MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany Kazakh Medical Diagnostic Forum...
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![Page 1: MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany Kazakh Medical Diagnostic Forum “Technological Innovations in radiology & functional.](https://reader035.fdocuments.in/reader035/viewer/2022062309/56649c7e5503460f9493367d/html5/thumbnