.9 cm. Other SAR indicators produced average distances that were all above 10 cm. Further, the predicted SAR peak location with V{sub 0.1} provides a 77% match with the region of complaint. The current study demonstrates that HTP is able to provide a global indication of the regions where hotspots during treatment will most likely occur. Further development of this technology is necessary in order to use HTP as a valuable toll for objective and advanced SAR steering. The latter is especially valid for applications that enable 3D SAR steering.

Optimizing deep hyperthermia treatments: are locations of patient pain complaints correlated with modelled SAR peak locations?

International Nuclear Information System (INIS)

Canters, R A M; Franckena, M; Van der Zee, J; Van Rhoon, G C

2011-01-01

During deep hyperthermia treatment, patient pain complaints due to heating are common when maximizing power. Hence, there exists a good rationale to investigate whether the locations of predicted SAR peaks by hyperthermia treatment planning (HTP) are correlated with the locations of patient pain during treatment. A retrospective analysis was performed, using the treatment reports of 35 patients treated with deep hyperthermia controlled by extensive treatment planning. For various SAR indicators, the average distance from a SAR peak to a patient discomfort location was calculated, for each complaint. The investigated V 0.1closest (i.e. the part of the 0.1th SAR percentile closest to the patient complaint) performed the best, and leads to an average distance between the SAR peak and the complaint location of 3.9 cm. Other SAR indicators produced average distances that were all above 10 cm. Further, the predicted SAR peak location with V 0.1 provides a 77% match with the region of complaint. The current study demonstrates that HTP is able to provide a global indication of the regions where hotspots during treatment will most likely occur. Further development of this technology is necessary in order to use HTP as a valuable toll for objective and advanced SAR steering. The latter is especially valid for applications that enable 3D SAR steering.

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

International Nuclear Information System (INIS)

Kerimaa, Pekka; Ojala, Risto; Markkanen, Paula; Tervonen, Osmo; Blanco Sequeiros, Roberto; Sinikumpu, Juha-Jaakko; Korhonen, Jussi; Hyvoenen, Pekka

2014-01-01

The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. (orig.)

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

Energy Technology Data Exchange (ETDEWEB)

Kerimaa, Pekka; Ojala, Risto; Markkanen, Paula; Tervonen, Osmo; Blanco Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Sinikumpu, Juha-Jaakko; Korhonen, Jussi [Oulu University Hospital, Department of Paediatric Surgery, Oulu (Finland); Hyvoenen, Pekka [Oulu University Hospital, Department of Surgery, Oulu (Finland)

2014-07-15

The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT). Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up. Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period. MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value. (orig.)

TU-EF-210-02: MRg Hyperthermia

Energy Technology Data Exchange (ETDEWEB)

Chopra, R. [UT Southwestern Medical Ctr at Dallas (United States)

2015-06-15

The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare.

TU-EF-210-02: MRg Hyperthermia

International Nuclear Information System (INIS)

Chopra, R.

2015-01-01

The use of therapeutic ultrasound to provide targeted therapy is an active research area that has a broad application scope. The invited talks in this session will address currently implemented strategies and protocols for both hyperthermia and ablation applications using therapeutic ultrasound. The role of both ultrasound and MRI in the monitoring and assessment of these therapies will be explored in both pre-clinical and clinical applications. Katherine Ferrara: High Intensity Focused Ultrasound, Drug Delivery, and Immunotherapy Rajiv Chopra: Translating Localized Doxorubicin Delivery to Pediatric Oncology using MRI-guided HIFU Elisa Konofagou: Real-time Ablation Monitoring and Lesion Quantification using Harmonic Motion Imaging Keyvan Farahani: AAPM Task Groups in Interventional Ultrasound Imaging and Therapy Learning Objectives: Understand the role of ultrasound in localized drug delivery and the effects of immunotherapy when used in conjunction with ultrasound therapy. Understand potential targeted drug delivery clinical applications including pediatric oncology. Understand the technical requirements for performing targeted drug delivery. Understand how radiation-force approaches can be used to both monitor and assess high intensity focused ultrasound ablation therapy. Understand the role of AAPM task groups in ultrasound imaging and therapies. Chopra: Funding from Cancer Prevention and Research Initiative of Texas (CPRIT), Award R1308 Evelyn and M.R. Hudson Foundation; Research Support from Research Contract with Philips Healthcare; COI are Co-founder of FUS Instruments Inc Ferrara: Supported by NIH, UCDavis and California (CIRM and BHCE) Farahani: In-kind research support from Philips Healthcare

Regional hyperthermia of the liver

International Nuclear Information System (INIS)

Petrovich, Z.; Langholz, B.; Astrahan, M.; Emami, B.; Oleson, J.R.

1989-01-01

From 1981 through 1986, 49 patients with metastatic liver tumors received deep regional hyperthermia in phase I protocols in six major medical centers in the United States. Adenocarcinoma was seen in 80% of patients with colon as the primary site in 26%. The remaining patients had the following histological diagnoses: Soft tissue sarcoma in seven, malignant melanoma in two and transitional cell carcinoma in one. Deep regional hyperthermia treatments with a BSD-1000 annular phased array were given once or twice a week with a total of 167 treatment sessions, mean 3.4 (range 1 to 8). In addition to deep regional hyperthermia, 17 patients received radiotherapy, and 14 received chemotherapy. The median survival for all patients was 25 weeks. Complete response was obtained in two patients and partial response in four patients. An additional ten patients had nominal response. There was no complete or partial response among the 14 hyperthermia alone treated patients. Of the 26 patients who presented with severe pain, five had complete pain relief, five had partial relief and the majority had a lesser degree of pain relief or no pain relief. Acute treatment toxicity consisted of pain in ten, systemic temperature increase to 39 0 C in four tachycardia in two, claustrophobia in one. The majority of patients did not experience acute toxicity. No late toxicity was recorded in this group of 49 patients. (orig./MG)

A system for the treatment of cancer by magnetically mediated arterial embolisation hyperthermia

International Nuclear Information System (INIS)

Jones, S.; Moroz, P.

2002-01-01

Full text: Sirtex Medical Limited is developing new technology to treat cancer by induced hyperthermia. A wealth of scientific data from laboratory and animal experimentation has shown that if the temperature of cancerous tissue is maintained for some time above about 42 deg C then that cancer will be destroyed. In current clinical practice, hyperthermia therapy is mostly used as an adjunct to radiotherapy in the treatment of superficial and other easily accessible tumour sites. Restrictions to the wider application of hyperthermia to the treatment of tumours located at deep body sites are technological in nature. There are presently no reliable non-invasive techniques that can be used to deliver an adequate heat dose to a deep seated tumour in an organ such as the liver without risking unacceptable heating of overlying and surrounding normal tissue. The Sirtex technology uses the heat generated in small magnetic particles when exposed to a high frequency magnetic field. The particles are delivered to the tumour via arterially infused microspheres which eventually embolise the tumour vasculature. The enhanced concentration of microspheres around the tumour ensures only the diseased tissue is heated. This paper reviews the current status of this research and presents recent experimental results including the differential heating and consequent destruction of experimental animal tumours. The pathway to clinical application will be discussed in light of these results

Effect of hyperthermia on blood flow in VX2 tumor transplanted in rabbit

International Nuclear Information System (INIS)

Arita, Takeshi

1994-01-01

Effect of hyperthermia on blood flow was evaluated using VX 2 rabbit carcinoma in both legs. Microwave energy at 2450 MHz was used to heat tumors for 40 minutes. An outer canula of 18 G Erasta was implanted in the depth of 2 cm in tumor to measure the temperature and to maintain at 43.0degC-44.0degC. The blood flow in tumors was evaluated by color doppler flow imaging and dynamic MRI. Disturbance of blood flow in the depth of surface 0 cm to 2 cm in tumors was showed at 10 minutes starting 43.0degC heating and at almost all sites disappearance of blood flow was showed at 40 minutes using color doppler flow imaging. But the blood flow beyond the depth of 2 cm was not so disturbed at 40 minutes, relatively. After hyperthermia T1WI and T2WI in heated tumor were no difference comparing with those in control tumor, but heated tumor showed no enhancement using dynamic MRI with TURBO-FLASH technique and post-enhanced T1WI. Histologically, there was extensive tumor necrosis and thrombus formation in heated tumor after 3 days and 1 week. Therefore color doppler flow imaging and dynamic MRI were considered to be useful for evaluation of blood flow in tumor after and during hyperthermia. (author)

FDTD verification of deep-set brain tumor hyperthermia using a spherical microwave source distribution

Energy Technology Data Exchange (ETDEWEB)

Dunn, D. [20th Intelligence Squadron, Offutt AFB, NE (United States); Rappaport, C.M. [Northeastern Univ., Boston, MA (United States). Center for Electromagnetics Research; Terzuoli, A.J. Jr. [Air Force Inst. of Tech., Dayton, OH (United States). Graduate School of Engineering

1996-10-01

Although use of noninvasive microwave hyperthermia to treat cancer is problematic in many human body structures, careful selection of the source electric field distribution around the entire surface of the head can generate a tightly focused global power density maximum at the deepest point within the brain. An analytic prediction of the optimum volume field distribution in a layered concentric head model based on summing spherical harmonic modes is derived and presented. This ideal distribution is then verified using a three-dimensional finite difference time domain (TDTD) simulation with a discretized, MRI-based head model excited by the spherical source. The numerical computation gives a very similar dissipated power pattern as the analytic prediction. This study demonstrates that microwave hyperthermia can theoretically be a feasible cancer treatment modality for tumors in the head, providing a well-resolved hot-spot at depth without overheating any other healthy tissue.

Biological effects of hyperthermia

International Nuclear Information System (INIS)

Okumura, Hiroshi

1980-01-01

Biological effects of hyperthermia and application of hyperthermia to cancer therapy were outlined. As to independent effects of hyperthermia, heat sensitivity of cancer cells, targets of hyperthermia, thermal tolerance of cancer cells, effects of pH on hyperthermic cell survival, effects of hyperthermia on normal tissues, and possibility of clinical application of hyperthermia were described. Combined effect of hyperthermia and x-irradiation to enhance radiosensitivity of cancer cells, its mechanism, effects of oxygen on cancer cells treated with hyperthermia and irradiation, and therapeutic ratio of combined hyperthermia and irradiation were also described. Finally, sensitizers were mentioned. (Tsunoda, M.)

Hyperthermia: clinical results

International Nuclear Information System (INIS)

Bicher, H.I.

1982-01-01

A large number of patients have now been entered into a phase I/II protocol to examine the effects of fractionated hyperthermia and radiation on tumor response. Included in the study were 11 different histologies with anatomical locations varying between peripheral and superficial metastases to deep-seated, solid tumors. Patients were treated with four fractions of microwave-induced hyperthermia (45.0 +- 0.5 0 C), each separated by intervals of 72 hours. Microwaves at frequencies of 915 MHz or 300 MHz were employed, Patients were given a one week rest following the first four treatments, following which a second series of four fractions were administered, again at 72 hour intervals. Each of these fractions consisted of a 400 rad dose of radiation followed within 20 min by hyperthermia (42.5 +- 5 0 C) for 1.5 hours. To date 121 fields have been treated by 82 patients. Total regression is seen in 65% of all cases, partial regression in 35% and no response is seen in only 5% of treatments. Adverse effects were rare. Site specific trials are currently in progress to study the feasibility of deep-seated heating with intracavitary antennae as well as to assess tumor response. In addition, a randomized trial to examine the clinical relevance of thermotolerance has been started

Improvement of locoregional hyperthermia treatments of oesophageal cancer using treatment planning

International Nuclear Information System (INIS)

Kok, H.P.; Haaren Van, P.M.A.; Kamer Van de, J.B.; Zum Voerde Sive Voerding, P.J.; Wiersma, J.; Hulshof, M.C.C.M; Geijsen, E.D.; Crezee, J.

2005-01-01

Full text: The thermal dose achieved in the clinic often remains too low due to the incidence of treatment limiting hot spots, which are difficult to avoid intuitively due to the large number of degrees of freedom (amplitudes and phases) of the heating device. To improve hyperthermia treatments of oesophagus carcinoma patients with the 70 MHz AMC-4 waveguide system we performed hyperthermia treatment planning (HTP) with high resolution temperature based optimization. With this optimization we obtain amplitude (A) and phase (p) settings for the antennas for optimal tumor heating (> 43 o C) while preventing hot spots in normal tissue ( o C) and maintaining the spinal cord temperature below 40 o C to prevent neurotoxicity. With the mixed A/P settings the highest absolute ΔT's were achieved, while the ratio was not much different from the other two configurations. This implies that with these settings the same tumor heating can be obtained with less applied power, resulting in more efficient heating. The fact that the combined numerical A/clinical P settings resulted in the highest absolute temperature rises in the oesophagus might be due to the difference in patient positioning between the planning and the actual treatment, since the location of the SAR focus in the tumor is constructed mainly by phase steering. The temperature rise near the spinal cord depends mainly on the power of the top antenna. The correlation coefficient was R=0.37, which was considerably higher than the correlation with the powers or phases of the other antennas. The temperature rise in the oesophagus depends mainly on the power of the top and bottom antenna together. The correlation coefficient was only R=0.12 but this was still more than 2 times higher than the correlation with the power of the left and right antenna. The relation between the temperature rise due to a power pulse of 30 seconds and the achieved steady state temperature was more or less linear, implying a higher T 90 and T 50

Improvement of locoregional hyperthermia treatments of oesophageal cancer using treatment planning

Energy Technology Data Exchange (ETDEWEB)

Kok, H P; Haaren Van, P M.A.; Kamer Van de, J B; Zum Voerde Sive Voerding, P.J.; Wiersma, J; Hulshof, M C.C.M; Geijsen, E D; Crezee, J [Department of Radiation Oncology, Academic Medical Center, University of Amsterdam (Netherlands)

2005-07-01

Full text: The thermal dose achieved in the clinic often remains too low due to the incidence of treatment limiting hot spots, which are difficult to avoid intuitively due to the large number of degrees of freedom (amplitudes and phases) of the heating device. To improve hyperthermia treatments of oesophagus carcinoma patients with the 70 MHz AMC-4 waveguide system we performed hyperthermia treatment planning (HTP) with high resolution temperature based optimization. With this optimization we obtain amplitude (A) and phase (p) settings for the antennas for optimal tumor heating (> 43 {sup o}C) while preventing hot spots in normal tissue (< 42 {sup o}C) and maintaining the spinal cord temperature below 40 {sup o}C to prevent neurotoxicity. With the mixed A/P settings the highest absolute {delta}T's were achieved, while the ratio was not much different from the other two configurations. This implies that with these settings the same tumor heating can be obtained with less applied power, resulting in more efficient heating. The fact that the combined numerical A/clinical P settings resulted in the highest absolute temperature rises in the oesophagus might be due to the difference in patient positioning between the planning and the actual treatment, since the location of the SAR focus in the tumor is constructed mainly by phase steering. The temperature rise near the spinal cord depends mainly on the power of the top antenna. The correlation coefficient was R=0.37, which was considerably higher than the correlation with the powers or phases of the other antennas. The temperature rise in the oesophagus depends mainly on the power of the top and bottom antenna together. The correlation coefficient was only R=0.12 but this was still more than 2 times higher than the correlation with the power of the left and right antenna. The relation between the temperature rise due to a power pulse of 30 seconds and the achieved steady state temperature was more or less linear

Motion compensation for MRI-compatible patient-mounted needle guide device: estimation of targeting accuracy in MRI-guided kidney cryoablations

Science.gov (United States)

Tokuda, Junichi; Chauvin, Laurent; Ninni, Brian; Kato, Takahisa; King, Franklin; Tuncali, Kemal; Hata, Nobuhiko

2018-04-01

Patient-mounted needle guide devices for percutaneous ablation are vulnerable to patient motion. The objective of this study is to develop and evaluate a software system for an MRI-compatible patient-mounted needle guide device that can adaptively compensate for displacement of the device due to patient motion using a novel image-based automatic device-to-image registration technique. We have developed a software system for an MRI-compatible patient-mounted needle guide device for percutaneous ablation. It features fully-automated image-based device-to-image registration to track the device position, and a device controller to adjust the needle trajectory to compensate for the displacement of the device. We performed: (a) a phantom study using a clinical MR scanner to evaluate registration performance; (b) simulations using intraoperative time-series MR data acquired in 20 clinical cases of MRI-guided renal cryoablations to assess its impact on motion compensation; and (c) a pilot clinical study in three patients to test its feasibility during the clinical procedure. FRE, TRE, and success rate of device-to-image registration were mm, mm, and 98.3% for the phantom images. The simulation study showed that the motion compensation reduced the targeting error for needle placement from 8.2 mm to 5.4 mm (p  <  0.0005) in patients under general anesthesia (GA), and from 14.4 mm to 10.0 mm () in patients under monitored anesthesia care (MAC). The pilot study showed that the software registered the device successfully in a clinical setting. Our simulation study demonstrated that the software system could significantly improve targeting accuracy in patients treated under both MAC and GA. Intraprocedural image-based device-to-image registration was feasible.

Similarities and differences in ablative and non-ablative iron oxide nanoparticle hyperthermia cancer treatment

Science.gov (United States)

Petryk, Alicia A.; Misra, Adwiteeya; Kastner, Elliot J.; Mazur, Courtney M.; Petryk, James D.; Hoopes, P. Jack

2015-03-01

The use of hyperthermia to treat cancer is well studied and has utilized numerous delivery techniques, including microwaves, radio frequency, focused ultrasound, induction heating, infrared radiation, warmed perfusion liquids (combined with chemotherapy), and recently, metallic nanoparticles (NP) activated by near infrared radiation (NIR) and alternating magnetic field (AMF) based platforms. It has been demonstrated by many research groups that ablative temperatures and cytotoxicity can be produced with locally NP-based hyperthermia. Such ablative NP techniques have demonstrated the potential for success. Much attention has also been given to the fact that NP may be administered systemically, resulting in a broader cancer therapy approach, a lower level of tumor NP content and a different type of NP cancer therapy (most likely in the adjuvant setting). To use NP based hyperthermia successfully as a cancer treatment, the technique and its goal must be understood and utilized in the appropriate clinical context. The parameters include, but are not limited to, NP access to the tumor (large vs. small quantity), cancer cell-specific targeting, drug carrying capacity, potential as an ionizing radiation sensitizer, and the material properties (magnetic characteristics, size and charge). In addition to their potential for cytotoxicity, the material properties of the NP must also be optimized for imaging, detection and direction. In this paper we will discuss the differences between, and potential applications for, ablative and non-ablative magnetic nanoparticle hyperthermia.

Long-Term Improvement in Treatment Outcome After Radiotherapy and Hyperthermia in Locoregionally Advanced Cervix Cancer: An Update of the Dutch Deep Hyperthermia Trial

International Nuclear Information System (INIS)

Franckena, Martine; Stalpers, Lukas J.A.; Koper, Peter C.M.; Wiggenraad, Ruud G.J.; Hoogenraad, Wim J.; Dijk, Jan D.P. van; Warlam-Rodenhuis, Carla C.; Jobsen, Jan J.; Rhoon, Gerard C. van; Zee, Jacoba van der

2008-01-01

Purpose: The local failure rate in patients with locoregionally advanced cervical cancer is 41-72% after radiotherapy (RT) alone, whereas local control is a prerequisite for cure. The Dutch Deep Hyperthermia Trial showed that combining RT with hyperthermia (HT) improved 3-year local control rates of 41-61%, as we reported earlier. In this study, we evaluate long-term results of the Dutch Deep Hyperthermia Trial after 12 years of follow-up. Methods and Materials: From 1990 to 1996, a total of 114 women with locoregionally advanced cervical carcinoma were randomly assigned to RT or RT + HT. The RT was applied to a median total dose of 68 Gy. The HT was given once weekly. The primary end point was local control. Secondary end points were overall survival and late toxicity. Results: At the 12-year follow-up, local control remained better in the RT + HT group (37% vs. 56%; p = 0.01). Survival was persistently better after 12 years: 20% (RT) and 37% (RT + HT; p = 0.03). World Health Organization (WHO) performance status was a significant prognostic factor for local control. The WHO performance status, International Federation of Gynaecology and Obstetrics (FIGO) stage, and tumor diameter were significant for survival. The benefit of HT remained significant after correction for these factors. European Organization for Research and Treatment of Cancer Grade 3 or higher radiation-induced late toxicities were similar in both groups. Conclusions: For locoregionally advanced cervical cancer, the addition of HT to RT resulted in long-term major improvement in local control and survival without increasing late toxicity. This combined treatment should be considered for patients who are unfit to receive chemotherapy. For other patients, the optimal treatment strategy is the subject of ongoing research

Effects of Radiofrequency Induced local Hyperthermia on Normal Canine Liver

International Nuclear Information System (INIS)

Suh, Chang Ok; Loh, John J. K.; Seong, Jin Sil

1991-01-01

In order to assess the effects of radiofrequency-induced local hyperthermia on the normal liver, histopathologic findings and biochemical changes after localized hyperthermia in canine liver were studied. Hyperthermia was externally administered using the Thermotron RF-8 (Yamamoto Vinyter Co., Japan; Capacitive type heating machine) with parallel opposed electrodes. Thirteen dogs were used and allocated into one control group (N=3) and two treatment groups according to the treatment temperature. Group I (N=5) was heated with 42.5±0.5.deg.C for 30 minutes, and Group(N=5) was heated with 45±0.5.deg.C for 15-30 minutes. Samples of liver tissue were obtained through a needle biopsy immediately after hyperthermia and 7, 14 and 28 days after treatment and examined for SGOT, SGPT and alkaline phosphatase. Although SGOT and SGPT were elevated after hyperthermia in both groups (three of five in each group), there was no liver cell necrosis or hyperthermia related mortality in Group I. A hydropic swelling of hepatocytes was prominent histologic finding. Hyperthermia with 45.deg.C for 30 minutes was fatal and showed extensive liver cell necrosis. In conclusion, liver damage day heat of 42.5±0.5.deg.C for 30 minutes is reversible, and liver damage by heat of 45±0.5.deg.C for 30 minutes can be fatal or irreversible. However, these results cannot be applied directly to human trial. Therefore, in order to apply hyperthermic treatment on human liver tumor safely, close observation of temperature with proper thermometry is mandatory. Hyperthermic treatment should be confined to the tumor area while sparing a normal liver as much as possible

Microwave beamforming for non-invasive patient-specific hyperthermia treatment of pediatric brain cancer

International Nuclear Information System (INIS)

Burfeindt, Matthew J; Zastrow, Earl; Hagness, Susan C; Van Veen, Barry D; Medow, Joshua E

2011-01-01

We present a numerical study of an array-based microwave beamforming approach for non-invasive hyperthermia treatment of pediatric brain tumors. The transmit beamformer is designed to achieve localized heating-that is, to achieve constructive interference and selective absorption of the transmitted electromagnetic waves at the desired focus location in the brain while achieving destructive interference elsewhere. The design process takes into account patient-specific and target-specific propagation characteristics at 1 GHz. We evaluate the effectiveness of the beamforming approach using finite-difference time-domain simulations of two MRI-derived child head models from the Virtual Family (IT'IS Foundation). Microwave power deposition and the resulting steady-state thermal distribution are calculated for each of several randomly chosen focus locations. We also explore the robustness of the design to mismatch between the assumed and actual dielectric properties of the patient. Lastly, we demonstrate the ability of the beamformer to suppress hot spots caused by pockets of cerebrospinal fluid (CSF) in the brain. Our results show that microwave beamforming has the potential to create localized heating zones in the head models for focus locations that are not surrounded by large amounts of CSF. These promising results suggest that the technique warrants further investigation and development.

Association of rectal toxicity with thermal dose parameters in treatment of locally advanced prostate cancer with radiation and hyperthermia

International Nuclear Information System (INIS)

Hurwitz, Mark D.; Kaplan, Irving D.; Hansen, Jorgen L.; Prokopios-Davos, Savina; Topulos, George P.; Wishnow, Kenneth; Manola, Judith; Bornstein, Bruce A.; Hynynen, Kullervo

2002-01-01

Purpose: Although hyperthermia has been used for more than two decades in the treatment of pelvic tumors, little is known about the potential impact of heat on rectal toxicity when combined with other treatment modalities. Because rectal toxicity is a concern with radiation and may be exacerbated by hyperthermia, definition of the association of thermal dose parameters with rectal toxicity is important. In this report, we correlate rectal toxicity with thermal dose parameters for patients treated with hyperthermia and radiation for prostate cancer. Methods and Materials: Thirty patients with T2b-T3b disease (1992 American Joint Committee On Cancer criteria) enrolled in a Phase II study of external beam radiation ± androgen-suppressive therapy with two transrectal ultrasound hyperthermia treatments were assessed for rectal toxicity. Prostatic and anterior rectal wall temperatures were monitored for all treatments. Rectal wall temperatures were limited to 40 deg. C in 19 patients, 41 deg. C in 3 patients, and 42 deg. C in 8 patients. Logistic regression was used to estimate the log hazard of developing National Cancer Institute Common Toxicity Criteria Grade 2 toxicity based on temperature parameters. The following were calculated: hazard ratios, 95% confidence intervals, p values for statistical significance of each parameter, and proportion of variability explained for each parameter. Results: Gastrointestinal toxicity was limited to Grade 2. The rate of acute Grade 2 proctitis was greater for patients with an allowable rectal wall temperature of >40 deg. C. In this group, 7 of 11 patients experienced acute Grade 2 proctitis, as opposed to 3 of 19 patients in the group with rectal wall temperatures limited to 40 deg. C (p=0.004). Preliminary assessment of long-term toxicity revealed no differences in toxicity. Hazard ratios for acute Grade 2 proctitis for allowable rectal wall temperature, average rectal wall Tmax, and average prostate Tmax were 9.33 (p=0.01), 3

Current Status and Perspectives of Hyperthermia in Cancer Therapy

Science.gov (United States)

Hiraoka, Masahiro; Nagata, Yasushi; Mitsumori, Michihide; Sakamoto, Masashi; Masunaga, Shin-ichiro

2004-08-01

Clinical trials of hyperthermia in combination with radiation therapy or chemotherapy undertaken over the past decades in Japan have been reviewed. Originally developed heating devices were mostly used for these trials, which include RF (radiofrequency) capacitive heating devices, a microwave heating device with a lens applicator, an RF intracavitary heating device, an RF current interstitial heating device, and ferromagnetic implant heating device. Non-randomized trials for various cancers, demonstrated higher response rate in thermoradiotherapy than in radiotherapy alone. Randomized trials undertaken for esophageal cancers also demonstrated improved local response with the combined use of hyperthermia. Furthermore, the complications associated with treatment were not generally serious. These clinical results indicate the benefit of combined treatment of hyperthermia and radiotherapy for various malignancies. On the other hand, the presently available heating devices are not satisfactory from the clinical viewpoints. With the advancement of heating and thermometry technologies, hyperthermia will be more widely and safely used in the treatment of cancers.

Interstitial hyperthermia and iridium-192 treatment alone vs. interstitial iridium-192 treatment/hyperthermia and low dose cisplatinum infusion in the treatment of locally advanced head and neck malignancies

International Nuclear Information System (INIS)

Schreiber, David P.; Overett, Thomas K.

1995-01-01

Purpose: To determine whether the addition of low dose platinum infusional chemotherapy adds to the effectiveness of interstitial hyperthermia/iridium-192 management of locally advanced head and neck malignancies. Methods and Materials: From 1987 to 1993, 36 patients with locally advanced head and neck malignancies were treated locally with interstitial hyperthermia and iridium-192 as part or all of their management. Twenty-two of the above-mentioned patients also received low dose infusional cisplatinum chemotherapy at 20 mg/M 2 per day during the time of the implant. No patient received greater than 100 mg/M 2 total dose. Implant times ranged from 38.5 to 134 h and total doses delivered with the radiation implants ranged from 15 to 39.9 Gy. Average implant volume was 50 cc. Twenty-three patients received external beam irradiation supplementation in a dose range from 25.2 to 64 Gy. Results: Median follow-up for the entire group was 8, months with 7 months for the chemotherapy group vs. 12 months for the no-chemotherapy group. Freedom from relapse rates for the chemotherapy group vs. the no-chemotherapy group were 70% at 41 months vs. 63% at 60 months, p not significant (p = NS). Overall survival by Life Table Analysis was 28% for the chemotherapy group at 41 months vs. 31% for the no-chemotherapy group at 60 months (p = NS). Complete response (CR) rates were 93% for the chemotherapy group vs. 86% for the no-chemotherapy group. Seven patients in the chemotherapy group had recurrent disease and four patients in the no-chemotherapy group were being treated for recurrent disease. Complication rates were similar in both groups, with two patients in the chemotherapy arm requiring hyperbaric oxygen treatments and one patient in the no-chemotherapy arm requiring hyperbaric oxygen treatments (for soft tissue necrosis). Conclusion: It appears that low dose platinum infusional chemotherapy can be added safely to patients receiving interstitial iridium-192 implants along with

Radiotherapy and local hyperthermia plus androgen suppression in locally advanced prostate cancer

International Nuclear Information System (INIS)

Maluta, S.; Marciai, N.; Gabbani, M.; Palazzi, M.; Dall'Oglio, S.; Grandinetti, A.

2005-01-01

Full text: In advanced prostatic cancer, hyperthermia may be useful in order to enhance irradiation efficacy so to avoid delivering of too high dose of radiotherapy which increases acute and late sequelae. A multi-centric phase II study is warranted to give hyperthermia a level 3 evidence in prostate cancer treatment. A randomized phase III study to demonstrate efficacy of hyperthermia is not available because of the optimal results obtained by using radiotherapy combined with androgen suppression. To evaluate hyperthermia gain, LHT should be combined with radiotherapy alone in patients refusing androgen suppression or affected by hormone refractory prostate carcinoma (HRPC). Patients with HRPC have multiple possibilities of treatment improving performance status and median survival, as chemotherapy regimens, and new agents. All these treatments modalities need to be confirmed by phase III trials. Also hyperthermia may be considered among these promising approaches. (author)

Shoulder-Mounted Robot for MRI-guided arthrography: Accuracy and mounting study.

Science.gov (United States)

Monfaredi, R; Wilson, E; Sze, R; Sharma, K; Azizi, B; Iordachita, I; Cleary, K

2015-08-01

A new version of our compact and lightweight patient-mounted MRI-compatible 4 degree-of-freedom (DOF) robot for MRI-guided arthrography procedures is introduced. This robot could convert the traditional two-stage arthrography procedure (fluoroscopy-guided needle insertion followed by a diagnostic MRI scan) to a one-stage procedure, all in the MRI suite. The results of a recent accuracy study are reported. A new mounting technique is proposed and the mounting stability is investigated using optical and electromagnetic tracking on an anthropomorphic phantom. Five volunteer subjects including 2 radiologists were asked to conduct needle insertion in 4 different random positions and orientations within the robot's workspace and the displacement of the base of the robot was investigated during robot motion and needle insertion. Experimental results show that the proposed mounting method is stable and promising for clinical application.

MO-FG-CAMPUS-JeP2-02: Audiovisual Biofeedback Guided Respiratory-Gated MRI: An Investigation of Tumor Definition and Scan Time for Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, D; Pollock, S; Keall, P [University of Sydney, Sydney, NSW (Australia); Greer, P; Lapuz, C; Ludbrook, J [Calvary Mater Newcastle, Newcastle, NSW (Australia); Kim, T [Virginia Commonwealth University, Glen Allen, VA (United States)

2016-06-15

Purpose: Breathing consistency variations can cause respiratory-related motion blurring and artifacts and increase in MRI scan time due to inadequate respiratory-gating and discarding of breathing cycles. In a previous study the concept of audiovisual biofeedback (AV) guided respiratory-gated MRI was tested with healthy volunteers and it demonstrated image quality improvement on anatomical structures and scan time reduction. This study tests the applicability of AV-guided respiratorygated MRI for lung cancer in a prospective patient study. Methods: Image quality and scan time were investigated in thirteen lung cancer patients who underwent two 3T MRI sessions. In the first MRI session (pre-treatment), respiratory-gated MR images with free breathing (FB) and AV were acquired at inhalation and exhalation. An RF navigator placed on the liver dome was employed for the respiratory-gated MRI. This was repeated in the second MRI session (mid-treatment). Lung tumors were delineated on each dataset. FB and AV were compared in terms of (1) tumor definition assessed by lung tumor contours and (2) intra-patient scan time variation using the total image acquisition time of inhalation and exhalation datasets from the first and second MRI sessions across 13 lung cancer patients. Results: Compared to FB AV-guided respiratory-gated MRI improved image quality for contouring tumors with sharper boundaries and less blurring resulted in the improvement of tumor definition. Compared to FB the variation of intra-patient scan time with AV was reduced by 48% (p<0.001) from 54 s to 28 s. Conclusion: This study demonstrated that AV-guided respiratorygated MRI improved the quality of tumor images and fixed tumor definition for lung cancer. These results suggest that audiovisual biofeedback breathing guidance has the potential to control breathing for adequate respiratory-gating for lung cancer imaging and radiotherapy.

MO-FG-CAMPUS-JeP2-02: Audiovisual Biofeedback Guided Respiratory-Gated MRI: An Investigation of Tumor Definition and Scan Time for Lung Cancer

International Nuclear Information System (INIS)

Lee, D; Pollock, S; Keall, P; Greer, P; Lapuz, C; Ludbrook, J; Kim, T

2016-01-01

Purpose: Breathing consistency variations can cause respiratory-related motion blurring and artifacts and increase in MRI scan time due to inadequate respiratory-gating and discarding of breathing cycles. In a previous study the concept of audiovisual biofeedback (AV) guided respiratory-gated MRI was tested with healthy volunteers and it demonstrated image quality improvement on anatomical structures and scan time reduction. This study tests the applicability of AV-guided respiratorygated MRI for lung cancer in a prospective patient study. Methods: Image quality and scan time were investigated in thirteen lung cancer patients who underwent two 3T MRI sessions. In the first MRI session (pre-treatment), respiratory-gated MR images with free breathing (FB) and AV were acquired at inhalation and exhalation. An RF navigator placed on the liver dome was employed for the respiratory-gated MRI. This was repeated in the second MRI session (mid-treatment). Lung tumors were delineated on each dataset. FB and AV were compared in terms of (1) tumor definition assessed by lung tumor contours and (2) intra-patient scan time variation using the total image acquisition time of inhalation and exhalation datasets from the first and second MRI sessions across 13 lung cancer patients. Results: Compared to FB AV-guided respiratory-gated MRI improved image quality for contouring tumors with sharper boundaries and less blurring resulted in the improvement of tumor definition. Compared to FB the variation of intra-patient scan time with AV was reduced by 48% (p<0.001) from 54 s to 28 s. Conclusion: This study demonstrated that AV-guided respiratorygated MRI improved the quality of tumor images and fixed tumor definition for lung cancer. These results suggest that audiovisual biofeedback breathing guidance has the potential to control breathing for adequate respiratory-gating for lung cancer imaging and radiotherapy.

Special article: Creation of a guide for the transfer of care of the malignant hyperthermia patient from ambulatory surgery centers to receiving hospital facilities.

Science.gov (United States)

Larach, Marilyn Green; Dirksen, Sharon J Hirshey; Belani, Kumar G; Brandom, Barbara W; Metz, Keith M; Policastro, Michael A; Rosenberg, Henry; Valedon, Arnaldo; Watson, Charles B

2012-01-01

Volatile anesthetics and/or succinylcholine may trigger a potentially lethal malignant hyperthermia (MH) event requiring critical care crisis management. If the MH triggering anesthetic is given in an ambulatory surgical center (ASC), then the patient will need to be transferred to a receiving hospital. Before May 2010, there was no clinical guide regarding the development of a specific transfer plan for MH patients in an ASC. MECHANISM BY WHICH THE STATEMENT WAS GENERATED: A consensual process lasting 18 months among 13 representatives of the Malignant Hyperthermia Association of the United States, the Ambulatory Surgery Foundation, the Society for Ambulatory Anesthesia, the Society for Academic Emergency Medicine, and the National Association of Emergency Medical Technicians led to the creation of this guide. EVIDENCE FOR THE STATEMENT: Most of the guide is based on the clinical experience and scientific expertise of the 13 representatives. The list of representatives appears in Appendix 1. The recommendation that IV dantrolene should be initiated pending transfer is also supported by clinical research demonstrating that the likelihood of significant MH complications doubles for every 30-minute delay in dantrolene administration (Anesth Analg 2010;110:498-507). This guide includes a list of potential clinical problems and therapeutic interventions to assist each ASC in the development of its own unique MH transfer plan. Points to consider include receiving health care facility capabilities, indicators of patient stability and necessary report data, transport team considerations and capabilities, implementation of transfer decisions, and coordination of communication among the ASC, the receiving hospital, and the transport team. See Appendix 2 for the guide.

Integrated navigation and control software system for MRI-guided robotic prostate interventions.

Science.gov (United States)

Tokuda, Junichi; Fischer, Gregory S; DiMaio, Simon P; Gobbi, David G; Csoma, Csaba; Mewes, Philip W; Fichtinger, Gabor; Tempany, Clare M; Hata, Nobuhiko

2010-01-01

A software system to provide intuitive navigation for MRI-guided robotic transperineal prostate therapy is presented. In the system, the robot control unit, the MRI scanner, and the open-source navigation software are connected together via Ethernet to exchange commands, coordinates, and images using an open network communication protocol, OpenIGTLink. The system has six states called "workphases" that provide the necessary synchronization of all components during each stage of the clinical workflow, and the user interface guides the operator linearly through these workphases. On top of this framework, the software provides the following features for needle guidance: interactive target planning; 3D image visualization with current needle position; treatment monitoring through real-time MR images of needle trajectories in the prostate. These features are supported by calibration of robot and image coordinates by fiducial-based registration. Performance tests show that the registration error of the system was 2.6mm within the prostate volume. Registered real-time 2D images were displayed 1.97 s after the image location is specified. Copyright 2009 Elsevier Ltd. All rights reserved.

Integrated navigation and control software system for MRI-guided robotic prostate interventions

Science.gov (United States)

Tokuda, Junichi; Fischer, Gregory S.; DiMaio, Simon P.; Gobbi, David G.; Csoma, Csaba; Mewes, Philip W.; Fichtinger, Gabor; Tempany, Clare M.; Hata, Nobuhiko

2010-01-01

A software system to provide intuitive navigation for MRI-guided robotic transperineal prostate therapy is presented. In the system, the robot control unit, the MRI scanner, and the open-source navigation software are connected together via Ethernet to exchange commands, coordinates, and images using an open network communication protocol, OpenIGTLink. The system has six states called “workphases” that provide the necessary synchronization of all components during each stage of the clinical workflow, and the user interface guides the operator linearly through these workphases. On top of this framework, the software provides the following features for needle guidance: interactive target planning; 3D image visualization with current needle position; treatment monitoring through real-time MR images of needle trajectories in the prostate. These features are supported by calibration of robot and image coordinates by fiducial-based registration. Performance tests show that the registration error of the system was 2.6 mm within the prostate volume. Registered real-time 2D images were displayed 1.97 s after the image location is specified. PMID:19699057

Surrogate MRI markers for hyperthermia-induced release of doxorubicin from thermosensitive liposomes in tumors.

Science.gov (United States)

Peller, Michael; Willerding, Linus; Limmer, Simone; Hossann, Martin; Dietrich, Olaf; Ingrisch, Michael; Sroka, Ronald; Lindner, Lars H

2016-09-10

The efficacy of systemically applied, classical anti-cancer drugs is limited by insufficient selectivity to the tumor and the applicable dose is limited by side effects. Efficacy could be further improved by targeting of the drug to the tumor. Using thermosensitive liposomes (TSL) as a drug carrier, targeting is achieved by control of temperature in the target volume. In such an approach, effective local hyperthermia (40-43°C) (HT) of the tumor is considered essential but technically challenging. Thus, visualization of local heating and drug release using TSL is considered an important tool for further improvement. Visualization and feasibility of chemodosimetry by magnetic resonance imaging (MRI) has previously been demonstrated using TSL encapsulating both, contrast agent (CA) and doxorubicin (DOX) simultaneously in the same TSL. Dosimetry has been facilitated using T1-relaxation time change as a surrogate marker for DOX deposition in the tumor. To allow higher loading of the TSL and to simplify clinical development of new TSL formulations a new approach using a mixture of TSL either loaded with DOX or MRI-CA is suggested. This was successfully tested using phosphatidyldiglycerol-based TSL (DPPG2-TSL) in Brown Norway rats with syngeneic soft tissue sarcomas (BN175) implanted at both hind legs. After intravenous application of DOX-TSL and CA-TSL, heating of one tumor above 40°C for 1h using laser light resulted in highly selective DOX uptake. The DOX-concentration in the heated tumor tissue compared to the non-heated tumor showed an almost 10-fold increase. T1 and additional MRI surrogate parameters such as signal phase change were correlated to intratumoral DOX concentration. Visualization of DOX delivery in the sense of a chemodosimetry was demonstrated. Although phase-based MR-thermometry was affected by CA-TSL, phase information was found suitable for DOX concentration assessment. Local differences of DOX concentration in the tumors indicated the need for

Comparative evaluation of combined irradiation and hyperthermia versus irradiation alone

International Nuclear Information System (INIS)

Sawas-Dimopoulou, C.; Iordanou, I.; Uzunoglu, N.; Dardoufas, K.; Kouloulias, V.; Maris, T.; Kotaridis, S.

1994-01-01

Controvesy remains as to the treatment schedule producing better results in combined hyperthermia and X-ray therapy. Our experience concerning combined therapy of the solid tumour Walker carcinoma is reported. Male Wistar rats were submitted to treatment on the ninth day after transplantation of the tumour. Two groups of rats received either a therapeutic X-ray dose of 800 cGy by a 6-MeV linear accelerator (Mevatron, Siemens) or treatment by 432 MHz of microwaves with continuous control of tumour tissue temperature to 44±1 C for 45 min. Another group of rats was submitted to a combined treatment, with X-ray therapy preceding hyperthermia by 24 h. The last group of animals constituted the control rats. Greater tumour regression and longer survival times were obtained with the combined treatment. The gain factor for survival time was equal to 1.85 after combined treatment compared with 1.30 after X-ray therapy and 1.05 after hyperthermia. In conclusion, the results suggest that in the above schedule of combined treatment, hyperthermia applied to a solid tumour 24 h after a single dose of X-rays enhances the beneficial effect of therapy. (orig.)

The application of early post-operative combination therapy with interstitial hyperthermia in the treatment of malignant gliomas

International Nuclear Information System (INIS)

Stahl, H.; Wust, P.; Maier-Hauff, K.; Seebass, M.; Mischel, M.; Grammler, M.; Golde, G.; Loeffel, J.; Felix, R.

1995-01-01

A pilot study was performed to examine practicality, tolerability, effectiveness and scope for improvement in early postoperative hyperthermia treatment following catheter implantation as part of (partial) tumor resection. Each CT data set was transferred into a VAX 3100 workstation for retrospective analysis of the hyperthermia treatment. The implanted catheters were segmented and the distributions of power density and temperature were simulated. We sought to achieve the best possible temperature distributions by optimising the catheter arrangement in the planning calculations. The corresponding Ir-192-source brachytherapy treatments were simulated in a similar way using the implanted, as well as optimised catheter arrays. Intraoperative catheter implantation in 4 patients was problem-free. Postoperative complications were not observed, neither were infections. Interstitial microwave hyperthermia in combination with percutaneous irradiation or chemotherapy a few days after the operation was also tolerated well by all patients. Effective temperatures (of at least 42 C) were regularly achieved at measurement points, but the temperature distributions were unsatisfactory, with T 90 values (the temperature reached in at least 90% of the target volume) of under 38 C. Measured temperature/position curves showed qualitative correlation with the simulated calculations. The catheter positions determined by optimisation varied significantly from the positions clinically used. (orig./MG) [de

Intracranial dual-mode IVUS and hyperthermia using circular arrays: preliminary experiments.

Science.gov (United States)

Patel, Vivek; Light, Edward; Herickhoff, Carl; Grant, Gerald; Britz, Gavin; Wilson, Christy; Palmeri, Mark; Smith, Stephen

2013-01-01

In this study, we investigated the feasibility of using 3.5-Fr (3 Fr = 1 mm) circular phased-array intravascular ultrasound (IVUS) catheters for minimally invasive, image-guided hyperthermia treatment of tumors in the brain. Feasibility was demonstrated in two ways: (1) by inserting a 3.5-Fr IVUS catheter through skull burr holes, for 20 MHz brain imaging in the pig model, and (2) by testing a modified circular array for therapy potential with 18.5-MHz and 9-MHz continuous wave (CW) excitation. The imaging transducer's performance was superior to our previous 9-MHz mechanical IVUS prototype. The therapy catheter transducer was driven by CW electrical power at 18.5 MHz, achieving temperature changes reaching +8°C at a depth of 2 mm in a human glioblastoma grown on the flank of a mouse with minimal transducer resistive heating of +2°C. Further hyperthermia trials showed that 9-MHz CW excitation produced temperature changes of +4.5°C at a depth of 12 mm-a sufficient temperature rise for our long-term goal of targeted, controlled drug release via thermosensitive liposomes for therapeutic treatment of 1-cm-diameter glioblastomas.

Feasibility of MRI-guided Focused Ultrasound as Organ-Sparing Treatment for Testicular Cancer

Science.gov (United States)

Staruch, Robert; Curiel, Laura; Chopra, Rajiv; Hynynen, Kullervo

2009-04-01

High cure rates for testicular cancer have prompted interest in organ-sparing surgery for patients with bilateral disease or single testis. Focused ultrasound (FUS) ablation could offer a noninvasive approach to organ-sparing surgery. The objective of this study was to determine the feasibility of using MR thermometry to guide organ-sparing focused ultrasound surgery in the testis. The testes of anesthetized rabbits were sonicated in several discrete locations using a single-element focused transducer operating at 2.787MHz. Focal heating was visualized with MR thermometry, using a measured PRF thermal coefficient of -0.0089±0.0003 ppm/° C. Sonications at 3.5-14 acoustic watts applied for 30 seconds produced maximum temperature elevations of 10-80° C, with coagulation verified by histology. Coagulation of precise volumes in the testicle is feasible with MRI-guided focused ultrasound. Variability in peak temperature for given sonication parameters suggests the need for online temperature feedback control.

Hyperthermia, a modality in the wings

Directory of Open Access Journals (Sweden)

Szasz A

2007-01-01

Full Text Available Hyperthermia is a heat-treatment. It is widely used in various medical fields and has a well-recognized effect in oncology. Its effect is achieved by overheating of the targeted tissues. It is an ancient treatment and a promising physical approach with lack of acceptance by the serious medical use. To accept the method we need strong proofs and stable, reproducible treatment quality, but we are limited by biological, physical/technical and physiological problems. However, the main point - I believe - is the incorrect characterization and unrealistic expectations from this capable method. The temperature concept of the quality assurance guidelines has to be replaced by the heat-dose sensitive characterization, pointing the essence of the hyperthermia method.

THE FIRST EXPERIENCE OF USING LOCAL HYPERTHERMIA IN COMBINED MODALITY TREATMENT OF OPERABLE NON-SMALL CELL LUNG CANCER

Directory of Open Access Journals (Sweden)

A. Yu. Dobrodeev

2015-01-01

Full Text Available The paper presents the first experience in treating 5 patients with stage II–III non-small cell lung cancer using combined modality treatment including 40 Gy preoperative hyperfractionated radiotherapy with concurrent 2 cycles of paclitaxel/carboplatin chemotherapy and local hyperthermia (10 sessions followed by radical surgery. The overal response rate to preoperative treatment was 80 %. Chemotherapy was well tolerated and hyperthermia resulted no in adverse effects. All patients underwent surgery (4 lobectomies and 1 pneumonectomy. No complications were observed in the postoperative period. The follow-up period ranged from 6 to 20 months. No evidence of disease progression and radiation-induced damages were observed.

Preliminary results of a new workflow for MRI/CT-based image-guided brachytherapy in cervical carcinoma.

Science.gov (United States)

Nemoto, Miho Watanabe; Iwai, Yuma; Togasaki, Gentaro; Kurokawa, Marie; Harada, Rintarou; Kobayashi, Hiroki; Uno, Takashi

2017-12-01

We propose a method of image-guided brachytherapy (IGBT) that combines MRI-based target volume delineation for the first fraction with CT datasets of subsequent fractions, using an automatic, applicator-based co-registration, and report our preliminary experience. The MRI of the first fraction was used for the first brachytherapy planning. For each subsequent brachytherapy fraction, after the same applicator insertion, a new CT scan with the applicator in place was obtained. The MR image set was registered to the subsequent brachytherapy treatment planning CT using the applicator for rigid body registration. To demonstrate the registration quality, we used here the Dice index as a measurement of tandem delineation overlap between CT and MRI. The median Dice index was 0.879 (range 0.610-0.932), which indicated that the contours on CT and MRI fitted well. With this combination method, the median D90 of HR CTV and the calculated D2 cm 3 of the bladder, rectum, and sigmoid in each fraction were 7.2 (4.0-10.4), 5.9 (2.3-7.7), 4.0 (1.9-6.7), and 3.8 (0.6-7.2) Gy, respectively. Our described method of MRI-guided IGBT offers a practical option for the benefits of target delineation.

In vitro application of Fe/MgO nanoparticles as magnetically mediated hyperthermia agents for cancer treatment

Energy Technology Data Exchange (ETDEWEB)

Chalkidou, A. [Department of Physics, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece); Molecular Oncology Laboratory, Theagenio Cancer Hospital, Alexandrou Simeonidi Street 2, 54 007 Thessaloniki (Greece); Simeonidis, K. [Department of Physics, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece); Angelakeris, M., E-mail: agelaker@auth.g [Department of Physics, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece); Samaras, T. [Department of Physics, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece); Martinez-Boubeta, C. [Departament d' Electronica, Universitat de Barcelona, Marti i Franques 1, Barcelona 08028 (Spain); Balcells, Ll. [ICMAB-CSIC, Campus UAB, Bellaterra 08193 (Spain); Papazisis, K. [Molecular Oncology Laboratory, Theagenio Cancer Hospital, Alexandrou Simeonidi Street 2, 54 007 Thessaloniki (Greece); Dendrinou-Samara, C. [Department of Chemistry, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece); Kalogirou, O. [Department of Physics, Aristotle University of Thessaloniki, 54 124 Thessaloniki (Greece)

2011-03-15

In this work we study the heating efficiency of Fe/MgO magnetic core/biocompatible shell nanoparticles and their in vitro application in magnetic hyperthermia on cancer cells. Different human breast cancer cell lines were used to assess the suitability of nanoparticles for in vivo application. The experiments revealed a very good cytotoxicity profile and significant uptake efficiency together with relatively high specific absorption rates and fast thermal response, features that are crucial for adequate thermal efficiency and minimum duration of treatment. - Research highlights: > Fe/MgO magnetic core/shell nanoparticles and their in vitro application for magnetic hyperthermia. > Very good cytotoxicity profile and significant uptake efficiency in three human breast cancer cell lines. > SAR values and fast thermal response guarantee adequate thermal efficiency and minimum treatment duration.

Respiratory motion-resolved, self-gated 4D-MRI using Rotating Cartesian K-space (ROCK): Initial clinical experience on an MRI-guided radiotherapy system.

Science.gov (United States)

Han, Fei; Zhou, Ziwu; Du, Dongsu; Gao, Yu; Rashid, Shams; Cao, Minsong; Shaverdian, Narek; Hegde, John V; Steinberg, Michael; Lee, Percy; Raldow, Ann; Low, Daniel A; Sheng, Ke; Yang, Yingli; Hu, Peng

2018-06-01

To optimize and evaluate the respiratory motion-resolved, self-gated 4D-MRI using Rotating Cartesian K-space (ROCK-4D-MRI) method in a 0.35 T MRI-guided radiotherapy (MRgRT) system. The study included seven patients with abdominal tumors treated on the MRgRT system. ROCK-4D-MRI and 2D-CINE, was performed immediately after one of the treatment fractions. Motion quantification based on 4D-MRI was compared with those based on 2D-CINE. The image quality of 4D-MRI was evaluated against 4D-CT. The gross tumor volumes (GTV) were defined based on individual respiratory phases of both 4D-MRI and 4D-CT and compared for their variability over the respiratory cycle. The motion measurements based on 4D-MRI matched well with 2D-CINE, with differences of 1.04 ± 0.52 mm in the superior-inferior and 0.54 ± 0.21 mm in the anterior-posterior directions. The image quality scores of 4D-MRI were significantly higher than 4D-CT, with better tumor contrast (3.29 ± 0.76 vs. 1.86 ± 0.90) and less motion artifacts (3.57 ± 0.53 vs. 2.29 ± 0.95). The GTVs were more consistent in 4D-MRI than in 4D-CT, with significantly smaller GTV variability (9.31 ± 4.58% vs. 34.27 ± 23.33%). Our study demonstrated the clinical feasibility of using the ROCK-4D-MRI to acquire high quality, respiratory motion-resolved 4D-MRI in a low-field MRgRT system. The 4D-MRI image could provide accurate dynamic information for radiotherapy treatment planning. Copyright © 2018 Elsevier B.V. All rights reserved.

MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy.

Science.gov (United States)

Li, Jie; Dershaw, D David; Lee, Carol H; Kaplan, Jennifer; Morris, Elizabeth A

2009-09-01

Follow-up MRI can be useful to confirm a benign diagnosis after MRI-guided breast biopsy. This retrospective study was undertaken to evaluate appropriate timing and imaging interpretation for the initial follow-up MRI when a benign, concordant histology is obtained using MRI-guided breast biopsy. Retrospective review was performed of 177 lesions visualized only by MRI in 172 women who underwent 9-gauge, vacuum-assisted core biopsy and marker placement with imaging-concordant benign histology. All underwent follow-up MRI within 12 months. Timing of the follow-up study, change in size, results of second biopsy if performed, and distance of localizing marker to the lesion on the follow-up study were recorded. At initial follow-up, 155 lesions were decreased or gone, 14 lesions were stable, and eight were enlarged. Seventeen (9.6%, 17/177) lesions underwent a second biopsy, including six enlarging, 10 stable, and one decreasing. Of these, four were malignant. Enlargement was seen in two carcinomas at 6 and 12 months. Two carcinomas, one stable at 2 months and another stable at 3 and 11 months, were rebiopsied because of suspicion of a missed lesion in the former and worrisome mammographic and sonographic changes in the latter. The distance of the marker from the lesion on follow-up did not correlate with biopsy accuracy. Follow-up MRI did not detect missed cancers because of lesion enlargement before 6 months after biopsy; two of four missed cancers were stable. The localizing marker can deploy away from the target despite successful sampling.

Multiple whole body hyperthermia treatments on normal beagles

International Nuclear Information System (INIS)

Geist, B.J.; Gillette, E.L.; Tucker, A.; Robertshaw, D.; Benjamin, S.A.; Macy, D.W.

1985-01-01

Twelve young adult male castrated beagles were randomized into either a treatment or a control group. The treatment group received 4 consecutive treatments at 1 week intertreatment intervals. A temperature and humidity controlled chamber was used to raise the core temperature to 42 0 C. Time required to raise the core temperature from 38 0 C to 42 0 C was approximately 70 minutes. Dogs were maintained at 42 0 C breathing halothane, 35% O/sub 2/ and 65 0 N/sub 2/ for 2 hours, followed by a 30 minute cool down period during which a shunt determination using 100% O/sub 2/ was done. No significant changes in temperature adjusted blood oxygen tension were noted during hyperthermia. Mean arterial blood pressure dropped an average of 15mm Hg during the 2 hour plateau. Cardiac rhythms remained stable and rates did not exceed 180 beats per minute. Central venous pressure remained stable and within normal range without treatment, 1.0 - 2.5 mm Hg. Dogs regained alertness and ambulation within 3 hours post treatment. No diarrhea was noted. The most significant acute changes appeared to be liver enzyme elevation, total protein decrement and transient changes in platelet and white blood cell counts

Clinical use of the hyperthermia treatment planning system HyperPlan to predict effectiveness and toxicity

International Nuclear Information System (INIS)

Sreenivasa, Geetha; Gellermann, Johanna; Rau, Beate; Nadobny, Jacek; Schlag, Peter; Deuflhard, Peter; Felix, Roland; Wust, Peter

2003-01-01

Purpose: The main aim is to prove the clinical practicability of the hyperthermia treatment planning system HyperPlan on a β-test level. Data and observations obtained from clinical hyperthermia are compared with the numeric methods FE (finite element) and FDTD (finite difference time domain), respectively. Methods and Materials: The planning system HyperPlan is built on top of the modular, object-oriented platform for visualization and model generation AMIRA. This system already contains powerful algorithms for image processing, geometric modeling, and three-dimensional graphics display. A number of hyperthermia-specific modules are provided, enabling the creation of three-dimensional tetrahedral patient models suitable for treatment planning. Two numeric methods, FE and FDTD, are implemented in HyperPlan for solving Maxwell's equations. Both methods base their calculations on segmented (contour based) CT or MR image data. A tetrahedral grid is generated from the segmented tissue boundaries, consisting of approximately 80,000 tetrahedrons per patient. The FE method necessitates, primarily, this tetrahedral grid for the calculation of the E-field. The FDTD method, on the other hand, calculates the E-field on a cubical grid, but also requires a tetrahedral grid for correction at electrical interfaces. In both methods, temperature distributions are calculated on the tetrahedral grid by solving the bioheat transfer equation with the FE method. Segmentation, grid generation, E-field, and temperature calculation can be carried out in clinical practice at an acceptable time expenditure of about 1-2 days. Results: All 30 patients we analyzed with cervical, rectal, and prostate carcinoma exhibit a good correlation between the model calculations and the attained clinical data regarding acute toxicity (hot spots), prediction of easy-to-heat or difficult-to-heat patients, and the dependency on various other individual parameters. We could show sufficient agreement between

Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: results from five randomized controlled trials

International Nuclear Information System (INIS)

Vernon, Clare C.; Hand, Jeffrey W.; Field, Stanley B.; Machin, David; Whaley, Jill B.; Zee, Jacoba van der; Putten, Wim L.J. van; Rhoon, Gerard C. van; Dijk, Jan D.P. van; Gonzalez, Dionisio Gonzalez; Liu, F.-F.; Goodman, Phyllis; Sherar, Michael

1996-01-01

Purpose: Claims for the value of hyperthermia as an adjunct to radiotherapy in the treatment of cancer have mostly been based on small Phase I or II trials. To test the benefit of this form of treatment, randomized Phase III trials were needed. Methods and Materials: Five randomized trials addressing this question were started between 1988 and 1991. In these trials, patients were eligible if they had advanced primary or recurrent breast cancer, and local radiotherapy was indicated in preference to surgery. In addition, heating of the lesions and treatment with a prescribed (re)irradiation schedule had to be feasible and informed consent was obtained. The primary endpoint of all trials was local complete response. Slow recruitment led to a decision to collaborate and combine the trial results in one analysis, and report them simultaneously in one publication. Interim analyses were carried out and the trials were closed to recruitment when a previously agreed statistically significant difference in complete response rate was observed in the two larger trials. Results: We report on pretreatment characteristics, the treatments received, the local response observed, duration of response, time to local failure, distant progression and survival, and treatment toxicity of the 306 patients randomized. The overall CR rate for RT alone was 41% and for the combined treatment arm was 59%, giving, after stratification by trial, an odds ratio of 2.3. Not all trials demonstrated an advantage for the combined treatment, although the 95% confidence intervals of the different trials all contain the pooled odds ratio. The greatest effect was observed in patients with recurrent lesions in previously irradiated areas, where further irradiation was limited to low doses. Conclusion: The combined result of the five trials has demonstrated the efficacy of hyperthermia as an adjunct to radiotherapy for treatment of recurrent breast cancer. The implication of these encouraging results is that

MRI-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture for treatment of cervical disc herniation: an initial experience

International Nuclear Information System (INIS)

Liu Ming; Li Chengli; Lu Yubo; Huang Jie; Song Jiqing; Li Lei; Bao Shougang; Cao Qianqian; Wu Lebin

2010-01-01

Objective: To explore the value of MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture for treatment of cervical disc herniation. Methods: Eight herniated cervical discs in 7 patients were diagnosed by MRI, inclluding 5 discs of lateral protruding type, 2 discs of paramedian protruding type and one disc of central protruding type. All patients underwent MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture. The procedures were guided by a set of 0.23 T open MR system mounted with iPath 200 optical tracking system. The herniated portion of the disc was punctured with a 14 G MR-comparible needle in the healthy side via anterolateral oblique route. The interventional steps were as follows: firstly, cut herniated part with percutaneous discectomy probe and inject 2ml oxygen-ozone mixture of 60 μg/ml; secondly, retreat the needle to the disc center, resect nucleus pulposus, and inject 2 ml oxygen-ozone mixture of 60 μg/ml; secondly, retreat the needle to the disc center, resect nucleus pulposus, and inject 2 ml oxygen-ozone mixture of 60 μg/ml. All patients were followed up for 6 months, with 4 patients by telephone and 3 patients in outpatient clinic. The effect of treatment was evaluated according to Williams postoperative assessment standard. Results: All procedures were performed successfully. The clinical outcome was evaluated as excellent in 5 cases, good in 1 cases and fair in 1 case. The total ratio of excellent and good was 85.7%. No serious complication occurred expect 1 case with intraoperative paroxysmal pain. Conclusion: MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture was a safe, effective and minimally invasive method for the treatment of cervical disc herniation. (authors)

Magnetisk resonans-imaging (MRI)-styret fokuseret ultralyd

DEFF Research Database (Denmark)

Salomir, Rares; Hokland, S.; Pedersen, M.

2005-01-01

Focussed ultrasound is the only known technology that allows non-invasive local hyperthermia. Since MRI may be employed to obtain real-time temperature maps non-invasively, the combination of these two technologies offers great advantages, specifically aimed towards oncological studies. Real......-time identification of the target region and accurate control of the temperature evolution during the treatment are now possible. Thermal ablation of pathological tissue, local drug delivery using thermosensitive microcarriers and controlled transgene expression using thermosensitive promoters have recently been...

Effect of SPIO Nanoparticle Concentrations on Temperature Changes for Hyperthermia via MRI

Directory of Open Access Journals (Sweden)

Alsayed A. M. Elsherbini

2013-01-01

Full Text Available Magnetic nanoparticles (MNPs are being developed for a wide range of biomedical applications. In particular, hyperthermia involves heating the MNPs through exposure to an alternating magnetic field (AMF. These materials offer the potential for selectively by heating cancer tissue locally and at the cellular level. This may be a successful method if there are enough particles in a tumor possessing sufficiently high specific absorption rate (SAR to deposit heat quickly while minimizing thermal damage to surrounding tissue. The current research aim is to study the influence of super paramagnetic iron oxides Fe3O4 (SPIO NPs concentration on the total heat energy dose and the rate of temperature change in AMF to induce hyperthermia in Ehrlich carcinoma cells implanted in female mice. The results demonstrated a linearly increasing trend between these two factors.

Development of a spherically focused phased array transducer for ultrasonic image-guided hyperthermia.

Science.gov (United States)

Liu, Jingfei; Foiret, Josquin; Stephens, Douglas N; Le Baron, Olivier; Ferrara, Katherine W

2016-07-21

A 1.5 MHz prolate spheroidal therapeutic array with 128 circular elements was designed to accommodate standard imaging arrays for ultrasonic image-guided hyperthermia. The implementation of this dual-array system integrates real-time therapeutic and imaging functions with a single ultrasound system (Vantage 256, Verasonics). To facilitate applications involving small animal imaging and therapy the array was designed to have a beam depth of field smaller than 3.5 mm and to electronically steer over distances greater than 1 cm in both the axial and lateral directions. In order to achieve the required f number of 0.69, 1-3 piezocomposite modules were mated within the transducer housing. The performance of the prototype array was experimentally evaluated with excellent agreement with numerical simulation. A focal volume (2.70 mm (axial)  ×  0.65 mm (transverse)  ×  0.35 mm (transverse)) defined by the  -6 dB focal intensity was obtained to address the dimensions needed for small animal therapy. An electronic beam steering range defined by the  -3 dB focal peak intensity (17 mm (axial)  ×  14 mm (transverse)  ×  12 mm (transverse)) and  -8 dB lateral grating lobes (24 mm (axial)  ×  18 mm (transverse)  ×  16 mm (transverse)) was achieved. The combined testing of imaging and therapeutic functions confirmed well-controlled local heating generation and imaging in a tissue mimicking phantom. This dual-array implementation offers a practical means to achieve hyperthermia and ablation in small animal models and can be incorporated within protocols for ultrasound-mediated drug delivery.

Development of a spherically focused phased array transducer for ultrasonic image-guided hyperthermia

Science.gov (United States)

Liu, Jingfei; Foiret, Josquin; Stephens, Douglas N.; Le Baron, Olivier; Ferrara, Katherine W.

2016-07-01

A 1.5 MHz prolate spheroidal therapeutic array with 128 circular elements was designed to accommodate standard imaging arrays for ultrasonic image-guided hyperthermia. The implementation of this dual-array system integrates real-time therapeutic and imaging functions with a single ultrasound system (Vantage 256, Verasonics). To facilitate applications involving small animal imaging and therapy the array was designed to have a beam depth of field smaller than 3.5 mm and to electronically steer over distances greater than 1 cm in both the axial and lateral directions. In order to achieve the required f number of 0.69, 1-3 piezocomposite modules were mated within the transducer housing. The performance of the prototype array was experimentally evaluated with excellent agreement with numerical simulation. A focal volume (2.70 mm (axial)  ×  0.65 mm (transverse)  ×  0.35 mm (transverse)) defined by the  -6 dB focal intensity was obtained to address the dimensions needed for small animal therapy. An electronic beam steering range defined by the  -3 dB focal peak intensity (17 mm (axial)  ×  14 mm (transverse)  ×  12 mm (transverse)) and  -8 dB lateral grating lobes (24 mm (axial)  ×  18 mm (transverse)  ×  16 mm (transverse)) was achieved. The combined testing of imaging and therapeutic functions confirmed well-controlled local heating generation and imaging in a tissue mimicking phantom. This dual-array implementation offers a practical means to achieve hyperthermia and ablation in small animal models and can be incorporated within protocols for ultrasound-mediated drug delivery.

Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning

International Nuclear Information System (INIS)

Paulson, Eric S.; Erickson, Beth; Schultz, Chris; Allen Li, X.

2015-01-01

Purpose: The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP. Methods: A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP of brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI-optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off-resonance and gradient nonlinearity-induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams. Results: The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast-to-noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off-resonance and gradient nonlinearity induced geometric distortions. Conclusions: The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In

Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning

Energy Technology Data Exchange (ETDEWEB)

Paulson, Eric S., E-mail: epaulson@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 and Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States); Erickson, Beth; Schultz, Chris; Allen Li, X. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226 (United States)

2015-01-15

Purpose: The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP. Methods: A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP of brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI-optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off-resonance and gradient nonlinearity-induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams. Results: The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast-to-noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off-resonance and gradient nonlinearity induced geometric distortions. Conclusions: The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In

Nanotechnology in hyperthermia cancer therapy: From fundamental principles to advanced applications.

Science.gov (United States)

Beik, Jaber; Abed, Ziaeddin; Ghoreishi, Fatemeh S; Hosseini-Nami, Samira; Mehrzadi, Saeed; Shakeri-Zadeh, Ali; Kamrava, S Kamran

2016-08-10

In this work, we present an in-depth review of recent breakthroughs in nanotechnology for hyperthermia cancer therapy. Conventional hyperthermia methods do not thermally discriminate between the target and the surrounding normal tissues, and this non-selective tissue heating can lead to serious side effects. Nanotechnology is expected to have great potential to revolutionize current hyperthermia methods. To find an appropriate place in cancer treatment, all nanotechnology-based hyperthermia methods and their risks/benefits must be thoroughly understood. In this review paper, we extensively examine and compare four modern nanotechnology-based hyperthermia methods. For each method, the possible physical mechanisms of heat generation and enhancement due to the presence of nanoparticles are explained, and recent in vitro and in vivo studies are reviewed and discussed. Nano-Photo-Thermal Therapy (NPTT) and Nano-Magnetic Hyperthermia (NMH) are reviewed as the two first exciting approaches for targeted hyperthermia. The third novel hyperthermia method, Nano-Radio-Frequency Ablation (NaRFA) is discussed together with the thermal effects of novel nanoparticles in the presence of radiofrequency waves. Finally, Nano-Ultrasound Hyperthermia (NUH) is described as the fourth modern method for cancer hyperthermia. Copyright © 2016 Elsevier B.V. All rights reserved.

Outcomes of Interventional-MRI Versus Microelectrode Recording-Guided Subthalamic Deep Brain Stimulation

Directory of Open Access Journals (Sweden)

Philip S. Lee

2018-04-01

Full Text Available In deep brain stimulation (DBS of the subthalamic nucleus (STN for Parkinson’s disease (PD, there is debate concerning the use of neuroimaging alone to confirm correct anatomic placement of the DBS lead into the STN, versus the use of microelectrode recording (MER to confirm functional placement. We performed a retrospective study of a contemporaneous cohort of 45 consecutive patients who underwent either interventional-MRI (iMRI or MER-guided DBS lead implantation. We compared radial lead error, motor and sensory side effect, and clinical benefit programming thresholds, and pre- and post-operative unified PD rating scale scores, and levodopa equivalent dosages. MER-guided surgery was associated with greater radial error compared to the intended target. In general, side effect thresholds during initial programming were slightly lower in the MER group, but clinical benefit thresholds were similar. No significant difference in the reduction of clinical symptoms or medication dosage was observed. In summary, iMRI lead implantation occurred with greater anatomic accuracy, in locations demonstrated to be the appropriate functional region of the STN, based on the observation of similar programming side effect and benefit thresholds obtained with MER. The production of equivalent clinical outcomes suggests that surgeon and patient preference can be used to guide the decision of whether to recommend iMRI or MER-guided DBS lead implantation to appropriate patients with PD.

Saline as the Sole Contrast Agent for Successful MRI-guided Epidural Injections

International Nuclear Information System (INIS)

Deli, Martin; Fritz, Jan; Mateiescu, Serban; Busch, Martin; Carrino, John A.; Becker, Jan; Garmer, Marietta; Grönemeyer, Dietrich

2013-01-01

Purpose. To assess the performance of sterile saline solution as the sole contrast agent for percutaneous magnetic resonance imaging (MRI)-guided epidural injections at 1.5 T. Methods. A retrospective analysis of two different techniques of MRI-guided epidural injections was performed with either gadolinium-enhanced saline solution or sterile saline solution for documentation of the epidural location of the needle tip. T1-weighted spoiled gradient echo (FLASH) images or T2-weighted single-shot turbo spin echo (HASTE) images visualized the test injectants. Methods were compared by technical success rate, image quality, table time, and rate of complications. Results. 105 MRI-guided epidural injections (12 of 105 with gadolinium-enhanced saline solution and 93 of 105 with sterile saline solution) were performed successfully and without complications. Visualization of sterile saline solution and gadolinium-enhanced saline solution was sufficient, good, or excellent in all 105 interventions. For either test injectant, quantitative image analysis demonstrated comparable high contrast-to-noise ratios of test injectants to adjacent body substances with reliable statistical significance levels (p < 0.001). The mean table time was 22 ± 9 min in the gadolinium-enhanced saline solution group and 22 ± 8 min in the saline solution group (p = 0.75). Conclusion. Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review

Science.gov (United States)

Iordachita, Iulian I.; Tokuda, Junichi; Hata, Nobuhiko; Liu, Xuan; Seifabadi, Reza; Xu, Sheng; Wood, Bradford; Fischer, Gregory S.

2017-01-01

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures. PMID:28652857

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review.

Science.gov (United States)

Su, Hao; Iordachita, Iulian I; Tokuda, Junichi; Hata, Nobuhiko; Liu, Xuan; Seifabadi, Reza; Xu, Sheng; Wood, Bradford; Fischer, Gregory S

2017-04-01

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures.

Development of a Pneumatic Robot for MRI-guided Transperineal Prostate Biopsy and Brachytherapy: New Approaches

Science.gov (United States)

Song, Sang-Eun; Cho, Nathan B.; Fischer, Gregory; Hata, Nobuhito; Tempany, Clare; Fichtinger, Gabor; Iordachita, Iulian

2011-01-01

Magnetic Resonance Imaging (MRI) guided prostate biopsy and brachytherapy has been introduced in order to enhance the cancer detection and treatment. For the accurate needle positioning, a number of robotic assistants have been developed. However, problems exist due to the strong magnetic field and limited workspace. Pneumatically actuated robots have shown the minimum distraction in the environment but the confined workspace limits optimal robot design and thus controllability is often poor. To overcome the problem, a simple external damping mechanism using timing belts was sought and a 1-DOF mechanism test result indicated sufficient positioning accuracy. Based on the damping mechanism and modular system design approach, a new workspace-optimized 4-DOF parallel robot was developed for the MRI-guided prostate biopsy and brachytherapy. A preliminary evaluation of the robot was conducted using previously developed pneumatic controller and satisfying results were obtained. PMID:21399734

Changes in tumor oxygenation during a combined treatment with fractionated irradiation and hyperthermia: an experimental study.

Science.gov (United States)

Zywietz, F; Reeker, W; Kochs, E

1997-01-01

To determine the influence of adjuvant hyperthermia on the oxygenation status of fractionated irradiated tumors. Oxygen partial pressure (pO2) in rat rhabdomyosarcomas (R1H) was measured sequentially at weekly intervals during a fractionated irradiation with 60Co-gamma-rays (60 Gy/20f/4 weeks) in combination with local hyperthermia (8 f(HT) at 43 degrees C, 1 h/4 weeks). Tumors were heated twice weekly with a 2450 MHz microwave device at 43 degrees C, 1 h starting 10 min after irradiation. The pO2 measurements (pO2-histograph, Eppendorf, Germany) were performed in anesthetized animals during mechanical ventilation and in hemodynamic steady state. All tumor pO2 measurements were correlated to measurements of the arterial oxygen partial pressure (paO2) determined by a blood gas analyzer. The oxygenation status of R1H tumors decreased continuously from the start of the combined treatment, with increasing radiation dose and number of heat fractions. In untreated controls a median tumor pO2 of 23 +/- 2 mmHg (mean +/- SEM) was measured. Tumor pO2 decreased to 11 +/- 2 mmHg after 30 Gy + 4 HT (2 weeks), and to 6 +/- 2 mmHg after 60 Gy + 8HT (4 weeks). The increase in the frequency of pO2-values below 5 mmHg and the decrease in the range of the pO2 histograms [delta p(10/90)] further indicated that tumor hypoxia increased relatively rapidly from the start of combined treatment. After 60 Gy + 8HT 48 +/- 5% (mean +/- SEM) of the pO2-values recorded were below 5 mmHg. These findings suggest that adjuvant hyperthermia to radiotherapy induces greater changes in tumor oxygenation than radiation alone [cf. (39)]. This might be of importance for the temporary application of hyperthermia in the course of a conventional radiation treatment.

Clinical outcome following a low-suspicion multiparametric prostate MRI or benign MRI-guided biopsy to detect prostate cancer

DEFF Research Database (Denmark)

Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke

2017-01-01

follow-up [132/156 (85%)] had decreasing levels of prostate-specific-antigen and could be monitored in primary care. CONCLUSION: A low-suspicion MRI in men with prior negative systematic biopsies has a high negative predictive value in ruling out longer term significant cancer. Therefore, immediate...... repeated biopsies are of limited clinical value and could be avoided even if prostate-specific-antigen levels are persistently elevated.......PURPOSE: To assess the future risk of detecting significant prostate cancer following either a low-suspicion MRI or suspicious MRI with benign MRI-guided biopsies in men with prior negative systematic biopsies. MATERIALS AND METHODS: 289 prospectively enrolled men underwent MRI followed by repeated...

Hyperthermia on skin immune system and its application in the treatment of HPV-infected skin diseases

Institute of Scientific and Technical Information of China (English)

Gao Xinghua; Chen Hongduo

2014-01-01

In this paper, the effects of hyperthermia on cells and immune system are introduced briefly. The mechanism of action of hyperthermia on human papilloma virus （HPV）-infected skin diseases was elaborated as an example in this paper. Many studies have proved that hyperthermia affects a number of cellular and molecu- lar constitutes in the skin immune system, involving both innate and adaptive immune responses; the efficacy of hyperthermia in treating some infectious and cancerous conditions has been validated and applied in clinics, while molecular mechanisms of hyperthermia affecting the immunereaction is still unclear.

A Concentric Tube Continuum Robot with Piezoelectric Actuation for MRI-Guided Closed-Loop Targeting

Science.gov (United States)

Su, Hao; Li, Gang; Rucker, D. Caleb; Webster, Robert J.; Fischer, Gregory S.

2017-01-01

This paper presents the design, modeling and experimental evaluation of a magnetic resonance imaging (MRI)-compatible concentric tube continuum robotic system. This system enables MRI-guided deployment of a precurved and steerable concentric tube continuum mechanism, and is suitable for clinical applications where a curved trajectory is needed. This compact 6 degree-of-freedom (DOF) robotic system is piezoelectrically-actuated, and allows simultaneous robot motion and imaging with no visually observable image artifact. The targeting accuracy is evaluated with optical tracking system and gelatin phantom under live MRI-guidance with Root Mean Square (RMS) errors of 1.94 and 2.17 mm respectively. Furthermore, we demonstrate that the robot has kinematic redundancy to reach the same target through different paths. This was evaluated in both free space and MRI-guided gelatin phantom trails, with RMS errors of 0.48 and 0.59 mm respectively. As the first of its kind, MRI-guided targeted concentric tube needle placements with ex vivo porcine liver are demonstrated with 4.64 mm RMS error through closed-loop control of the piezoelectrically-actuated robot. PMID:26983842

Hyperthermia and radiotherapy

International Nuclear Information System (INIS)

Dietzel, F.

1979-01-01

Of decisive importance for superadditive enhancement is the close temporal correlation of hyperthermia and radiotherapy. It is recommended to first irradiate and then use heat treatment in order to ensure that dividable tumour cells are irradiated before hyperthermia. To achieve an optimal enhancing effect, temperatures of appr. 42 0 are sufficient. In order to be able to neglect temperature regulation and convection effects, hyperthermia for clinical use must be carried out in doses high enough to ensure that it can be finished within 3-4 minutes. It is necessary to make efforts to find out which forms of application can be realised in order to reach deeper tissue regions, thus making possible at least a half-depth-therapy. Up to day, only the 2 cm near to the surface can be heated in a sufficiently homogeneous way. In the FRG, there are more than 200 high-volt-therapy systems, including electron accelerators and telegamma systems. This is a dense network of radiation-therapeutical supply. An improved therapy effect of loose ionising rays which, with the help of the hypertherming, would almost be equal to irradiation with high ionisation density, is not only of scientific interest, but also of high interest for public health. (orig./MG) 891 MG/orig.- 892 RDG [de

Preparation of Multifunctional Fe@Au Core-Shell Nanoparticles with Surface Grafting as a Potential Treatment for Magnetic Hyperthermia.

Science.gov (United States)

Chung, Ren-Jei; Shih, Hui-Ting

2014-01-24

Iron core gold shell nanoparticles grafted with Methotrexate (MTX) and indocyanine green (ICG) were synthesized for the first time in this study, and preliminarily evaluated for their potential in magnetic hyperthermia treatment. The core-shell Fe@Au nanoparticles were prepared via the microemulsion process and then grafted with MTX and ICG using hydrolyzed poly(styrene-alt-maleic acid) (PSMA) to obtain core-shell Fe@Au-PSMA-ICG/MTX nanoparticles. MTX is an anti-cancer therapeutic, and ICG is a fluorescent dye. XRD, TEM, FTIR and UV-Vis spectrometry were performed to characterize the nanoparticles. The data indicated that the average size of the nanoparticles was 6.4 ± 09 nm and that the Au coating protected the Fe core from oxidation. MTX and ICG were successfully grafted onto the surface of the nanoparticles. Under exposure to high frequency induction waves, the superparamagnetic nanoparticles elevated the temperature of a solution in a few minutes, which suggested the potential for an application in magnetic hyperthermia treatment. The in vitro studies verified that the nanoparticles were biocompatible; nonetheless, the Fe@Au-PSMA-ICG/MTX nanoparticles killed cancer cells (Hep-G2) via the magnetic hyperthermia mechanism and the release of MTX.

The correlation between the rise of the tumor temperature during the hyperthermia treatment and the tumor blood flow measured by dynamic CT and 15O gas-positron emission tomography

International Nuclear Information System (INIS)

Hattori, Hideyuki

1993-01-01

This study was designed to determine the correlation between the rise of tumor temperature during hyperthermia treatment and the blood flow of the tumors measured by dynamic CT (DCT) and 15 O gas-positron emission tomography. In this report, we observed 20 patients with malignant tumors which underwent hyperthermia treatment. In each case, the temperature of the tumor was monitored with a photofiber sensor. DCT's and 15 O gas-positron emission tomographies were applied before the hyperthermia treatment. During the DCT, the tumor blood flow of each tumor was estimated by analyzing the time-dependent activity curve after a bolus injection. During the 15 O gas-positron emission tomography, the tumor blood flow was estimated by the C 15 O 2 -steady-state method. The value of the tumor blood flow estimated by DCT were proportional to those calculated by the 15 O gas-positron emission tomography. These values were inversely proportional to the rise of the temperature of the tumors during hyperthermia treatment. Our results imply that DCT as well as the 15 O gas-positron emission tomography can be used for the prediction of the tumor temperature rise during the hyperthermia treatment. (author)

TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

International Nuclear Information System (INIS)

Ghanouni, P.

2015-01-01

MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips

TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

Energy Technology Data Exchange (ETDEWEB)

Ghanouni, P. [Stanford University (United States)

2015-06-15

MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

Magnetomotive Optical Coherence Elastography for Magnetic Hyperthermia Dosimetry Based on Dynamic Tissue Biomechanics

Science.gov (United States)

Huang, Pin-Chieh; Pande, Paritosh; Ahmad, Adeel; Marjanovic, Marina; Spillman, Darold R.; Odintsov, Boris; Boppart, Stephen A.

2016-01-01

Magnetic nanoparticles (MNPs) have been used in many diagnostic and therapeutic biomedical applications over the past few decades to enhance imaging contrast, steer drugs to targets, and treat tumors via hyperthermia. Optical coherence tomography (OCT) is an optical biomedical imaging modality that relies on the detection of backscattered light to generate high-resolution cross-sectional images of biological tissue. MNPs have been utilized as imaging contrast and perturbative mechanical agents in OCT in techniques called magnetomotive OCT (MM-OCT) and magnetomotive elastography (MM-OCE), respectively. MNPs have also been independently used for magnetic hyperthermia treatments, enabling therapeutic functions such as killing tumor cells. It is well known that the localized tissue heating during hyperthermia treatments result in a change in the biomechanical properties of the tissue. Therefore, we propose a novel dosimetric technique for hyperthermia treatment based on the viscoelasticity change detected by MM-OCE, further enabling the theranostic function of MNPs. In this paper, we first review the basic principles and applications of MM-OCT, MM-OCE, and magnetic hyperthermia, and present new preliminary results supporting the concept of MM-OCE-based hyperthermia dosimetry. PMID:28163565

Biopsy guided by real-time sonography fused with MRI: a phantom study

DEFF Research Database (Denmark)

Ewertsen, C.; Grossjohann, Hanne Sønder; Nielsen, Kristina Rue

2008-01-01

OBJECTIVE: The purpose of our study was to test the accuracy of sonographically guided biopsies in a phantom of structures not visible on sonography but shown on MRI by using commercially available sonography systems with image fusion software. MATERIALS AND METHODS: A previously recorded MRI...

Technical Note: Dosimetric effects of couch position variability on treatment plan quality with an MRI-guided Co-60 radiation therapy machine

Energy Technology Data Exchange (ETDEWEB)

Chow, Phillip E., E-mail: pechow@mednet.ucla.edu; Thomas, David H.; Agazaryan, Nzhde; Cao, Minsong; Low, Daniel A.; Yang, Yingli; Steinberg, Michael L.; Lee, Percy; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095 (United States)

2016-08-15

Purpose: Magnetic resonance imaging (MRI) guidance in radiation therapy brings real-time imaging and adaptive planning into the treatment vault where it can account for interfraction and intrafraction movement of soft tissue. The only commercially available MRI-guided radiation therapy device is a three-head {sup 60}Co and MRI system with an integrated treatment planning system (TPS). Couch attenuation of the beam of up to 20% is well modeled in the TPS. Variations in the patient’s day-to-day position introduce discrepancies in the actual couch attenuation as modeled in the treatment plan. For this reason, the authors’ institution avoids plans with beams that pass through or near the couch edges. This study investigates the effects of differential beam attenuation by the couch due to couch shifts in order to determine whether couch edge avoidance restrictions can be lifted. Couch shifts were simulated using a Monte Carlo treatment planning system and ion chamber measurements performed for validation. Methods: A total of 27 plans from 23 patients were investigated. Couch shifts of 1 and 2 cm were introduced in combinations of lateral and vertical directions to simulate patient position variations giving 16 shifted plans per reference plan. The 1 and 2 cm shifts were based on shifts recorded in 320 treatment fractions. Results: Following TG176 recommendations for measurement methods, couch attenuation measurements agreed with TPS modeled attenuation to within 2.1%. Planning target volume D95 changed less than 1% for 1 and 2 cm couch shifts in only the x-direction and less than 3% for all directions. Conclusions: Dosimetry of all plans tested was robust to couch shifts up to ±2 cm. In general, couch shifts resulted in clinically insignificant dosimetric deviations. It is conceivable that in certain cases with large systematic couch shifts and plans that are particularly sensitive to shifts, dosimetric changes might rise to a clinically significant level.

Investigation properties of superparamagnetic nanoparticles and magnetic field-dependent hyperthermia therapy

Science.gov (United States)

Hedayatnasab, Z.; Abnisa, F.; Daud, W. M. A. Wan

2018-03-01

The application of superparamagnetic nanoparticles as heating agents in hyperthermia therapy has made a therapeutic breakthrough in cancer treatment. The high efficiency of this magnetic hyperthermia therapy has derived from a great capability of superparamagnetic nanoparticles to generate focused heat in inaccessible tumors being effectively inactivated. The main challenges of this therapy are the improvement of the induction heating power of superparamagnetic nanoparticles and the control of the hyperthermia temperature in a secure range of 42 °C to 47 °C, at targeted area. The variation of these hyperthermia properties is principally dependent on the magnetic nanoparticles as well as the magnetic field leading to enhance the efficiency of magnetic hyperthermia therapy at targeted area and also avoid undue heating to healthy cells. The present study evaluates the magnetic hyperthermia therapy through the determination of superparamagnetic nanoparticles properties and magnetic field’ parameters.

Combined effects of hyperthermia and radiation in cultured mammalian cells

International Nuclear Information System (INIS)

Ben-Hur, E.; Elkind, M.M.; Riklis, E.

1977-01-01

Hyperthermia (temperatures of 39 0 C or higher) enhances the killing of mammalian cells by ionizing radiation (fission-spectrum neutrons and x-rays). The nature and the magnitude of the enhanced radiation killing varies with temperature and for a fixed temperature during irradiation, the enhanced lethality varies inversely with dose rate. For temperatures up to 41 0 C, dose fractionation measurements indicate that hyperthermia inhibits the repair of sublethal damage. At higher temperatures, the expression of potentially lethal damage is enhanced. Since the effect of heat is greatest in cells irradiated during DNA synthesis, the radiation age-response pattern is flattened by hyperthermia. In addition to the enhanced cell killing described above, three other features of the effect of hyperthermia are important in connection with the radiation treatment of cancer. The first is that heat selectively sensitizes S-phase cells to radiation. The second is that it takes radiation survivors 10 to 20 hrs after a modest heat treatment to recover their ability to repair sublethal damage. And the third is that hyperthermia reduces the magnitude of the oxygen enhancement ratio. Thus, heat if applied selectively, could significantly increase the margin of damage between tumors and normal tissues

ADPRT inhibitors and hyperthermia as radiosensitizers

International Nuclear Information System (INIS)

Jonsson, G.G.

1985-01-01

Hyperthermia given in combination with gamma radiation has given considerable improvement in the therapeutic results for treatment of malignant tumors. The mechanism behind the hyperthermia effect is probably operative at the tissue level as well as at the molecular level. The metabolism of NAD + in relation to the activity of the chromosomal enzyme ADP-ribosyl transferase (ADPRT) has been studied as a possible molecular mechanism for this effect. The ADPRT activity was measured after radiosensitization with both hyperthermia and nicotinamide, which is a potent inhibitor of ADPRT. The results indicate that hyperthermia can improve the effect of radiotherapy by reducing the supply of NAD + , which is a co-substrate for ADPRT, while nicotinamide functions as a radiosensitizing agent by direct inhibition of the enzyme. The hypothesis is discussed in the thesis where inhibition of ADPRT might increase the radiosensitivity because the radiation-induced DNA damage can not be repaired with normal efficiency. The function of nicotinamide as a radiosensitizer was verified by studies on C3H mice with transplanted spontaneous mammary tumors. Because nicotinamide is not toxic, it seems quite attractive to test this vitamin as a radiosensitizing agent against human tumors. (251 refs.) (author)

Magnetic Hyperthermia and Radiation Therapy: Radiobiological Principles and Current Practice †

Directory of Open Access Journals (Sweden)

Spiridon V. Spirou

2018-06-01

Full Text Available Hyperthermia, though by itself generally non-curative for cancer, can significantly increase the efficacy of radiation therapy, as demonstrated by in vitro, in vivo, and clinical results. Its limited use in the clinic is mainly due to various practical implementation difficulties, the most important being how to adequately heat the tumor, especially deep-seated ones. In this work, we first review the effects of hyperthermia on tissue, the limitations of radiation therapy and the radiobiological rationale for combining the two treatment modalities. Subsequently, we review the theory and evidence for magnetic hyperthermia that is based on magnetic nanoparticles, its advantages compared with other methods of hyperthermia, and how it can be used to overcome the problems associated with traditional techniques of hyperthermia.

Piezoelectrically Actuated Robotic System for MRI-Guided Prostate Percutaneous Therapy

OpenAIRE

Su, Hao; Shang, Weijian; Cole, Gregory; Li, Gang; Harrington, Kevin; Camilo, Alexander; Tokuda, Junichi; Tempany, Clare M.; Hata, Nobuhiko; Fischer, Gregory S.

2014-01-01

This paper presents a fully-actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the surgical workflow of intra-operative MRI-guided surgical procedures. We present the development of a 6-degree-of-freedom (DOF) needle placement robot for transperineal prostate interventions. The robot consists of a 3-DOF needle driver module and a 3-DOF Cartesian...

WE-B-BRD-00: MRI for Radiation Oncology

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptive QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.

Safety and efficacy of targeted hyperthermia treatment utilizing gold nanorod therapy in spontaneous canine neoplasia.

Science.gov (United States)

Schuh, Elizabeth M; Portela, Roberta; Gardner, Heather L; Schoen, Christian; London, Cheryl A

2017-10-02

Hyperthermia is an established anti-cancer treatment but is limited by tolerance of adjacent normal tissues. Parenteral administration of gold nanorods (NRs) as a photosensitizer amplifies the effects of hyperthermia treatment while sparing normal tissues. This therapy is well tolerated and has demonstrated anti-tumor effects in mouse models. The purpose of this phase 1 study was to establish the safety and observe the anti-tumor impact of gold NR enhanced (plasmonic) photothermal therapy (PPTT) in client owned canine patients diagnosed with spontaneous neoplasia. Seven dogs underwent gold NR administration and subsequent NIR PPTT. Side effects were mild and limited to local reactions to NIR laser. All of the dogs enrolled in the study experienced stable disease, partial remission or complete remission. The overall response rate (ORR) was 28.6% with partial or complete remission of tumors at study end. PPTT utilizing gold nanorod therapy can be safely administered to canine patients. Further studies are needed to determine the true efficacy in a larger population of canine cancer patients and to and identify those patients most likely to benefit from this therapy.

Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI.

Science.gov (United States)

Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

2011-03-29

During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens.

Radiofrequency hyperthermia for advanced malignant liver tumors

International Nuclear Information System (INIS)

Nagata, Y.; Okuno, Y.; Mitsumori, M.; Akuta, K.; Nishimura, Y.; Masunaga, S.; Kanamori, S.; Fujishiro, M.; Hiraoka, M.; Takahashi, M.; Abe, M.

1996-01-01

Purpose: To evaluate thermometry and the clinical results of radiofrequency (RF) thermotherapy for advanced malignant liver tumors. Materials and Methods One-hundred and seventy-three patients with malignant liver tumors treated between 1983 and 1995 underwent hyperthermia. Surgery were contraindicated in all patients. The 173 tumors consisted of 114 hepatocellular carcinomas(HCCs), and 59 non-HCCs(45 metastatic liver tumors and 12 cholangiocarcinomas). Eight MHz RF capacitive heating equipment was used for hyperthermia. Two opposing 25-cm or 30-cm electrodes were generally used for heating liver tumors. Our standard protocol was to administer hyperthermia 40-50 minutes twice a week to a total of 8 sessions. Temperature of the liver tumor was measured by microthermocouples. In each patient, a single catheter was inserted into the liver tumor through the normal liver. Transcatheter arterial embolization, radiotherapy, immunotherapy, and chemotherapy were combined with hyperthermia depending on the patient's liver function and tumor location. The therapeutic efficacy was evaluated by the change in tumor size assessed by computed tomography (CT) three or four months after the completion of treatment. Results One-hundred and forty (81%) of 173 patients underwent hyperthermia more than 4 times. Thermometry could be performed in 77(55%) of these 140 patients. Neither systolic nor diastolic blood pressure changed significantly after hyperthermia. However, pulse rate significantly increased from 82.8 ± 1.1 to 96.5 ± 1.3 beats/min. Only 21 patients (11%) showed a decrease in pulse rate after hyperthermia. Body temperature increased from 36.3 ±0.1 to 37.4±0.2 after hyperthermia. Sequelae of hyperthermia included focal fat burning in 20 (12%), gastric ulceration in 4 (2%), and liver necrosis in 1(1%). Sequelae of thermometry were severe peritoneal pain in 7 (11%), intraperitoneal hematoma in 1(1%), and pneumothorax in one (1%) patient. The maximal tumor temperature

Effect of Prostate Magnetic Resonance Imaging/Ultrasound Fusion-guided Biopsy on Radiation Treatment Recommendations

Energy Technology Data Exchange (ETDEWEB)

Reed, Aaron; Valle, Luca F.; Shankavaram, Uma; Krauze, Andra; Kaushal, Aradhana; Schott, Erica; Cooley-Zgela, Theresa [Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Wood, Bradford [Center for Interventional Oncology, National Institutes of Health, Bethesda, Maryland (United States); Pinto, Peter [Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Choyke, Peter; Turkbey, Baris [Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Citrin, Deborah E., E-mail: citrind@mail.nih.gov [Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

2017-04-01

Purpose: Targeted magnetic resonance imaging (MRI)/ultrasound fusion prostate biopsy (MRI-Bx) has recently been compared with the standard of care extended sextant ultrasound-guided prostate biopsy (SOC-Bx), with the former associated with an increased rate of detection of clinically significant prostate cancer. The present study sought to determine the influence of MRI-Bx on radiation therapy and androgen deprivation therapy (ADT) recommendations. Methods and Materials: All patients who had received radiation treatment and had undergone SOC-Bx and MRI-Bx at our institution were included. Using the clinical T stage, pretreatment prostate-specific antigen, and Gleason score, patients were categorized into National Comprehensive Cancer Network risk groups and radiation treatment or ADT recommendations assigned. Intensification of the recommended treatment after multiparametric MRI, SOC-Bx, and MRI-Bx was evaluated. Results: From January 2008 to January 2016, 73 patients received radiation therapy at our institution after undergoing a simultaneous SOC-Bx and MRI-Bx (n=47 with previous SOC-Bx). Repeat SOC-Bx and MRI-Bx resulted in frequent upgrading compared with previous SOC-Bx (Gleason score 7, 6.7% vs 44.6%; P<.001; Gleason score 8-10, 2.1% vs 38%; P<.001). MRI-Bx increased the proportion of patients classified as very high risk from 24.7% to 41.1% (P=.027). Compared with SOC-Bx alone, including the MRI-Bx findings resulted in a greater percentage of pathologically positive cores (mean 37% vs 44%). Incorporation of multiparametric MRI and MRI-Bx results increased the recommended use and duration of ADT (duration increased in 28 of 73 patients and ADT was added for 8 of 73 patients). Conclusions: In patients referred for radiation treatment, MRI-Bx resulted in an increase in the percentage of positive cores, Gleason score, and risk grouping. The benefit of treatment intensification in accordance with the MRI-Bx findings is unknown.

Numerical modeling for an electric-field hyperthermia applicator

Science.gov (United States)

Wu, Te-Kao; Chou, C. K.; Chan, K. W.; Mcdougall, J.

1993-01-01

Hyperthermia, in conjunction with radiation and chemotherapy for treatment of cancers, is an area of current concern. Experiments have shown that hyperthermia can increase the potency of many chemotherapy drugs and the effectiveness of radiation for treating cancer. A combination of whole body or regional hyperthermia with chemotherapy or radiation should improve treatment results. Conventional methods for inducing whole body hyperthermia, such as exposing a patient in a radiant cabinet or under a hot water blanket, conduct heat very slowly from the skin to the body core. Thus a more efficient system, such as the three-plate electric-field hyperthermia applicator (EHA), is developed. This three-plate EHA has one top plate over and two lower plates beneath the patient. It is driven at 27.12 MHz with 500 Watts through a matching circuit. Using this applicator, a 50 kg pig was successfully heated to 42 C within 45 minutes. However, phantom and animal studies have indicated non-uniform heating near the side of the body. In addition, changes in the size and distance between the electrode plates can affect the heating (or electromagnetic field) pattern. Therefore, numerical models using the method of moments (MOM) or the finite difference time domain (FDTD) technique are developed to optimize the heating pattern of this EHA before it is used for human trials. The accuracy of the numerical modeling has been achieved by the good agreement between the MOM and FDTD results for the three-plate EHA without a biological body. The versatile FDTD technique is then applied to optimize the EHA design with a human body. Both the numerical and measured data in phantom blocks will be presented. The results of this study will be used to design an optimized system for whole body or regional hyperthermia.

Comparison of microwave and magnetic nanoparticle hyperthermia radiosensitization in murine breast tumors

Science.gov (United States)

Giustini, Andrew J.; Petryk, Alicia A.; Hoopes, Paul J.

2011-03-01

Hyperthermia has been shown to be an effective radiosensitizer. Its utility as a clinical modality has been limited by a minimally selective tumor sensitivity and the inability to be delivered in a tumor-specific manner. Recent in vivo studies (rodent and human) have shown that cancer cell-specific cytotoxicity can be effectively and safely delivered via iron oxide magnetic nanoparticles (mNP) and an appropriately matched noninvasive alternating magnetic field (AMF). To explore the tumor radiosensitization potential of mNP hyperthermia we used a syngeneic mouse breast cancer model, dextran-coated 110 nm hydrodynamic diameter mNP and a 169 kHz / 450 Oe (35.8 kA/m) AMF. Intradermally implanted (flank) tumors (150 +/- 40 mm3) were treated by injection of 0.04 ml mNP (7.5 mg Fe) / cm3 into the tumor and an AMF (35.8 kA/m and 169 kHz) exposure necessary to achieve a CEM (cumulative equivalent minute) thermal dose of 60 (CEM 60). Tumors were treated with mNP hyperthermia (CEM 60), radiation alone (15 Gy, single dose) and in combination. Compared to the radiation and heat alone treatments, the combined treatment resulted in a greater than two-fold increase in tumor regrowth tripling time (tumor treatment efficacy). None of the treatments resulted in significant normal tissue toxicity or morbidity. Studies were also conducted to compare the radiosensitization effect of mNP hyperthermia with that of microwave-induced hyperthermia. The effects of incubation of nanoparticles within tumors (to allow nanoparticles to be endocytosed) before application of AMF and radiation were determined. This preliminary information suggests cancer cell specific hyperthermia (i.e. antibody-directed or anatomically-directed mNP) is capable of providing significantly greater radiosensitization / therapeutic ratio enhancement than other forms of hyperthermia delivery.

Modification of radiosensitivity of mammalian cells by means of hyperthermia and chemical agent. Coordinated programme on improvement of cancer therapy by the combination of treatment by conventional radiation and physical or chemical means

International Nuclear Information System (INIS)

Djordjevic, O.

1984-11-01

The effect of the treatment of the cultured mammalian cells with a relatively new anti-cancer drug teniposide (VM26), radiation (4 Gy), hyperthermia (42 deg. C and 45 deg. C) and caffeine, in various combinations, has been studied. The following conclusions can be drawn from the data obtained: The cultured mammalian cells respond to the anti-cancer drug VM26 treatment in a dose and time dependent manner. Significant potentiation of cell killing was demonstrated when they are exposed simultaneously to VM26 and hyperthermia. Post-treatment incubation of the cells in non-toxic concentration of caffeine (2 mM) has produced a marked potentiation of the lethal effect, indicating that caffeine interferes with the repair processes in these cells. Combination of VM26, hyperthermia and caffeine produced a maximum killing effect compared to VM26 treatment only. When the cells are exposed to initial (90 min. at 42 deg. C or 40 min. at 45 deg. C) and subsequent hyperthermia (60 min. at 42 deg. C or 60 min. at 45 deg. C) the thermotolerance will develop depending on the degree of initial and subsequent temperature. The combination of hyperthermia with irradiation results in a potentiation of the effect of treatment compared to the treatment with only irradiation or hyperthermia. Maximum killing of the cells will be obtained when irradiation is applied immediately after hyperthermia. The results obtained should be regarded as useful in case of clinical application of the tested agents

Development of a Pneumatic Robot for MRI-guided Transperineal Prostate Biopsy and Brachytherapy: New Approaches

OpenAIRE

Song, Sang-Eun; Cho, Nathan B.; Fischer, Gregory; Hata, Nobuhito; Tempany, Clare; Fichtinger, Gabor; Iordachita, Iulian

2010-01-01

Magnetic Resonance Imaging (MRI) guided prostate biopsy and brachytherapy has been introduced in order to enhance the cancer detection and treatment. For the accurate needle positioning, a number of robotic assistants have been developed. However, problems exist due to the strong magnetic field and limited workspace. Pneumatically actuated robots have shown the minimum distraction in the environment but the confined workspace limits optimal robot design and thus controllability is often poor....

Preparation of Multifunctional Fe@Au Core-Shell Nanoparticles with Surface Grafting as a Potential Treatment for Magnetic Hyperthermia

Directory of Open Access Journals (Sweden)

Ren-Jei Chung

2014-01-01

Full Text Available Iron core gold shell nanoparticles grafted with Methotrexate (MTX and indocyanine green (ICG were synthesized for the first time in this study, and preliminarily evaluated for their potential in magnetic hyperthermia treatment. The core-shell Fe@Au nanoparticles were prepared via the microemulsion process and then grafted with MTX and ICG using hydrolyzed poly(styrene-alt-maleic acid (PSMA to obtain core-shell Fe@Au-PSMA-ICG/MTX nanoparticles. MTX is an anti-cancer therapeutic, and ICG is a fluorescent dye. XRD, TEM, FTIR and UV-Vis spectrometry were performed to characterize the nanoparticles. The data indicated that the average size of the nanoparticles was 6.4 ± 09 nm and that the Au coating protected the Fe core from oxidation. MTX and ICG were successfully grafted onto the surface of the nanoparticles. Under exposure to high frequency induction waves, the superparamagnetic nanoparticles elevated the temperature of a solution in a few minutes, which suggested the potential for an application in magnetic hyperthermia treatment. The in vitro studies verified that the nanoparticles were biocompatible; nonetheless, the Fe@Au-PSMA-ICG/MTX nanoparticles killed cancer cells (Hep-G2 via the magnetic hyperthermia mechanism and the release of MTX.

The Dartmouth Center for Cancer Nanotechnology Excellence: magnetic hyperthermia.

Science.gov (United States)

Baker, Ian; Fiering, Steve N; Griswold, Karl E; Hoopes, P Jack; Kekalo, Katerina; Ndong, Christian; Paulsen, Keith; Petryk, Alicea A; Pogue, Brian; Shubitidze, Fridon; Weaver, John

2015-01-01

The Dartmouth Center for Cancer Nanotechnology Excellence - one of nine funded by the National Cancer Institute as part of the Alliance for Nanotechnology in Cancer - focuses on the use of magnetic nanoparticles for cancer diagnostics and hyperthermia therapy. It brings together a diverse team of engineers and biomedical researchers with expertise in nanomaterials, molecular targeting, advanced biomedical imaging and translational in vivo studies. The goal of successfully treating cancer is being approached by developing nanoparticles, conjugating them with Fabs, hyperthermia treatment, immunotherapy and sensing treatment response.

Effects of hyperthermia on repair of radiation-induced DNA strand breaks

International Nuclear Information System (INIS)

Mills, M.D.; Meyn, R.E.

1981-01-01

Previous reports have suggested a relationship between the heat-induced changes in nucleoprotein and the hyperthermic enhancement of radiation sensitivity. In an effort to further understand these relationships, we measured the level of initial DNA strand break damage and the DNA strand break rejoining kinetics in Chinese hamster ovary cells following combined hyperthermia and ionizing radiation treatments. The amount of protein associated with DNA measured as the ratio of [ 3 H)leucine to [ 14 C]thymidine was also compared in chromatin isolated from both heated and unheated cells. The results of these experiments show that the initial level of radiation-induced DNA strand breaks is significantly enhanced by a prior hyperthermia treatment of 43 0 C for 30 min. Treatments at higher temperatures and longer treatments at the same temperature magnified this effect. Hyperthermia was also shown to cause a substantial inhibition of the DNA strand break rejoining after irradiation. Both the initial level of DNA damage and the rejoining kinetics recovered to normal levels with incubation at 37 0 C between the hyperthermia and radiation treatments. Recovery of these parameters coincided with the return of the amount of protein associated with DNA to normal values, further suggesting a relationship between the changes in nucleoprotein and the hyperthermic enhancement of radiation sensivivity

Clinically Relevant Pharmacological Strategies That Reverse MDMA-Induced Brain Hyperthermia Potentiated by Social Interaction.

Science.gov (United States)

Kiyatkin, Eugene A; Ren, Suelynn; Wakabayashi, Ken T; Baumann, Michael H; Shaham, Yavin

2016-01-01

MDMA-induced hyperthermia is highly variable, unpredictable, and greatly potentiated by the social and environmental conditions of recreational drug use. Current strategies to treat pathological MDMA-induced hyperthermia in humans are palliative and marginally effective, and there are no specific pharmacological treatments to counteract this potentially life-threatening condition. Here, we tested the efficacy of mixed adrenoceptor blockers carvedilol and labetalol, and the atypical antipsychotic clozapine, in reversing MDMA-induced brain and body hyperthermia. We injected rats with a moderate non-toxic dose of MDMA (9 mg/kg) during social interaction, and we administered potential treatment drugs after the development of robust hyperthermia (>2.5 °C), thus mimicking the clinical situation of acute MDMA intoxication. Brain temperature was our primary focus, but we also simultaneously recorded temperatures from the deep temporal muscle and skin, allowing us to determine the basic physiological mechanisms of the treatment drug action. Carvedilol was modestly effective in attenuating MDMA-induced hyperthermia by moderately inhibiting skin vasoconstriction, and labetalol was ineffective. In contrast, clozapine induced a marked and immediate reversal of MDMA-induced hyperthermia via inhibition of brain metabolic activation and blockade of skin vasoconstriction. Our findings suggest that clozapine, and related centrally acting drugs, might be highly effective for reversing MDMA-induced brain and body hyperthermia in emergency clinical situations, with possible life-saving results.

Radiation plus local hyperthermia versus radiation plus the combination of local and whole-body hyperthermia in canine sarcomas

International Nuclear Information System (INIS)

Thrall, Donald E.; Prescott, Deborah M.; Samulski, Thaddeus V.; Rosner, Gary L.; Denman, David L.; Legorreta, Roberto L.; Dodge, Richard K.; Page, Rodney L.; Cline, J. Mark; Lee Jihjong; Case, Beth C.; Evans, Sydney M.; Oleson, James R.; Dewhirst, Mark W.

1996-01-01

Purpose: The purpose of this study was to assess the effect of increasing intratumoral temperatures by the combination of local hyperthermia (LH) and whole body hyperthermia (WBH) on the radiation response of canine sarcomas. Methods and Materials: Dogs with spontaneous soft tissue sarcomas and no evidence of metastasis were randomized to be treated with radiation combined with either LH alone or LH + WBH. Dogs were accessioned for treatment at two institutions. The radiation dose was 56.25 Gy, given in 25 2.25 Gy daily fractions. Two hyperthermia treatments were given; one during the first and one during the last week of treatment. Dogs were evaluated after treatment for local recurrence, metastasis, and complications. Results: Sixty-four dogs were treated between 1989 and 1993. The use of LH+WBH resulted in statistically significant increases in the low and middle regions of the temperature distributions. The largest increase was in the low temperatures with median CEM 43 T90 values of 4 vs. 49 min for LH vs. LH + WBH, respectively (p < 0.001). There was no difference in duration of local tumor control between hyperthermia groups (p = 0.59). The time to metastasis was shorter for dogs receiving LH + WBH (p = 0.02); the hazard ratio for metastatic disease for dogs in the LH + WBH group was 2.5 (95% confidence interval, 1.2-5.4) with respect to dogs in the LH group. Complications were greater in larger tumors and in tumors treated with LH + WBH. Conclusion: The combination of LH + WBH with radiation therapy, as described herein, was not associated with an increase in local tumor control in comparison to use of LH with radiation therapy. The combination of LH + WBH also appeared to alter the biology of the metastatic process and was associated with more complications than LH. We identified no rationale for further study of LH + WBH in combination with radiation for treatment of solid tumors

Positioning device for MRI-guided high intensity focused ultrasound system

Energy Technology Data Exchange (ETDEWEB)

Damianou, Christakis [Frederick Institute of Technology (FIT), Limassol (Cyprus); MEDSONIC, LTD, Limassol (Cyprus); Ioannides, Kleanthis [Polikliniki Igia, Limassol (Cyprus); Milonas, Nicos [Frederick Institute of Technology (FIT), Limassol (Cyprus)

2008-04-15

A prototype magnetic resonance imaging (MRI)- compatible positioning device was used to move an MRI-guided high intensity focused ultrasound (HIFU) transducer. The positioning device has three user-controlled degrees of freedom that allow access to various targeted lesions. The positioning device was designed and fabricated using construction materials selected for compatibility with high magnetic fields and fast switching magnetic field gradients encountered inside MRI scanners. The positioning device incorporates only MRI compatible materials such as piezoelectric motors, plastic sheets, brass screws, plastic pulleys and timing belts. The HIFU/MRI system includes the multiple subsystems (a) HIFU system, (b) MR imaging, (c) Positioning device (robot) and associate drivers, (d) temperature measurement, (e) cavitation detection, (f) MRI compatible camera, and (g) Soft ware. The MRI compatibility of the system was successfully demonstrated in a clinical high-field MRI scanner. The ability of the robot to accurately move the transducer thus creating discrete and overlapping lesions in biological tissue was tested successfully. A simple, cost effective, portable positioning device has been developed which can be used in virtually any clinical MRI scanner since it can be sited on the scanner's table. The propagation of HIFU can use either a lateral or superior-inferior approach. Discrete and large lesions were created successfully with reproducible results. (orig.)

Multiparametric MRI fusion-guided biopsy for the diagnosis of prostate cancer.

Science.gov (United States)

Kesch, Claudia; Schütz, Viktoria; Dieffenbacher, Svenja; Bonekamp, David; Hadaschik, Boris Alexander; Hohenfellner, Markus; Radtke, Jan P

2018-03-01

To discuss the timing, benefits, limitations and current controversies of multiparametric magnet resonance imaging (mpMRI) combined with fusion-guided biopsy and consider how additional incorporation of multivariable risk stratification might further improve prostate cancer diagnosis. MpMRI has been proven advantageous over standard practice for biopsy-naïve men and men with previous biopsy in large prospective studies providing level 1b evidence. Upfront multivariable risk stratification followed by or combined with mpMRI further improves diagnostic accuracy. Regarding active surveillance, mpMRI in combination with fusion biopsy can support initial candidate selection and may help to monitor disease progression. mpMRI and fusion biopsy, however, do not spare failure and conflicting data exists to what extend (systematic) biopsies can be omitted. Integration of mpMRI into the diagnostic pathway for prostate cancer is beneficial; yet more prospective and randomized data is needed to establish reliable procedure standards after mpMRI acquisition.

Early experience in the combination of regional hyperthermia and radiotherapy

International Nuclear Information System (INIS)

Howard, G.C.W.; Bleehen, N.M.

1987-01-01

An annular array of radiative radiofrequency applicators (APA) has been developed by the BSD Corporation, Salt Lake City (USA) which has been shown to be capable of deep heating. The BSD 1000 clinical hyperthermia system has been installed at Cambridge for 18 months and a pilot study has been performed to assess the feasibility of pelvic regional hyperthermia in the treatment of extensive pelvic malignancy. The study confirms published data that the APA is capable of heating at depth within the pelvis. Therapeutic temperatures may be reached in the majority of treatments but are difficult to maintain due to acute toxicity. Steering of the area of maximal energy deposition may improve treatments considerably. A randomised trial is now being designed to assess whether the synergism between radiation and hyperthermia seen in superficial lesions can be demonstrated in tumours occurring in the pelvis. (orig./MG)

Totally Accessible MRI A User's Guide to Principles, Technology, and Applications

CERN Document Server

Lipton, Michael L

2008-01-01

This is a practical guide that offers a lucid introduction to the principles of MRI physics. The author, recognized in the imaging community for his exceptional teaching methods and lectures, has written an easy to understand text. Each chapter explains the "why" and "how" behind MRI physics. Readers will understand how altering MRI parameters will have many different consequences for image quality and the speed in which images are generated. Practical topics, selected for their value to clinical practice, include progressive changes in key MRI parameters, imaging time, and signal to noise ratio. A wealth of high quality illustrations, complemented by concise text, enables readers to gain a thorough understanding of the subject without requiring prior in-depth knowledge

MRI-guided trephine biopsy and fine-needle aspiration in the diagnosis of bone lesions in low-field (0.23 T) MRI system using optical instrument tracking

International Nuclear Information System (INIS)

Blanco Sequeiros, Roberto; Klemola, Rauli; Ojala, Risto; Jyrkinen, Lasse; Tervonen, Osmo; Lappi-Blanco, Elisa; Soini, Ylermi

2002-01-01

The purpose of this study was to evaluate the feasibility of MRI-guided bone biopsy with optical instrument tracking and evaluate advantage of combined fine-needle aspiration (FNA) with trephine biopsy. Twenty trephine bone biopsies and 13 FNAs were performed under MRI and CT guidance in 14 patients. Informed consent was obtained from all patients. The evaluation of diagnostic accuracy was achieved by comparing the histopathological and cytological diagnosis with current or final diagnosis made during 6-month clinical follow-up. A 0.23-T open MRI scanner with interventional tools (Outlook Proview, Marconi Medical Systems, Cleveland, Ohio) was used. A surface coil was used. For trephine biopsy MRI-compatible bone biopsy set (Daum medical, Schwerin, Germany) was used. The FNA was performed with MRI compatible 20-G needle (Cook, Bloomington, Ind.). The diagnostic accuracy of MRI-guided trephine biopsy was 95%. The FNA sample diagnosis concurred with the histological in 54%. Our results show that MRI guidance in bone biopsies is accurate and safe. It is comparable to CT-guided or open biopsy. The role of combined FNA with bone biopsies remains controversial. (orig.)

Hyperthermia generated by Foucault currents for oncological treatments with COMSOL

International Nuclear Information System (INIS)

Romero C, R. L.; Cordova F, T.; Basurto I, G.; Guzman C, R.; Castro L, J.

2017-10-01

The hyperthermia generated by variable magnetic fields is a promising power method for oncological therapy, because apoptosis is induced in tumor cells at temperatures between 42 and 45 degrees Celsius. It is known that an alternating magnetic field on the FeO 4 magnetite particles produces heat through three paths: is generated by parasitic currents, lost in hysteresis cycles and losses by magnetization relaxation; taking advantage of the energy losses through the joule effect and the transformation into heat, a simulation is shown in COMSOL about the temporal distribution of temperature in transformed biological systems, to have an estimate of the properties and behavior of the temperature gradient when magnetic hyperthermia is generated in human transformed tissue. (Author)

FDTD analysis of a noninvasive hyperthermia system for brain tumors.

Science.gov (United States)

Yacoob, Sulafa M; Hassan, Noha S

2012-08-14

Hyperthermia is considered one of the new therapeutic modalities for cancer treatment and is based on the difference in thermal sensitivity between healthy tissues and tumors. During hyperthermia treatment, the temperature of the tumor is raised to 40-45°C for a definite period resulting in the destruction of cancer cells. This paper investigates design, modeling and simulation of a new non-invasive hyperthermia applicator system capable of effectively heating deep seated as well as superficial brain tumors using inexpensive, simple, and easy to fabricate components without harming surrounding healthy brain tissues. The proposed hyperthermia applicator system is composed of an air filled partial half ellipsoidal chamber, a patch antenna, and a head model with an embedded tumor at an arbitrary location. The irradiating antenna is placed at one of the foci of the hyperthermia chamber while the center of the brain tumor is placed at the other focus. The finite difference time domain (FDTD) method is used to compute both the SAR patterns and the temperature distribution in three different head models due to two different patch antennas at a frequency of 915 MHz. The obtained results suggest that by using the proposed noninvasive hyperthermia system it is feasible to achieve sufficient and focused energy deposition and temperature rise to therapeutic values in deep seated as well as superficial brain tumors without harming surrounding healthy tissue. The proposed noninvasive hyperthermia system proved suitable for raising the temperature in tumors embedded in the brain to therapeutic values by carefully selecting the systems components. The operator of the system only needs to place the center of the brain tumor at a pre-specified location and excite the antenna at a single frequency of 915 MHz. Our study may provide a basis for a clinical applicator prototype capable of heating brain tumors.

TH-F-202-01: MRI Basics

International Nuclear Information System (INIS)

Miller, W.

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

TH-F-202-01: MRI Basics

Energy Technology Data Exchange (ETDEWEB)

Miller, W. [University of Virginia School of Medicine (United States)

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

Analysis of histological findings obtained combining US/mp-MRI fusion-guided biopsies with systematic US biopsies: mp-MRI role in prostate cancer detection and false negative.

Science.gov (United States)

Faiella, Eliodoro; Santucci, Domiziana; Greco, Federico; Frauenfelder, Giulia; Giacobbe, Viola; Muto, Giovanni; Zobel, Bruno Beomonte; Grasso, Rosario Francesco

2018-02-01

To evaluate the diagnostic accuracy of mp-MRI correlating US/mp-MRI fusion-guided biopsy with systematic random US-guided biopsy in prostate cancer diagnosis. 137 suspected prostatic abnormalities were identified on mp-MRI (1.5T) in 96 patients and classified according to PI-RADS score v2. All target lesions underwent US/mp-MRI fusion biopsy and prostatic sampling was completed by US-guided systematic random 12-core biopsies. Histological analysis and Gleason score were established for all the samples, both target lesions defined by mp-MRI, and random biopsies. PI-RADS score was correlated with the histological results, divided in three groups (benign tissue, atypia and carcinoma) and with Gleason groups, divided in four categories considering the new Grading system of the ISUP 2014, using t test. Multivariate analysis was used to correlate PI-RADS and Gleason categories to PSA level and abnormalities axial diameter. When the random core biopsies showed carcinoma (mp-MRI false-negatives), PSA value and lesions Gleason median value were compared with those of carcinomas identified by mp-MRI (true-positives), using t test. There was statistically significant difference between PI-RADS score in carcinoma, atypia and benign lesions groups (4.41, 3.61 and 3.24, respectively) and between PI-RADS score in Gleason  7 group (4.14 and 4.79, respectively). mp-MRI performance was more accurate for lesions > 15 mm and in patients with PSA > 6 ng/ml. In systematic sampling, 130 (11.25%) mp-MRI false-negative were identified. There was no statistic difference in Gleason median value (7.0 vs 7.06) between this group and the mp-MRI true-positives, but a significant lower PSA median value was demonstrated (7.08 vs 7.53 ng/ml). mp-MRI remains the imaging modality of choice to identify PCa lesions. Integrating US-guided random sampling with US/mp-MRI fusion target lesions sampling, 3.49% of false-negative were identified.

Magneticresonanceimaging-guided percutaneouscryoablationofhepatocellular carcinomainspecialregions

Institute of Scientific and Technical Information of China (English)

Bin Wu; Yue-Yong Xiao; Xiao Zhang; Ai-Lian Zhang; Hong-Jun Li; Deng-Fa Gao

2010-01-01

BACKGROUND:Local cryoablation guided by CT or ultrasound has been widely applied in the treatment of hepatocellular carcinoma. However, it is still dififcult to apply this technique in certain regions such as the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. This study aimed to evaluate the safety and efifcacy of using magnetic resonance imaging (MRI)-guided percutaneous cryoablation as well as the effect of using an open MRI system in guiding and monitoring the treatment of hepatocellular carcinoma in these regions. METHODS:Cryoablation, guided by an open 0.35T MRI scanner and with the assistance of an MRI-compatible optical navigation system, was performed on 32 patients with hepatocellular carcinoma at the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. Each patient had one or two tumors. The total number of tumors treated was 36. The tumor diameters ranged from 2.5 to 10.0 cm (mean 4.7±1.8 cm). The cryosurgical system was MRI-compatible and equipped with cryoprobes 1.47 mm in outside diameter. Under the guidance of MRI in combination with the optical navigation system, the cryoprobes were introduced percutaneously into a tumor at the planned targeting points while critical organs or tissues were avoided. Each cryoablation procedure included two freezing-thawing cycles, and MRI images were acquired dynamically to monitor the ablation of the tumor from time to time during the operation. In order to investigate the therapeutic effects of a cryoablation procedure, AFP measurements and liver-enhanced MRI or CT-enhanced scans were performed at regular times. RESULTS:MRI and optical navigation system-guided cryo-ablation procedures were successfully performed on all 32 patients (36 tumor sites) and no serious complications occurred. The follow-up period ranged from 5 to 12 months. The 6-and 12-month overall survival rates were 96.8%and 90.6%, respectively. According to the diagnosis of liver

Re-irradiation and hyperthermia after surgery for recurrent breast cancer

International Nuclear Information System (INIS)

Linthorst, Marianne; Geel, Albert N. van; Baaijens, Margreet; Ameziane, Ali; Ghidey, Wendim; Rhoon, Gerard C. van; Zee, Jacoba van der

2013-01-01

Purpose: Evaluation of efficacy and side effects of combined re-irradiation and hyperthermia electively or for subclinical disease in the management of locoregional recurrent breast cancer. Methods and materials: Records of 198 patients with recurrent breast cancer treated with re-irradiation and hyperthermia from 1993 to 2010 were reviewed. Prior treatments included surgery (100%), radiotherapy (100%), chemotherapy (42%), and hormonal therapy (57%). Ninety-one patients were treated for microscopic residual disease following resection or systemic therapy and 107 patients were treated electively for areas at high risk for local recurrences. All patients were re-irradiated to 28–36 Gy (median 32) and treated with 3–8 hyperthermia treatments (mean 4.36). Forty percent of the patients received concurrent hormonal therapy. Patient and tumor characteristics predictive for actuarial local control (LC) and toxicity were studied in univariate and multivariate analysis. Results: The median follow-up was 42 months. Three and 5 year LC-rates were 83% and 78%. Mean of T90 (tenth percentile of temperature distribution), maximum and average temperatures were 39.8 °C, 43.6 °C, and 41.2 °C, respectively. Mean of the cumulative equivalent minutes (CEM43) at T90 was 4.58 min. Number of previous chemotherapy and surgical procedures were most predictive for LC. Cumulative incidence of grade 3 and 4 late toxicity at 5 years was 11.9%. The number of thermometry sensors and depth of treatment volume were associated with acute hyperthermia toxicity. Conclusions: The combination of re-irradiation and hyperthermia results in a high LC-rate with acceptable toxicity

Experimental validation of hyperthermia SAR treatment planning using MR B1+ imaging

International Nuclear Information System (INIS)

Berg, Cornelis A T van den; Bartels, Lambertus W; Leeuw, Astrid A C De; Lagendijk, Jan J W; Kamer, Jeroen B Van de

2004-01-01

In this paper the concept of using B 1+ imaging as a means to validate SAR models for radiofrequency hyperthermia is presented. As in radiofrequency hyperthermia, in common clinical MR imaging which applies RF frequencies between 64 and 128 MHz, the RF field distribution inside a patient is largely determined by the dielectric distribution of the anatomy. Modern MR imaging techniques allow measurement of the RF magnetic field component B 1+ making it possible to measure at high resolution the dielectric interaction of the RF field with the patient. Given these considerations, we propose to use MR imaging to verify the validity of our dielectric patient model used for SAR models of radiofrequency hyperthermia. The aim of this study was to investigate the feasibility of this concept by performing B 1+ measurements and simulations on cylindrical split phantoms consisting of materials with dielectric properties similar to human tissue types. Important topics of investigation were the accuracy and sensitivity of B 1+ measurements and the validity of the electric model of the MR body coil. The measurements were performed on a clinical 1.5 T MR scanner with its quadrature body coil operating at 64 MHz. It was shown that even small B 1+ variations of 2 to 5% could be measured reliably in the phantom experiments. An electrical model of the transmit coil was implemented on our FDTD-based hyperthermia treatment planning platform and the RF field distributions were calculated assuming an idealized quadrature current distribution in the coil. A quantitatively good correlation between measurements and simulations was found for phantoms consisting of water and oil, while highly conductive phantoms show considerable deviations. However, assuming linear excitation for these conductive phantoms resulted in good correspondence. As an explanation it is suggested that the coil is being detuned due to the inductive nature of the conductive phantoms, breaking up the phase difference of �

A novel approach of fMRI-guided tractography analysis within a group: construction of an fMRI-guided tractographic atlas.

Science.gov (United States)

Preti, Maria Giulia; Makris, Nikos; Laganà, Maria Marcella; Papadimitriou, George; Baglio, Francesca; Griffanti, Ludovica; Nemni, Raffaello; Cecconi, Pietro; Westin, Carl-Fredrik; Baselli, Giuseppe

2012-01-01

Diffusion Tensor Imaging (DTI) tractography and functional Magnetic Resonance Imaging (fMRI) investigate two complementary aspects of brain networks: white matter (WM) anatomical connectivity and gray matter (GM) function. However, integration standards have yet to be defined; namely, individual fMRI-driven tractography is usually applied and only few studies address group analysis. This work proposes an efficient method of fMRI-driven tractography at group level through the creation of a tractographic atlas starting from the GM areas activated by a verbal fluency task in 11 healthy subjects. The individual tracts were registered to the MNI space. Selection ROIs derived by GM masking and dilation of group activated areas were applied to obtain the fMRI-driven subsets within tracts. An atlas of the tracts recruited among the population was obtained by selecting for each subject the fMRI-guided tracts passing through the high probability voxels (the voxels recruited by the 90% of the subjects) and merging them together. The reliability of this approach was assessed by comparing it with the probabilistic atlas previously introduced in literature. The introduced method allowed to successfully reconstruct activated tracts, which comprehended corpus callosum, left cingulum and arcuate, a small portion of the right arcuate, both cortico-spinal tracts and inferior fronto-occipital fasciculi. Moreover, it proved to give results concordant with the previously introduced probabilistic approach, allowing in addition to reconstruct 3D trajectories of the activated fibers, which appear particularly helpful in the detection of WM connections.

Chemo-radiotherapy plus hyperthermia in locally advanced cervical cancer: preliminary results of an institutional phase II study

International Nuclear Information System (INIS)

Gabbani, M.; Marciai, N.; Maluta, S.; Griso, C.; Merlin, F.; Cassandrini, P.; Giudici, S.; Franchi, M.; Zanini, L.

2005-01-01

Full text: Radiotherapy given concurrently with a cisplatin-based regimen has shown a benefit in patients with locally advanced cervical cancer so becoming the new standard treatment according to EBM criteria. Addition of hyperthermia to radiotherapy has also been proved to yield an advantage in survival and local control in pts affected by recurrent and local advanced cervical cancer in the Dutch Phase III trial so that the Consensus Forum of Kadota (Osaha June 2004) included cervical cancer among tumors treatable with hyperthermia. In our institutional multidisciplinary team a pilot study has been designed in order to evaluate feasibility, outcome and toxicity of tri-modality treatment in pts with locally advanced cervical cancer in our daily practice. Since January 2003 to now eight patients affected by cervical cancer with stage IB2 through IVA N0-N+ pelvic or paraaortic were entered the study. Six patients were treated at initial diagnosis and two patients after chemotherapy which had achieved stable disease. Treatment regimen consisted in 5 courses of weekly chemotherapy (cisplatin 40 mg/mq) with concurrent external radiotherapy to a total dose of 64-66 Gy on CTV1 and 45 Gy on para-aortic nodes plus boost in pts with enlarged nodes identified by imaging. Five weekly sessions of hyperthermia were performed by using BSD 2000 system and sigma 60 applicator. No significant toxicity occurred and all of the patients completed tri-modality treatment in accordance with the study protocol. Seven pts experienced a complete clinical remission and one patient a partial remission as defined by clinical and imaging examinations. After four months from the end of the treatment a patient with Stage IIB bulky tumor plus one pelvic positive node who was in complete remission (Clinical examination, MRI and TAC-PET three months from the end of the treatment were negative for evidence of disease) developed a bleeding recto-vaginal fistula plus central pelvic necrosis for which an

Piezoelectrically Actuated Robotic System for MRI-Guided Prostate Percutaneous Therapy

Science.gov (United States)

Su, Hao; Shang, Weijian; Cole, Gregory; Li, Gang; Harrington, Kevin; Camilo, Alexander; Tokuda, Junichi; Tempany, Clare M.; Hata, Nobuhiko; Fischer, Gregory S.

2014-01-01

This paper presents a fully-actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the surgical workflow of intra-operative MRI-guided surgical procedures. We present the development of a 6-degree-of-freedom (DOF) needle placement robot for transperineal prostate interventions. The robot consists of a 3-DOF needle driver module and a 3-DOF Cartesian motion module. The needle driver provides needle cannula translation and rotation (2-DOF) and stylet translation (1-DOF). A custom robot controller consisting of multiple piezoelectric motor drivers provides precision closed-loop control of piezoelectric motors and enables simultaneous robot motion and MR imaging. The developed modular robot control interface software performs image-based registration, kinematics calculation, and exchanges robot commands and coordinates between the navigation software and the robot controller with a new implementation of the open network communication protocol OpenIGTLink. Comprehensive compatibility of the robot is evaluated inside a 3-Tesla MRI scanner using standard imaging sequences and the signal-to-noise ratio (SNR) loss is limited to 15%. The image deterioration due to the present and motion of robot demonstrates unobservable image interference. Twenty-five targeted needle placements inside gelatin phantoms utilizing an 18-gauge ceramic needle demonstrated 0.87 mm root mean square (RMS) error in 3D Euclidean distance based on MRI volume segmentation of the image-guided robotic needle placement procedure. PMID:26412962

Temperature simulations in hyperthermia treatment planning of the head and neck region. Rigorous optimization of tissue properties

International Nuclear Information System (INIS)

Verhaart, Rene F.; Rijnen, Zef; Verduijn, Gerda M.; Paulides, Margarethus M.; Fortunati, Valerio; Walsum, Theo van; Veenland, Jifke F.

2014-01-01

Hyperthermia treatment planning (HTP) is used in the head and neck region (H and N) for pretreatment optimization, decision making, and real-time HTP-guided adaptive application of hyperthermia. In current clinical practice, HTP is based on power-absorption predictions, but thermal dose-effect relationships advocate its extension to temperature predictions. Exploitation of temperature simulations requires region- and temperature-specific thermal tissue properties due to the strong thermoregulatory response of H and N tissues. The purpose of our work was to develop a technique for patient group-specific optimization of thermal tissue properties based on invasively measured temperatures, and to evaluate the accuracy achievable. Data from 17 treated patients were used to optimize the perfusion and thermal conductivity values for the Pennes bioheat equation-based thermal model. A leave-one-out approach was applied to accurately assess the difference between measured and simulated temperature (∇T). The improvement in ∇T for optimized thermal property values was assessed by comparison with the ∇T for values from the literature, i.e., baseline and under thermal stress. The optimized perfusion and conductivity values of tumor, muscle, and fat led to an improvement in simulation accuracy (∇T: 2.1 ± 1.2 C) compared with the accuracy for baseline (∇T: 12.7 ± 11.1 C) or thermal stress (∇T: 4.4 ± 3.5 C) property values. The presented technique leads to patient group-specific temperature property values that effectively improve simulation accuracy for the challenging H and N region, thereby making simulations an elegant addition to invasive measurements. The rigorous leave-one-out assessment indicates that improvements in accuracy are required to rely only on temperature-based HTP in the clinic. (orig.) [de

Ultrasound-guided percutaneous treatment of hepatocellular carcinoma by radiofrequency hyperthermia with a 'cooled-tip needle'. A preliminary clinical experience.

Science.gov (United States)

Francica, G; Marone, G

1999-05-01

three recorded deaths, two were due to intrahepatic tumor diffusion. In our experience radiofrequency hyperthermia with the cooled-tip needle afforded an effective and safe percutaneous ablative method for HCC in cirrhosis and shortened treatment time.

3D-Printed Patient-Specific ACL Femoral Tunnel Guide from MRI.

Science.gov (United States)

Rankin, Iain; Rehman, Haroon; Frame, Mark

2018-01-01

Traditional ACL reconstruction with non-anatomic techniques can demonstrate unsatisfactory long-term outcomes with regards instability and the degenerative knee changes observed with these results. Anatomic ACL reconstruction attempts to closely reproduce the patient's individual anatomic characteristics with the aim of restoring knee kinematics, in order to improve patient short and long-term outcomes. We designed an arthroscopic, patient-specific, ACL femoral tunnel guide to aid anatomical placement of the ACL graft within the femoral tunnel. The guide design was based on MRI scan of the subject's uninjured contralateral knee, identifying the femoral footprint and its anatomical position relative to the borders of the femoral articular cartilage. Image processing software was used to create a 3D computer aided design which was subsequently exported to a 3D-printing service. Transparent acrylic based photopolymer, PA220 plastic and 316L stainless steel patient-specific ACL femoral tunnel guides were created; the models produced were accurate with no statistical difference in size and positioning of the center of the ACL femoral footprint guide to MRI ( p =0.344, p =0.189, p =0.233 respectively). The guides aim to provide accurate marking of the starting point of the femoral tunnel in arthroscopic ACL reconstruction. This study serves as a proof of concept for the accurate creation of 3D-printed patient-specific guides for the anatomical placement of the femoral tunnel during ACL reconstruction.

MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults

Energy Technology Data Exchange (ETDEWEB)

Shenoy-Bhangle, Anuradha; Nimkin, Katherine; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Department of Radiology, Boston, MA (United States); Goldner, Dana; Israel, Esther J. [Massachusetts General Hospital for Children, Harvard Medical School, Department of Pediatrics, Boston, MA (United States); Bradley, William F. [Analog Devices, Lyric Labs, Cambridge, MA (United States)

2014-01-15

Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease. (orig.)

MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults

International Nuclear Information System (INIS)

Shenoy-Bhangle, Anuradha; Nimkin, Katherine; Gee, Michael S.; Goldner, Dana; Israel, Esther J.; Bradley, William F.

2014-01-01

Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease. (orig.)

Hormonal, Biochemical and Haematological Changes in Response to Acute Hyperthermia in Rabbits

International Nuclear Information System (INIS)

Zahran, N.A.R.M.

2004-01-01

Today, hyperthermia plays a significant role in the evidence-based on treatment of cancer patients. Such promising endeavor is due to the fact that neoplastic cells are more heat sensitive than normal cells. the prospect of using hyperthermia alone to treat cancer tumours is appealing because hyperthermia is a physical treatment and so would have fewer side effects than chemotherapy or radiotherapy and, it could be used in combination with these therapeutic approaches. much more consistent evidence has been obtained experimentally, and continuing clinical interest has been encouraged by confirmation that, at relatively low temperature (37-41.5 C), heat enhances cell growth and may well enhance also the growth and proliferation of tumours, while above 45 C heat begins to damage both normal and malignant cells in both animal and human. So, the goal is to achieve a selective temperature elevation between 42-45 C at the tumour site while maintaining healthy tissue temperatures in a physiological save range.This study was undertaken to investigate the effect of acute whole body hyperthermia , (WBH) (rectal temperature 43 c) on biochemical , hormonal and haematological changes in normal healthy local strain (baladi) rabbits.The thermal late effects (recovery) at 24 hr-post whole body hyperthermia was also undertaken , in the attempt to evaluate the degree of safety , when hyperthermia is applied in the clinic for treating cancer and other diseases

Simple and Rapid Synthesis of Magnetite/Hydroxyapatite Composites for Hyperthermia Treatments via a Mechanochemical Route

Science.gov (United States)

Iwasaki, Tomohiro; Nakatsuka, Ryo; Murase, Kenya; Takata, Hiroshige; Nakamura, Hideya; Watano, Satoru

2013-01-01

This paper presents a simple method for the rapid synthesis of magnetite/hydroxyapatite composite particles. In this method, superparamagnetic magnetite nanoparticles are first synthesized by coprecipitation using ferrous chloride and ferric chloride. Immediately following the synthesis, carbonate-substituted (B-type) hydroxyapatite particles are mechanochemically synthesized by wet milling dicalcium phosphate dihydrate and calcium carbonate in a dispersed suspension of magnetite nanoparticles, during which the magnetite nanoparticles are incorporated into the hydroxyapatite matrix. We observed that the resultant magnetite/hydroxyapatite composites possessed a homogeneous dispersion of magnetite nanoparticles, characterized by an absence of large aggregates. When this material was subjected to an alternating magnetic field, the heat generated increased with increasing magnetite concentration. For a magnetite concentration of 30 mass%, a temperature increase greater than 20 K was achieved in less than 50 s. These results suggest that our composites exhibit good hyperthermia properties and are promising candidates for hyperthermia treatments. PMID:23629669

Simple and Rapid Synthesis of Magnetite/Hydroxyapatite Composites for Hyperthermia Treatments via a Mechanochemical Route

Directory of Open Access Journals (Sweden)

Tomohiro Iwasaki

2013-04-01

Full Text Available This paper presents a simple method for the rapid synthesis of magnetite/hydroxyapatite composite particles. In this method, superparamagnetic magnetite nanoparticles are first synthesized by coprecipitation using ferrous chloride and ferric chloride. Immediately following the synthesis, carbonate-substituted (B-type hydroxyapatite particles are mechanochemically synthesized by wet milling dicalcium phosphate dihydrate and calcium carbonate in a dispersed suspension of magnetite nanoparticles, during which the magnetite nanoparticles are incorporated into the hydroxyapatite matrix. We observed that the resultant magnetite/hydroxyapatite composites possessed a homogeneous dispersion of magnetite nanoparticles, characterized by an absence of large aggregates. When this material was subjected to an alternating magnetic field, the heat generated increased with increasing magnetite concentration. For a magnetite concentration of 30 mass%, a temperature increase greater than 20 K was achieved in less than 50 s. These results suggest that our composites exhibit good hyperthermia properties and are promising candidates for hyperthermia treatments.

MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

Energy Technology Data Exchange (ETDEWEB)

Spick, Claudio; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna (AKH), General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Wien (Austria); Rudas, Margaretha [Medical University of Vienna (AKH), Clinical Institute of Pathology, Wien (Austria)

2014-06-15

To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI). This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis. Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53 ± 0.38 x 10{sup -3} mm{sup 2}/s in benign lesions and 1.06 ± 0.27 x 10{sup -3} mm{sup 2}/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58 x 10{sup -3} mm{sup 2}/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis. Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols. (orig.)

Hybrid Approach for Biliary Interventions Employing MRI-Guided Bile Duct Puncture with Near-Real-Time Imaging

Energy Technology Data Exchange (ETDEWEB)

Wybranski, Christian, E-mail: Christian.Wybranski@uk-koeln.de [University Hospital of Cologne, Department of Diagnostic and Interventional Radiology (Germany); Pech, Maciej [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany); Lux, Anke [Otto-von-Guericke University Medical School, Institute of Biometry and Medical Informatics (Germany); Ricke, Jens; Fischbach, Frank; Fischbach, Katharina [Otto-von-Guericke University Medical School, Department of Radiology and Nuclear Medicine (Germany)

2017-06-15

ObjectiveTo assess the feasibility of a hybrid approach employing MRI-guided bile duct (BD) puncture for subsequent fluoroscopy-guided biliary interventions in patients with non-dilated (≤3 mm) or dilated BD (≥3 mm) but unfavorable conditions for ultrasonography (US)-guided BD puncture.MethodsA total of 23 hybrid interventions were performed in 21 patients. Visualization of BD and puncture needles (PN) in the interventional MR images was rated on a 5-point Likert scale by two radiologists. Technical success, planning time, BD puncture time and positioning adjustments of the PN as well as technical success of the biliary intervention and complication rate were recorded.ResultsVisualization even of third-order non-dilated BD and PN was rated excellent by both radiologists with good to excellent interrater agreement. MRI-guided BD puncture was successful in all cases. Planning and BD puncture times were 1:36 ± 2.13 (0:16–11:07) min. and 3:58 ± 2:35 (1:11–9:32) min. Positioning adjustments of the PN was necessary in two patients. Repeated capsular puncture was not necessary in any case. All biliary interventions were completed successfully without major complications.ConclusionA hybrid approach which employs MRI-guided BD puncture for subsequent fluoroscopy-guided biliary intervention is feasible in clinical routine and yields high technical success in patients with non-dilated BD and/or unfavorable conditions for US-guided puncture. Excellent visualization of BD and PN in near-real-time interventional MRI allows successful cannulation of the BD.

Edge-oriented dual-dictionary guided enrichment (EDGE) for MRI-CT image reconstruction.

Science.gov (United States)

Li, Liang; Wang, Bigong; Wang, Ge

2016-01-01

In this paper, we formulate the joint/simultaneous X-ray CT and MRI image reconstruction. In particular, a novel algorithm is proposed for MRI image reconstruction from highly under-sampled MRI data and CT images. It consists of two steps. First, a training dataset is generated from a series of well-registered MRI and CT images on the same patients. Then, an initial MRI image of a patient can be reconstructed via edge-oriented dual-dictionary guided enrichment (EDGE) based on the training dataset and a CT image of the patient. Second, an MRI image is reconstructed using the dictionary learning (DL) algorithm from highly under-sampled k-space data and the initial MRI image. Our algorithm can establish a one-to-one correspondence between the two imaging modalities, and obtain a good initial MRI estimation. Both noise-free and noisy simulation studies were performed to evaluate and validate the proposed algorithm. The results with different under-sampling factors show that the proposed algorithm performed significantly better than those reconstructed using the DL algorithm from MRI data alone.

Utility and translatability of mathematical modeling, cell culture and small and large animal models in magnetic nanoparticle hyperthermia cancer treatment research

Science.gov (United States)

Hoopes, P. J.; Petryk, Alicia A.; Misra, Adwiteeya; Kastner, Elliot J.; Pearce, John A.; Ryan, Thomas P.

2015-03-01

For more than 50 years, hyperthermia-based cancer researchers have utilized mathematical models, cell culture studies and animal models to better understand, develop and validate potential new treatments. It has been, and remains, unclear how and to what degree these research techniques depend on, complement and, ultimately, translate accurately to a successful clinical treatment. In the past, when mathematical models have not proven accurate in a clinical treatment situation, the initiating quantitative scientists (engineers, mathematicians and physicists) have tended to believe the biomedical parameters provided to them were inaccurately determined or reported. In a similar manner, experienced biomedical scientists often tend to question the value of mathematical models and cell culture results since those data typically lack the level of biologic and medical variability and complexity that are essential to accurately study and predict complex diseases and subsequent treatments. Such quantitative and biomedical interdependence, variability, diversity and promise have never been greater than they are within magnetic nanoparticle hyperthermia cancer treatment. The use of hyperthermia to treat cancer is well studied and has utilized numerous delivery techniques, including microwaves, radio frequency, focused ultrasound, induction heating, infrared radiation, warmed perfusion liquids (combined with chemotherapy), and, recently, metallic nanoparticles (NP) activated by near infrared radiation (NIR) and alternating magnetic field (AMF) based platforms. The goal of this paper is to use proven concepts and current research to address the potential pathobiology, modeling and quantification of the effects of treatment as pertaining to the similarities and differences in energy delivered by known external delivery techniques and iron oxide nanoparticles.

WE-EF-BRD-02: Battling Maxwell’s Equations: Physics Challenges and Solutions for Hybrid MRI Systems

Energy Technology Data Exchange (ETDEWEB)

Keall, P. [University of Sydney (Australia)

2015-06-15

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

WE-EF-BRD-02: Battling Maxwell’s Equations: Physics Challenges and Solutions for Hybrid MRI Systems

International Nuclear Information System (INIS)

Keall, P.

2015-01-01

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php

Effect of hyperthermia on radiation damage and its repair in Tribolium confusum

International Nuclear Information System (INIS)

Lai, P.K.

1977-01-01

A series of temperature tolerance curves from 43.5 0 C to 46.0 0 C in 0.5 0 C increment were determined. Two non-lethal hyperthermia schemes, i.e., 45.0 0 C for 2 hr and 43.0 0 C for 2 hr were chosen to examine the sensitizing effect of heat on lethality produced by radiation in flour beetles. When hyperthermia was applied either immediately before or after irradiation, the sensitizing effect of hyperthermia was indicated by the shifting of the regression line of survival in probits on dose to the left of that of the control. The sensitizing effect as measured by decreased LD 50 did not reveal any definite trend related to the order of application of the two modalities in immediate sequence. The effect of hyperthermia was more dramatic in dose-fractionation experiments. Flour beetles exhibited typical Elkind kinetics of split-dose repair and recovery, and the amount of the sparing effect of dose-fractionation (sdf) was influenced by interfraction temperature. Both interfraction hypothermia (i.e., less than or equal to 10 0 C) and interfraction hyperthermia (i.e., > 42.0 0 C) completely suppress sdf. However, the mechanism involved in the suppression of sdf by hypothermia was different than that by hyperthermia. In the former, the suppression of sdf was reversible immediately upon return to the normal incubation temperature of 30 0 C; in the latter, the suppression of sdf was protracted and the reversibility of sdf depended on the severity of the hyperthermia treatment. Hyperthermia of 43.0 0 C for 2 hr, applied either immediately before or after the first radiation dose, suppressed sdf for 6-10 hr, and then sdf reappeared slowly, so that the final level of survival was slightly less than that of the comparable groups maintained at 30 0 C. With the more severe hyperthermia treatment of 45.0 0 C for 2 hr, sdf was suppressed for almost 36 hr after return to 30 0 C although there were some slight surges in survival

Multi-Channel RF System for MRI-Guided Transurethral Ultrasound Thermal Therapy

Science.gov (United States)

Yak, Nicolas; Asselin, Matthew; Chopra, Rajiv; Bronskill, Michael

2009-04-01

MRI-guided transurethral ultrasound thermal therapy is an approach to treating localized prostate cancer which targets precise deposition of thermal energy within a confined region of the gland. This treatment requires a system incorporating a heating applicator with multiple planar ultrasound transducers and associated RF electronics to control individual elements independently in order to achieve accurate 3D treatment. We report the design, construction, and characterization of a prototype multi-channel system capable of controlling 16 independent RF signals for a 16-element heating applicator. The main components are a control computer, microcontroller, and a 16-channel signal generator with 16 amplifiers, each incorporating a low-pass filter and transmitted/reflected power detection circuit. Each channel can deliver from 0.5 to 10 W of electrical power and good linearity from 3 to 12 MHz. Harmonic RF signals near the Larmor frequency of a 1.5 T MRI were measured to be below -30 dBm and heating experiments within the 1.5 T MR system showed no significant decrease in SNR of the temperature images. The frequency and power for all 16 channels could be changed in less than 250 ms, which was sufficiently rapid for proper performance of the control algorithms. A common backplane design was chosen which enabled an inexpensive, modular approach for each channel resulting in an overall system with minimal footprint.

Dependence of excitation frequency of resonant circuit on RF irradiation position of MRI equipment

International Nuclear Information System (INIS)

Shimizu, Masato; Yamada, Tsutomu; Takemura, Yasushi; Niwa, Touru; Inoue, Tomio

2010-01-01

Hyperthermia using implants is a cancer treatment in which cancer tissue is heated to over 42.5 deg C to selectively kill the cancer cells. In this study, a resonant circuit was used as an implant, and a weak magnetic field of radiofrequency (RF) pulses from a magnetic resonance imaging (MRI) device was used as an excitation source. We report here how the temperature of the resonant circuit was controlled by changing the excitation frequency of the MRI. As a result, the temperature rise of the resonant circuit was successfully found to depend on its position in the MRI device. This significant result indicates that the temperature of the resonant circuit can be controlled only by adjusting the excitation position. Accurate temperature control is therefore expected to be possible by combining this control technique with the temperature measurement function of MRI equipment. (author)

Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

Science.gov (United States)

Wootton, Jeffery H.; Prakash, Punit; Hsu, I.-Chow Joe; Diederich, Chris J.

2011-07-01

Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue >=41 °C in a hyperthermia treatment volume was maximized with constraints Tmax 200 cm3) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 °C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T90 in example patient cases was 40.5-42.7 °C (1.9-39.6 EM43 °C) at 1 kg m-3 s-1 with 10/14 patients >=41 °C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T90 >= 41 °C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show potential to generate conformal therapeutic heating ranging from a single endocervical device targeting small volumes local to the cervix (directional interstitial applicators in the lateral periphery to target much larger volumes (6 cm radial), while preferentially limiting heating of the bladder and rectum.

FDTD analysis of a noninvasive hyperthermia system for brain tumors

Directory of Open Access Journals (Sweden)

Yacoob Sulafa M

2012-08-01

Full Text Available Abstract Background Hyperthermia is considered one of the new therapeutic modalities for cancer treatment and is based on the difference in thermal sensitivity between healthy tissues and tumors. During hyperthermia treatment, the temperature of the tumor is raised to 40–45°C for a definite period resulting in the destruction of cancer cells. This paper investigates design, modeling and simulation of a new non-invasive hyperthermia applicator system capable of effectively heating deep seated as well as superficial brain tumors using inexpensive, simple, and easy to fabricate components without harming surrounding healthy brain tissues. Methods The proposed hyperthermia applicator system is composed of an air filled partial half ellipsoidal chamber, a patch antenna, and a head model with an embedded tumor at an arbitrary location. The irradiating antenna is placed at one of the foci of the hyperthermia chamber while the center of the brain tumor is placed at the other focus. The finite difference time domain (FDTD method is used to compute both the SAR patterns and the temperature distribution in three different head models due to two different patch antennas at a frequency of 915 MHz. Results The obtained results suggest that by using the proposed noninvasive hyperthermia system it is feasible to achieve sufficient and focused energy deposition and temperature rise to therapeutic values in deep seated as well as superficial brain tumors without harming surrounding healthy tissue. Conclusions The proposed noninvasive hyperthermia system proved suitable for raising the temperature in tumors embedded in the brain to therapeutic values by carefully selecting the systems components. The operator of the system only needs to place the center of the brain tumor at a pre-specified location and excite the antenna at a single frequency of 915 MHz. Our study may provide a basis for a clinical applicator prototype capable of heating brain tumors.

MRI-guided periradicular nerve root infiltration therapy in low-field (0.23-T) MRI system using optical instrument tracking

International Nuclear Information System (INIS)

Sequeiros, Roberto Blanco; Ojala, Risto O.; Klemola, Rauli; Jyrkinen, Lasse; Tervonen, Osmo A.; Vaara, Teuvo J.

2002-01-01

The purpose of this study was to evaluate the feasibility of the MRI-guided periradicular nerve root infiltration therapy. Sixty-seven nerve root infiltrations under MRI guidance were done for 61 patients suffering from lumbosacral radicular pain. Informed consent was acquired from all patients. A 0.23-T open-MRI scanner with interventional tools (Outlook Proview, Philips Medical Systems, MR Technologies, Finland) was used. A surface coil was used in all cases. Nerve root infiltration was performed with MRI-compatible 20-G needle (Chiba type MReye, Cook, Bloomington, Ind.; or Manan type, MD Tech, Florida). The evaluation of clinical outcome was achieved with 6 months of clinical follow-up and questionnaire. The effect of nerve root infiltration to the radicular pain was graded: 1=good to excellent, i.e., no pain or not disturbing pain allowing normal physical activity at 3 months from the procedure; 2=temporary, i.e., temporary relief of pain; 3=no relief of pain; and 4=worsening of pain. As an adjunct to MRI-guided positioning of the needle the correct needle localization by the nerve root was confirmed with saline injection to nerve root channel and single-shot fast spin echo (SSFSE) imaging. The MRI guidance allowed adequate needle positioning in all but 1 case (98.5%). This failure was caused by degeneration-induced changes in anatomy. Of patients, 51.5% had good to excellent effect with regard to radicular pain from the procedure, 22.7% had temporary relief, 21.2% had no effect, and in 4.5% the pain worsened. Our results show that MRI guidance is accurate and safe in performing nerve root infiltration at lumbosacral area. The results of radicular pain relief from nerve root infiltration are comparable to CT or fluoroscopy studies on the subject. (orig.)

Targeting therapy-resistant cancer stem cells by hyperthermia

DEFF Research Database (Denmark)

Oei, A L; Vriend, L E M; Krawczyk, P M

2017-01-01

Eradication of all malignant cells is the ultimate but challenging goal of anti-cancer treatment; most traditional clinically-available approaches fail because there are cells in a tumour that either escape therapy or become therapy-resistant. A subpopulation of cancer cells, the cancer stem cells...... are limited. Here, we argue that hyperthermia - a therapeutic approach based on local heating of a tumour - is potentially beneficial for targeting CSCs in solid tumours. First, hyperthermia has been described to target cells in hypoxic and nutrient-deprived tumour areas where CSCs reside and ionising...

Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

International Nuclear Information System (INIS)

Wootton, Jeffery H; Prakash, Punit; Hsu, I-Chow Joe; Diederich, Chris J

2011-01-01

Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue ≥41 deg. C in a hyperthermia treatment volume was maximized with constraints T max ≤ 47 deg. C, T rectum ≤ 41.5 deg. C, and T bladder ≤ 42.5 deg. C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360 0 or 2 x 180 0 output; 6 mm OD) and interstitial (180 0 , 270 0 , or 360 0 output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m -3 s -1 ) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm 3 ) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 deg. C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T 90 in example patient cases was 40.5-42.7 deg. C (1.9-39.6 EM 43deg.C ) at 1 kg m -3 s -1 with 10/14 patients ≥41 deg. C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T 90 ≥ 41 deg. C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show

On the temperature control in self-controlling hyperthermia therapy

Energy Technology Data Exchange (ETDEWEB)

Ebrahimi, Mahyar, E-mail: ebrahimi_m@mehr.sharif.ir

2016-10-15

In self-controlling hyperthermia therapy, once the desired temperature is reached, the heat generation ceases and overheating is prevented. In order to design a system that generates sufficient heat without thermal ablation of surrounding healthy tissue, a good understanding of temperature distribution and its change with time is imperative. This study is conducted to extend our understanding about the heat generation and transfer, temperature distribution and temperature rise pattern in the tumor and surrounding tissue during self-controlling magnetic hyperthermia. A model consisting of two concentric spheres that represents the tumor and its surrounding tissue is considered and temperature change pattern and temperature distribution in tumor and surrounding tissue are studied. After describing the model and its governing equations and constants precisely, a typical numerical solution of the model is presented. Then it is showed that how different parameters like Curie temperature of nanoparticles, magnetic field amplitude and nanoparticles concentration can affect the temperature change pattern during self-controlling magnetic hyperthermia. The model system herein discussed can be useful to gain insight on the self-controlling magnetic hyperthermia while applied to cancer treatment in real scenario and can be useful for treatment strategy determination. - Highlights: • Temperature change pattern in tumor and surrounding tissue are studied. • The model system herein can be useful for treatment strategy determination. • In the work described herein, emphasis is on the effect of low Curie temperature. • If the equilibrium temperature can be tuned appropriately, the stay time will be infinite.

On the temperature control in self-controlling hyperthermia therapy

International Nuclear Information System (INIS)

Ebrahimi, Mahyar

2016-01-01

In self-controlling hyperthermia therapy, once the desired temperature is reached, the heat generation ceases and overheating is prevented. In order to design a system that generates sufficient heat without thermal ablation of surrounding healthy tissue, a good understanding of temperature distribution and its change with time is imperative. This study is conducted to extend our understanding about the heat generation and transfer, temperature distribution and temperature rise pattern in the tumor and surrounding tissue during self-controlling magnetic hyperthermia. A model consisting of two concentric spheres that represents the tumor and its surrounding tissue is considered and temperature change pattern and temperature distribution in tumor and surrounding tissue are studied. After describing the model and its governing equations and constants precisely, a typical numerical solution of the model is presented. Then it is showed that how different parameters like Curie temperature of nanoparticles, magnetic field amplitude and nanoparticles concentration can affect the temperature change pattern during self-controlling magnetic hyperthermia. The model system herein discussed can be useful to gain insight on the self-controlling magnetic hyperthermia while applied to cancer treatment in real scenario and can be useful for treatment strategy determination. - Highlights: • Temperature change pattern in tumor and surrounding tissue are studied. • The model system herein can be useful for treatment strategy determination. • In the work described herein, emphasis is on the effect of low Curie temperature. • If the equilibrium temperature can be tuned appropriately, the stay time will be infinite.

Intraoperative MRI-guided resection of focal cortical dysplasia in pediatric patients: technique and outcomes.

Science.gov (United States)

Sacino, Matthew F; Ho, Cheng-Ying; Murnick, Jonathan; Tsuchida, Tammy; Magge, Suresh N; Keating, Robert F; Gaillard, William D; Oluigbo, Chima O

2016-06-01

OBJECTIVE Previous meta-analysis has demonstrated that the most important factor in seizure freedom following surgery for focal cortical dysplasia (FCD) is completeness of resection. However, intraoperative detection of epileptogenic dysplastic cortical tissue remains a challenge, potentially leading to a partial resection and the need for reoperation. The objective of this study was to determine the role of intraoperative MRI (iMRI) in the intraoperative detection and localization of FCD as well as its impact on surgical decision making, completeness of resection, and seizure control outcomes. METHODS The authors retrospectively reviewed the medical records of pediatric patients who underwent iMRI-assisted resection of FCD at the Children's National Health System between January 2014 and April 2015. Data reviewed included demographics, length of surgery, details of iMRI acquisition, postoperative seizure freedom, and complications. Postsurgical seizure outcome was assessed utilizing the Engel Epilepsy Surgery Outcome Scale. RESULTS Twelve consecutive pediatric patients (8 females and 4 males) underwent iMRI-guided resection of FCD lesions. The mean age at the time of surgery was 8.8 years ± 1.6 years (range 0.7 to 18.8 years), and the mean duration of follow up was 3.5 months ± 1.0 month. The mean age at seizure onset was 2.8 years ± 1.0 year (range birth to 9.0 years). Two patients had Type 1 FCD, 5 patients had Type 2A FCD, 2 patients had Type 2B FCD, and 3 patients had FCD of undetermined classification. iMRI findings impacted intraoperative surgical decision making in 5 (42%) of the 12 patients, who then underwent further exploration of the resection cavity. At the time of the last postoperative follow-up, 11 (92%) of the 12 patients were seizure free (Engel Class I). No patients underwent reoperation following iMRI-guided surgery. CONCLUSIONS iMRI-guided resection of FCD in pediatric patients precluded the need for repeat surgery. Furthermore, it resulted

Effects of hyperthermia on the hamster immune system

International Nuclear Information System (INIS)

Gangavalli, R.; Cain, C.A.; Tompkins, W.A.F.

1984-01-01

In previous studies, the authors have shown that hyperthermia can enhance antibody-complement chytotoxicity of hamster and human tumor cells. Moreover, whole body microwave exposure of hamsters resulted in activation of peritoneal macrophages to a viricidal state and transient suppression of natural killer (NK) cell activity. In this study, the authors compare the effects of whole body heating by microwaves or by an environmental chamber (hot air) on the hamster immune system. Microwave exposure (25mW/cm/sup 2/; 1 hr) caused viricidal activation of peritoneal macrophages which resulted in restriction of vaccinia and vesicular stomatitis virs (VSV) growth. However, heating in an environmental chamber (41 0 C; 1 hr) did not activate macrophages to a viricidal state. Both microwave and hot air hyperthermia caused significant augmentation of antibody producing spleen cell response to sheep red blood cells (SRBC), using the Jerne hymolytic plaque assay, four days post exposure and immunization with SRBC. Natural killer spleen cell cytotoxicity was suppressed by microwave and hot air hyperthermia showing that NK lymphocytes are extremely sensitive to changes in temperature. These alterations in cellular immune response due to hyperthermia could be of significance in treatment of tumors and viral infections

MRI-guided brachytherapy for cancer of the oesophagus

International Nuclear Information System (INIS)

Aydin, H.; Bachmann, G.; Lieven, H. von; Sens, M.

1993-01-01

A method of brachytherapy treatment planning using MRI is presented. In 13 patients with inoperable squamous cell cancer of the thoracic oesophagus an intraluminal afterloading boost with MRI assistance was performed. A new type of flexible catheter was filled with 1/100 diluted Gd-DTPA and introduced into the oesophagus before performing MRI in the sagittal, coronal and transverse planes. One sagittal or coronal picture which showed the catheter tip and the residual cancer was magnified to ''life size''. The position of the catheter was corrected if necessary and the treatment volume decided. The contrast medium was then aspirated out of the catheter and a thinner afterloading catheter pushed into the outer catheter. The patient was moved immediately to the afterloading room and received the first dose of boost irradiation. This method allows much more precise brachytherapy planning since it shows the cancer and the catheter together. It is superior to localising the cancer with a barium swallow or endoscopy because MRI visualises the whole extent of the residual cancer, which can then be covered with the necessary dose. (orig.)

SU-E-J-04: Integration of Interstitial High Intensity Therapeutic Ultrasound Applicators On a Clinical MRI-Guided High Intensity Focused Ultrasound Treatment Planning Software Platform

Energy Technology Data Exchange (ETDEWEB)

Ellens, N [Johns Hopkins University, Baltimore, Maryland (United States); Partanen, A [Philips Healthcare, Andover, Massachusetts (United States); Ghoshal, G; Burdette, E [Acoustic MedSystems Inc., Savoy, IL (United States); Farahani, K [National Cancer Institute, Bethesda, MD (United States)

2015-06-15

Purpose: Interstitial high intensity therapeutic ultrasound (HITU) applicators can be used to ablate tissue percutaneously, allowing for minimally-invasive treatment without ionizing radiation [1,2]. The purpose of this study was to evaluate the feasibility and usability of combining multielement interstitial HITU applicators with a clinical magnetic resonance imaging (MRI)-guided focused ultrasound software platform. Methods: The Sonalleve software platform (Philips Healthcare, Vantaa, Finland) combines anatomical MRI for target selection and multi-planar MRI thermometry to provide real-time temperature information. The MRI-compatible interstitial US applicators (Acoustic MedSystems, Savoy, IL, USA) had 1–4 cylindrical US elements, each 1 cm long with either 180° or 360° of active surface. Each applicator (4 Fr diameter, enclosed within a 13 Fr flexible catheter) was inserted into a tissue-mimicking agar-silica phantom. Degassed water was circulated around the transducers for cooling and coupling. Based on the location of the applicator, a virtual transducer overlay was added to the software to assist targeting and to allow automatic thermometry slice placement. The phantom was sonicated at 7 MHz for 5 minutes with 6–8 W of acoustic power for each element. MR thermometry data were collected during and after sonication. Results: Preliminary testing indicated that the applicator location could be identified in the planning images and the transducer locations predicted within 1 mm accuracy using the overlay. Ablation zones (thermal dose ≥ 240 CEM43) for 2 active, adjacent US elements ranged from 18 mm × 24 mm (width × length) to 25 mm × 25 mm for the 6 W and 8 W sonications, respectively. Conclusion: The combination of interstitial HITU applicators and this software platform holds promise for novel approaches in minimally-invasive MRI-guided therapy, especially when bony structures or air-filled cavities may preclude extracorporeal HIFU.[1] Diederich et al

Effects of hyperthermia, radiotherapy and thermoradiotherapy on tumor microvasculature

International Nuclear Information System (INIS)

Fujiwara, Kouji

1987-01-01

The therapeutic effects of hyperthermia (immersion of tumor-bearing leg in a water bath at 46 deg C for 60 min), radiotherapy (500 rad or 1000 rad) and thermoradiotherapy on VX-2 tumors of the rabbits were studied morphologically. Especially, vascular morphological changes and vascular permeability to ferritin after treatment were investigated by electron microscopy. As assessed by decrease in tumor volume, local hyperthermia potentiated the destructive effect of radiotherapy. The light microscopic pictures invariably suggested prolonged necrotic tendency of tumor cells following thermoradiotherapy. Electron microscopically, 1 day and 3 days after thermoradiotherapy, small blood vessels in the tumors showed swelling and protrusion of endothelial cells in the lumen. Similar morphological changes were obtained only at 3 days after radiotherapy. When vascular permeability to ferritin was examined by electron microscopy, an increase in tumor vascular permeability was occured at 1 day after hyperthermia or thermoradiotherapy, while at 3 days after radiotherapy. These results suggest that the early reaction of tumor microvasculature may be a contributing factor to delayed cell death in tumors after hyperthermia or thermoradiotherapy. (author)

In-bore setup and software for 3T MRI-guided transperineal prostate biopsy

International Nuclear Information System (INIS)

Tokuda, Junichi; Tuncali, Kemal; Song, Sang-Eun; Fedorov, Andriy; Oguro, Sota; Fennessy, Fiona M; Tempany, Clare M; Hata, Nobuhiko; Iordachita, Iulian; Lasso, Andras

2012-01-01

MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 T MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right–left (RP) and anterior–posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior–inferior axes were (0.8 ± 1.0)°, (1.7 ± 1.6)° and (0.0 ± 0.0)°, respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet. (paper)

Quantifying the Combined Effect of Radiation Therapy and Hyperthermia in Terms of Equivalent Dose Distributions

International Nuclear Information System (INIS)

Kok, H. Petra; Crezee, Johannes; Franken, Nicolaas A.P.; Stalpers, Lukas J.A.; Barendsen, Gerrit W.; Bel, Arjan

2014-01-01

Purpose: To develop a method to quantify the therapeutic effect of radiosensitization by hyperthermia; to this end, a numerical method was proposed to convert radiation therapy dose distributions with hyperthermia to equivalent dose distributions without hyperthermia. Methods and Materials: Clinical intensity modulated radiation therapy plans were created for 15 prostate cancer cases. To simulate a clinically relevant heterogeneous temperature distribution, hyperthermia treatment planning was performed for heating with the AMC-8 system. The temperature-dependent parameters α (Gy −1 ) and β (Gy −2 ) of the linear–quadratic model for prostate cancer were estimated from the literature. No thermal enhancement was assumed for normal tissue. The intensity modulated radiation therapy plans and temperature distributions were exported to our in-house-developed radiation therapy treatment planning system, APlan, and equivalent dose distributions without hyperthermia were calculated voxel by voxel using the linear–quadratic model. Results: The planned average tumor temperatures T90, T50, and T10 in the planning target volume were 40.5°C, 41.6°C, and 42.4°C, respectively. The planned minimum, mean, and maximum radiation therapy doses were 62.9 Gy, 76.0 Gy, and 81.0 Gy, respectively. Adding hyperthermia yielded an equivalent dose distribution with an extended 95% isodose level. The equivalent minimum, mean, and maximum doses reflecting the radiosensitization by hyperthermia were 70.3 Gy, 86.3 Gy, and 93.6 Gy, respectively, for a linear increase of α with temperature. This can be considered similar to a dose escalation with a substantial increase in tumor control probability for high-risk prostate carcinoma. Conclusion: A model to quantify the effect of combined radiation therapy and hyperthermia in terms of equivalent dose distributions was presented. This model is particularly instructive to estimate the potential effects of interaction from different treatment

Real-time virtual sonography (RVS)-guided vacuum-assisted breast biopsy for lesions initially detected with breast MRI.

Science.gov (United States)

Uematsu, Takayoshi

2013-12-01

To report on our initial experiences with a new method of real-time virtual sonography (RVS)-guided 11-gauge vacuum-assisted breast biopsy for lesions that were initially detected with breast MRI. RVS-guided 11-gauge vacuum-assisted biopsy is performed when a lesion with suspicious characteristics is initially detected with breast MRI and is occult on mammography, sonography, and physical examination. Live sonographic images were co-registered to the previously loaded second-look spine contrast-enhanced breast MRI volume data to correlate the sonography and MR images. Six lesions were examined in six consecutive patients scheduled to undergo RVS-guided 11-gauge vacuum-assisted biopsy. One patient was removed from the study because of non-visualization of the lesion in the second-look spine contrast-enhanced breast MRI. Five patients with non-mass enhancement lesions were biopsied. The lesions ranged in size from 9 to 13 mm (mean 11 mm). The average procedural time, including the sonography and MR image co-registration time, was 25 min. All biopsies resulted in tissue retrieval. One was fibroadenomatous nodules, and those of four were fibrocystic changes. There were no complications during or after the procedures. RVS-guided 11-gauge vacuum-assisted breast biopsies provide a safe and effective method for the examination of suspicious lesions initially detected with MRI.

Distortion-free diffusion MRI using an MRI-guided Tri-Cobalt 60 radiotherapy system: Sequence verification and preliminary clinical experience.

Science.gov (United States)

Gao, Yu; Han, Fei; Zhou, Ziwu; Cao, Minsong; Kaprealian, Tania; Kamrava, Mitchell; Wang, Chenyang; Neylon, John; Low, Daniel A; Yang, Yingli; Hu, Peng

2017-10-01

Monitoring tumor response during the course of treatment and adaptively modifying treatment plan based on tumor biological feedback may represent a new paradigm for radiotherapy. Diffusion MRI has shown great promises in assessing and predicting tumor response to radiotherapy. However, the conventional diffusion-weighted single-shot echo-planar-imaging (DW-ssEPI) technique suffers from limited resolution, severe distortion, and possibly inaccurate ADC at low field strength. The purpose of this work was to develop a reliable, accurate and distortion-free diffusion MRI technique that is practicable for longitudinal tumor response evaluation and adaptive radiotherapy on a 0.35 T MRI-guided radiotherapy system. A diffusion-prepared turbo spin echo readout (DP-TSE) sequence was developed and compared with the conventional diffusion-weighted single-shot echo-planar-imaging sequence on a 0.35 T MRI-guided radiotherapy system (ViewRay). A spatial integrity phantom was used to quantitate and compare the geometric accuracy of the two diffusion sequences for three orthogonal orientations. The apparent diffusion coefficient (ADC) accuracy was evaluated on a diffusion phantom under both 0 °C and room temperature to cover a diffusivity range between 0.40 × 10 -3 and 2.10 × 10 -3 mm 2 /s. Ten room temperature measurements repeated on five different days were conducted to assess the ADC reproducibility of DP-TSE. Two glioblastoma (GBM) and six sarcoma patients were included to examine the in vivo feasibility. The target registration error (TRE) was calculated to quantitate the geometric accuracy where structural CT or MR images were co-registered to the diffusion images as references. ADC maps from DP-TSE and DW-ssEPI were calculated and compared. A tube phantom was placed next to patients not treated on ViewRay, and ADCs of this reference tube were also compared. The proposed DP-TSE passed the spatial integrity test (< 1 mm within 100 mm radius and < 2 mm within 175 mm radius

Accuracy of applicator tip reconstruction in MRI-guided interstitial 192Ir-high-dose-rate brachytherapy of liver tumors

International Nuclear Information System (INIS)

Wybranski, Christian; Eberhardt, Benjamin; Fischbach, Katharina; Fischbach, Frank; Walke, Mathias; Hass, Peter; Röhl, Friedrich-Wilhelm; Kosiek, Ortrud; Kaiser, Mandy; Pech, Maciej; Lüdemann, Lutz; Ricke, Jens

2015-01-01

Background and purpose: To evaluate the reconstruction accuracy of brachytherapy (BT) applicators tips in vitro and in vivo in MRI-guided 192 Ir-high-dose-rate (HDR)-BT of inoperable liver tumors. Materials and methods: Reconstruction accuracy of plastic BT applicators, visualized by nitinol inserts, was assessed in MRI phantom measurements and in MRI 192 Ir-HDR-BT treatment planning datasets of 45 patients employing CT co-registration and vector decomposition. Conspicuity, short-term dislocation, and reconstruction errors were assessed in the clinical data. The clinical effect of applicator reconstruction accuracy was determined in follow-up MRI data. Results: Applicator reconstruction accuracy was 1.6 ± 0.5 mm in the phantom measurements. In the clinical MRI datasets applicator conspicuity was rated good/optimal in ⩾72% of cases. 16/129 applicators showed not time dependent deviation in between MRI/CT acquisition (p > 0.1). Reconstruction accuracy was 5.5 ± 2.8 mm, and the average image co-registration error was 3.1 ± 0.9 mm. Vector decomposition revealed no preferred direction of reconstruction errors. In the follow-up data deviation of planned dose distribution and irradiation effect was 6.9 ± 3.3 mm matching the mean co-registration error (6.5 ± 2.5 mm; p > 0.1). Conclusion: Applicator reconstruction accuracy in vitro conforms to AAPM TG 56 standard. Nitinol-inserts are feasible for applicator visualization and yield good conspicuity in MRI treatment planning data. No preferred direction of reconstruction errors were found in vivo

TH-F-202-00: MRI for Radiation Therapy

International Nuclear Information System (INIS)

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

TH-F-202-00: MRI for Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

Covalent DNA-protein crosslinking occurs after hyperthermia and radiation

International Nuclear Information System (INIS)

Cress, A.E.; Bowden, G.T.

1983-01-01

Covalent DNA-protein crosslinks occur in exponentially growing mouse leukemia cells (L1210) after exposure to ionizing radiation. The amount of DNA-protein crosslinks as measured by a filter binding assay is dose dependent upon X irradiation. Although hyperthermia and radiation in combination are synergistic with respect to cell lethality, the combination does not result in an increase of DNA-protein crosslinks when assayed immediately following treatments. Hyperthermia (43 degrees C/15 min) given prior to radiation does not alter the radiation dose dependency of the amount of initial crosslinking. In addition, the amount of DNA-protein crosslinking produced by heat plus radiation is independent of the length of heating the cells at 43 degrees C. The DNA-protein crosslinks produced by 50-Gy X ray alone are removed after 2 hr at 37 degrees C. However, if hyperthermia (43 degrees C/15 min) is given prior to 100-Gy X ray, the removal of DNA-protein crosslinks is delayed until 4.0 hr after radiation. Phospho-serine and phospho-threonine bonds are not produced with either radiation or the combination of hyperthermia plus radiation as judged by the resistance of the bonds to guanidine hydrochloride. However, hyperthermia plus radiation causes an increase in phosphate to nitrogen type bonding. These results show that radiation alone causes covalent DNA-protein crosslinks. Hyperthermia in combination with radiation does not increase the total amount of the crosslinks but delays the removal of the crosslinks and alters the distribution of the types of chemical bonding. These data suggest that the synergistic action on hyperthermia with radiation is more related to the rate of removal and the type of chemical bonding involved in the covalent DNA-protein crosslinks rather than the amount of DNA-protein crosslinks

MRI-guided robot for needle interventions in the prostate

NARCIS (Netherlands)

van den Bosch, M.R.

2011-01-01

Magnetic resonance imaging (MRI) is applied to non-invasively visualize patient’s anatomy and tumour suspicious regions with superior soft tissue contrast. Amongst others, online MRI is valuable in the diagnostic and treatment techniques for prostate cancer. Clinical MR scanners are suitable to

Daily Tracking of Glioblastoma Resection Cavity, Cerebral Edema, and Tumor Volume with MRI-Guided Radiation Therapy.

Science.gov (United States)

Mehta, Shahil; Gajjar, Shefali R; Padgett, Kyle R; Asher, David; Stoyanova, Radka; Ford, John C; Mellon, Eric A

2018-03-19

Radiation therapy (RT) plays a critical role in the treatment of glioblastoma. Studies of brain imaging during RT for glioblastoma have demonstrated changes in the brain during RT. However, frequent or daily utilization of standalone magnetic resonance imaging (MRI) scans during RT have limited feasibility. The recent release of the tri-cobalt-60 MRI-guided RT (MR-IGRT) device (ViewRay MRIdian, Cleveland, OH) allows for daily brain MRI for the RT setup. Daily MRI of three postoperative patients undergoing RT and temozolomide for glioblastoma over a six-week course allowed for the identification of changes to the cavity, edema, and visible tumor on a daily basis. The volumes and dimensions of the resection cavities, edema, and T2-hyperintense tumor were measured. A general trend of daily decreases in cavity measurements was observed in all patients. For the one patient with edema, a trend of daily increases followed by a trend of daily decreases were observed. These results suggest that daily MRI could be used for onboard resimulation and adaptive RT for future fluctuations in the sizes of brain tumors, cavities, or cystic components. This could improve tumor targeting and reduce RT of healthy brain tissue.

Microwave hyperthermia as an adjuvant to radiation therapy. Summary experience of 256 multifraction treatment cases

International Nuclear Information System (INIS)

Bicher, H.I.

1985-01-01

Analysis is presented of a series of 256 human tumors treated under multifraction protocol regimes with standard controlled hyperthermia parameters and increasing doses of radiation therapy. Air cooled microwave applicators intracavitary and interstitial antennae operating at 915 or 300 MHz were used in various sites. Temperatures were measured by micro-thermocouples. Minimum tumor temperatures of 42 0 C were maintained at 1 hour, twice weekly. Treatment included a radiation dose of 1600-1700 rads. Tumor response was 94% with 60% or more total response. Frequency and duration of total responses depended mainly on the radiation dose. Skin tumors, melanomas, chest wall recurrences responded better than head and neck or intrapelvic recurrences. Side effects observed were minor burns; proctitis or oesophagitis with intracavitary devices; ulcerations or fistulae due to rapid tumor regression; 4 cases of pleuritis treating chest wall. Overall toxicity was less than 5%. In conclusion: 1) Combination heat-low dose radiation offers good palliation. 2) Response depends on radiation dose. 3) Combination of full dose radiation therapy plus hyperthermia proves to be well tolerated

Covalent DNA-protein crosslinking occurs after hyperthermia and radiation

International Nuclear Information System (INIS)

Cress, A.E.; Bowden, G.T.

1983-01-01

Covalent DNA-protein crosslinks occur in exponentially growing mouse leukemia cells (L1210) after exposure to ionizing radiation. The amount of DNA-protein crosslinks as measured by a filter binding assay is dose dependent upon x irradiation. Although hyperthermia and radiation in combination are synergistic with respect to cell lethality, the combination does not result in an increase of DNA-protein crosslinks when assayed immediately following treatments. Hyperthermia (43 0 C/15 min) given prior to radiation dose not alter the radiation dose dependency of the amount of initial crosslinking. In addition, the amount of DNA-protein crosslinking produced by heat plus radiation is independent of the length of heating the cells at 43 0 C. The DNA-protein crosslinks produced y 50-Gy x ray alone are removed after 2 hr at 37 0 C. However, if hyperthermia (43 0 C/15 min) is given prior to 100-Gy x ray, the removal of DNA-protein crosslinks is delayed until 4.0 hr after radiation. Phospho-serine and phospho-threonine bonds are not produced with either radiation or the combination of hyperthermia plus radiation as judged by the resistance of the bonds to guanidine hydrochloride. However, hyperthermia plus radiation causes an increase in phosphate to nitrogen type bonding. These results show that radiation alone causes covalent DNA-protein crosslinks. Hyperthermia in combination with radiation does not increase the total amount of the crosslinks but delays the removal of the crosslinks and alters the distribution of the types of chemical bonding

Magnetic hyperthermia with hard-magnetic nanoparticles

Energy Technology Data Exchange (ETDEWEB)

Kashevsky, Bronislav E., E-mail: bekas@itmo.by [A.V Luikov Heat and Mass Transfer Institute, Belarus Academy of Sciences, P. Brovka str. 15, Minsk 220072 (Belarus); Kashevsky, Sergey B.; Korenkov, Victor S. [A.V Luikov Heat and Mass Transfer Institute, Belarus Academy of Sciences, P. Brovka str. 15, Minsk 220072 (Belarus); Istomin, Yuri P. [N. N. Alexandrov National Cancer Center of Belarus, Lesnoy-2, Minsk 223040 (Belarus); Terpinskaya, Tatyana I.; Ulashchik, Vladimir S. [Institute of Physiology, Belarus Academy of Sciences, Akademicheskaya str. 28, Minsk 220072 (Belarus)

2015-04-15

Recent clinical trials of magnetic hyperthermia have proved, and even hardened, the Ankinson-Brezovich restriction as upon magnetic field conditions applicable to any site of human body. Subject to this restriction, which is harshly violated in numerous laboratory and small animal studies, magnetic hyperthermia can relay on rather moderate heat source, so that optimization of the whole hyperthermia system remains, after all, the basic problem predetermining its clinical perspectives. We present short account of our complex (theoretical, laboratory and small animal) studies to demonstrate that such perspectives should be related with the hyperthermia system based on hard-magnetic (Stoner–Wohlfarth type) nanoparticles and strong low-frequency fields rather than with superparamagnetic (Brownian or Neél) nanoparticles and weak high-frequency fields. This conclusion is backed by an analytical evaluation of the maximum absorption rates possible under the field restriction in the ideal hard-magnetic (Stoner–Wohlarth) and the ideal superparamagnetic (single relaxation time) systems, by theoretical and experimental studies of the dynamic magnetic hysteresis in suspensions of movable hard-magnetic particles, by producing nanoparticles with adjusted coercivity and suspensions of such particles capable of effective energy absorption and intratumoral penetration, and finally, by successful treatment of a mice model tumor under field conditions acceptable for whole human body. - Highlights: • Hard-magnetic nanoparticles are shown superior for hyperthetmia to superparamagnetic. • Optimal system parameters are found from magnetic reversal model in movable particle. • Penetrating suspension of HM particles with aggregation-independent SAR is developed. • For the first time, mice with tumors are healed in AC field acceptable for human body.

Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

Energy Technology Data Exchange (ETDEWEB)

Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C. [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany); Gabbert, H.E. [University Dusseldorf, Medical Faculty, Department of Pathology, Dusseldorf (Germany)

2016-11-15

This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

International Nuclear Information System (INIS)

Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G.; Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C.; Gabbert, H.E.

2016-01-01

This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

WE-EF-BRD-04: MR in the OR: The Growth and Applications of MRI for Interventional Radiology and Surgery

Energy Technology Data Exchange (ETDEWEB)

Fahrig, R. [Stanford University (United States)

2015-06-15

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

Model-based feasibility assessment and evaluation of prostate hyperthermia with a commercial MR-guided endorectal HIFU ablation array

Science.gov (United States)

Salgaonkar, Vasant A.; Prakash, Punit; Rieke, Viola; Ozhinsky, Eugene; Plata, Juan; Kurhanewicz, John; Hsu, I.-C. Joe; Diederich, Chris J.

2017-03-01

Here, operational modifications to a commercial MR-guided ultrasound phased array designed for prostate ablation (part of ExAblate 2100, InSightec Ltd) are presented for the delivery of protracted mild (40 - 45°C) hyperthermia to large contiguous target volumes in the prostate. This high-intensity focused ultrasound phased array is already in clinical trials for prostate ablation, and can be potentially fast-tracked for clinical hyperthermia treatments. As a part of this preliminary feasibility study, patient-specific numerical simulations were performed using Pennes bioheat model and acoustic field calculations were conducted using the rectangular radiator method for the ExAblate prostate array (2.3 MHz, 2.3×4.0 cm2, ˜1000 channels). Thermal solutions were computed using 3D finite element methods (FEM) implemented using Comsol Multiphysics (Comsol Inc). The patient-specific geometries were created through manual segmentation of anatomical structures from representative patient MRIs and 3D rendering (Mimics 15.01, Materialise) and generation of finite element meshes (3-Matic 7.01, Materialise). Array beamforming was employed and acoustic fields were synthesized (Matlab 2010a, MathWorks) to deliver protracted continuous wave hyperthermia to focal prostate cancer targets identified in the patient-specific models. Constraints on power densities, sonication durations and switching speeds imposed by ExAblate hardware and software were incorporated in the models. Sonication strategies explored during modeling were implemented on the ExAblate prostate array and preliminary experiments were conducted in tissue mimicking phantoms under MR temperature monitoring at 3 T (GE Discovery MR750W). Therapeutic temperatures (40 - 45 °C) could be established conformably in focal cancer volumes in a single prostate quadrant using focused heating patterns and hemi-gland heating was possible using diffused heating patterns (iso-phase or diverging). T>41 °C was calculated in 13

SU-F-J-150: Development of An End-To-End Chain Test for the First-In-Man MR-Guided Treatments with the MRI Linear Accelerator by Using the Alderson Phantom

Energy Technology Data Exchange (ETDEWEB)

Hoogcarspel, S; Kerkmeijer, L; Lagendijk, J; Van Vulpen, M; Raaymakers, B [University Medical Center Utrecht, Utrecht, Utrecht (Netherlands)

2016-06-15

The Alderson phantom is a human shaped quality assurance tool that has been used for over 30 years in radiotherapy. The phantom can provide integrated tests of the entire chain of treatment planning and delivery. The purpose of this research was to investigate if this phantom can be used to chain test a treatment on the MRI linear accelerator (MRL) which is currently being developed at the UMC Utrecht, in collaboration with Elekta and Philips. The latter was demonstrated by chain testing the future First-in-Man treatments with this system.An Alderson phantom was used to chain test an entire treatment with the MRL. First, a CT was acquired of the phantom with additional markers that are both visible on MR and CT. A treatment plan for treating bone metastases in the sacrum was made. The phantom was consecutively placed in the MRL. For MRI imaging, an 3D volume was acquired. The initially developed treatment plan was then simulated on the new MRI dataset. For simulation, both the MR and CT data was used by registering them together. Before treatment delivery a MV image was acquired and compared with a DRR that was calculated form the MR/CT registration data. Finally, the treatment was delivered. Figure 1 shows both the T1 weighted MR-image of the phantom and the CT that was registered to the MR image. Figure 2 shows both the calculated and measured MV image that was acquired by the MV panel. Figure 3 shows the dose distribution that was simulated. The total elapsed time for the entire procedure excluding irradiation was 13:35 minutes.The Alderson Phantom yields sufficient MR contrast and can be used for full MR guided radiotherapy treatment chain testing. As a result, we are able to perform an end-to-end chain test of the future First-in-Man treatments.

Mild hyperthermia can induce adaptation to cytogenetic damage caused by subsequent X irradiation

International Nuclear Information System (INIS)

Cai, Lu.; Jiang, Jie.

1995-01-01

Many low-level environmental agents are able to induce an increased resistance to subsequent mutagenic effects induced by ionizing radiation. In this paper, an induced cytogenetic adaptation to radiation in human lymphocytes was studied with mild hyperthermia as the adaptive treatment and compared with that induced by low-dose radiation. We found that this adaptation could be induced not only in PHA-stimulated human lymphocytes (at 14, 38 and 42 h after addition of PHA), but also in unstimulated G 0 -phase cells (before addition of PHA) by mild hyperthermia (41 degrees C for 1 h) as well as 50 mGy X rays. When the two adaptive treatments were combined, no additive effects on the magnitude of the adaptation induced were observed, suggesting that low-dose radiation and hyperthermia may share one mechanism of induction of adaptation to cytogenetic damage. Some mechanisms which may be involved in the induction of adaptation to cytogenetic damage by low-dose radiation are discussed and compared with the effects of mild hyperthermia in inducing thermotolerance and radioresistance. 56 refs., 4 figs., 3 tabs

Influence of patient mispositioning on SAR distribution and simulated temperature in regional deep hyperthermia

Science.gov (United States)

Aklan, Bassim; Gierse, Pia; Hartmann, Josefin; Ott, Oliver J.; Fietkau, Rainer; Bert, Christoph

2017-06-01

Patient positioning plays an important role in regional deep hyperthermia to obtain a successful hyperthermia treatment. In this study, the influence of possible patient mispositioning was systematically assessed on specific absorption rate (SAR) and temperature distribution. With a finite difference time domain approach, the SAR and temperature distributions were predicted for six patients at 312 positions. Patient displacements and rotations as well as the combination of both were considered inside the Sigma-Eye applicator. Position sensitivity is assessed for hyperthermia treatment planning -guided steering, which relies on model-based optimization of the SAR and temperature distribution. The evaluation of the patient mispositioning was done with and without optimization. The evaluation without optimization was made by creating a treatment plan for the patient reference position in the center of the applicator and applied for all other positions, while the evaluation with optimization was based on creating an individual plan for each position. The parameter T90 was used for the temperature evaluation, which was defined as the temperature that covers 90% of the gross tumor volume (GTV). Furthermore, the hotspot tumor quotient (HTQ) was used as a goal function to assess the quality of the SAR and temperature distribution. The T90 was shown considerably dependent on the position within the applicator. Without optimization, the T90 was clearly decreased below 40 °C by patient shifts and the combination of shifts and rotations. However, the application of optimization for each positon led to an increase of T90 in the GTV. Position inaccuracies of less than 1 cm in the X-and Y-directions and 2 cm in the Z-direction, resulted in an increase of HTQ of less than 5%, which does not significantly affect the SAR and temperature distribution. Current positioning precision is sufficient in the X (right-left)-direction, but position accuracy is required in the Y-and Z-directions.

Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group

DEFF Research Database (Denmark)

Glahn, K P E; Ellis, F R; Halsall, P J

2010-01-01

Survival from a malignant hyperthermia (MH) crisis is highly dependent on early recognition and prompt action. MH crises are very rare and an increasing use of total i.v. anaesthesia is likely to make it even rarer, leading to the potential risk of reduced awareness of MH. In addition, dantrolene....... The guidelines consist of two textboxes: Box 1 on recognizing MH and Box 2 on the treatment of an MH crisis....

Atlas-based deformable image registration for MRI-guided prostate radiation therapy

International Nuclear Information System (INIS)

Dowling, J.; Fripp, J.; Salvado, O.; Lambert, J.; Denham, J.W.; Capp, A.; Grer, P.B.; Parker, J.

2010-01-01

Full text: To develop atlas-based deformable image registration methods to automatically segment organs and map electron densities to pelvic MRI scans for MRI-guided radiation therapy. Methods An MRT pelvic atlas and corresponding CT atlas were developed based on whole pelvic T 2 MRI scans and CT scans for 39 patients. Expert manual segmentations on both MRI and CT scans were obtained. The atlas was deformably registered to the individual patient MRI scans for automatic prostate, rectum, bladder and bone segmentation. These were compared to the manual segmentations using the Dice overlap coefficient. The same deformation vectors were then applied to the CT-atlas to produce pseudo-CT scans that correspond to the patient MRI scan anatomy but are populated with Hounsfield units. The original patient plan was recalculated on the pseudo-CT and compared to the original CT plan and bulk density plans on the MRI scans. Results Dice coefficient results were high (>0.8) for bone and prostate but lower (<0.7) for bladder and rectum which exhibit greater changes in shape and volume. Doses calculated on pseudo-CT scans were within 3% of original patient plans. Two sources of discrepancy were found; MR anatomy differences from CT due to patient setup differences at the MR scanner. and Hounsfield unit differences for bone in the pseudo-CT from original CT. Patient setup will be adressed with a

Treatment of malignant brain tumor. Today and tomorrow. Image-guided neurosurgery for brain tumor. A current perspective

International Nuclear Information System (INIS)

Kajita, Yasukazu; Fujii, Masazumi; Yoshida, Jun; Maesawa, Satoshi

2008-01-01

Although usefulness of the image-guided neurosurgery is well documented, there are scarce facilities having the actually operating system in Japan. Since 2006, authors' Nagoya University Hospital has had an operating room named ''Brain THEATER'', where an open MRI system APERTO (Hitachi-Medical Co.) and a navigation system Vector Vision (BrainLAB) are connected to conduct the complete image-guided neurosurgery for brain tumor by using the intraoperative MRI for continuously updating the residual tumor tissue to be dissected out. The room is pre- and intra-operatively supported by Departments of image analysis and of radiation technology in the University, and as well, is connected by net-working with another image-guided surgical room ''Brain Suite'' (Siemens 1.5 T MRI system: BrainLAB) in the neighboring facility, Nagoya Central Hospital. This paper describes the circumstances of the introduction of these systems in the Hospital, details of the image-guided surgery in the operation rooms with illustration of actual photos of the rooms and of pre-, intra- and post-operative images, outcomes of image-guided neurosurgery for brain tumor reported hitherto, image-guided neurosurgery for brain tumor's future perspectives involving robotic surgery and operation on the virtual 3D image including the net-worked one. Efforts should be made to further spread the system for performing the more non-invasive and precise surgery, and for conducting the diagnosis united with treatment. (R.T.)

Acute whole-body cooling for exercise-induced hyperthermia: a systematic review.

Science.gov (United States)

McDermott, Brendon P; Casa, Douglas J; Ganio, Matthew S; Lopez, Rebecca M; Yeargin, Susan W; Armstrong, Lawrence E; Maresh, Carl M

2009-01-01

To assess existing original research addressing the efficiency of whole-body cooling modalities in the treatment of exertional hyperthermia. During April 2007, we searched MEDLINE, EMBASE, Scopus, SportDiscus, CINAHL, and Cochrane Reviews databases as well as ProQuest for theses and dissertations to identify research studies evaluating whole-body cooling treatments without limits. Key words were cooling, cryotherapy, water immersion, cold-water immersion, ice-water immersion, icing, fanning, bath, baths, cooling modality, heat illness, heat illnesses, exertional heatstroke, exertional heat stroke, heat exhaustion, hyperthermia, hyperthermic, hyperpyrexia, exercise, exertion, running, football, military, runners, marathoner, physical activity, marathoning, soccer, and tennis. Two independent reviewers graded each study on the Physiotherapy Evidence Database (PEDro) scale. Seven of 89 research articles met all inclusion criteria and a minimum score of 4 out of 10 on the PEDro scale. After an extensive and critical review of the available research on whole-body cooling for the treatment of exertional hyperthermia, we concluded that ice-water immersion provides the most efficient cooling. Further research comparing whole-body cooling modalities is needed to identify other acceptable means. When ice-water immersion is not possible, continual dousing with water combined with fanning the patient is an alternative method until more advanced cooling means can be used. Until future investigators identify other acceptable whole-body cooling modalities for exercise-induced hyperthermia, ice-water immersion and cold-water immersion are the methods proven to have the fastest cooling rates.

Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

Energy Technology Data Exchange (ETDEWEB)

Schouten, Martijn G. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); University Medical Centre Nijmegen, Department of Radiology, Nijmegen (Netherlands); Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Rothgang, Eva [Pattern Recognition Lab, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen (Germany); Center for Applied Medical Imaging, Siemens Corporate Research (Germany); Center for Applied Medical Imaging, Siemens Corporate Research, Baltimore, MD (United States); Misra, Sarthak [University of Twente, MIRA-Institute of Biomedical Technology and Technical Medicine, Enschede (Netherlands)

2012-02-15

To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

International Nuclear Information System (INIS)

Schouten, Martijn G.; Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J.; Rothgang, Eva; Misra, Sarthak

2012-01-01

To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

Enhancement of immunological activity after mild hyperthermia

International Nuclear Information System (INIS)

Noguchi, Kenichi; Hasegawa, Takeo; Takahashi, Tohru

2002-01-01

At present, hyperthermia is clinically very important as interdisciplinary therapeutic method, and studies are being performed on combined effects with surgical treatment, radiotherapy, chemotherapy and gene therapy for the treatment of malignant tumors. We evaluated the effects of hyperthermia under temperature of 42.5C and demonstrated that the activation of immunological response is increased and anti-tumor effect cabn be obtained in this studies. We used animals were C3H mice (male,7W) bearing SCC-VII tumor on femur skin. Then, the mice were divided to 10 mice in each group, and only femur region was immersed in warm water for thermal treatment. Also we measured the tumor growth, changes of blood cell fraction and NK cell activity. The results of the present study confirmed: (1) Anti-tumor effect can be given by thermal treatment at relatively mild temperature (mild temperature at 39C-42C); (2) The increase of neutrophils is dependent on the quantity of heat added; (3) Immunological response of monocytes and lymphocytes is associated with it; (4) Activity of the immunological potency as a whole such as activation of NK cells was also confirmed

TH-CD-202-09: Free-Breathing Proton MRI Functional Lung Avoidance Maps to Guide Radiation Therapy

International Nuclear Information System (INIS)

Capaldi, D; Sheikh, K; Parraga, G; Hoover, D; Yaremko, B; Palma, D

2016-01-01

Purpose: Pulmonary functional MRI using inhaled gas contrast agents was previously investigated as a way to identify well-functioning lung in patients with NSCLC who are clinical candidates for radiotherapy. Hyperpolarized noble-gas ( 3 He and 129 Xe) MRI has also been optimized to measure functional lung information, but for a number of reasons, the clinical translation of this approach to guide radiotherapy planning has been limited. As an alternative, free-breathing pulmonary 1H MRI using clinically available MRI systems and pulse sequences provides a non-contrast-enhanced method to generate both ventilation and perfusion maps. Free-breathing 1 H MRI exploits non-rigid registration and Fourier decomposition of MRI signal intensity differences (Bauman et al., MRM, 2009) that may be generated during normal tidal breathing. Here, our objective was to generate free-breathing 1 H MRI ventilation and lung function avoidance maps in patients with NSCLC as a way to guide radiation therapy planning. Methods: Stage IIIA/IIIB NSCLC patients (n=8, 68±9yr) provided written informed consent to a randomized controlled clinical trial ( https://clinicaltrials.gov/ct2/show/NCT02002052 ) that aimed to compare outcomes related to image-guided versus conventional radiation therapy planning. Hyperpolarized 3 He/ 129 Xe and dynamic free tidal-breathing 1 H MRI were acquired as previously described (Capaldi et al., Acad Radiol, 2015). Non-rigid registration was performed using the modality-independent-neighbourhood-descriptor (MIND) deformable approach (Heinrich et al., Med Image Anal, 2012). Ventilation-defect-percent ( 3 He:VDP He , 129 Xe:VDP Xe , Free-breathing- 1 H:VDP FB ) and the corresponding ventilation maps were compared using Pearson correlation coefficients (r) and the Dice similarity coefficient (DSC). Results: VDP FB was significantly related to VDP He (r=.71; p=.04) and VDP Xe (r=.80; p=.01) and there were also strong spatial relationships (DSC He /DSC Xe =89±3%/77±11

A tool for validating MRI-guided strategies: a digital breathing CT/MRI phantom of the abdominal site.

Science.gov (United States)

Paganelli, Chiara; Summers, Paul; Gianoli, Chiara; Bellomi, Massimo; Baroni, Guido; Riboldi, Marco

2017-11-01

Dynamic magnetic resonance imaging (MRI) is emerging as the elected image modality for organ motion quantification and management in image-guided radiotherapy. However, the lack of validation tools is an open issue for image guidance in the abdominal and thoracic organs affected by organ motion due to respiration. We therefore present an abdominal four-dimensional (4D) CT/MRI digital phantom, including the estimation of MR tissue parameters, simulation of dedicated abdominal MR sequences, modeling of radiofrequency coil response and noise, followed by k-space sampling and image reconstruction. The phantom allows the realistic simulation of images generated by MR pulse sequences with control of scan and tissue parameters, combined with co-registered CT images. In order to demonstrate the potential of the phantom in a clinical scenario, we describe the validation of a virtual T1-weighted 4D MRI strategy. Specifically, the motion extracted from a T2-weighted 4D MRI is used to warp a T1-weighted breath-hold acquisition, with the aim of overcoming trade-offs that limit T1-weighted acquisitions. Such an application shows the applicability of the digital CT/MRI phantom as a validation tool, which should be especially useful for cases unsuited to obtain real imaging data.

Cellular radiation effects and hyperthermia cell cycle kinetics of radiation sensitive mutants of saccharomyces cerevisiae after x-irradiation and hyperthermia

International Nuclear Information System (INIS)

Fingerhut, R.; Kiefer, J.; Otto, F.

1983-01-01

Radiosensitive mutants rad2, rad9, and rad51 of Saccharomyces cerevisiae were X-irradiated with 120 Gy or 60 Gy, heated at 50 0 C for 30 min or treated with a combination of both and incubated in nutrient medium at 30 0 C. Cell number, percentage of budding cells, and cell cycle progression were determined in 45-min intervals. Cell cycle kinetics were investigated by flow cytofluorometry. Hyperthermia leads mainly to a lengthening of G1, whereas X-rays arrest cells of the rad2 and rad9 mutant in G2 and the rad51 - mutant additionaly in a state with DNA contents above G2. Cell division dealy is influenced by oxygen in all strains but to a lesser extent in the rad2 mutant. The effect of the combined treatment appears to be merely additive in the rad2 and rad9 mutant while the rad51 mutant is sensitized to X-irradiation by hyperthermia. No selective action of hyperthermia on hypoxic cells was found. (orig.)

MRI screening-detected breast lesions in high-risk young women: the value of targeted second-look ultrasound and imaging-guided biopsy.

Science.gov (United States)

Peter, P; Dhillon, R; Bose, S; Bourke, A

2016-10-01

To analyse the value of targeted second-look ultrasound and imaging-guided biopsy in high-risk young women eligible for screening magnetic resonance imaging (MRI) in a tertiary referral centre in Perth, Western Australia. A retrospective analysis of eligible high-risk young women who underwent screening breast MRI and targeted second-look ultrasound between June 2012 and June 2014 was performed with review of data. Over a 2-year period, 139 women underwent high-risk screening MRI. Of these, 30 women (with a total of 45 lesions) were recalled for targeted second-look ultrasound. Thirty-four MRI-detected lesions were identified on targeted ultrasound with 19 of them proceeding to ultrasound-guided biopsy, while the remaining 15 lesions were considered benign on ultrasound, were not biopsied, and were stable on follow-up imaging 12 months later. One lesion proceeded to an MRI-guided biopsy to confirm a benign result. Of the 11 lesions not seen on ultrasound, nine underwent MRI biopsy, one proceeded directly to hook wire localisation and excision, and one did not return for biopsy and was lost to follow-up. The overall biopsy rate was 14.4%. The cancer detection rate was 1.4%. The results of this study indicate that targeted second-look ultrasound and ultrasound-guided biopsy is a cost-effective and time-efficient approach for MRI-detected lesions in young women at high risk of developing breast cancer. MRI-guided biopsy should be considered for ultrasonographically occult suspicious lesions as there is a low, but definite, risk of cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

MRI-Guided High–Dose-Rate Intracavitary Brachytherapy for Treatment of Cervical Cancer: The University of Pittsburgh Experience

Energy Technology Data Exchange (ETDEWEB)

Gill, Beant S.; Kim, Hayeon; Houser, Christopher J. [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Kelley, Joseph L.; Sukumvanich, Paniti; Edwards, Robert P.; Comerci, John T.; Olawaiye, Alexander B.; Huang, Marilyn; Courtney-Brooks, Madeleine [Department of Gynecologic Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States)

2015-03-01

Purpose: Image-based brachytherapy is increasingly used for gynecologic malignancies. We report early outcomes of magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Consecutive patient cases with FIGO stage IB1 to IVA cervical cancer treated at a single institution were retrospectively reviewed. All patients received concurrent cisplatin with external beam radiation therapy along with interdigitated high–dose-rate intracavitary brachytherapy. Computed tomography or MRI was completed after each application, the latter acquired for at least 1 fraction. High-risk clinical target volume (HRCTV) and organs at risk were identified by Groupe Européen de Curiethérapie and European SocieTy for Radiotherapy and Oncology guidelines. Doses were converted to equivalent 2-Gy doses (EQD{sub 2}) with planned HRCTV doses of 75 to 85 Gy. Results: From 2007 to 2013, 128 patients, median 52 years of age, were treated. Predominant characteristics included stage IIB disease (58.6%) with a median tumor size of 5 cm, squamous histology (82.8%), and no radiographic nodal involvement (53.1%). Most patients (67.2%) received intensity modulated radiation therapy (IMRT) at a median dose of 45 Gy, followed by a median brachytherapy dose of 27.5 Gy (range, 25-30 Gy) in 5 fractions. At a median follow up of 24.4 months (range, 2.1-77.2 months), estimated 2-year local control, disease-free survival, and cancer-specific survival rates were 91.6%, 81.8%, and 87.6%, respectively. Predictors of local failure included adenocarcinoma histology (P<.01) and clinical response at 3 months (P<.01). Among the adenocarcinoma subset, receiving HRCTV D{sub 90} EQD{sub 2} ≥84 Gy was associated with improved local control (2-year local control rate 100% vs 54.5%, P=.03). Grade 3 or greater gastrointestinal or genitourinary late toxicity occurred at a 2-year actuarial rate of 0.9%. Conclusions: This study constitutes one of the largest reported series of MRI-guided

Temperature mapping and thermal dose calculation in combined radiation therapy and 13.56 MHz radiofrequency hyperthermia for tumor treatment

Science.gov (United States)

Kim, Jung Kyung; Prasad, Bibin; Kim, Suzy

2017-02-01

To evaluate the synergistic effect of radiotherapy and radiofrequency hyperthermia therapy in the treatment of lung and liver cancers, we studied the mechanism of heat absorption and transfer in the tumor using electro-thermal simulation and high-resolution temperature mapping techniques. A realistic tumor-induced mouse anatomy, which was reconstructed and segmented from computed tomography images, was used to determine the thermal distribution in tumors during radiofrequency (RF) heating at 13.56 MHz. An RF electrode was used as a heat source, and computations were performed with the aid of the multiphysics simulation platform Sim4Life. Experiments were carried out on a tumor-mimicking agar phantom and a mouse tumor model to obtain a spatiotemporal temperature map and thermal dose distribution. A high temperature increase was achieved in the tumor from both the computation and measurement, which elucidated that there was selective high-energy absorption in tumor tissue compared to the normal surrounding tissues. The study allows for effective treatment planning for combined radiation and hyperthermia therapy based on the high-resolution temperature mapping and high-precision thermal dose calculation.

Cellular and tissue effects of hyperthermia and radiation

International Nuclear Information System (INIS)

Field, S.B.

1989-01-01

This paper presents the idea that hyperthermia is likely to be most effective in poorly perfused regions, which is where radiotherapy and chemotherapy are least effective. The author suggests that a therapeutic gain might, therefore, be obtained by combined treatments

Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

Energy Technology Data Exchange (ETDEWEB)

Portalez, Daniel [Clinique Pasteur, 45, Department of Radiology, Toulouse (France); Rollin, Gautier; Mouly, Patrick; Jonca, Frederic; Malavaud, Bernard [Hopital de Rangueil, Department of Urology, Toulouse Cedex 9 (France); Leandri, Pierre [Clinique Saint Jean, 20, Department of Urology, Toulouse (France); Elman, Benjamin [Clinique Pasteur, 45, Department of Urology, Toulouse (France)

2010-12-15

To compare T2-weighted MRI and functional MRI techniques in guiding repeat prostate biopsies. Sixty-eight patients with a history of negative biopsies, negative digital rectal examination and elevated PSA were imaged before repeat biopsies. Dichotomous criteria were used with visual validation of T2-weighted MRI, dynamic contrast-enhanced MRI and literature-derived cut-offs for 3D-spectroscopy MRI (choline-creatine-to-citrate ratio >0.86) and diffusion-weighted imaging (ADC x 10{sup 3} mm{sup 2}/s < 1.24). For each segment and MRI technique, results were rendered as being suspicious/non-suspicious for malignancy. Sextant biopsies, transition zone biopsies and at least two additional biopsies of suspicious areas were taken. In the peripheral zones, 105/408 segments and in the transition zones 19/136 segments were suspicious according to at least one MRI technique. A total of 28/68 (41.2%) patients were found to have cancer. Diffusion-weighted imaging exhibited the highest positive predictive value (0.52) compared with T2-weighted MRI (0.29), dynamic contrast-enhanced MRI (0.33) and 3D-spectroscopy MRI (0.25). Logistic regression showed the probability of cancer in a segment increasing 12-fold when T2-weighted and diffusion-weighted imaging MRI were both suspicious (63.4%) compared with both being non-suspicious (5.2%). The proposed system of analysis and reporting could prove clinically relevant in the decision whether to repeat targeted biopsies. (orig.)

Preliminary clinical results of locoregional hyperthermia for primary and secondary bone tumors

Energy Technology Data Exchange (ETDEWEB)

Zhu, J.L.; Nagata, Yasushi; Kanamori, Shuichi; Mitsumori, Michihide; Okuno, Yoshishige; Horii, Naotoshi; Nishimura, Yasumasa; Masunaga, Shinitiro; Hiraoka, Masahiro [Kyoto Univ. (Japan). Graduate School of Medicine

2000-03-01

Nineteen primary and secondary bone tumors in 16 patients were treated with hyperthermia plus radiotherapy and/or chemotherapy between 1982 and 1997 at Kyoto University Hospital. The thermometric and clinical results were analyzed retrospectively. In 55 of 86 hyperthermia sessions, the intratumor temperature was measured using a thermometer. Of the 19 tumors, 16 (84%) received heat treatment 4-7 times, and 3 (16%) received 1 or 2 treatments of hyperthermia. The mean maximum, mean minimum and average intratumor temperatures were 42.9, 40.4 and 41.6 deg C, respectively, and 12 (67%) reached a tumor maximum temperature above 42.5 deg C. The durations that intratumor points exceeded 42, 41 and 40 deg C were 27, 34 and 38 min, respectively. The local tumor response to treatment was assessed using X-ray computed tomography. The local response rate was 16% and the local pain relief rate was 63%. The 1-year cumulative survival rate was 60%. Our preliminary results indicated that thermoradiotherapy and thermochemotherapy are clinicaly feasible and potentially beneficial in the management of locally advanced bone tumors. (author)

Magnetic fluid hyperthermia (MFH) as an alternative option in the treatment of recurrent malignant gliomas

International Nuclear Information System (INIS)

Maier-Hauff, K.; Jordan, A.; Nestler, D.; Scholz, R.; Feussner, A.; Gneveckow, U.; Wust, P.; Felix, R.

2005-01-01

Full text: The prognosis of glioblastoma (GB) remains poor despite the better neuro-imaging modalities and neurosurgical techniques. The survival of patients (PTS) depends on local tumor control, which is not guaranteed by the actual standard therapy. Magnetic fluid hyperthermia (MFH) in combination with external irradiation (RT) is a worldwide new method, which heats up selectively tumor tissue coupling a magnetic field to the applicated magnetic fluid (MF). In a phase I study with 16 PTS the applicability and tolerance of MFH combined with RT was evaluated. We present our preliminary results in 16 PTS. Depending on the tumor volume we implanted navigated 1-4 ml MF in the tumor area. The MF consists of iron oxide nanoparticles coated with a MG-specific shell dispersed in water. When the particles are exposed to an externally applied AC magnetic field, intratumoral steady-state temperatures of 43-50 o C or even higher for thermo ablation, were achieved during 60 minutes. The target temperature was measures continuously on-line by a 0.5 mm fibre optic invasive thermometry and controlled by the field strength of the AC magnetic field applicator. Four days after surgery irradiation was applied with 2 Gy / fraction 5 times a week plus 2 sessions of hyperthermia per week over 3 weeks. Because tumor power absorption was highly reproducible in each session, only the first six MFH treatments required thermometry. Further MFH applications were completely non-invasive. In 16 PTS 98 MFH therapies were done without side effects. In-vivo measured temperatures of 46 - 50 o C were highly reproducible in the target volume. In 16 cases MFH has been completed. During actual 15 months follow-up, 10 PTS showed no tumor progress where as in five PTS the tumor volume increased. Five PTS died of non tumor related complications and two PTS of tumor progress. The magnetic fluid hyperthermia in combination with radiation is a useful method for an intensified local treatment of recurrent

TH-AB-BRA-02: Automated Triplet Beam Orientation Optimization for MRI-Guided Co-60 Radiotherapy

International Nuclear Information System (INIS)

Nguyen, D; Thomas, D; Cao, M; O’Connor, D; Lamb, J; Sheng, K

2016-01-01

Purpose: MRI guided Co-60 provides daily and intrafractional MRI soft tissue imaging for improved target tracking and adaptive radiotherapy. To remedy the low output limitation, the system uses three Co-60 sources at 120° apart, but using all three sources in planning is considerably unintuitive. We automate the beam orientation optimization using column generation, and then solve a novel fluence map optimization (FMO) problem while regularizing the number of MLC segments. Methods: Three patients—1 prostate (PRT), 1 lung (LNG), and 1 head-and-neck boost plan (H&NBoost)—were evaluated. The beamlet dose for 180 equally spaced coplanar beams under 0.35 T magnetic field was calculated using Monte Carlo. The 60 triplets were selected utilizing the column generation algorithm. The FMO problem was formulated using an L2-norm minimization with anisotropic total variation (TV) regularization term, which allows for control over the number of MLC segments. Our Fluence Regularized and Optimized Selection of Triplets (FROST) plans were compared against the clinical treatment plans (CLN) produced by an experienced dosimetrist. Results: The mean PTV D95, D98, and D99 differ by −0.02%, +0.12%, and +0.44% of the prescription dose between planning methods, showing same PTV dose coverage. The mean PTV homogeneity (D95/D5) was at 0.9360 (FROST) and 0.9356 (CLN). R50 decreased by 0.07 with FROST. On average, FROST reduced Dmax and Dmean of OARs by 6.56% and 5.86% of the prescription dose. The manual CLN planning required iterative trial and error runs which is very time consuming, while FROST required minimal human intervention. Conclusions: MRI guided Co-60 therapy needs the output of all sources yet suffers from unintuitive and laborious manual beam selection processes. Automated triplet orientation optimization is shown essential to overcome the difficulty and improves the dosimetry. A novel FMO with regularization provides additional controls over the number of MLC segments

TH-AB-BRA-02: Automated Triplet Beam Orientation Optimization for MRI-Guided Co-60 Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Nguyen, D; Thomas, D; Cao, M; O’Connor, D; Lamb, J; Sheng, K [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA (United States)

2016-06-15

Purpose: MRI guided Co-60 provides daily and intrafractional MRI soft tissue imaging for improved target tracking and adaptive radiotherapy. To remedy the low output limitation, the system uses three Co-60 sources at 120° apart, but using all three sources in planning is considerably unintuitive. We automate the beam orientation optimization using column generation, and then solve a novel fluence map optimization (FMO) problem while regularizing the number of MLC segments. Methods: Three patients—1 prostate (PRT), 1 lung (LNG), and 1 head-and-neck boost plan (H&NBoost)—were evaluated. The beamlet dose for 180 equally spaced coplanar beams under 0.35 T magnetic field was calculated using Monte Carlo. The 60 triplets were selected utilizing the column generation algorithm. The FMO problem was formulated using an L2-norm minimization with anisotropic total variation (TV) regularization term, which allows for control over the number of MLC segments. Our Fluence Regularized and Optimized Selection of Triplets (FROST) plans were compared against the clinical treatment plans (CLN) produced by an experienced dosimetrist. Results: The mean PTV D95, D98, and D99 differ by −0.02%, +0.12%, and +0.44% of the prescription dose between planning methods, showing same PTV dose coverage. The mean PTV homogeneity (D95/D5) was at 0.9360 (FROST) and 0.9356 (CLN). R50 decreased by 0.07 with FROST. On average, FROST reduced Dmax and Dmean of OARs by 6.56% and 5.86% of the prescription dose. The manual CLN planning required iterative trial and error runs which is very time consuming, while FROST required minimal human intervention. Conclusions: MRI guided Co-60 therapy needs the output of all sources yet suffers from unintuitive and laborious manual beam selection processes. Automated triplet orientation optimization is shown essential to overcome the difficulty and improves the dosimetry. A novel FMO with regularization provides additional controls over the number of MLC segments

Thermoseeds for interstitial magnetic hyperthermia: from bioceramics to nanoparticles

International Nuclear Information System (INIS)

Baeza, A; Arcos, D; Vallet-Regí, M

2013-01-01

The development of magnetic materials for interstitial hyperthermia treatment of cancer is an ever evolving research field which provides new alternatives to antitumoral therapies. The development of biocompatible magnetic materials has resulted in new biomaterials with multifunctional properties, which are able to adapt to the complex scenario of tumoral processes. Once implanted or injected in the body, magnetic materials can behave as thermoseeds under the effect of AC magnetic fields. Magnetic bioceramics aimed to treat bone tumors and magnetic nanoparticles are among the most studied thermoseeds, and supply different solutions for the different scenarios in cancerous processes. This paper reviews some of the biomaterials used for bone cancer treatment and skeletal reinforcing, as well as the more complex topic of magnetic nanoparticles for intracellular targeting and hyperthermia. (topical review)

The effect of hyperthermia and radiation on lysosomal enzyme activity of mouse mammary tumours

International Nuclear Information System (INIS)

Barratt, G.M.; Wills, E.D.

1979-01-01

The effects of hyperthermia and radiation have been studied on the acid phosphatase and β-glucuronidase activities in lysosomes of C3H mice mammary tumours and of the spleen. Quantitative histochemical methods have been used. Hyperthermic treatment of both spontaneous and transplanted tumours caused an increase in the activity of both acid phosphatase and β-glucuronase when measured immediately after treatment, but the activities returned to normal after 24 hours. In contrast a radiation dose of 3500 rad did not cause an increase in activity of either enzyme immediately, but a large activation was observed after 24 hr. Combination of hyperthermic and radiation treatment caused increases in enzyme activities which were dependent on the time after treatment. Hyperthermic treatment of the lower body of mice bearing tumours also caused activation of lysosomal enzymes in the spleen. This may be hormone mediated. It is considered that the increased lysosomal enzyme activity observed after hyperthermia may be a consequence of increased permeability of the lysosomal membrane caused by hyperthermia. (author)

Modification of radiation damage in CHO cells by hyperthermia at 40 and 450C

International Nuclear Information System (INIS)

Henle, K.J.; Leeper, D.B.

1977-01-01

Low hyperthermia at 40 0 C either before or after X irradiation did not alter the slope of the radiation dose-cell survival curve but reduced the D/sub q/ from 145 to 41 or to 0 rad for a pre- or postirradiation incubation period of 2 hr at 40 0 C, respectively. In contrast, hyperthermia at 45 0 C increased the slope of the radiation survival curve by a factor of 1.7 for a radiation pretreatment of 10 min at 45 0 C, but only by 1.3 for the same treatment immediately after irradiation. The corresponding D/sub q/'s were 262 and 138 rad, respectively. A combination of 45 and 40 0 C hyperthermia (10 min at 45 0 C + 2 hr at 40 0 C + X) resulted in a superposition of the individual effects of 45 or 40 0 C hyperthermia on the radiation survival curve. In addition, the radiation survival curve was shifted downward by a factor of three due to the potentiation of 45 0 C hyperthermia damage by postincubation at 40 0 C. Repair of sublethal radiation damage was completely suppressed during incubation at 40 following hyperthermia at 45 0 C. However, when cells were returned to 37 0 C, even after 6 hr at 40 following 45 0 C hyperthermia, the capacity to accumulate and repair sublethal radiation damage was immediately restored. These findings imply that the hyperthermia damage from low or high temperatures interacts differentially with radiation damage. Low hyperthermia at 40 0 C may affect principally the radiation repair system, whereas 45 0 C hyperthermia probably alters the radiation target more severely than the repair system

MRI-Guided Regional Personalized Electrical Stimulation in Multisession and Home Treatments

Directory of Open Access Journals (Sweden)

Andrea Cancelli

2018-05-01

Full Text Available The shape and position of the electrodes is a key factor for the efficacy of transcranial electrical stimulations (tES. We have recently introduced the Regional Personalized Electrode (RePE, a tES electrode fitting the personal cortical folding, that has been able to differentiate the stimulation of close by regions, in particular the primary sensory (S1 and motor (M1 cortices, and to personalize tES onto such an extended cortical district. However, neuronavigation on individual brain was compulsory for the correct montage. Here, we aimed at developing and testing a neuronavigation-free procedure for easy and quick positioning RePE, enabling multisession RePE-tES at home. We used off-line individual MRI to shape RePE via an ad-hoc computerized procedure, while an ad-hoc developed Adjustable Helmet Frame (AHF was used to properly position it in multisession treatments, even at home. We used neuronavigation to test the RePE shape and position obtained by the new computerized procedure and the re-positioning obtained via the AHF. Using Finite Element Method (FEM model, we also estimated the intra-cerebral current distribution induced by transcranial direct current stimulation (tDCS comparing RePE vs. non-RePE with fixed reference. Additionally, we tested, using FEM, various shapes, and positions of the reference electrode taking into account possible small displacements of RePE, to test feasibility of RePE-tES sessions at home. The new RePE neuronavigation-free positioning relies on brain MRI space distances, and produced a mean displacement of 3.5 ± 0.8 mm, and the re-positioning of 4.8 ± 1.1 mm. Higher electric field in S1 than in M1 was best obtained with the occipital reference electrode, a montage that proved to feature low sensitivity to typical RePE millimetric displacements. Additionally, a new tES accessory was developed to enable repositioning the electrodes over the scalp also at home, with a precision which is acceptable according to

The Positive Outcome of MRI-Guided Vacuum Assisted Core Needle Breast Biopsies Is Not Influenced by a Prior Negative Targeted Second-Look Ultrasound.

Science.gov (United States)

Ferré, Romuald; AlSharif, Shaza; Aldis, Ann; Mesurolle, Benoît

2017-11-01

The study sought to investigate the outcome of breast magnetic resonance-guided biopsies as a function of the indication for magnetic resonance imaging (MRI), the MRI features of the lesions, and the performance or not of a targeted second-look ultrasound (SLUS) prior breast MRI-guided biopsy. We identified 158 women with MRI-detected breast lesions scheduled for MRI-guided biopsy (2007-2013). Patient demographics, performance of targeted SLUS, imaging characteristics, and subsequent pathology results were reviewed. Three biopsies were deferred, and 155 lesions were biopsied under MRI guidance (155 women; median age 55.14 years; range 27-80 years). Ninety-eight women underwent a SLUS prior to the MRI-guided biopsy (63%). Of the 155 biopsied lesions, 23 (15%) were malignant, 106 (68%) were benign, and 26 (17%) were high risk. Four of 15 surgically excised high-risk lesions were upgraded to malignancy (27%). Most of the biopsied lesions corresponded to non-mass-like enhancement (81%, 126 of 155) and most of the biopsies (52%, 81 of 155) were performed in a screening context. No demographic or MRI features were associated with malignancy. No differences were noted between the 2 subgroups (prior SLUS vs no prior SLUS) except for the presence of a synchronous carcinoma associated with a likelihood of targeted SLUS before MRI-guided biopsy (P = .001). A negative SLUS does not influence the pathology outcome of a suspicious lesion biopsied under MR guidance. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

TH-F-202-02: Current Applications of MRI in Radiotherapy

International Nuclear Information System (INIS)

Li, G.

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

TH-F-202-02: Current Applications of MRI in Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Li, G. [Memorial Sloan Kettering Cancer Center (United States)

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

TH-F-202-03: Advances in MRI for Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Cai, J. [Duke University Medical Center (United States)

2016-06-15

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai.

TH-F-202-03: Advances in MRI for Radiation Therapy

International Nuclear Information System (INIS)

Cai, J.

2016-01-01

MRI has excellent soft tissue contrast and can provide both anatomical and physiological information. It is becoming increasingly important in radiation therapy for treatment planning, image-guided radiation therapy, and treatment assessment. It is critically important at this time point to educate and update our medical physicists about MRI to prepare for the upcoming surge of MRI applications in radiation therapy. This session will review important basics of MR physics, pulse sequence designs, and current radiotherapy application, as well as showcase exciting new developments in MRI that can be potentially useful in radiation therapy. Learning Objectives: To learn basics of MR physics and understand the differences between various pulse sequences To review current applications of MRI in radiation therapy.To discuss recent MRI advances for future MRI guided radiation therapy Partly supported by NIH (1R21CA165384).; W. Miller, Research supported in part by Siemens Healthcare; G. Li, My clinical research is in part supported by NIH U54CA137788. I have a collaborative research project with Philips Healthcare.; J. Cai, jing cai

On-line MRI guidance for Radiotherapy

NARCIS (Netherlands)

Crijns, S.P.M.

2013-01-01

Image-guided radiotherapy has the potential to increase success of treatment by decreasing uncertainties concerning tumour position and shape. MRI is the modality of choice when it comes to imaging for tumour delineation and characterisation, set-up correction, treatment plan adaptation, response

Combined transperineal radiofrequency (RF) interstitial hyperthermia and brachytherapy for localized prostate cancer (PC)

International Nuclear Information System (INIS)

Urakami, Shinji; Gonda, Nobuko; Kikuno, Nobuyuki

2001-01-01

Hyperthermia has been used effectively as a radiation sensitizer. Interstitial hyperthermoradiotherapy has been therefore utilized as a minimal invasive therapy in attempts to improve local tumor control for various cancers, but not for urological cancer. The purpose of this study was to investigate the safety and feasibility of transperineal hyperthermoradiotherapy for localized PC. Based on our basic study of hyperthermoradiotherapy, we devised the procedure of combined transperineal RF interstitial hyperthermia and brachytherapy for localized prostate cancer. Two patients with localized PC underwent transperineal RF interstitial hyperthermia combined with brachytherapy operation the 192-Ir remote after-loading system (RALS). Under transrectal ultrasound guidance, a total number of 12-18 stainless steel needles for 192-Ir RALS were implanted into the prostatic gland and seminal vesicles (SV) in an optimized pattern. Eight of the needles were used as electrodes for hyperthermia, and were electrically insultated using the vinyl catheter along the length of the subdermal fatty tissue to protect from overheating. Three other needles were utilized for continuous temperature mapping in the prostate. Rectal temperature was also monitored. Total radiation doses of 70 Gy to the prostate and SV were planned as a combination of brachytherapy (24 Gy/4 fraction) and external irradiation using a four-field box technique (46 Gy/23 fraction). Hyperthermic treatment (goal of 42 to 43 deg C for 60 minutes) was performed twice following the 1st and 4th brachytherapy at an interval of more than 48 hours for the recovery of cancer cells from thermotolerance. Both patients reached the treatment goal of all intraprostatic temperatures >43.0 deg C, which was considered favorable for hyperthermia, and the rectal temperatures of both patients remained <38 deg C during hyperthermia. In serial PSA measurements of both patients, serum PSA was less than 1.0 ng/ml within 3 months and has since

A Concentric Tube Continuum Robot with Piezoelectric Actuation for MRI-Guided Closed-Loop Targeting

OpenAIRE

Su, Hao; Li, Gang; Rucker, D. Caleb; Webster, Robert J.; Fischer, Gregory S.

2016-01-01

This paper presents the design, modeling and experimental evaluation of a magnetic resonance imaging (MRI)-compatible concentric tube continuum robotic system. This system enables MRI-guided deployment of a precurved and steerable concentric tube continuum mechanism, and is suitable for clinical applications where a curved trajectory is needed. This compact 6 degree-of-freedom (DOF) robotic system is piezoelectrically-actuated, and allows simultaneous robot motion and imaging with no visually...

Intestinal cell proliferation following hyperthermia-radiation combinations

International Nuclear Information System (INIS)

Burholt, D.R.; Wilkinson, D.A.; Shrivastava, P.N.

1987-01-01

The present work is an investigation of the extent to which hyperthermia enhances x-ray induced inhibition of intestinal epithelial cell proliferation in mice. Hyperthermia was achieved by whole body immersion of anesthetized ice in a temperature controlled water bath (+-0.1 0 C). Post-treatment proliferative activity was monitored by determining the incorporation of /sup 3/H-TdR into intestinal crypt cells and by the counting of epithelial cell mitotic figures. Initial levels of cell kill were assessed by the microcolony crypt survival technique. All heat treatments were 41.5 0 C for 0.5h. Heat alone reduced the /sup 3/H-TdR incorporation to 50% of the control value by 2h post-treatment. This was followed by a return to control value by 10h and a slight hyperplasia at 24h. Heat either immediately before or after 2Gy abdominal field x-irradiation produced a prolonged period of depressed cell proliferation: /sup 3/H-TdR incorporation remained below control value for the first 24h. As the heat and radiation were separated in time from each other (up to 4h) the interaction between the two decreased. The development of thermotolerance was observed following the second and third treatment during either a heat-only or a heat-radiation multifraction treatments schedule with the treatment spaced 24h apart

SU-E-J-201: Investigation of MRI Guided Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Li, JS [Fox Chase Cancer Center, Philadelphia, PA (United States)

2015-06-15

Purpose: Image-guided radiation therapy has been employed for cancer treatment to improve the tumor localization accuracy. Radiation therapy with proton beams requires more on this accuracy because the proton beam has larger uncertainty and dramatic dose variation along the beam direction. Among all the image modalities, magnetic-resonance image (MRI) is the best for soft tissue delineation and real time motion monitoring. In this work, we investigated the behavior of the proton beam in magnetic field with Monte Carlo simulations. Methods: A proton Monte Carlo platform, TOPAS, was used for this investigation. Dose calculations were performed with this platform in a 30cmx30cmx30cm water phantom for both pencil and broad proton beams with different energies (120, 150 and 180MeV) in different magnetic fields (0.5T, 1T and 3T). The isodose distributions, dose profiles in lateral and beam direction were evaluated. The shifts of the Bragg peak in different magnetic fields for different proton energies were compared and the magnetic field effects on the characters of the dose distribution were analyzed. Results: Significant effects of magnetic field have been observed on the proton beam dose distributions, especially for magnetic field of 1T and up. The effects are more significant for higher energy proton beam because higher energy protons travel longer distance in the magnetic field. The Bragg peak shift in the lateral direction is about 38mm for 180MeV and 11mm for 120MeV proton beams in 3T magnetic field. The peak positions are retracted back for 6mm and 2mm, respectively. The effect on the beam penumbra and dose falloff at the distal edge of the Bragg peak is negligible. Conclusion: Though significant magnetic effects on dose distribution have been observed for proton beams, MRI guided proton therapy is feasible because the magnetic effects on dose is predictable and can be considered in patient dose calculation.

Predicting thermal history a-priori for magnetic nanoparticle hyperthermia of internal carcinoma

Science.gov (United States)

Dhar, Purbarun; Sirisha Maganti, Lakshmi

2017-08-01

This article proposes a simplistic and realistic method where a direct analytical expression can be derived for the temperature field within a tumour during magnetic nanoparticle hyperthermia. The approximated analytical expression for thermal history within the tumour is derived based on the lumped capacitance approach and considers all therapy protocols and parameters. The present method is simplistic and provides an easy framework for estimating hyperthermia protocol parameters promptly. The model has been validated with respect to several experimental reports on animal models such as mice/rabbit/hamster and human clinical trials. It has been observed that the model is able to accurately estimate the thermal history within the carcinoma during the hyperthermia therapy. The present approach may find implications in a-priori estimation of the thermal history in internal tumours for optimizing magnetic hyperthermia treatment protocols with respect to the ablation time, tumour size, magnetic drug concentration, field strength, field frequency, nanoparticle material and size, tumour location, and so on.

TH-CD-202-09: Free-Breathing Proton MRI Functional Lung Avoidance Maps to Guide Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Capaldi, D; Sheikh, K; Parraga, G [Robarts Research Institute, The University of Western Ontario, London, Ontario, CA (United States); Department of Medical Biophysics, The University of Western Ontario, London, Ontario, CA (United States); Hoover, D; Yaremko, B; Palma, D [Department of Medical Biophysics, The University of Western Ontario, London, Ontario, CA (United States); Department of Oncology, The University of Western Ontario, London, Ontario, CA (United States)

2016-06-15

Purpose: Pulmonary functional MRI using inhaled gas contrast agents was previously investigated as a way to identify well-functioning lung in patients with NSCLC who are clinical candidates for radiotherapy. Hyperpolarized noble-gas ({sup 3}He and {sup 129}Xe) MRI has also been optimized to measure functional lung information, but for a number of reasons, the clinical translation of this approach to guide radiotherapy planning has been limited. As an alternative, free-breathing pulmonary 1H MRI using clinically available MRI systems and pulse sequences provides a non-contrast-enhanced method to generate both ventilation and perfusion maps. Free-breathing {sup 1}H MRI exploits non-rigid registration and Fourier decomposition of MRI signal intensity differences (Bauman et al., MRM, 2009) that may be generated during normal tidal breathing. Here, our objective was to generate free-breathing {sup 1}H MRI ventilation and lung function avoidance maps in patients with NSCLC as a way to guide radiation therapy planning. Methods: Stage IIIA/IIIB NSCLC patients (n=8, 68±9yr) provided written informed consent to a randomized controlled clinical trial ( https://clinicaltrials.gov/ct2/show/NCT02002052 ) that aimed to compare outcomes related to image-guided versus conventional radiation therapy planning. Hyperpolarized {sup 3}He/{sup 129}Xe and dynamic free tidal-breathing {sup 1}H MRI were acquired as previously described (Capaldi et al., Acad Radiol, 2015). Non-rigid registration was performed using the modality-independent-neighbourhood-descriptor (MIND) deformable approach (Heinrich et al., Med Image Anal, 2012). Ventilation-defect-percent ({sup 3}He:VDP{sub He}, {sup 129}Xe:VDP{sub Xe}, Free-breathing-{sup 1}H:VDP{sub FB}) and the corresponding ventilation maps were compared using Pearson correlation coefficients (r) and the Dice similarity coefficient (DSC). Results: VDP{sub FB} was significantly related to VDP{sub He} (r=.71; p=.04) and VDP{sub Xe} (r=.80; p=.01) and

Comparison between target magnetic resonance imaging (MRI) in-gantry and cognitively directed transperineal or transrectal-guided prostate biopsies for Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 MRI lesions.

Science.gov (United States)

Yaxley, Anna J; Yaxley, John W; Thangasamy, Isaac A; Ballard, Emma; Pokorny, Morgan R

2017-11-01

To compare the detection rates of prostate cancer (PCa) in men with Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 abnormalities on 3-Tesla multiparametric (mp) magnetic resonance imaging (MRI) using in-bore MRI-guided biopsy compared with cognitively directed transperineal (cTP) biopsy and transrectal ultrasonography (cTRUS) biopsy. This was a retrospective single-centre study of consecutive men attending the private practice clinic of an experienced urologist performing MRI-guided biopsy and an experienced urologist performing cTP and cTRUS biopsy techniques for PI-RADS 3-5 lesions identified on 3-Tesla mpMRI. There were 595 target mpMRI lesions from 482 men with PI-RADS 3-5 regions of interest during 483 episodes of biopsy. The abnormal mpMRI target lesion was biopsied using the MRI-guided method for 298 biopsies, the cTP method for 248 biopsies and the cTRUS method for 49 biopsies. There were no significant differences in PCa detection among the three biopsy methods in PI-RADS 3 (48.9%, 40.0% and 44.4%, respectively), PI-RADS 4 (73.2%, 81.0% and 85.0%, respectively) or PI-RADS 5 (95.2, 92.0% and 95.0%, respectively) lesions, and there was no significant difference in detection of significant PCa among the biopsy methods in PI-RADS 3 (42.2%, 30.0% and 33.3%, respectively), PI-RADS 4 (66.8%, 66.0% and 80.0%, respectively) or PI-RADS 5 (90.5%, 89.8% and 90.0%, respectively) lesions. There were also no differences in PCa or significant PCa detection based on lesion location or size among the methods. We found no significant difference in the ability to detect PCa or significant PCa using targeted MRI-guided, cTP or cTRUS biopsy methods. Identification of an abnormal area on mpMRI appears to be more important in increasing the detection of PCa than the technique used to biopsy an MRI abnormality. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Effects of intraoperative irradiation (IORT) and intraoperative hyperthermia (IOHT) on canine sciatic nerve: histopathological and morphometric studies

International Nuclear Information System (INIS)

Vujaskovic, Zeljko; Powers, Barbara E.; Paardekoper, Gabriel; Gillette, Sharon M.; Gillette, Edward L.; Colacchio, Thomas A.

1999-01-01

Purpose/Objective: Peripheral neuropathies have emerged as the major dose-limiting complication reported after intraoperative radiation therapy (IORT). The combination of IORT with hyperthermia may further increase the risk of peripheral nerve injury. The objective of this study was to evaluate histopathological and histomorphometric changes in the sciatic nerve of dogs, after IORT with or without hyperthermia treatment. Methods and Materials: Young adult beagle dogs were randomized into five groups of 3-5 dogs each to receive IORT doses of 16, 20, 24, 28, or 32 Gy. Six groups of 4-5 dogs each received IORT doses of 12, 16, 20, 24, or 28 Gy simultaneously with 44 deg. C of intraoperative hyperthermia (IOHT) for 60 min. One group of dogs acted as hyperthermia-alone controls. Two years after the treatment, dogs were euthanized, and histopathological and morphometric analyses were performed. Results: Qualitative histological analysis showed prominant changes such as focal necrosis, mineralization, fibrosis, and severe fiber loss in dogs which received combined treatment. Histomorphometric results showed a significantly higher decrease in axon and myelin and small blood vessels, with a corresponding increase in connective tissue in dogs receiving IORT plus hyperthermia treatment. The effective dose for 50% of nerve fiber loss (ED 50 ) in dogs exposed to IORT only was 25.3 Gy. The ED 50 for nerve fiber loss in dogs exposed to IORT combined with IOHT was 14.8 Gy. The thermal enhancement ratio (TER) was 1.7. Conclusion: The probability of developing peripheral neuropathies in a large animal model is higher when IORT is combined with IOHT, when compared to IORT application alone. To minimize the risk of peripheral neuropathy, clinical treatment protocols for the combination of IORT and hyperthermia should not assume a thermal enhancement ratio (TER) to be lower than 1.5

MRI-guided tumor tracking in lung cancer radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Cervino, Laura I; Jiang, Steve B [Center for Advanced Radiotherapy Technology and Department of Radiation Oncology, University of California San Diego, 3960 Health Sciences Dr., La Jolla, CA 92093-0865 (United States); Du, Jiang, E-mail: lcervino@ucsd.edu [Department of Radiology, University of California San Diego, 200 West Arbor Dr., San Diego, CA 92103-8226 (United States)

2011-07-07

Precise tracking of lung tumor motion during treatment delivery still represents a challenge in radiation therapy. Prototypes of MRI-linac hybrid systems are being created which have the potential of ionization-free real-time imaging of the tumor. This study evaluates the performance of lung tumor tracking algorithms in cine-MRI sagittal images from five healthy volunteers. Visible vascular structures were used as targets. Volunteers performed several series of regular and irregular breathing. Two tracking algorithms were implemented and evaluated: a template matching (TM) algorithm in combination with surrogate tracking using the diaphragm (surrogate was used when the maximum correlation between the template and the image in the search window was less than specified), and an artificial neural network (ANN) model based on the principal components of a region of interest that encompasses the target motion. The mean tracking error e and the error at 95% confidence level e{sub 95} were evaluated for each model. The ANN model led to e = 1.5 mm and e{sub 95} = 4.2 mm, while TM led to e = 0.6 mm and e{sub 95} = 1.0 mm. An extra series was considered separately to evaluate the benefit of using surrogate tracking in combination with TM when target out-of-plane motion occurs. For this series, the mean error was 7.2 mm using only TM and 1.7 mm when the surrogate was used in combination with TM. Results show that, as opposed to tracking with other imaging modalities, ANN does not perform well in MR-guided tracking. TM, however, leads to highly accurate tracking. Out-of-plane motion could be addressed by surrogate tracking using the diaphragm, which can be easily identified in the images.

Hyperthermia-induced alteration of yeast susceptibility to mutation

International Nuclear Information System (INIS)

Mitchel, R.E.J.; Morrison, D.P.

1985-01-01

Diploid yeast (s. cerevisiae) were examined for alterations in susceptibility to induced mutation following hyperthermia treatment. In cells grown at 23 0 C, a non-lethal heat exposure (38 0 C, 30 min) markedly suppressed mutation induced by a subsequent non-killing dose of MNNG of MNU. Mutation by ENU, 8-MOP + UVA, or γ-rays was not affected. An intermediate level of mutation suppression was observed for mutation by 254nm UV or MMS. Mutation by MNNG was not suppressed by the same heat treatment delivered after the mutagen exposure. In a split dose experiment (two MNNG treatments separated by a heat exposure) no suppression of mutation was observed. Treatment with cycloheximide mimicked the effect of heat treatment. These data suggest that mutation induction by MNNG or MNU is protein synthesis dependent, i.e. an error-prone repair system is induced by exposure to MNNG or MNU but not by ENU, 8-MOP+UVA or γ-irradiation. We propose that hyperthermia treatment, by inducing stress protein synthesis at the expense of normal protein synthesis, precludes induction of this error-prone system. Therefore, in heat treated cells, DNA lesions produced by MNNG or MNU exposure must be resolved by an essentially constitutive system which is less error-prone than the inducible one

Practical textbook of cardiac CT and MRI

Energy Technology Data Exchange (ETDEWEB)

Lim, Tae-Hwan (ed.) [ASAN Medical Center, Seoul (Korea, Republic of). Dept. of Radiology

2015-04-01

Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

Practical textbook of cardiac CT and MRI

International Nuclear Information System (INIS)

Lim, Tae-Hwan

2015-01-01

Guide to the interpretation of cardiac CT and MRI for the purposes of diagnosis, treatment planning, and follow-up. Emphasis on applications in a wide range of real clinical situations. Numerous informative illustrations. Summarizing sections permitting rapid retrieval of information. QR codes allowing access to references, additional figures, and motion pictures from the internet. This up-to-date textbook comprehensively reviews all aspects of cardiac CT and MRI and demonstrates the value of these techniques in clinical practice. A wide range of applications are considered, including imaging of atherosclerotic and non-atherosclerotic coronary artery disease, coronary revascularization, ischemic heart disease, non-ischemic cardiomyopathy, valvular heart disease, cardiac tumors, and pericardial disease. The numerous high-quality images illustrate how to interpret cardiac CT and MRI correctly for the purposes of diagnosis, treatment planning, and follow-up. Helpful summarizing sections in every chapter will facilitate rapid retrieval of information. This book will be of great value to radiologists and cardiologists seeking a reliable guide to the optimal use of cardiac CT and MRI in real clinical situations.

Effect of prior hyperthermia on subsequent thermal enhancement of radiation damage in mouse intestine

International Nuclear Information System (INIS)

Marigold, J.C.L.; Hume, S.P.

1982-01-01

Hyperthermia given in conjunction with X-rays results in a greater level of radiation injury than following X-rays alone, giving a thermal enhancement ratio (TER). The effect of prior hyperthermia ('priming') on TER was studied in the small intestine of mouse by giving 42.0 deg C for 1 hour at various times before the combined heat and X-ray treatments. Radiation damage was assessed by measuring crypt survival 4 days after radiation. TER was reduced when 'priming' hyperthermia was given 24-48 hours before the combined treatments. The reduction in effectiveness of the second heat treatment corresponded to a reduction in hyperthermal temperature of approximately 0.5 deg C, a value similar to that previously reported for induced resistance to heat given alone ('thermotolerance') (Hume and Marigold 1980). However, the time courses for development and decay of the TER response were much longer than those for 'thermotolerance', suggesting that different mechanisms are involved in thermal damage following heat alone and thermal enhancement of radiation damage

Preferential radiosensitization of human prostatic carcinoma cells by mild hyperthermia

International Nuclear Information System (INIS)

Ryu, Samuel; Brown, Stephen L.; Kim, Sang-Hie; Khil, Mark S.; Kim, Jae Ho

1996-01-01

Purpose: Recent cell culture studies by us and others suggest that some human carcinoma cells are more sensitive to heat than are rodent cells following mild hyperthermia. In studying the cellular mechanism of enhanced thermosensitivity of human tumor cells to hyperthermia, prostatic carcinoma cells of human origin were found to be more sensitive to mild hyperthermia than other human cancer cells. The present study was designed to determine the magnitude of radiosensitization of human prostatic carcinoma cells by mild hyperthermia and to examine whether the thermal radiosensitization is related to the intrinsic thermosensitivity of cancer cells. Methods and Materials: Two human prostatic carcinoma cell lines (DU-145 and PC-3) and other carcinoma cells of human origin, in particular, colon (HT-29), breast (MCF-7), lung (A-549), and brain (U-251) were exposed to temperatures of 40-41 deg. C. Single acute dose rate radiation and fractionated radiation were combined with mild hyperthermia to determine thermal radiosensitization. The end point of the study was the colony-forming ability of single-plated cells. Results: DU-145 and PC-3 cells were found to be exceedingly thermosensitive to 41 deg. C for 24 h, relative to other cancer cell lines. Ninety percent of the prostatic cancer cells were killed by a 24 h heat exposure. Prostatic carcinoma cells exposed to a short duration of heating at 41 deg. C for 2 h resulted in a substantial enhancement of radiation-induced cytotoxicity. The thermal enhancement ratios (TERs) of single acute dose radiation following heat treatment 41 deg. C for 2 h were 2.0 in DU-145 cells and 1.4 in PC-3 cells. The TERs of fractionated irradiation combined with continuous heating at 40 deg. C were similarly in the range of 2.1 to 1.4 in prostate carcinoma cells. No significant radiosensitization was observed in MCF-7 and HT-29 cells under the same conditions. Conclusion: The present data suggest that a significant radiosensitization of

Thermal wave propagation in blood perfused tissues under hyperthermia treatment for unique oscillatory heat flux at skin surface and appropriate initial condition

Science.gov (United States)

Dutta, Jaideep; Kundu, Balaram

2018-05-01

This paper aims to develop an analytical study of heat propagation in biological tissues for constant and variable heat flux at the skin surface correlated with Hyperthermia treatment. In the present research work we have attempted to impose two unique kind of oscillating boundary condition relevant to practical aspect of the biomedical engineering while the initial condition is constructed as spatially dependent according to a real life situation. We have implemented Laplace's Transform method (LTM) and Green Function (GFs) method to solve single phase lag (SPL) thermal wave model of bioheat equation (TWMBHE). This research work strongly focuses upon the non-invasive therapy by employing oscillating heat flux. The heat flux at the skin surface is considered as constant, sinusoidal, and cosine forms. A comparative study of the impact of different kinds of heat flux on the temperature field in living tissue explored that sinusoidal heat flux will be more effective if the time of therapeutic heating is high. Cosine heating is also applicable in Hyperthermia treatment due to its precision in thermal waveform. The result also emphasizes that accurate observation must be required for the selection of phase angle and frequency of oscillating heat flux. By possible comparison with the published experimental research work and published mathematical study we have experienced a difference in temperature distribution as 5.33% and 4.73%, respectively. A parametric analysis has been devoted to suggest an appropriate procedure of the selection of important design variables in viewpoint of an effective heating in hyperthermia treatment.

Water bath hyperthermia is a simple therapy for psoriasis and also stimulates skin tanning in response to sunlight

Energy Technology Data Exchange (ETDEWEB)

Boreham, D.R.; Gasmann, H.C.; Mitchel, R.E.J

1994-07-01

An eight week trial, involving superficial hyperthermia delivered biweekly via simple water bath immersion, was tested for its ability to clear mild to moderate psoriatic lesions. Seven patients were treated and three cases rapidly improved. In the remaining patients, the treatment frequency was increased to alternate days; two cases improved significantly, one patient showed a partial response, and the fourth had no visible change (this was the only patient taking concurrent drug therapy - etretinate). In addition to resolving psoriatic lesions, water bath hyperthermia also reduced edema (swelling) and relieved pruritus (itching) in all patients, both during the treatment period and for up to several months after lesions had returned. Lesion reappearance occurred within one to three months after the last heat treatment. We retreated one patient and produced a second complete remission. These results indicate that simple repetitive water bath hyperthermia alone is effective in the treatment of psoriatic lesions in heatable locations. An unexpected side effect was enhanced melanin content (tanning) in all areas where hyperthermia treated skin was exposed to sunlight. (author)

Assessment of immunomodulating action of combined therapy with UHF-hyperthermia in children with osteogenic sarcoma

International Nuclear Information System (INIS)

Neprina, G.S.; Panteleeva, E.S.; Vatin, O.E.; Bizer, V.A.; Bojko, I.N.

1989-01-01

The paper is concerned with immunological evaluation of different stages of combined therapy with local UHF-hyperthermia in children with osteogenic sarcoma. Combined therapy (polychemo- and raditherapy) was shown to cause a decrease in the number of immunocompetent cells, to enhance dysbalance of immunoregulatory T-lymphocytes, to weaken T-lymphocyte function on PHA; immunosuppressive action of combined therapy did not depend on a tumor site. The incorporation of UHF-hyperthermia in the therapeutic scheme weakened the manifestations of secondary immunodeficiency, got back to normal structure of T-lymphocyte population. A favorable immunomodulating effect of hyperthermia was more frequently observed in patients with crural bone tumors. The effect of hyperthermia was revealed after direct influence of thermotherapy but it was absent in continuation of combined treatment

A MR-conditional High-torque Pneumatic Stepper Motor for MRI-guided and Robot-assisted Intervention

Science.gov (United States)

Chen, Yue; Kwok, Ka-Wai; Tse, Zion Tsz Ho

2015-01-01

Magnetic Resonance Imaging allows for visualizing detailed pathological and morphological changes of soft tissue. This increasingly attracts attention on MRI-guided intervention; hence, MR-conditional actuations have been widely investigated for development of image-guided and robot-assisted surgical devices under the MRI. This paper presents a simple design of MR-conditional stepper motor which can provide precise and high-torque actuation without adversely affecting the MR image quality. This stepper motor consists of two MR-conditional pneumatic cylinders and the corresponding supporting structures. Alternating the pressurized air can drive the motor to rotate each step in 3.6° with the motor coupled to a planetary gearbox. Experimental studies were conducted to validate its dynamics performance. Maximum 800mNm output torque can be achieved. The motor accuracy independently varied by two factors: motor operating speed and step size, was also investigated. The motor was tested within a Siemens 3T MRI scanner. The image artifact and the signal-to-noise ratio (SNR) were evaluated in order to study its MRI compliancy. The results show that the presented pneumatic stepper motor generated 2.35% SNR reduction in MR images and no observable artifact was presented besides the motor body itself. The proposed motor test also demonstrates a standard to evaluate the motor capability for later incorporation with motorized devices used in robot-assisted surgery under MRI. PMID:24957635

Physical mechanism and modeling of heat generation and transfer in magnetic fluid hyperthermia through Néelian and Brownian relaxation: a review.

Science.gov (United States)

Suriyanto; Ng, E Y K; Kumar, S D

2017-03-23

Current clinically accepted technologies for cancer treatment still have limitations which lead to the exploration of new therapeutic methods. Since the past few decades, the hyperthermia treatment has attracted the attention of investigators owing to its strong biological rationales in applying hyperthermia as a cancer treatment modality. Advancement of nanotechnology offers a potential new heating method for hyperthermia by using nanoparticles which is termed as magnetic fluid hyperthermia (MFH). In MFH, superparamagnetic nanoparticles dissipate heat through Néelian and Brownian relaxation in the presence of an alternating magnetic field. The heating power of these particles is dependent on particle properties and treatment settings. A number of pre-clinical and clinical trials were performed to test the feasibility of this novel treatment modality. There are still issues yet to be solved for the successful transition of this technology from bench to bedside. These issues include the planning, execution, monitoring and optimization of treatment. The modeling and simulation play crucial roles in solving some of these issues. Thus, this review paper provides a basic understanding of the fundamental and rationales of hyperthermia and recent development in the modeling and simulation applied to depict the heat generation and transfer phenomena in the MFH.

Cellular radiation effects and hyperthermia: Cytokinetic investigations with stationary phase yeast cells

International Nuclear Information System (INIS)

Fingerhut, R.; Otto, F.; Oldiges, H.; Kiefer, J.

1980-01-01

Wild type diploid yeast, Saccharomyces cerevisiae strain 211, was subjected to 250 kV X-rays or 50 0 C heat treatment for 30 min or to a combination of both. X-ray exposure took place either in air or in nitrogen. Cell number, percentage of budding cells and cell cycle progression was followed for up to 12 h post irradiation. The distribution of cell cycle stages was determined by flow cytofluorometry. All treatments cause a retardation of cell division rate. Hyperthermia leads mainly to a lengthening of G 1 , whereas X-rays arrest the cells reversibly in G 2 . The effect of the combined treatment appears to be merely additive. No selective action of hyperthermia on hypoxic cells was found. (orig.) [de

Extracting visual evoked potentials from EEG data recorded during fMRI-guided transcranial magnetic stimulation.

Science.gov (United States)

Sadeh, Boaz; Yovel, Galit

2014-05-12

Transcranial Magnetic Stimulation (TMS) is an effective method for establishing a causal link between a cortical area and cognitive/neurophysiological effects. Specifically, by creating a transient interference with the normal activity of a target region and measuring changes in an electrophysiological signal, we can establish a causal link between the stimulated brain area or network and the electrophysiological signal that we record. If target brain areas are functionally defined with prior fMRI scan, TMS could be used to link the fMRI activations with evoked potentials recorded. However, conducting such experiments presents significant technical challenges given the high amplitude artifacts introduced into the EEG signal by the magnetic pulse, and the difficulty to successfully target areas that were functionally defined by fMRI. Here we describe a methodology for combining these three common tools: TMS, EEG, and fMRI. We explain how to guide the stimulator's coil to the desired target area using anatomical or functional MRI data, how to record EEG during concurrent TMS, how to design an ERP study suitable for EEG-TMS combination and how to extract reliable ERP from the recorded data. We will provide representative results from a previously published study, in which fMRI-guided TMS was used concurrently with EEG to show that the face-selective N1 and the body-selective N1 component of the ERP are associated with distinct neural networks in extrastriate cortex. This method allows us to combine the high spatial resolution of fMRI with the high temporal resolution of TMS and EEG and therefore obtain a comprehensive understanding of the neural basis of various cognitive processes.

Extracting Visual Evoked Potentials from EEG Data Recorded During fMRI-guided Transcranial Magnetic Stimulation

Science.gov (United States)

Sadeh, Boaz; Yovel, Galit

2014-01-01

Transcranial Magnetic Stimulation (TMS) is an effective method for establishing a causal link between a cortical area and cognitive/neurophysiological effects. Specifically, by creating a transient interference with the normal activity of a target region and measuring changes in an electrophysiological signal, we can establish a causal link between the stimulated brain area or network and the electrophysiological signal that we record. If target brain areas are functionally defined with prior fMRI scan, TMS could be used to link the fMRI activations with evoked potentials recorded. However, conducting such experiments presents significant technical challenges given the high amplitude artifacts introduced into the EEG signal by the magnetic pulse, and the difficulty to successfully target areas that were functionally defined by fMRI. Here we describe a methodology for combining these three common tools: TMS, EEG, and fMRI. We explain how to guide the stimulator's coil to the desired target area using anatomical or functional MRI data, how to record EEG during concurrent TMS, how to design an ERP study suitable for EEG-TMS combination and how to extract reliable ERP from the recorded data. We will provide representative results from a previously published study, in which fMRI-guided TMS was used concurrently with EEG to show that the face-selective N1 and the body-selective N1 component of the ERP are associated with distinct neural networks in extrastriate cortex. This method allows us to combine the high spatial resolution of fMRI with the high temporal resolution of TMS and EEG and therefore obtain a comprehensive understanding of the neural basis of various cognitive processes. PMID:24893706

Novel hyperthermia applicator system allows adaptive treatment planning: Preliminary clinical results in tumour-bearing animals.

Science.gov (United States)

Dressel, S; Gosselin, M-C; Capstick, M H; Carrasco, E; Weyland, M S; Scheidegger, S; Neufeld, E; Kuster, N; Bodis, S; Rohrer Bley, C

2017-09-11

Hyperthermia (HT) as an adjuvant to radiation therapy (RT) is a multimodality treatment method to enhance therapeutic efficacy in different tumours. High demands are placed on the hardware and treatment planning software to guarantee adequately planned and applied HT treatments. The aim of this prospective study was to determine the effectiveness and safety of the novel HT system in tumour-bearing dogs and cats in terms of local response and toxicity as well as to compare planned with actual achieved data during heating. A novel applicator with a flexible number of elements and integrated closed-loop temperature feedback control system, and a tool for patient-specific treatment planning were used in a combined thermoradiotherapy protocol. Good agreement between predictions from planning and clinical outcome was found in 7 of 8 cases. Effective HT treatments were planned and verified with the novel system and provided improved quality of life in all but 1 patient. This individualized treatment planning and controlled heat exposure allows adaptive, flexible and safe HT treatments in palliatively treated animal patients. © 2017 John Wiley & Sons Ltd.

TU-AB-BRA-07: Distortion-Free 3D Diffusion MRI On An MRI-Guided Radiotherapy System for Longitudinal Tumor Response Assessment

International Nuclear Information System (INIS)

Gao, Y; Yang, Y; Rangwala, N; Cao, M; Low, D; Hu, P

2016-01-01

Purpose: To develop a reliable, 3D distortion-free diffusion MRI technique for longitudinal tumor response assessment and MRI-guided adaptive radiotherapy(RT). Methods: A diffusion prepared 3D turbo spin echo readout (DP-TSE) sequence was developed and compared with the conventional diffusion-weighted single-shot echo-planar-imaging (DW-ssEPI) sequence in a commercially available diffusion phantom, and one head-and-neck and one brain cancer patient on an MRI-guided RT system (ViewRay). In phantom study, the geometric fidelity was quantified as the ratio between the left-right (RL) and anterior-posterior (AP) dimension. Ten slices were measured on DP-TSE, DW-ssEPI and standard TSE images where the later was used as the geometric reference. ADC accuracy was verified at both 0°C (reference ADC available) and room temperature with a range of diffusivity between 0.35 and 2.0*10"−"3mm"2/s. The ADC reproducibility was assessed based on 8 room-temperature measurements on 6 different days. In the pilot single-slice in-vivo study, CT images were used as the geometric reference, and ADC maps from both diffusion sequences were compared. Results: Distortion and susceptive-related artifact were severe in DW-ssEPI, with significantly lower RL/AP ratio (0.9579±0.0163) than DP-TSE (0.9990±0.0031) and TSE (0.9995±0.0031). ADCs from the two diffusion sequences both matched well with the vendor-provided values at 0°C; however DW-ssEPI fails to provide accurate ADC for high diffusivity vials at room temperature due to high noise level (10 times higher than DP-TSE). The DP-TSE sequence had excellent ADC reproducibility with <4% ADC variation among 8 separate measurements. In patient study, DP-TSE exhibited substantially improved geometric reliability. ROI analysis in ADC maps generated from DP-TSE and DW-ssEPI showed <5% difference where high b-value images were excluded from the latter approach due to excessive noise level. Conclusion: A diffusion MRI sequence with excellent

TU-AB-BRA-07: Distortion-Free 3D Diffusion MRI On An MRI-Guided Radiotherapy System for Longitudinal Tumor Response Assessment

Energy Technology Data Exchange (ETDEWEB)

Gao, Y; Yang, Y; Rangwala, N; Cao, M; Low, D; Hu, P [UCLA School of Medicine, Los Angeles, CA (United States)

2016-06-15

Purpose: To develop a reliable, 3D distortion-free diffusion MRI technique for longitudinal tumor response assessment and MRI-guided adaptive radiotherapy(RT). Methods: A diffusion prepared 3D turbo spin echo readout (DP-TSE) sequence was developed and compared with the conventional diffusion-weighted single-shot echo-planar-imaging (DW-ssEPI) sequence in a commercially available diffusion phantom, and one head-and-neck and one brain cancer patient on an MRI-guided RT system (ViewRay). In phantom study, the geometric fidelity was quantified as the ratio between the left-right (RL) and anterior-posterior (AP) dimension. Ten slices were measured on DP-TSE, DW-ssEPI and standard TSE images where the later was used as the geometric reference. ADC accuracy was verified at both 0°C (reference ADC available) and room temperature with a range of diffusivity between 0.35 and 2.0*10{sup −3}mm{sup 2}/s. The ADC reproducibility was assessed based on 8 room-temperature measurements on 6 different days. In the pilot single-slice in-vivo study, CT images were used as the geometric reference, and ADC maps from both diffusion sequences were compared. Results: Distortion and susceptive-related artifact were severe in DW-ssEPI, with significantly lower RL/AP ratio (0.9579±0.0163) than DP-TSE (0.9990±0.0031) and TSE (0.9995±0.0031). ADCs from the two diffusion sequences both matched well with the vendor-provided values at 0°C; however DW-ssEPI fails to provide accurate ADC for high diffusivity vials at room temperature due to high noise level (10 times higher than DP-TSE). The DP-TSE sequence had excellent ADC reproducibility with <4% ADC variation among 8 separate measurements. In patient study, DP-TSE exhibited substantially improved geometric reliability. ROI analysis in ADC maps generated from DP-TSE and DW-ssEPI showed <5% difference where high b-value images were excluded from the latter approach due to excessive noise level. Conclusion: A diffusion MRI sequence with

A randomized clinical trial of hyperthermia and radiation versus radiation alone for superficially located cancers

International Nuclear Information System (INIS)

Egawa, Sunao; Tsukiyama, Iwao; Watanabe, Shaw

1989-01-01

A randomized clinical trial was performed in order to evaluate the effect of combined hyperthermia and radiation for superficially located tumors. Ten institutions participated in this study and 92 evaluable patients were entered from September 1985 to March 1987 (44 patients for radiation plus hyperthermia and 48 for radiation only). Superficially located tumors, more than 3x3 cm in diameter, regardless of whether they were primary or metastatic, and of their histology, were included in the study. Radiotherapy was performed by the conventional fractionation method (2 Gyx5/week). Hyperthermia was conducted once a week. There was no statistical difference between the two groups regarding age, sex, the distribution of tumors and treatment parameters. The complete response (CR) and partial response (PR) rate for the hyperthermia plus radiation group was 81.8%, while the rate for the radiation alone group was 62.6% (p<0.05). Six factors were selected for analysis of the above effect by a multiple logistic model. Sex contributed the most (p=0.001), then the site of the tumor (p=0.016) and the method of treatment (p=0.023). Sex and the site influenced the results. Age, irradiation dose and frequency and duration of heating were not significant factors for response to treatment. (author)

Effects of hyperthermia and X-irradiation on mouse stromal tissue

International Nuclear Information System (INIS)

Wondergem, J.; Haveman, J.

1986-01-01

The sensitivity of normal stroma to heat, irradiation and heat combined with irradiation, was studied using the tumour bed effect (TBE) assay. Irradiation before implantation led to a TBE, dose dependent below 15 Gy, but remaining relatively constant above. The interval (0-90 days) between irradiation and tumour implantation did not influence the magnitude of the TBE. Hyperthermia with large heat doses (45-60 min at 44 0 C) before implantation may lead to a TBE. The interval between hyperthermia and tumour implantation was very important. Results showed that the recovery from heat-induced stromal damage is very rapid. When the interval between hyperthermia and tumour implantation was 10 days or longer, no TBE could be observed. Irradiation combined with large heat doses (30-60 min at 44 0 C) decreased the radiation-induced TBE. The combination of irradiation with mild heat treatments (15 min at 44 0 C) could lead to a larger TBE then after irradiation alone. When hyperthermia was given prior to irradiation, the interval between heat and irradiation proved to be very important. With large intervals (21 days or longer), TBE values were about the same as with irradiation alone. When heat was given after irradiation, irradiation-induced TBE was always reduced. (UK)

31P-MRS study for the assessment of tumor response after radiotherapy and/or hyperthermia

International Nuclear Information System (INIS)

Kimura, Hirohiko; Itho, Satoshi; Nakatsugawa, Sigekazu; Maeda, Masayuki; Iwasaki, Toshiko; Yamamoto, Kazutaka; Ishii, Yasushi

1992-01-01

The metabolic changes of human lung cancer implanted in nude mice were studied by the use of in vivo 31 P nuclear magnetic resonance spectroscopy ( 31 P-MRS) after radiotherapy, hyperthermia or the combined therapy of radiation and hyperthermia. 31 P-MRS of the tumors showed increased Pi/β-NTP ratio and acidic pH value on 1 day after hyperthermia, that indicated metabolic decline caused by hyperthermia. On the other hand, lower Pi/β-NTP ratios during 3 to 10 days after irradiation suggested metabolic activation of the tumors. In the tumors treated with the combined therapy, 31 P-MRS revealed increase of Pi/β-NTP ratio within 1 day and its decrease subsequent 6 to 10 days after treatment, that indicated additive bi-phasic changes induced by radiation and hyperthermia, respectively. Since Pi/β-NTP ratio had significant correlation to the tumor blood perfusion measured by hydrogen gas clearance studies, these bi-phasic changes were considered to correspond to two different physiological states, namely, ischemic and reperfused states. 31 P-MRS obtained from tumors could be useful to asses the physiological consequence following radiation, hyperthermia or the combined therapy. (author)

Cost-Effectiveness Comparison of Imaging-Guided Prostate Biopsy Techniques: Systematic Transrectal Ultrasound, Direct In-Bore MRI, and Image Fusion

NARCIS (Netherlands)

Venderink, W.; Govers, T.M.; Rooij, M. de; Futterer, J.J.; Sedelaar, J.P.M.

2017-01-01

OBJECTIVE: Three commonly used prostate biopsy approaches are systematic transrectal ultrasound guided, direct in-bore MRI guided, and image fusion guided. The aim of this study was to calculate which strategy is most cost-effective. MATERIALS AND METHODS: A decision tree and Markov model were

Combined treatment of 8 MHz radiofrequency hyperthermia and irradiation for advanced urological malignancies

International Nuclear Information System (INIS)

Nakajima, Kazuyoshi; Hisazumi, Haruo; Yamamoto, Hajime; Naito, Katsusuke; Misaki, Toshimitsu; Kobashi, Kazunori; Yokoyama, Osamu; Saito, Yasuo

1986-01-01

A combined therapy of irradiation and 8 MHz radiofrequency hyperthermia using Thermotron-RF Model 8 was carried out in a total of 26 patients with urological malignancies; 9 renal cancers, 1 renal capsular tumor, multiple liver metastatic lesions of renal cancer, a postoperative mediastinal metastasis of renal cancer, 2 ureteral cancers associated with bladder cancers, 4 bladder cancers, 4 prostatic cancers, a postoperative local recurrent tumor of an adult type Wilms' tumor, and multiple skin metastatic lesions of a penile cancer. Previous therapies were unsuccessful, or surgical interventions were not indicated because of poor general conditions. They were irradiated with daily 1.8 to 2.0 Gy, 5 times a week, or daily 2.0 to 4.0 Gy twice a week. Hyperthermia was induced twice a week within one hour after each irradiation, in total 10 times for 5 weeks. Intratumoral temperature was kept between 42.0 to 44.0 deg C. Clinical efficacy was evaluated by CT, ultrasound and biochemical data. Partial tumor regression, defined as the regression of 50 % or more, was obtained in one of the 9 renal cancers, in the mediastinal metastasis of renal cancer, 2 of the 4 prostatic cancers, one of the 4 bladder cancers and the 2 ureteral cancers, CR was obtained in the 2 associated bladder cancers. As side effects, a mild skin burns and anorexia were observed in approximately 50 % of the cases. Subcutaneous fat tissue indurations occurred in 6 of the 30 patients, who had 15 mm or more thickness of subdermal fat tissues, after treatment. (author)

A TMS coil positioning/holding system for MR image-guided TMS interleaved with fMRI.

Science.gov (United States)

Bohning, Daryl E; Denslow, S; Bohning, P A; Walker, J A; George, M S

2003-11-01

Transcranial magnetic stimulation (TMS) can be interleaved with fMRI to visualize regional brain activity in response to direct, non-invasive, cortical stimulation, making it a promising tool for studying brain function. A major practical difficulty is accurately positioning the TMS coil within the MRI scanner for stimulating a particular area of brain cortex. The objective of this work was to design and build a self-contained hardware/software system for MR-guided TMS coil positioning in interleaved TMS/fMRI studies. A compact, manually operated, articulated TMS coil positioner/holder with 6 calibrated degrees of freedom was developed for use inside a cylindrical RF head coil, along with a software package for transforming between MR image coordinates, MR scanner space coordinates, and positioner/holder settings. Phantom calibration studies gave an accuracy for positioning within setups of dx=+/-1.9 mm, dy=+/-1.4 mm, dz=+/-0.8 mm and a precision for multiple setups of dx=+/-0.8 mm, dy=+/-0.1 mm, dz=+/-0.1 mm. This self-contained, integrated MR-guided TMS system for interleaved TMS/fMRI studies provides fast, accurate location of motor cortex stimulation sites traditionally located functionally, and a means of consistent, anatomy-based TMS coil positioning for stimulation of brain areas without overt response.

WE-EF-BRD-00: New Developments in Hybrid MR-Treatment: Applications

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

WE-EF-BRD-00: New Developments in Hybrid MR-Treatment: Applications

International Nuclear Information System (INIS)

2015-01-01

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php

Hyperthermia and chemotherapy agent

International Nuclear Information System (INIS)

Roizin-Towle, L.; Hall, E.J.

1981-01-01

The use of chemotherapeutic agents for the treatment of cancer dates back to the late 19th century, but the modern era of chemotherapy drugs was ushered in during the 1940's with the development of the polyfunctional alkylating agent. Since then, numerous classes of drugs have evolved and the combined use of antineoplastic agents with other treatment modalities such as radiation or heat, remains a large relatively unexplored area. This approach, combining local hyperthermia with chemotherapy agents affords a measure of targeting and selective toxicity not previously available for drugs. In this paper, the effects of adriamycin, bleomycin and cis-platinum are examined. The adjuvant use of heat may also reverse the resistance of hypoxic cells noted for some chemotherapy agents

Application and possible mechanisms of combining LLLT (low level laser therapy), infrared hyperthermia and ionizing radiation in the treatment of cancer

Science.gov (United States)

Abraham, Edward H.; Woo, Van H.; Harlin-Jones, Cheryl; Heselich, Anja; Frohns, Florian

2014-02-01

Benefit of concomitant infrared hyperthermia and low level laser therapy and ionizing radiation is evaluated in this study. The purpose/objectives: presentation with locally advanced bulky superficial tumors is clinically challenging. To enhance the efficacy of chemotherapy and IMRT (intensity-modulated radiation therapy) and/or electron beam therapy we have developed an inexpensive and clinically effective infrared hyperthermia approach that combines black-body infrared radiation with halogen spectrum radiation and discrete wave length infrared clinical lasers LLLT. The goal is to produce a composite spectrum extending from the far infrared to near infrared and portions of the visible spectrum with discrete penetrating wavelengths generated by the clinical infrared lasers with frequencies of 810 nm and/or 830 nm. The composite spectrum from these sources is applied before and after radiation therapy. We monitor the surface and in some cases deeper temperatures with thermal probes, but use an array of surface probes as the limiting safe thermal constraint in patient treatment while at the same time maximizing infrared entry to deeper tissue layers. Fever-grade infrared hyperthermia is produced in the first centimeters while non-thermal infrared effects act at deeper tissue layers. The combination of these effects with ionizing radiation leads to improved tumor control in many cancers.

MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility

Energy Technology Data Exchange (ETDEWEB)

Garnon, J., E-mail: juliengarnon@gmail.com [Nouvel Hôpital Civil, Department of Interventional Radiology (France); Ramamurthy, N., E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Caudrelier J, J., E-mail: caudjean@yahoo.fr [Nouvel Hôpital Civil, Department of Interventional Radiology (France); Erceg, G., E-mail: erceggorislav@yahoo.com; Breton, E., E-mail: ebreton@unistra.fr [ICube, University of Strasbourg, CNRS (France); Tsoumakidou, G., E-mail: gtsoumakidou@yahoo.com; Rao, P., E-mail: pramodrao@me.com; Gangi, A., E-mail: gangi@unistra.fr [Nouvel Hôpital Civil, Department of Interventional Radiology (France)

2016-05-15

ObjectiveTo evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner.Materials and MethodsThis is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed.ResultsTarget lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6–11 cm). Average time for needle placement was 9.4 min (range 3–18 min); average duration of entire procedure was 42 min (range 27–62 min). 2–5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100 %, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5 %, respectively.ConclusionMRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.

Novel use of ViewRay MRI guidance for high-dose-rate brachytherapy in the treatment of cervical cancer.

Science.gov (United States)

Ko, Huaising C; Huang, Jessie Y; Miller, Jessica R; Das, Rupak K; Wallace, Charles R; De Costa, Anna-Maria A; Francis, David M; Straub, Margaret R; Anderson, Bethany M; Bradley, Kristin A

To characterize image quality and feasibility of using ViewRay MRI (VR)-guided brachytherapy planning for cervical cancer. Cervical cancer patients receiving intracavitary brachytherapy with tandem and ovoids, planned using 0.35T VR MRI at our institution, were included in this series. The high-risk clinical target volume (HR-CTV), visible gross tumor volume, bladder, sigmoid, bowel, and rectum contours for each fraction of brachytherapy were evaluated for dosimetric parameters. Typically, five brachytherapy treatments were planned using the T2 sequence on diagnostic MRI for the first and third fractions, and a noncontrast true fast imaging with steady-state precession sequence on VR or CT scan for the remaining fractions. Most patients received 5.5 Gy × 5 fractions using high-dose-rate Ir-192 following 45 Gy of whole-pelvis radiotherapy. The plan was initiated at 5.5 Gy to point A and subsequently optimized and prescribed to the HR-CTV. The goal equivalent dose in 2 Gy fractions for the combined external beam and brachytherapy dose was 85 Gy. Soft-tissue visualization using contrast-to-noise ratios to distinguish normal tissues from tumor at their interface was compared between diagnostic MRI, CT, and VR. One hundred and forty-two fractions of intracavitary brachytherapy were performed from April 2015 to January 2017 on 29 cervical cancer patients, ranging from stages IB1 to IVA. The median HR-CTV was 27.78 cc, with median D 90 HR-CTV of 6.1 Gy. The median time from instrument placement to start of treatment using VR was 65 min (scan time 2 min), compared to 105 min using diagnostic MRI (scan time 11 min) (t-test, p < 0.01). The contrast-to-noise ratio of tumor to cervix in both diagnostic MRI and VR had significantly higher values compared to CT (ANOVA and t-tests, p < 0.01). We report the first clinical use of VR-guided brachytherapy. Time to treatment using this approach was shorter compared to diagnostic MRI. VR also provided significant

Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

Energy Technology Data Exchange (ETDEWEB)

Ross, Anthony B [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Diederich, Chris J [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Nau, William H [Thermal Therapy Research Group, UCSF Radiation Oncology, San Francisco, CA (United States); Gill, Harcharan [Department of Urology, Stanford University, Stanford, CA (United States); Bouley, Donna M [Department of Comparative Medicine, Stanford University, Stanford, CA (United States); Daniel, Bruce [Department of Radiology, Stanford University, Stanford, CA (United States); Rieke, Viola [Department of Radiology, Stanford University, Stanford, CA (United States); Butts, R Kim [Department of Radiology, Stanford University, Stanford, CA (United States); Sommer, Graham [Department of Radiology, Stanford University, Stanford, CA (United States)

2004-01-21

Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the tubular applicator ) produced coagulated zones covering a wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, {approx}8 MHz) generated thermal lesions of {approx}30 extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 each) demonstrated controllable coagulation of a 270 contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

Dedifferentiated chondrosarcoma: use of MRI to guide needle biopsy

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Saifuddin, A. E-mail: asaifuddin@aol.com; Mann, B.S.; Mahroof, S.; Pringle, J.A.S.; Briggs, T.W.R.; Cannon, S.R

2004-03-01

AIM: To describe the use of MRI to identify and biopsy areas of dedifferentiation in patients with a suspected diagnosis of dedifferentiated chondrosarcoma. MATERIALS AND METHODS: Low-grade chondrosarcoma is characterized at magnetic resonance imaging (MRI) as having a lobulate, hyperintense appearance on T2-weighted spin-echo sequences. T2-weighted MR images were assessed in 15 patients with a final pathological diagnosis of dedifferentiated chondrosarcoma for regions of atypical reduced signal intensity. Information regarding the site of ultrasound or computed tomography (CT)-guided biopsy was available in 10 cases. RESULTS: Nine patients were male and six female with a mean age of 60 years (range 25-77 years). The sites involved were the distal femur (n=4), pelvis (n=3), proximal femur (n=4), femoral diaphysis (n=1), proximal humerus (n=2) and proximal tibia (n=1). The dedifferentiated component consisted of osteosarcoma (n=5), malignant fibrous histiocytoma (n=6), spindle cell sarcoma (n=1), leiomyosarcoma (n=1) and pleomorphic sarcoma (n=1). In 14 of the 15 cases, areas of lower signal intensity lacking in lobulation were identified. In nine of the 10 cases, biopsy site included such areas and yielded high-grade sarcoma. CONCLUSIONS: Dedifferentiation within chondrosarcoma may be identified on T2-weighted MRI as areas of reduced signal intensity. These areas should be the preferred site of biopsy.

Efficiency of lipofection combined with hyperthermia in Lewis lung carcinoma cells and a rodent pleural dissemination model of lung carcinoma.

Science.gov (United States)

Okita, Atsushi; Mushiake, Hiroyuki; Tsukuda, Kazunori; Aoe, Motoi; Murakami, Masakazu; Andou, Akio; Shimizu, Nobuyoshi

2004-06-01

We have previously reported that hyperthermia at 41 degrees C enhanced lipofection-mediated gene transduction into cultured cells. In this study, we adapted hyperthermia technique to novel cationic liposome (Lipofectamine 2000) mediated gene transfection into Lewis lung carcinoma cells in vitro and in vivo. In vitro, transfection efficiencies were 38.9+/-3.3% by lipofection alone and 52.1+/-2.6% by lipofection with hyperthermia for 30 min, and 62.5+/-5.5% and 81.4+/-3.2% for 1 h, respectively. Hyperthermia significantly enhanced gene transfection efficiency 1.2-1.4 times more than that with lipofection only. We also evaluated the effect of hyperthermia with a pleural dissemination model of lung carcinoma of mice. We developed a model which was well-tolerated with hyperthermia with lipofection by the mice. In spite of repeated treatments, transfection efficiencies were very low and we could not show the augmentation of gene transfection by hyperthermia. Though Lipofectamine 2000 showed strong gene transduction effect and hyperthermia augmented its effect in vitro, further evaluation is needed to adapt both techniques in vivo.

The application of hyperthermia in regional chemotherapy.

Science.gov (United States)

Di Filippo, F; Anzà, M; Rossi, C R; Cavaliere, F; Botti, C; Lise, M; Garinei, R; Giannarelli, D; Vasselli, S; Zupi, G; Cavaliere, R

1998-01-01

To evaluate the role of hyperthermia combined with chemotherapy in the loco-regional treatment of tumors, a retrospective analysis was done with 228 limb melanoma patients treated with hyperthermic antiblastic perfusion (HAP). A series of treatment- and tumor-related prognostic factors was analyzed to establish their influence on tumor response, loco-regional control, and survival. Concerning tumor response, the logistic model showed that the number of lesions and the minimal tumor temperature (min T) maintained their individual predictive values (P < 0.000001 and P = 0.04, respectively). For loco-regional control, only the number of lesions had a significant predictive value. No direct correlation was found between the treatment-related variables and loco-regional control. However, the 5-year survival rate was significantly higher for patients who achieved a complete response (CR) (51.5%, P = 0.0033) as compared to those who did not (33.3%), providing indirect evidence of the role of the treatment. Multivariate analysis showed that both disease-free and overall survival are strongly influenced by numerous clinical variables and the min T always maintained its significance. When analyzing the subgroup of 119 patients evaluable for tumor response, the Cox model selected the tumor response as the dominant factor for both disease-free and overall survival. These data seem to demonstrate that the optimization of treatment parameters is crucial in determining the CR rate, which, in turn, positively affects the disease outcome. HAP is the treatment of choice for recurrent limb melanoma, and hyperthermia plays an important role in exploiting the efficacy of this technique.

Lobular neoplasia detected in MRI-guided core biopsy carries a high risk for upgrade: a study of 63 cases from four different institutions

Science.gov (United States)

Khoury, Thaer; Kumar, Prasanna R; Li, Zaibo; Karabakhtsian, Rouzan G; Sanati, Souzan; Chen, Xiwei; Wang, Dan; Liu, Song; Reig, Beatriu

2017-01-01

There are certain criteria to recommend surgical excision for lobular neoplasia diagnosed in mammographically detected core biopsy. The aims of this study are to explore the rate of upgrade of lobular neoplasia detected in magnetic resonance imaging (MRI)-guided biopsy and to investigate the clinicopathological and radiological features that could predict upgrade. We reviewed 1655 MRI-guided core biopsies yielding 63 (4%) cases of lobular neoplasia. Key clinical features were recorded. MRI findings including mass vs non-mass enhancement and the reason for biopsy were also recorded. An upgrade was defined as the presence of invasive carcinoma or ductal carcinoma in situ in subsequent surgical excision. The overall rate of lobular neoplasia in MRI-guided core biopsy ranged from 2 to 7%, with an average of 4%. A total of 15 (24%) cases had an upgrade, including 5 cases of invasive carcinoma and 10 cases of ductal carcinoma in situ. Pure lobular neoplasia was identified in 34 cases, 11 (32%) of which had upgrade. In this group, an ipsilateral concurrent or past history of breast cancer was found to be associated with a higher risk of upgrade (6/11, 55%) than contralateral breast cancer (1 of 12, 8%; P = 0.03). To our knowledge, this is the largest series of lobular neoplasia diagnosed in MRI-guided core biopsy. The incidence of lobular neoplasia is relatively low. Lobular neoplasia detected in MRI-guided biopsy carries a high risk for upgrade warranting surgical excision. However, more cases from different types of institutions are needed to verify our results. PMID:26564004

Temperature simulations in hyperthermia treatment planning of the head and neck region. Rigorous optimization of tissue properties

Energy Technology Data Exchange (ETDEWEB)

Verhaart, Rene F.; Rijnen, Zef; Verduijn, Gerda M.; Paulides, Margarethus M. [Erasmus MC - Cancer Institute, Department of Radiation Oncology, Hyperthermia Unit, Rotterdam (Netherlands); Fortunati, Valerio; Walsum, Theo van; Veenland, Jifke F. [Erasmus MC, Departments of Medical Informatics and Radiology, Biomedical Imaging Group Rotterdam, Rotterdam (Netherlands)

2014-12-15

Hyperthermia treatment planning (HTP) is used in the head and neck region (H and N) for pretreatment optimization, decision making, and real-time HTP-guided adaptive application of hyperthermia. In current clinical practice, HTP is based on power-absorption predictions, but thermal dose-effect relationships advocate its extension to temperature predictions. Exploitation of temperature simulations requires region- and temperature-specific thermal tissue properties due to the strong thermoregulatory response of H and N tissues. The purpose of our work was to develop a technique for patient group-specific optimization of thermal tissue properties based on invasively measured temperatures, and to evaluate the accuracy achievable. Data from 17 treated patients were used to optimize the perfusion and thermal conductivity values for the Pennes bioheat equation-based thermal model. A leave-one-out approach was applied to accurately assess the difference between measured and simulated temperature (∇T). The improvement in ∇T for optimized thermal property values was assessed by comparison with the ∇T for values from the literature, i.e., baseline and under thermal stress. The optimized perfusion and conductivity values of tumor, muscle, and fat led to an improvement in simulation accuracy (∇T: 2.1 ± 1.2 C) compared with the accuracy for baseline (∇T: 12.7 ± 11.1 C) or thermal stress (∇T: 4.4 ± 3.5 C) property values. The presented technique leads to patient group-specific temperature property values that effectively improve simulation accuracy for the challenging H and N region, thereby making simulations an elegant addition to invasive measurements. The rigorous leave-one-out assessment indicates that improvements in accuracy are required to rely only on temperature-based HTP in the clinic. (orig.) [German] Die Hyperthermiebehandlungsplanung (HTP, ''hyperthermia treatment planning'') wird in der Kopf- und Halsregion zur Optimierung der

In vivo MR guided boiling histotripsy in a mouse tumor model evaluated by MRI and histopathology.

Science.gov (United States)

Hoogenboom, Martijn; Eikelenboom, Dylan; den Brok, Martijn H; Veltien, Andor; Wassink, Melissa; Wesseling, Pieter; Dumont, Erik; Fütterer, Jurgen J; Adema, Gosse J; Heerschap, Arend

2016-06-01

Boiling histotripsy (BH) is a new high intensity focused ultrasound (HIFU) ablation technique to mechanically fragmentize soft tissue into submicrometer fragments. So far, ultrasound has been used for BH treatment guidance and evaluation. The in vivo histopathological effects of this treatment are largely unknown. Here, we report on an MR guided BH method to treat subcutaneous tumors in a mouse model. The treatment effects of BH were evaluated one hour and four days later with MRI and histopathology, and compared with the effects of thermal HIFU (T-HIFU). The lesions caused by BH were easily detected with T2 w imaging as a hyper-intense signal area with a hypo-intense rim. Histopathological evaluation showed that the targeted tissue was completely disintegrated and that a narrow transition zone (<200 µm) containing many apoptotic cells was present between disintegrated and vital tumor tissue. A high level of agreement was found between T2 w imaging and H&E stained sections, making T2 w imaging a suitable method for treatment evaluation during or directly after BH. After T-HIFU, contrast enhanced imaging was required for adequate detection of the ablation zone. On histopathology, an ablation zone with concentric layers was seen after T-HIFU. In line with histopathology, contrast enhanced MRI revealed that after BH or T-HIFU perfusion within the lesion was absent, while after BH in the transition zone some micro-hemorrhaging appeared. Four days after BH, the transition zone with apoptotic cells was histologically no longer detectable, corresponding to the absence of a hypo-intense rim around the lesion in T2 w images. This study demonstrates the first results of in vivo BH on mouse tumor using MRI for treatment guidance and evaluation and opens the way for more detailed investigation of the in vivo effects of BH. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Robust medical image segmentation for hyperthermia treatment planning

International Nuclear Information System (INIS)

Neufeld, E.; Chavannes, N.; Kuster, N.; Samaras, T.

2005-01-01

Full text: This work is part of an ongoing effort to develop a comprehensive hyperthermia treatment planning (HTP) tool. The goal is to unify all the steps necessary to perform treatment planning - from image segmentation to optimization of the energy deposition pattern - in a single tool. The bases of the HTP software are the routines and know-how developed in our TRINTY project that resulted the commercial EM platform SEMCAD-X. It incorporates the non-uniform finite-difference time-domain (FDTD) method, permitting the simulation of highly detailed models. Subsequently, in order to create highly resolved patient models, a powerful and robust segmentation tool is needed. A toolbox has been created that allows the flexible combination of various segmentation methods as well as several pre-and postprocessing functions. It works primarily with CT and MRI images, which it can read in various formats. A wide variety of segmentation methods has been implemented. This includes thresholding techniques (k-means classification, expectation maximization and modal histogram analysis for automatic threshold detection, multi-dimensional if required), region growing methods (with hysteretic behavior and simultaneous competitive growing), an interactive marker based watershed transformation, level-set methods (homogeneity and edge based, fast-marching), a flexible live-wire implementation as well as fuzzy connectedness. Due to the large number of tissues that need to be segmented for HTP, no methods that rely on prior knowledge have been implemented. Various edge extraction routines, distance transforms, smoothing techniques (convolutions, anisotropic diffusion, sigma filter...), connected component analysis, topologically flexible interpolation, image algebra and morphological operations are available. Moreover, contours or surfaces can be extracted, simplified and exported. Using these different techniques on several samples, the following conclusions have been drawn: Due to the

Intracavitary ultrasound phased arrays for thermal therapies

Science.gov (United States)

Hutchinson, Erin

Currently, the success of hyperthermia and thermal surgery treatments is limited by the technology used in the design and fabrication of clinical heating devices and the completeness of the thermometry systems used for guidance. For both hyperthermia and thermal surgery, electrically focused ultrasound generated by phased arrays provides a means of controlling localized energy deposition in body tissues. Intracavitary applicators can be used to bring the energy source close to a target volume, such as the prostate, thereby minimizing normal tissue damage. The work performed in this study was aimed at improving noninvasive prostate thermal therapies and utilized three research approaches: (1) Acoustic, thermal and optimization simulations, (2) Design and fabrication of multiple phased arrays, (3) Ex vivo and in vivo experimental testing of the heating capabilities of the phased arrays. As part of this study, a novel aperiodic phased array design was developed which resulted in a 30- 45% reduction in grating lobe levels when compared to conventional phased arrays. Measured acoustic fields generated by the constructed aperiodic arrays agreed closely with the fields predicted by the theoretical simulations and covered anatomically appropriate ranges. The power capabilities of these arrays were demonstrated to be sufficient for the purposes of hyperthermia and thermal surgery. The advantage of using phased arrays in place of fixed focus transducers was shown by demonstrating the ability of electronic scanning to increase the size of the necrosed tissue volume while providing a more uniform thermal dose, which can ultimately reduce patient treatment times. A theoretical study on the feasibility of MRI (magnetic resonance imaging) thermometry for noninvasive temperature feedback control was investigated as a means to improve transient and steady state temperature distributions achieved in hyperthermia treatments. MRI guided ex vivo and in vivo experiments demonstrated

The ViewRay system: magnetic resonance-guided and controlled radiotherapy.

Science.gov (United States)

Mutic, Sasa; Dempsey, James F

2014-07-01

A description of the first commercially available magnetic resonance imaging (MRI)-guided radiation therapy (RT) system is provided. The system consists of a split 0.35-T MR scanner straddling 3 (60)Co heads mounted on a ring gantry, each head equipped with independent doubly focused multileaf collimators. The MR and RT systems share a common isocenter, enabling simultaneous and continuous MRI during RT delivery. An on-couch adaptive RT treatment-planning system and integrated MRI-guided RT control system allow for rapid adaptive planning and beam delivery control based on the visualization of soft tissues. Treatment of patients with this system commenced at Washington University in January 2014. Copyright © 2014 Elsevier Inc. All rights reserved.

Thermal Skin Damage During Reirradiation and Hyperthermia Is Time-Temperature Dependent

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Bakker, Akke, E-mail: akke.bakker@amc.uva.nl [Department of Radiation Oncology, Academic Medical Center (AMC), Amsterdam (Netherlands); Kolff, M. Willemijn [Department of Radiation Oncology, Academic Medical Center (AMC), Amsterdam (Netherlands); Holman, Rebecca [Clinical Research Unit, Academic Medical Center (AMC), Amsterdam (Netherlands); Leeuwen, Caspar M. van; Korshuize-van Straten, Linda; Kroon-Oldenhof, Rianne de; Rasch, Coen R.N.; Tienhoven, Geertjan van; Crezee, Hans [Department of Radiation Oncology, Academic Medical Center (AMC), Amsterdam (Netherlands)

2017-06-01

Purpose: To investigate the relationship of thermal skin damage (TSD) to time–temperature isoeffect levels for patients with breast cancer recurrence treated with reirradiation plus hyperthermia (reRT + HT), and to investigate whether the treatment history of previous treatments (scar tissue) is a risk factor for TSD. Methods and Materials: In this observational study, temperature characteristics of hyperthermia sessions were analyzed in 262 patients with recurrent breast cancer treated in the AMC between 2010 and 2014 with reirradiation and weekly hyperthermia for 1 hour. Skin temperature was measured using a median of 42 (range, 29-82) measurement points per hyperthermia session. Results: Sixty-eight patients (26%) developed 79 sites of TSD, after the first (n=26), second (n=17), third (n=27), and fourth (n=9) hyperthermia session. Seventy percent of TSD occurred on or near scar tissue. Scar tissue reached higher temperatures than other skin tissue (0.4°C, P<.001). A total of 102 measurement points corresponded to actual TSD sites in 35 of 79 sessions in which TSD developed. Thermal skin damage sites had much higher maximum temperatures than non-TSD sites (2.8°C, P<.001). Generalized linear mixed models showed that the probability of TSD is related to temperature and thermal dose values (P<.001) and that scar tissue is more at risk (odds ratio 0.4, P<.001). Limiting the maximum temperature of a measurement point to 43.7°C would mean that the probability of observing TSD was at most 5%. Conclusion: Thermal skin damage during reRT + HT for recurrent breast cancer was related to higher local temperatures and time–temperature isoeffect levels. Scar tissue reached higher temperatures than other skin tissue, and TSD occurred at lower temperatures and thermal dose values in scar tissue compared with other skin tissue. Indeed, TSD developed often on and around scar tissue from previous surgical procedures.

On the Potential Role of MRI Biomarkers of COPD to Guide Bronchoscopic Lung Volume Reduction.

Science.gov (United States)

Adams, Colin J; Capaldi, Dante P I; Di Cesare, Robert; McCormack, David G; Parraga, Grace

2018-02-01

In patients with severe emphysema and poor quality of life, bronchoscopic lung volume reduction (BLVR) may be considered and guided based on lobar emphysema severity. In particular, x-ray computed tomography (CT) emphysema measurements are used to identify the most diseased and the second-most diseased lobes as BLVR targets. Inhaled gas magnetic resonance imaging (MRI) also provides chronic obstructive pulmonary disease (COPD) biomarkers of lobar emphysema and ventilation abnormalities. Our objective was to retrospectively evaluate CT and MRI biomarkers of lobar emphysema and ventilation in patients with COPD eligible for BLVR. We hypothesized that MRI would provide complementary biomarkers of emphysema and ventilation that help determine the most appropriate lung lobar targets for BLVR in patients with COPD. We retrospectively evaluated 22 BLVR-eligible patients from the Thoracic Imaging Network of Canada cohort (diffusing capacity of the lung for carbon monoxide = 37 ± 12% predicted , forced expiratory volume in 1 second = 34 ± 7% predicted , total lung capacity = 131 ± 17% predicted , and residual volume = 216 ± 36% predicted ). Lobar CT emphysema, measured using a relative area of concept retrospective analysis, quantitative MRI ventilation and CT emphysema measurements provided different BLVR targets in over 30% of the patients. The presence of large MRI ventilation defects in lobes next to CT-targeted lobes might also change the decision to proceed or to guide BLVR to a different lobar target. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Prospective phase II trial of regional hyperthermia and whole liver irradiation for numerous chemorefratory liver metastases from colerectal cancer

Energy Technology Data Exchange (ETDEWEB)

Yu, Jeong Il; Park, Hee Chul; Choi, Doo Ho [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

2016-03-15

A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.

MRI of pituitary adenomas following treatment

Energy Technology Data Exchange (ETDEWEB)

Gouliamos, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Athanassopoulou, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Rologis, D. [Neurosurgical Clinic, Athens General Hospital (Greece); Kalovidouris, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Kotoulas, G. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Vlahos, L. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Papavassiliou, C. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece)

1993-10-01

The purpose of this study was to assess pituitary adenomas following surgical and/or medical treatment in 28 patients. All patients were evaluated with both computed tomography (CT) and magnetic resonance imaging (MRI). The results were correlated with the clinical findings. Apart from the visualization of the adenoma itself (either residual or recurrent) other findings and in particular, morphological changes of the optic chiasm, the pituitary stalk and the sellar floor were evaluated with both imaging modalities. By comparing the two imaging modalities it was found that MRI was superior to CT in demonstrating residual/recurrent adenoma as well as evaluating the morphological changes of the optic chiasm and optic nerves. CT was superior or equal to MR in demonstrating the sellar floor changes. The intra-operatively implanted fat was equally seen by CT and MR. In conclusion, the anatomical variations of the optic chiasm and pituitary stalk are better visualized by MRI and allow a more precise evaluation of changes attributed to surgical or medical treatment of pituitary adenomas. (orig.)

MRI of pituitary adenomas following treatment

International Nuclear Information System (INIS)

Gouliamos, A.; Athanassopoulou, A.; Rologis, D.; Kalovidouris, A.; Kotoulas, G.; Vlahos, L.; Papavassiliou, C.

1993-01-01

The purpose of this study was to assess pituitary adenomas following surgical and/or medical treatment in 28 patients. All patients were evaluated with both computed tomography (CT) and magnetic resonance imaging (MRI). The results were correlated with the clinical findings. Apart from the visualization of the adenoma itself (either residual or recurrent) other findings and in particular, morphological changes of the optic chiasm, the pituitary stalk and the sellar floor were evaluated with both imaging modalities. By comparing the two imaging modalities it was found that MRI was superior to CT in demonstrating residual/recurrent adenoma as well as evaluating the morphological changes of the optic chiasm and optic nerves. CT was superior or equal to MR in demonstrating the sellar floor changes. The intra-operatively implanted fat was equally seen by CT and MR. In conclusion, the anatomical variations of the optic chiasm and pituitary stalk are better visualized by MRI and allow a more precise evaluation of changes attributed to surgical or medical treatment of pituitary adenomas. (orig.)

Inverse treatment planning based on MRI for HDR prostate brachytherapy

International Nuclear Information System (INIS)

Citrin, Deborah; Ning, Holly; Guion, Peter; Li Guang; Susil, Robert C.; Miller, Robert W.; Lessard, Etienne; Pouliot, Jean; Xie Huchen; Capala, Jacek; Coleman, C. Norman; Camphausen, Kevin; Menard, Cynthia

2005-01-01

Purpose: To develop and optimize a technique for inverse treatment planning based solely on magnetic resonance imaging (MRI) during high-dose-rate brachytherapy for prostate cancer. Methods and materials: Phantom studies were performed to verify the spatial integrity of treatment planning based on MRI. Data were evaluated from 10 patients with clinically localized prostate cancer who had undergone two high-dose-rate prostate brachytherapy boosts under MRI guidance before and after pelvic radiotherapy. Treatment planning MRI scans were systematically evaluated to derive a class solution for inverse planning constraints that would reproducibly result in acceptable target and normal tissue dosimetry. Results: We verified the spatial integrity of MRI for treatment planning. MRI anatomic evaluation revealed no significant displacement of the prostate in the left lateral decubitus position, a mean distance of 14.47 mm from the prostatic apex to the penile bulb, and clear demarcation of the neurovascular bundles on postcontrast imaging. Derivation of a class solution for inverse planning constraints resulted in a mean target volume receiving 100% of the prescribed dose of 95.69%, while maintaining a rectal volume receiving 75% of the prescribed dose of <5% (mean 1.36%) and urethral volume receiving 125% of the prescribed dose of <2% (mean 0.54%). Conclusion: Systematic evaluation of image spatial integrity, delineation uncertainty, and inverse planning constraints in our procedure reduced uncertainty in planning and treatment

Computational evaluation of amplitude modulation for enhanced magnetic nanoparticle hyperthermia.

Science.gov (United States)

Soetaert, Frederik; Dupré, Luc; Ivkov, Robert; Crevecoeur, Guillaume

2015-10-01

Magnetic nanoparticles (MNPs) can interact with alternating magnetic fields (AMFs) to deposit localized energy for hyperthermia treatment of cancer. Hyperthermia is useful in the context of multimodality treatments with radiation or chemotherapy to enhance disease control without increased toxicity. The unique attributes of heat deposition and transfer with MNPs have generated considerable attention and have been the focus of extensive investigations to elucidate mechanisms and optimize performance. Three-dimensional (3D) simulations are often conducted with the finite element method (FEM) using the Pennes' bioheat equation. In the current study, the Pennes' equation was modified to include a thermal damage-dependent perfusion profile to improve model predictions with respect to known physiological responses to tissue heating. A normal distribution of MNPs in a model liver tumor was combined with empirical nanoparticle heating data to calculate tumor temperature distributions and resulting survival fraction of cancer cells. In addition, calculated spatiotemporal temperature changes were compared among magnetic field amplitude modulations of a base 150-kHz sinusoidal waveform, specifically, no modulation, sinusoidal, rectangular, and triangular modulation. Complex relationships were observed between nanoparticle heating and cancer tissue damage when amplitude modulation and damage-related perfusion profiles were varied. These results are tantalizing and motivate further exploration of amplitude modulation as a means to enhance efficiency of and overcome technical challenges associated with magnetic nanoparticle hyperthermia (MNH).

A Reconstruction Method for the Estimation of Temperatures of Multiple Sources Applied for Nanoparticle-Mediated Hyperthermia.

Science.gov (United States)

Steinberg, Idan; Tamir, Gil; Gannot, Israel

2018-03-16

Solid malignant tumors are one of the leading causes of death worldwide. Many times complete removal is not possible and alternative methods such as focused hyperthermia are used. Precise control of the hyperthermia process is imperative for the successful application of such treatment. To that end, this research presents a fast method that enables the estimation of deep tissue heat distribution by capturing and processing the transient temperature at the boundary based on a bio-heat transfer model. The theoretical model is rigorously developed and thoroughly validated by a series of experiments. A 10-fold improvement is demonstrated in resolution and visibility on tissue mimicking phantoms. The inverse problem is demonstrated as well with a successful application of the model for imaging deep-tissue embedded heat sources. Thereby, allowing the physician then ability to dynamically evaluate the hyperthermia treatment efficiency in real time.

A thermocouple thermometry system for ultrasound hyperthermia

International Nuclear Information System (INIS)

Ozarka, M.; Gharakhani, A.; Magin, R.; Cain, C.

1984-01-01

A thermometry system designed to be used in the treatment of cancer by ultrasound hyperthermia is described. The system monitors tumor temperatures using 16 type T (copper-constantan) thermocouples and is controlled by a 12 MHz Intel 8031 microcomputer. An analog circuit board contains the thermocouple amplifiers, an analog multiplexer, scaling circuitry, and an analog to digital converter. A digital board contains the Intel 8031, program memory, data memory, as well as circuitry for control and data communications. Communication with the hyperthermia system control computer is serially by RS-232 with selectable baud rate. Since the thermocouple amplifiers may have slight differences in gain and offset, a calibrated offset is added to a lookup table value to obtain the proper display temperature to within +- 0.1 0 C. The calibration routine, implemented in software, loads a nonvolatile random access memory chip with the proper offset values based on the outputs of each thermocouple channel at known temperatures which bracket a range of interest

Combination of hyperthermia and radiation in the treatment of experimental tumours in mice

International Nuclear Information System (INIS)

Jansen, W.

1980-01-01

The effects of hyperthermia as a single agent and in interaction with ionizing radiation are investigated on tumours in mice. The degree of enhancement of the radiation reaction by heat proved to be similar to that found for mouse skin. (Auth.)

Transient mild hyperthermia induces E-selectin mediated localization of mesoporous silicon vectors in solid tumors.

Directory of Open Access Journals (Sweden)

Dickson K Kirui

Full Text Available BACKGROUND: Hyperthermia treatment has been explored as a strategy to overcome biological barriers that hinder effective drug delivery in solid tumors. Most studies have used mild hyperthermia treatment (MHT to target the delivery of thermo-sensitive liposomes carriers. Others have studied its application to permeabilize tumor vessels and improve tumor interstitial transport. However, the role of MHT in altering tumor vessel interfacial and adhesion properties and its relationship to improved delivery has not been established. In the present study, we evaluated effects of MHT treatment on tumor vessel flow dynamics and expression of adhesion molecules and assessed enhancement in particle localization using mesoporous silicon vectors (MSVs. We also determined the optimal time window at which maximal accumulation occur. RESULTS: In this study, using intravital microscopy analyses, we showed that temporal mild hyperthermia (∼1 W/cm(2 amplified delivery and accumulation of MSVs in orthotopic breast cancer tumors. The number of discoidal MSVs (1000×400 nm adhering to tumor vasculature increased 6-fold for SUM159 tumors and 3-fold for MCF-7 breast cancer tumors. By flow chamber experiments and Western blotting, we established that a temporal increase in E-selectin expression correlated with enhanced particle accumulation. Furthermore, MHT treatment was shown to increase tumor perfusion in a time-dependent fashion. CONCLUSIONS: Our findings reveal that well-timed mild hyperthermia treatment can transiently elevate tumor transport and alter vascular adhesion properties and thereby provides a means to enhance tumor localization of non-thermally sensitive particles such as MSVs. Such enhancement in accumulation could be leveraged to increase therapeutic efficacy and reduce drug dosing in cancer therapy.

Methamphetamine-induced hyperthermia and dopaminergic neurotoxicity in mice: pharmacological profile of protective and nonprotective agents.

Science.gov (United States)

Albers, D S; Sonsalla, P K

1995-12-01

Neurotoxic doses of methamphetamine (METH) can cause hyperthermia in experimental animals. Damage sustained to dopaminergic nerve terminals by this stimulant can be reduced by environmental cooling or by pharmacological manipulation which attenuates the hyperthermia. Many pharmacological agents with very diverse actions protect against METH-induced neuropathology. Several of these compounds, as well as drugs which do not protect, were investigated to determine if there was a relationship between protection and METH-induced hyperthermia. Mice received METH with or without concurrent administration of other drugs and core (i.e., colonic) temperature was monitored during treatment. The animals were sacrificed > or = 5 days later and neostriatal tyrosine hydroxylase activity and dopamine were measured. Core temperature was significantly elevated (> or = 2 degrees C) in mice treated with doses of METH which produced > or = 90% losses in striatal dopamine but not in mice less severally affected (only 50% loss of dopamine). Concurrent treatment of mice with METH and pharmacological agents which protected partially or completely from METH-induced toxicity also prevented the hyperthermic response (i.e., dopamine receptor antagonists, fenfluramine, dizocilpine, alpha-methyl-p-tyrosine, phenytoin, aminooxyacetic acid and propranol). These findings are consistent with the hypothesis that the hyperthermia produced by METH contributes to its neuropathology. However, studies with reserpine, a compound which dramatically lowers core temperature, demonstrated that hyperthermia per se is not a requirement for METH-induced neurotoxicity. Although core temperature was elevated in reserpinized mice treated with METH as compared with reserpinized control mice, their temperatures remained significantly lower than in nonreserpinized control mice. However, the hypothermic state produced in the reserpinized mice did not provide protection from METH-induced toxicity. These data demonstrate

Improving efficacy of hyperthermia in oncology by exploiting biological mechanisms

DEFF Research Database (Denmark)

van den Tempel, Nathalie; Horsman, Michael R; Kanaar, Roland

2016-01-01

It has long been established that hyperthermia increases the therapeutic benefit of radiation and chemotherapy in cancer treatment. During the last few years there have been substantial technical improvements in the sources used to apply and measure heat, which greatly increases enthusiasm for th...

A flexible 70 MHz phase-controlled double waveguide system for hyperthermia treatment of superficial tumours with deep infiltration.

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van Stam, Gerard; Kok, H Petra; Hulshof, Maarten C C M; Kolff, M Willemijn; van Tienhoven, Geertjan; Sijbrands, Jan; Bakker, Akke; Zum Vörde Sive Vörding, Paul J; Oldenborg, Sabine; de Greef, Martijn; Rasch, Coen R N; Crezee, Hans

2017-11-01

Superficial tumours with deep infiltration in the upper 15 cm of the trunk cannot be treated adequately with existing hyperthermia systems. The aim of this study was to develop, characterise and evaluate a new flexible two-channel hyperthermia system (AMC-2) for tumours in this region. The two-channel AMC-2 system has two horizontally revolving and height adjustable 70 MHz waveguides. Three different interchangeable antennas with sizes 20 × 34, 15 × 34 and 8.5 × 34 cm were developed and their electrical properties were determined. The performance of the AMC-2 system was tested by measurements of the electric field distribution in a saline water filled elliptical phantom, using an electric field vector probe. Clinical feasibility was demonstrated by treatment of a melanoma in the axillary region. Phantom measurements showed a good performance for all waveguides. The large reflection of the smallest antenna has to be compensated by increased forward power. Field patterns become asymmetrical when using smaller top antennas, necessitating phase corrections. The clinical application showed that tumours deeper than 4 cm can be heated adequately. A median tumour temperature of 42 °C can be reached up to 12 cm depth with adequate antenna positioning and phase-amplitude steering. This 70 MHz AMC-2 waveguide system is a useful addition to existing loco-regional hyperthermia equipment as it is capable of heating axillary tumours and other tumours deeper than 4 cm.

Part-body hyperthermia with a radiofrequency multiantenna applicator under online control in 1,5 T MR-tomograph

International Nuclear Information System (INIS)

Wust, P.; Gellermann, J.; Faehling, H.; Wlodarczyk, W.; Felix, R.; Seebass, M.; Turner, P.; Nadobny, J.; Rau, B.; Hildebrandt, B.; Schlag, P.M.; Oppelt, A.

2004-01-01

Objective of this study is the integration of a multiantenna applicator for part-body hyperthermia (BSD 2000/3D) in a 1.5 T MR-tomograph (Siemens Magnetom Symphony) in order to perform noninvasive MR monitoring in real time to increase safety and effectiveness of heat treatments. The positioning unit is mechanically coupled to the MR gantry from the back side and the body coil is utilised for imaging. For that purpose, the hyperthermia antenna system (100 MHz, 1.500 W) and the MR receiver(63.9 MHs) have to be decoupled in terms of high frequency (filter) and electromagnetically (emc). The processing of MR data sets is performed in a hyperthermia planning system. A simultaneous operation of radiofrequency hyperthermia and MR system is possible at clinically relevant power levels. MR imaging is used for tumor diagnostics (standard spin echo sequences), for hyperthermia planning (T1-weighted gradient echo sequences in equal- and opposed-phase techniques), and for temperature measurements according to the proton resonance frequency method (PRF method, phase evaluation registration using a gradient echo sequence with long echo time). In 33 patients with advanced pelvic and abdominal tumors we performed 150 heat sessions under MR monitoring. For 70% of these patients a visualisation of temperature sensitive data during treatment was possible. The evaluated difference images represent a superposition of real temperature increase and a (temperature-induced) perfusion elevation. The hybrid approach renders development of part body hyperthermia possible as an MR-controlled intervention in radiology. (orig.) [de

Individualised 3D printed vaginal template for MRI guided brachytherapy in locally advanced cervical cancer

DEFF Research Database (Denmark)

Lindegaard, Jacob Christian; Lænsø Madsen, Mads; Hansen, Anders Traberg

2016-01-01

Intracavitary–interstitial applicators for MRI guided brachytherapy are becoming increasingly important in locally advanced cervical cancer. The 3D printing technology enables a versatile method for obtaining a high degree of individualisation of the implant. Our clinical workflow is presented...

Depression of DNA synthesis rate following hyperthermia, gamma irradiation, cyclotron neutrons and mixed modalities

International Nuclear Information System (INIS)

Weber, H.J.; Muehlensiepen, H.; Porschen, W.; Feinendegen, L.E.; Dietzel, F.

1978-01-01

The incorporation of the thymidine analogue I-UdR is proportional to the activity of DNA synthesis. The maximum depression of 125-I-UdR incorporation occurs approximately 4 hours after all kinds of treatment. The increase which follow reflects cell processes like reoxygeneration, recovery, recycling and recruitment (although a direct relation is not yet demonstrable). The degree of depression 4 hours after treatment and the time required needs to reach control level is dependent on dose and radiation quaility but no such dependence could be clearly seen for the times of hyperthermia treatment we used. Neutron irradiation and the combination gamma irradiation + hyperthermia show a higher depression and a slower return to normal than gamma irradiation at the same dose. (orig.) [de

Materials Characterization of Feraheme/Ferumoxytol and Preliminary Evaluation of Its Potential for Magnetic Fluid Hyperthermia

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Jon Dobson

2013-08-01

Full Text Available Feraheme, is a recently FDA-cleared superparamagnetic iron oxide nanoparticle (SPION-based MRI contrast agent that is also employed in the treatment of iron deficiency anemia. Feraheme nanoparticles have a hydrodynamic diameter of 30 nm and consist of iron oxide crystallites complexed with a low molecular weight, semi-synthetic carbohydrate. These features are attractive for other potential biomedical applications such as magnetic fluid hyperthermia (MFH, since the carboxylated polymer coating affords functionalization of the particle surface and the size allows for accumulation in highly vascularized tumors via the enhanced permeability and retention effect. This work presents morphological and magnetic characterization of Feraheme by transmission electron microscopy (TEM, Energy dispersive X-ray spectroscopy (EDX, and superconducting quantum interference device (SQUID magnetometry. Additionally, the results of an initial evaluation of the suitability of Feraheme for MFH applications are described, and the data indicate the particles possess promising properties for this application.

Effects of methylglyoxal bis(guanylhydrazone) on tumour and skin responses to hyperthermia in mice

International Nuclear Information System (INIS)

Miyakoshi, J.; Oda, W.; Inagaki, C.; Hiraoka, M.; Takahashi, M.; Abe, M.

1984-01-01

Effects of methylglyoxal bis(guanylhydrazone) (MGBG) on tumour and skin responses to hyperthermia (42degC) were examined in C3H mice. MGBG (50 mg/kg) was administered intraperitoneally to mice 4 hours before hyperthermic treatment. The tumour (FM3A) growth time was elongated by an amount dependent on the exposure time of treatment at 42degC (60, 90 and 120 min). Pre-treatment of mice with MGBG (50 mg/kg, i.p.) apparently further lengthened the tumour growth time after treatment at 42degC. No significant damage of foot skin was caused by 42degC hyperthermia. Pre-treatment with MGBG did not make the foot skin susceptible to the heating. From these findings, it can be considered that MGBG or related less-toxic compounds may have a clinical advantage for the mild (42degC) hyperthermic treatment in cancer therapy. (author)

Effects of methylglyoxal bis(guanylhydrazone) on tumour and skin responses to hyperthermia in mice

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Miyakoshi, J.; Oda, W.; Inagaki, C. (Kyoto Coll. of Pharmacy (Japan)); Hiraoka, M.; Takahashi, M.; Abe, M. (Kyoto Univ. (Japan). Faculty of Medicine)

1984-09-01

Effects of methylglyoxal bis(guanylhydrazone) (MGBG) on tumour and skin responses to hyperthermia (42degC) were examined in C3H mice. MGBG (50 mg/kg) was administered intraperitoneally to mice 4 hours before hyperthermic treatment. The tumour (FM3A) growth time was elongated by an amount dependent on the exposure time of treatment at 42degC (60, 90 and 120 min). Pre-treatment of mice with MGBG (50 mg/kg, i.p.) apparently further lengthened the tumour growth time after treatment at 42degC. No significant damage of foot skin was caused by 42degC hyperthermia. Pre-treatment with MGBG did not make the foot skin susceptible to the heating. From these findings, it can be considered that MGBG or related less-toxic compounds may have a clinical advantage for the mild (42degC) hyperthermic treatment in cancer therapy.

Effect of hypothermia on cell kinetics and response to hyperthermia and x rays

International Nuclear Information System (INIS)

van Rijn, J.; van den Berg, J.; Kipp, J.B.A.; Schamhart, D.H.J.; van Wijk, R.

1985-01-01

Hyperthermia is a potent radio enhancer. Studies using hypothermia in combination with irradiation have given confusing results due to lack of uniformity in experimental design. This report shows that hypothermia might have potential significance in the treatment of malignant cells with both thermo- and radiotherapy. Reuber H35 hepatoma cells, clone KRC-7 were used to study the effect of hypothermia on cell kinetics and subsequent response to hyperthermia and/or X rays. Cells were incubated at 8.5 0 C or between 25 and 37 0 C for 24 hr prior to hyperthermia or irradiation. Hypothermia caused sensitization to both hyperthermia and X rays. In contrast to the effect of hypothermia on either hyperthermia or X rays alone, thermal radiosensitization was decreased in hypothermically pretreated cells (24 hr at 25 0 C) compared to control cells (37 0 C). The expression of thermotolerance and the rate of development at 37 0 C after an initial heating at 42.5 0 C were not influenced after preincubation at 25 0 C for 24 hr. The expression of thermotolerance for heat or heat plus X rays during incubation at 41 0 C occurred in a significantly smaller number of cells after 24 hr preincubation at 25 0 C. The enhanced thermo- and radiosensitivity in hypothermically treated cells disappeared in approximately 6 hr after return to 37 0 C

SU-C-BRA-01: Interactive Auto-Segmentation for Bowel in Online Adaptive MRI-Guided Radiation Therapy by Using a Multi-Region Labeling Algorithm

International Nuclear Information System (INIS)

Lu, Y; Chen, I; Kashani, R; Wan, H; Maughan, N; Muccigrosso, D; Parikh, P

2016-01-01

Purpose: In MRI-guided online adaptive radiation therapy, re-contouring of bowel is time-consuming and can impact the overall time of patients on table. The study aims to auto-segment bowel on volumetric MR images by using an interactive multi-region labeling algorithm. Methods: 5 Patients with locally advanced pancreatic cancer underwent fractionated radiotherapy (18–25 fractions each, total 118 fractions) on an MRI-guided radiation therapy system with a 0.35 Tesla magnet and three Co-60 sources. At each fraction, a volumetric MR image of the patient was acquired when the patient was in the treatment position. An interactive two-dimensional multi-region labeling technique based on graph cut solver was applied on several typical MRI images to segment the large bowel and small bowel, followed by a shape based contour interpolation for generating entire bowel contours along all image slices. The resulted contours were compared with the physician’s manual contouring by using metrics of Dice coefficient and Hausdorff distance. Results: Image data sets from the first 5 fractions of each patient were selected (total of 25 image data sets) for the segmentation test. The algorithm segmented the large and small bowel effectively and efficiently. All bowel segments were successfully identified, auto-contoured and matched with manual contours. The time cost by the algorithm for each image slice was within 30 seconds. For large bowel, the calculated Dice coefficients and Hausdorff distances (mean±std) were 0.77±0.07 and 13.13±5.01mm, respectively; for small bowel, the corresponding metrics were 0.73±0.08and 14.15±4.72mm, respectively. Conclusion: The preliminary results demonstrated the potential of the proposed algorithm in auto-segmenting large and small bowel on low field MRI images in MRI-guided adaptive radiation therapy. Further work will be focused on improving its segmentation accuracy and lessening human interaction.

SU-C-BRA-01: Interactive Auto-Segmentation for Bowel in Online Adaptive MRI-Guided Radiation Therapy by Using a Multi-Region Labeling Algorithm

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Lu, Y; Chen, I; Kashani, R; Wan, H; Maughan, N; Muccigrosso, D; Parikh, P [Washington University School of Medicine, Saint Louis, MO (United States)

2016-06-15

Purpose: In MRI-guided online adaptive radiation therapy, re-contouring of bowel is time-consuming and can impact the overall time of patients on table. The study aims to auto-segment bowel on volumetric MR images by using an interactive multi-region labeling algorithm. Methods: 5 Patients with locally advanced pancreatic cancer underwent fractionated radiotherapy (18–25 fractions each, total 118 fractions) on an MRI-guided radiation therapy system with a 0.35 Tesla magnet and three Co-60 sources. At each fraction, a volumetric MR image of the patient was acquired when the patient was in the treatment position. An interactive two-dimensional multi-region labeling technique based on graph cut solver was applied on several typical MRI images to segment the large bowel and small bowel, followed by a shape based contour interpolation for generating entire bowel contours along all image slices. The resulted contours were compared with the physician’s manual contouring by using metrics of Dice coefficient and Hausdorff distance. Results: Image data sets from the first 5 fractions of each patient were selected (total of 25 image data sets) for the segmentation test. The algorithm segmented the large and small bowel effectively and efficiently. All bowel segments were successfully identified, auto-contoured and matched with manual contours. The time cost by the algorithm for each image slice was within 30 seconds. For large bowel, the calculated Dice coefficients and Hausdorff distances (mean±std) were 0.77±0.07 and 13.13±5.01mm, respectively; for small bowel, the corresponding metrics were 0.73±0.08and 14.15±4.72mm, respectively. Conclusion: The preliminary results demonstrated the potential of the proposed algorithm in auto-segmenting large and small bowel on low field MRI images in MRI-guided adaptive radiation therapy. Further work will be focused on improving its segmentation accuracy and lessening human interaction.

MRI-Guided Diffuse Optical Spectroscopy of Malignant and Benign Breast Lesions

Directory of Open Access Journals (Sweden)

Vasilis Ntziachristos

2002-01-01

Full Text Available We present the clinical implementation of a novel hybrid system that combines magnetic resonance imaging (MRI and near-infrared (NIR optical measurements for the noninvasive study of breast cancer in vivo. Fourteen patients were studied with a MR-NIR prototype imager and spectrometer. A diffuse optical tomographic scheme employed the MR images as a priori information to implement an image-guided NIR localized spectroscopic scheme. All patients who entered the study also underwent gadolinium-enhanced MRI and biopsy so that the optical findings were crossvalidated with MR readings and histopathology. The technique quantified the oxy-and deoxyhemoglobin of five malignant and nine benign breast lesions in vivo. Breast cancers were found with decreased oxygen saturation and higher blood concentration than most benign lesions. The average hemoglobin concentration ([H] of cancers was 0.130±0.100 mM, and the average hemoglobin saturation (Y was 60±9% compared to [H]=0.018±0.005 mM and Y=69±6% of background tissue. Fibroadenomas exhibited high hemoglobin concentration [H]=0.060±0.010 mM and mild decrease in oxygen saturation Y=67±2%. Cysts and other normal lesions were easily differentiated based on intrinsic contrast information. This novel optical technology can be a significant add-on in MR examinations and can be used to characterize functional parameters of cancers with diagnostic and treatment prognosis potential. It is foreseen that the technique can play a major role in functional activation studies of brain and muscle as well.

Alginate Microspheres Containing Temperature Sensitive Liposomes (TSL for MR-Guided Embolization and Triggered Release of Doxorubicin.

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Merel van Elk

Full Text Available The objective of this study was to develop and characterize alginate microspheres suitable for embolization with on-demand triggered doxorubicin (DOX release and whereby the microspheres as well as the drug releasing process can be visualized in vivo using MRI.For this purpose, barium crosslinked alginate microspheres were loaded with temperature sensitive liposomes (TSL/TSL-Ba-ms, which release their payload upon mild hyperthermia. These TSL contained DOX and [Gd(HPDO3A(H2O], a T1 MRI contrast agent, for real time visualization of the release. Empty alginate microspheres crosslinked with holmium ions (T2* MRI contrast agent, Ho-ms were mixed with TSL-Ba-ms to allow microsphere visualization. TSL-Ba-ms and Ho-ms were prepared with a homemade spray device and sized by sieving. Encapsulation of TSL in barium crosslinked microspheres changed the triggered release properties only slightly: 95% of the loaded DOX was released from free TSL vs. 86% release for TSL-Ba-ms within 30 seconds in 50% FBS at 42°C. TSL-Ba-ms (76 ± 41 μm and Ho-ms (64 ± 29 μm had a comparable size, which most likely will result in a similar in vivo tissue distribution after an i.v. co-injection and therefore Ho-ms can be used as tracer for the TSL-Ba-ms. MR imaging of a TSL-Ba-ms and Ho-ms mixture (ratio 95:5 before and after hyperthermia allowed in vitro and in vivo visualization of microsphere deposition (T2*-weighted images as well as temperature-triggered release (T1-weighted images. The [Gd(HPDO3A(H2O] release and clusters of microspheres containing holmium ions were visualized in a VX2 tumor model in a rabbit using MRI.In conclusion, these TSL-Ba-ms and Ho-ms are promising systems for real-time, MR-guided embolization and triggered release of drugs in vivo.

Neuronal Rat Brain Damage Caused by Endogenous and Exogenous Hyperthermia

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Mustafa Aydın

2012-03-01

Full Text Available OBJECTIVE: Hyperthermia may induce pathologic alterations within body systems and organs including brain. In this study, neuronal effects of endogenous and exogenous hyperthermia (41°C were studied in rats. METHODS: The endogenous hyperthermia (41°C was induced by lipopolysaccharide and the exogenous by an (electric heater. Possible neuronal damage was evaluated by examining healthy, apoptotic and necrotic cells, and heat shock proteins (HSP 27, HSP 70 in the cerebral cortex, cerebellum and hypothalamus RESULTS: At cellular level, when all neuronal tissues are taken into account; (i a significant increase in the necrotic cells was observed in the both groups (p0.05. CONCLUSION: The neural tissue of brain can show different degree of response to hyperthermia. But we can conclude that endogenous hyperthermia is more harmful to central nervous system than exogenous hyperthermia

WE-EF-BRD-03: I Want It Now!: Advances in MRI Acquisition, Reconstruction and the Use of Priors to Enable Fast Anatomic and Physiologic Imaging to Inform Guidance and Adaptation Decisions

Energy Technology Data Exchange (ETDEWEB)

Hu, Y. [Mayo Clinic Arizona (United States)

2015-06-15

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

A Reconstruction Method for the Estimation of Temperatures of Multiple Sources Applied for Nanoparticle-Mediated Hyperthermia

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Idan Steinberg

2018-03-01

Full Text Available Solid malignant tumors are one of the leading causes of death worldwide. Many times complete removal is not possible and alternative methods such as focused hyperthermia are used. Precise control of the hyperthermia process is imperative for the successful application of such treatment. To that end, this research presents a fast method that enables the estimation of deep tissue heat distribution by capturing and processing the transient temperature at the boundary based on a bio-heat transfer model. The theoretical model is rigorously developed and thoroughly validated by a series of experiments. A 10-fold improvement is demonstrated in resolution and visibility on tissue mimicking phantoms. The inverse problem is demonstrated as well with a successful application of the model for imaging deep-tissue embedded heat sources. Thereby, allowing the physician then ability to dynamically evaluate the hyperthermia treatment efficiency in real time.

Extended Remediation of Sleep Deprived-Induced Working Memory Deficits Using fMRI-guided Transcranial Magnetic Stimulation

Science.gov (United States)

Luber, Bruce; Steffener, Jason; Tucker, Adrienne; Habeck, Christian; Peterchev, Angel V.; Deng, Zhi-De; Basner, Robert C.; Stern, Yaakov; Lisanby, Sarah H.

2013-01-01

Study Objectives: We attempted to prevent the development of working memory (WM) impairments caused by sleep deprivation using fMRI-guided repetitive transcranial magnetic stimulation (rTMS). Novel aspects of our fMRI-guided rTMS paradigm included the use of sophisticated covariance methods to identify functional networks in imaging data, and the use of fMRI-targeted rTMS concurrent with task performance to modulate plasticity effects over a longer term. Design: Between-groups mixed model. Setting: TMS, MRI, and sleep laboratory study. Participants: 27 subjects (13 receiving Active rTMS, and 14 Sham) completed the sleep deprivation protocol, with another 21 (10 Active, 11 Sham) non-sleep deprived subjects run in a second experiment. Interventions: Our previous covariance analysis had identified a network, including occipital cortex, which demonstrated individual differences in resilience to the deleterious effects of sleep deprivation on WM performance. Five Hz rTMS was applied to left lateral occipital cortex while subjects performed a WM task during 4 sessions over the course of 2 days of total sleep deprivation. Measurements and Results: At the end of the sleep deprivation period, Sham sleep deprived subjects exhibited degraded performance in the WM task. In contrast, those receiving Active rTMS did not show the slowing and lapsing typical in sleep deprivation, and instead performed similarly to non- sleep deprived subjects. Importantly, the Active sleep deprivation group showed rTMS-induced facilitation of WM performance a full 18 hours after the last rTMS session. Conclusions: Over the course of sleep deprivation, these results indicate that rTMS applied concurrently with WM task performance affected neural circuitry involved in WM to prevent its full impact. Citation: Luber B; Steffener J; Tucker A; Habeck C; Peterchev AV; Deng ZD; Basner RC; Stern Y; Lisanby SH. Extended remediation of sleep deprived-induced working memory deficits using fMRI-guided

Late response to whole-lung irradiation alone and with whole-body hyperthermia in dogs

International Nuclear Information System (INIS)

Gillette, S.M.; Gillette, E.L.; Dawson, C.A.

1997-01-01

The late effects of whole-lung irradiation with and without whole-body hyperthermia were studied in beagle dogs. The reference doses ranged from 18 to 49.5 Gy given in 1.5-Gy fractions over 6 weeks. Whole-body hyperthermia was given in three 2-h treatments to a deep rectal temperature of 42.0 degrees C. Radiation was given simultaneously with hyperthermia on those days. Physiological and histopathological responses were evaluated. Physiological changes included decreases in cardiac output, systemic blood pressure, dynamic compliance and serotonin uptake. Early changes included an increase in extravascular water and total protein in the lavage. These changes were considered mild, were compensated for and occurred only in dogs receiving doses of 40.5 Gy or greater given in 1.5-Gy fractions over 6 weeks. Histopathological change were typical of irradiated lung and included pleural fibrosis, interstitial fibrosis, fibrotic foci, and peribronchial and perivascular fibrosis. There was no enhancement of late injury to lung by hyperthermia seen in this study. 17 refs., 3 figs., 2 tabs

Stereotactic technique of RF antenna implantation for brain hyperthermia

International Nuclear Information System (INIS)

Takahashi, H.; Uzuka, T.; Grinev, I.; Tanaka, R.

2005-01-01

Full text: We have tried 13.56 MHz RF interstitial hyperthermia for the patients with malignant brain tumor. The purpose of this report is to assess the complication risk rate and the achievement yield of stereotactic procedure for RF antenna implantation into the deep-seated brain tumor. One hundred and twenty-five patients underwent 144 stereotactic RF antenna implantation procedures for interstitial hyperthermia for malignant brain tumors at Niigata University, Japan. One hundred and eight patients had malignant gliomas (54 primary, 54 recurrent), 24 had metastatic tumors, 5 had malignant lymphomas, 5 had meningiomas and 2 had miscellaneous tumors. Indication of this trial was the tumor with inoperative deep-seated tumor or elderly patients. RF antennas and catheters for thermistor probes were set into the tumor with stereotactic apparatus under local anesthesia. Postoperative CT scan underwent in order to assess the accuracy of antenna setting and to check the complications. The hyperthermic treatment underwent with a single antenna in 85 patients, 2 antennas in 43 patients, 3 in 2, 4 in 12, 5 in 1 and 6 antennas in 1 patient. Appropriate RF antenna positioning was obtained in 138 of 144 procedures (95.8 %). Six patients incurred complications (4.2 %). Three patients suffered intratumoral hemorrhage. RF antennas were set into the inappropriate position in 2 cases, hyperthermia was not achieved. One patient occurred with liquorrhea. However, six patients (4.2 %) incurred complications, stereotactic RF antenna setting was a safe and reliable technique of the hyperthermic treatment for the patients with malignant brain tumors. (author)

Signal-inducing bone cements for MRI-guided spinal cementoplasty: evaluation of contrast-agent-based polymethylmethacrylate cements

International Nuclear Information System (INIS)

Bail, Hermann Josef; Tsitsilonis, Serafim; Wichlas, Florian; Sattig, Christoph; Papanikolaou, Ioannis; Teichgraeber, Ulf Karl Mart

2012-01-01

The purpose of this work is to evaluate two signal-inducing bone cements for MRI-guided spinal cementoplasty. The bone cements were made of polymethylmethacrylate (PMMA, 5 ml monomeric, 12 g polymeric) and gadoterate meglumine as a contrast agent (CA, 0-40 μl) with either saline solution (NaCl, 2-4 ml) or hydroxyapatite bone substitute (HA, 2-4 ml). The cement's signal was assessed in an open 1-Tesla MR scanner, with T1W TSE and fast interventional T1W TSE pulse sequences, and the ideal amount of each component was determined. The compressive and bending strength for different amounts of NaCl and HA were evaluated. The cement's MRI signal depended on the concentration of CA, the amount of NaCl or HA, and the pulse sequence. The signal peaks were recorded between 1 and 10 μl CA per ml NaCl or HA, and were higher in fast T1W TSE than in T1W TSE images. The NaCl-PMMA-CA cements had a greater MRI signal intensity and compressive strength; the HA-PMMA-CA cements had a superior bending strength. Concerning the MR signal and biomechanical properties, these cements would permit MRI-guided cementoplasty. Due to its higher signal and greater compressive strength, the NaCl-PMMA-CA compound appears to be superior to the HA-PMMA-CA compound. (orig.)

Inhibition by hyperthermia of repair synthesis and chromatin reassembly of ultraviolet-induced damage to DNA

International Nuclear Information System (INIS)

Bodell, W.J.; Cleaver, J.E.; Roti Roti, J.L.

1984-01-01

The authors have investigated the effects of hyperthermia treatment on sequential steps of the repair of UV-induced DNA damage in HeLa cells. DNA repair synthesis was inhibited by 40% after 15 min of hyperthermia treatment at 45 0 C; greater inhibition of repair synthesis occurred with prolonged incubation at 45 0 C. Enzymatic digestion of repair-labeled DNA with Exonuclease III indicated that once DNA repair was initiated, the DNA repair patch was synthesized to completion and that ligation of the DNA repair patch occurred. Thus, the observed inhibition of UV-induced DNA repair synthesis by hyperthermia treatment may be the result of inhibition of enzymes involved in the initiating steps(s) of DNA repair. DNA repair patches synthesized in UV-irradiated cells labeled at 37 0 C with[ 3 H]Thd were 2.2-fold more sensitive to micrococcal nuclease digestion than was parental DNA; if the length of the labeling period was prolonged, the nuclease sensitivity of the repair patch synthesized approached that of the parental DNA. DNA repair patches synthesized at 45 0 C, however, remained sensitive to micrococcal nuclease digestion even after long labeling periods, indicating that heat treatment inhibits the reassembly of the DNA repair patch into nucleosomal structures. 23 references, 3 figures, 2 tables

Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study

DEFF Research Database (Denmark)

Issels, Rolf D; Lindner, Lars H; Verweij, Jaap

2010-01-01

The optimum treatment for high-risk soft-tissue sarcoma (STS) in adults is unclear. Regional hyperthermia concentrates the action of chemotherapy within the heated tumour region. Phase 2 studies have shown that chemotherapy with regional hyperthermia improves local control compared with chemother...

Magnetic Hyperthermia and Oxidative Damage to DNA of Human Hepatocarcinoma Cells.

Science.gov (United States)

Cellai, Filippo; Munnia, Armelle; Viti, Jessica; Doumett, Saer; Ravagli, Costanza; Ceni, Elisabetta; Mello, Tommaso; Polvani, Simone; Giese, Roger W; Baldi, Giovanni; Galli, Andrea; Peluso, Marco E M

2017-04-29

Nanotechnology is addressing major urgent needs for cancer treatment. We conducted a study to compare the frequency of 3-(2-deoxy-β-d-erythro-pentafuranosyl)pyrimido[1,2-α]purin-10(3 H )-one deoxyguanosine (M₁dG) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) adducts, biomarkers of oxidative stress and/or lipid peroxidation, on human hepatocarcinoma HepG2 cells exposed to increasing levels of Fe₃O₄-nanoparticles (NPs) versus untreated cells at different lengths of incubations, and in the presence of increasing exposures to an alternating magnetic field (AMF) of 186 kHz using 32 P-postlabeling. The levels of oxidative damage tended to increase significantly after ≥24 h of incubations compared to controls. The oxidative DNA damage tended to reach a steady-state after treatment with 60 μg/mL of Fe₃O₄-NPs. Significant dose-response relationships were observed. A greater adduct production was observed after magnetic hyperthermia, with the highest amounts of oxidative lesions after 40 min exposure to AMF. The effects of magnetic hyperthermia were significantly increased with exposure and incubation times. Most important, the levels of oxidative lesions in AMF exposed NP treated cells were up to 20-fold greater relative to those observed in nonexposed NP treated cells. Generation of oxidative lesions may be a mechanism by which magnetic hyperthermia induces cancer cell death.

MR-guided facet joint injection therapy using an open 1.0-T MRI system: an outcome study

International Nuclear Information System (INIS)

Freyhardt, Patrick; Bucourt, Maximilian de; Maurer, Martin; Renz, Diane; Gebauer, Bernhard; Hamm, Bernd; Streitparth, Florian; Hartwig, Tony; Teichgraeber, Ulf K.M.

2013-01-01

To evaluate the accuracy, safety and efficacy of magnetic resonance imaging (MRI)-guided facet joint injection therapy using a 1.0-T open MRI. One hundred and sixty-six facet joint blocks in 45 patients with lower back pain were performed under MR fluoroscopic guidance using a proton-density-weighted turbo-spin-echo sequence. An in-room monitor, wireless MR-mouse for operator-controlled multiplanar navigation, a flexible surface coil and MR-compatible 20-G needle were used. Clinical outcome was evaluated by questionnaire before intervention and after 1 week, 3, 6 and 12 months using a numerical visual analogue scale (VAS). All facet joint blocks were considered technically successful with distribution of the injectant within and/or around the targeted facet joint. No major complications occurred. The final outcome analysis included 38 patients. An immediate effect was reported by 63 % of the patients. A positive mid-/long-term effect was seen in 13 patients (34 %) after 6 months and in 9 patients (24 %) after 12 months. Mean VAS was reduced from 7.1 ± 1.7 (baseline) to 3.5 ± 2.2, 4.1 ± 3.0, 3.8 ± 2.9 and 4.6 ± 2.9 at 1 week, 3, 6 and 12 months (P < 0.01). MR-guided facet joint injection therapy of the lumbosacral spine is accurate, safe and efficient in the symptomatic treatment of lower back pain. (orig.)

pH- and NIR Light-Responsive Polymeric Prodrug Micelles for Hyperthermia-Assisted Site-Specific Chemotherapy to Reverse Drug Resistance in Cancer Treatment.

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Li, Zuhong; Wang, Haibo; Chen, Yangjun; Wang, Yin; Li, Huan; Han, Haijie; Chen, Tingting; Jin, Qiao; Ji, Jian

2016-05-01

Despite the exciting advances in cancer chemotherapy over past decades, drug resistance in cancer treatment remains one of the primary reasons for therapeutic failure. IR-780 loaded pH-responsive polymeric prodrug micelles with near infrared (NIR) photothermal effect are developed to circumvent the drug resistance in cancer treatment. The polymeric prodrug micelles are stable in physiological environment, while exhibit fast doxorubicin (DOX) release in acidic condition and significant temperature elevation under NIR laser irradiation. Phosphorylcholine-based biomimetic micellar shell and acid-sensitive drug conjugation endow them with prolonged circulation time and reduced premature drug release during circulation to conduct tumor site-specific chemotherapy. The polymeric prodrug micelles combined with NIR laser irradiation could significantly enhance intracellular DOX accumulation and synergistically induce the cell apoptosis in DOX-resistant MCF-7/ADR cells. Meanwhile, the tumor site-specific chemotherapy combined with hyperthermia effect induces significant inhibition of MCF-7/ADR tumor growth in tumor-bearing mice. These results demonstrate that the well-designed IR-780 loaded polymeric prodrug micelles for hyperthermia-assisted site-specific chemotherapy present an effective approach to reverse drug resistance. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Thermometric analysis of intra-cavitary hyperthermia for esophageal cancer.

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Qi, C; Li, D J

1999-01-01

Thermometric analysis was carried out in 51 patients with esophageal cancer treated with intra-cavitary hyperthermia combined with radio chemotherapy, to test whether temperature index (T20, T50) and T90) could be used as an indicator for tumour control. Hyperthermia was administered by intra-cavitary microwave applicator. The T20, T50 and T90 were deducted from the temperature sensors T0 and T3 situated at the center of the tumour surface and 3cm from it. Eighteen patients with local control > or =36 months were named long term control patients (LC), 24 patients with local recurrence within 24 months (LR) (there were no events occurring between 24 and 36 months) and nine patients died of metastasis without local recurrence (DM). The overall survival rates were 80.4 +/- 5.6% at 1 year, 38.3 +/- 6.9% at 3 years and 31 +/- 6.7% at 5 years, respectively. Chi-square test showed no influence of the number of hyperthermia sessions on the local control (p > 0.25). The 5-year local control rate was 18.8% for the patients with T90 or = 43 degrees C (p < 0.01). The average T90 was 43.76 +/- 0.74 degrees C for the LC patients and 43.17 +/- 0.57 degrees C for those LR (p = 0.024). The mean T90 was higher than 43 degrees C in 94.4% of LC, whereas in 58.8% of LR. The study suggested that T90 was a good parameter for thermal dose in the intracavitary hyperthermia for the treatment of esophageal cancer.

High-resolution temperature-based optimization for hyperthermia treatment planning

International Nuclear Information System (INIS)

Kok, H P; Haaren, P M A van; Kamer, J B Van de; Wiersma, J; Dijk, J D P Van; Crezee, J

2005-01-01

In regional hyperthermia, optimization techniques are valuable in order to obtain amplitude/phase settings for the applicators to achieve maximal tumour heating without toxicity to normal tissue. We implemented a temperature-based optimization technique and maximized tumour temperature with constraints on normal tissue temperature to prevent hot spots. E-field distributions are the primary input for the optimization method. Due to computer limitations we are restricted to a resolution of 1 x 1 x 1 cm 3 for E-field calculations, too low for reliable treatment planning. A major problem is the fact that hot spots at low-resolution (LR) do not always correspond to hot spots at high-resolution (HR), and vice versa. Thus, HR temperature-based optimization is necessary for adequate treatment planning and satisfactory results cannot be obtained with LR strategies. To obtain HR power density (PD) distributions from LR E-field calculations, a quasi-static zooming technique has been developed earlier at the UMC Utrecht. However, quasi-static zooming does not preserve phase information and therefore it does not provide the HR E-field information required for direct HR optimization. We combined quasi-static zooming with the optimization method to obtain a millimetre resolution temperature-based optimization strategy. First we performed a LR (1 cm) optimization and used the obtained settings to calculate the HR (2 mm) PD and corresponding HR temperature distribution. Next, we performed a HR optimization using an estimation of the new HR temperature distribution based on previous calculations. This estimation is based on the assumption that the HR and LR temperature distributions, though strongly different, respond in a similar way to amplitude/phase steering. To verify the newly obtained settings, we calculate the corresponding HR temperature distribution. This method was applied to several clinical situations and found to work very well. Deviations of this estimation method for

MRI-powered biomedical devices.

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Hovet, Sierra; Ren, Hongliang; Xu, Sheng; Wood, Bradford; Tokuda, Junichi; Tse, Zion Tsz Ho

2017-11-16

Magnetic resonance imaging (MRI) is beneficial for imaging-guided procedures because it provides higher resolution images and better soft tissue contrast than computed tomography (CT), ultrasound, and X-ray. MRI can be used to streamline diagnostics and treatment because it does not require patients to be repositioned between scans of different areas of the body. It is even possible to use MRI to visualize, power, and control medical devices inside the human body to access remote locations and perform minimally invasive procedures. Therefore, MR conditional medical devices have the potential to improve a wide variety of medical procedures; this potential is explored in terms of practical considerations pertaining to clinical applications and the MRI environment. Recent advancements in this field are introduced with a review of clinically relevant research in the areas of interventional tools, endovascular microbots, and closed-loop controlled MRI robots. Challenges related to technology and clinical feasibility are discussed, including MRI based propulsion and control, navigation of medical devices through the human body, clinical adoptability, and regulatory issues. The development of MRI-powered medical devices is an emerging field, but the potential clinical impact of these devices is promising.

Diagnostic Accuracy of MRI-guided Percutaneous Transthoracic Needle Biopsy of Solitary Pulmonary Nodules

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Liu, Shangang, E-mail: 1198685580@qq.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China); Li, Chengli, E-mail: chenglilichina@yeah.net [Shandong University, Department of Interventional MRI, Shandong Medical Imaging Research Institute (China); Yu, Xuejuan, E-mail: yuxuejuan2011@126.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China); Liu, Ming, E-mail: mingliuyxs@163.com [Shandong University, Department of Interventional MRI, Shandong Medical Imaging Research Institute (China); Fan, Tingyong, E-mail: FTY681105@sohu.com; Chen, Dong, E-mail: 857984870@qq.com; Zhang, Pinliang, E-mail: zhangpinliang@163.com; Ren, Ruimei, E-mail: liusg708@qq.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China)

2015-04-15

ObjectiveThe purpose of our study was to evaluate the diagnostic accuracy of MRI-guided percutaneous transthoracic needle biopsy (PTNB) of solitary pulmonary nodules (SPNs).MethodsRetrospective review of 69 patients who underwent MR-guided PTNB of SPNs was performed. Each case was reviewed for complications. The final diagnosis was established by surgical pathology of the nodule or clinical and imaging follow-up. Pneumothorax rate and diagnostic accuracy were compared between two groups according to nodule diameter (≤2 vs. >2 cm) using χ{sup 2} chest and Fisher’s exact test, respectively.ResultsThe success rate of single puncture was 95.6 %. Twelve (17.4 %) patients had pneumothorax, with 1 (1.4 %) requiring chest tube insertion. Mild hemoptysis occurred in 7 (7.2 %) patients. All of the sample material was sufficient for histological diagnostic evaluation. Pathological analysis of biopsy specimens showed 46 malignant, 22 benign, and 1 nondiagnostic nodule. The final diagnoses were 49 malignant nodules and 20 benign nodules basing on postoperative histopathology and clinical follow-up data. One nondiagnostic sample was excluded from calculating diagnostic performance. A sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in diagnosing SPNs were 95.8, 100, 97.0, 100, and 90.9 %, respectively. Pneumothorax rate, diagnostic sensitivity, and accuracy were not significantly different between the two groups (P > 0.05).ConclusionsMRI-guided PTNB is safe, feasible, and high accurate diagnostic technique for pathologic diagnosis of pulmonary nodules.

SU-F-303-17: Real Time Dose Calculation of MRI Guided Co-60 Radiotherapy Treatments On Free Breathing Patients, Using a Motion Model and Fast Monte Carlo Dose Calculation

International Nuclear Information System (INIS)

Thomas, D; O’Connell, D; Lamb, J; Cao, M; Yang, Y; Agazaryan, N; Lee, P; Low, D

2015-01-01

Purpose: To demonstrate real-time dose calculation of free-breathing MRI guided Co−60 treatments, using a motion model and Monte-Carlo dose calculation to accurately account for the interplay between irregular breathing motion and an IMRT delivery. Methods: ViewRay Co-60 dose distributions were optimized on ITVs contoured from free-breathing CT images of lung cancer patients. Each treatment plan was separated into 0.25s segments, accounting for the MLC positions and beam angles at each time point. A voxel-specific motion model derived from multiple fast-helical free-breathing CTs and deformable registration was calculated for each patient. 3D images for every 0.25s of a simulated treatment were generated in real time, here using a bellows signal as a surrogate to accurately account for breathing irregularities. Monte-Carlo dose calculation was performed every 0.25s of the treatment, with the number of histories in each calculation scaled to give an overall 1% statistical uncertainty. Each dose calculation was deformed back to the reference image using the motion model and accumulated. The static and real-time dose calculations were compared. Results: Image generation was performed in real time at 4 frames per second (GPU). Monte-Carlo dose calculation was performed at approximately 1frame per second (CPU), giving a total calculation time of approximately 30 minutes per treatment. Results show both cold- and hot-spots in and around the ITV, and increased dose to contralateral lung as the tumor moves in and out of the beam during treatment. Conclusion: An accurate motion model combined with a fast Monte-Carlo dose calculation allows almost real-time dose calculation of a free-breathing treatment. When combined with sagittal 2D-cine-mode MRI during treatment to update the motion model in real time, this will allow the true delivered dose of a treatment to be calculated, providing a useful tool for adaptive planning and assessing the effectiveness of gated treatments

Photoacoustic-Based-Close-Loop Temperature Control for Nanoparticle Hyperthermia.

Science.gov (United States)

Xiaohua, Feng; Fei, Gao; Yuanjin, Zheng

2015-07-01

Hyperthermia therapy requires tight temperature control to achieve selective killing of cancerous tissue with minimal damage on surrounding healthy tissues. To this end, accurate temperature monitoring and subsequent heating control are critical. However, an economic, portable, and real-time temperature control solution is currently lacking. To bridge this gap, we present a novel portable close-loop system for hyperthermia temperature control, in which photoacoustic technique is proposed for noninvasive real-time temperature measurement. Exploiting the high sensitivity of photoacoustics, the temperature is monitored with an accuracy of around 0.18 °C and then fed back to a controller implemented on field programmable gate array (FPGA) for temperature control. Dubbed as portable hyperthermia feedback controller (pHFC), it stabilizes the temperature at preset values by regulating the hyperthermia power with a proportional-integral-derivative (PID) algorithm; and to facilitate digital implementation, the pHFC further converts the PID output into switching values (0 and 1) with the pulse width modulation (PWM) algorithm. Proof-of-concept hyperthermia experiments demonstrate that the pHFC system is able to bring the temperature from baseline to predetermined value with an accuracy of 0.3° and a negligible temperature overshoot. The pHFC can potentially be translated to clinical applications with customized hyperthermia system design. This paper can facilitate future efforts in seamless integration of close-loop temperature control solution and various clinical hyperthermia systems.

Clinical hyperthermia of prostate cancer using magnetic nanoparticles - preliminary experience with a new interstitial technique

International Nuclear Information System (INIS)

Johannsen, M.; Gneveckow, U.; Eckelt, L.; Feussner, A.; Waldoefner, N.; Scholz, R.; Deger, S.; Wust, P.; Loening, S.A.; Jordan, A.

2005-01-01

Full text: Thermotherapy using biocompatible superparamagnetic nanoparticles, also referred to as magnetic fluid hyperthermia (MFH), has been shown to inhibit prostate cancer growth in the Dunning rat model. Here we present the first clinical application of interstitial hyperthermia using magnetic nanoparticles in locally recurrent prostate cancer. Treatment planning was carried out using computerized tomography (CT) of the prostate. Based on the individual anatomy of the prostate and the estimated specific absorption rate (SAR) of magnetic fluids in prostatic tissue, the number and position of magnetic fluid depots required for sufficient heat deposition was calculated using the AMIRA software and a newly developed prostate module. Nanoparticle suspensions (MagForce MFL AS, MagForce Nanotechnologies GmbH, Berlin, Germany) were injected transperineally into the prostate under transrectal ultrasound and flouroscopy guidance. Treatments were delivered in the first magnetic field applicator for use in humans (MFH300F, MagForce Nanotechnologies GmbH, Berlin), using an alternating magnetic field with a frequency of 100 kHz and variable field strength (0-18 kA/m). Invasive thermometry of the prostate was carried out in the first and last of 6 weekly hyperthermia sessions of 60 min duration. CT-scans of the prostate were repeated following the first and last hyperthermia treatment to document magnetic nanoparticle distribution and the position of the thermometry probes in the prostate. Nanoparticles were retained in the prostate during the treatment interval of 6 weeks, as documented by CT. Treatment was well tolerated. During the first treatment, maximum intra-prostatic temperatures measured by 4 thermometry probes at a magnetic field strength of 4.0-5.0 kA/m were 48.5, 43.0, 43.7 and 43.6 o C, whereas minimal temperatures were 41.2, 40.3, 40.0 and 41.1 o C, respectively. During the sixth and last treatment of the same patient, maximum intraprostatic temperatures were 42

A seven-year disease-free survivor of malignant pleural mesothelioma treated with hyperthermia and chemotherapy: a case report

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Okonogi Noriyuki

2012-12-01

Full Text Available Abstract Introduction Malignant pleural mesothelioma was once a rare finding but its incidence is increasing worldwide, most likely because of widespread exposure to asbestos. Although complete surgical resection is considered the only curative treatment, the results of surgery have shown a median survival time of only one year. In inoperable cases, chemotherapy, radiotherapy, and a combination of both have been considered as palliative therapy. Therefore, outcomes for inoperable cases have been poor. Here, we report the case of a long-term survivor treated with hyperthermia and chemotherapy. Case presentation A 61-year-old Japanese man with a performance status of 1 due to chest pain was referred to our hospital. He had a history of asbestos exposure for approximately five years. A computed tomography scan showed diffuse extensive right pleural thickening with small nodular lesions, and video-assisted thoracoscopy revealed tumor invasion of the ipsilateral chest wall muscles. The histopathologic findings were consistent with a diagnosis of malignant pleural mesothelioma (sarcomatoid type. The tumor was diagnosed as being stage cT3N0M0. Our patient refused any invasive therapies including surgery and radiotherapy, and was therefore treated with hyperthermia and systemic chemotherapy with agents such as cisplatin and irinotecan. He underwent three hyperthermia sessions and a single course of chemotherapy without any severe complications. One month after treatment, a follow-up computed tomography scan showed no definitive abnormality in the thoracic space. Our patient has subsequently survived without any evident disease for more than seven years. Conclusions The combination of hyperthermia and chemotherapy may be a novel and safe therapeutic option for malignant pleural mesothelioma, and can be considered for patients ineligible for radical treatment. Further clinical studies of the combination of hyperthermia and chemotherapy are needed to

The individual and combined effects of γ rays and hyperthermia on the development of embryonic brains

International Nuclear Information System (INIS)

Yang Yepeng; Ruan Ming; Liu Jingyuan; Hong Min; Lu Chunlin

2000-01-01

Objective: To observe the individual and combined effects of exposure to γ rays and hyperthermia on the development of embryonic brains. Methods: the pregnant LACA mice were exposed to 1.0 Gy 60 Co-γ rays, 42 degree C hyperthermia for 10 minutes or the two treatments combined together on day 9 of pregnancy. The females were sacrificed on day 18 of pregnancy and the fetuses were gained by cesarean section. The appearance of fetuses was observed and, then, the weight of fetal brains, the cell number of whole brains, the contents of nucleic acid and protein in brain tissue and the activity of acetylcholine esterase (AChE) in brain tissue as a marker for cholinergic neurons were determined. Results: Nervous tube defects did not occur in all groups. Compared with the control group, all the indices determined significantly declined in the radiation group while the cell number of whole brains and the AChE activity in brain tissue significantly decreased in the hyperthermia group. In the group of hyperthermia in advance, 4 hours later, followed by exposure to radiation, the AChE activity in brain tissue was significantly higher than the single radiation group. In the group of prior radiation exposure, 4 hours later, followed by hyperthermia, all the indices did not present significant difference from the single radiation group. Conclusion: The effects of 42 degree C hyperthermia for 10 minutes on the development of mouse embryo's brains are much weaker than 1.0 Gy γ radiation. It seems that the hyperthermia in advance can induce mouse fetuses to produce the cross adaptability to the following exposure to radiation. Exposure to γ radiation followed by hyperthermia does not present and additive action or a synergistic action

Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features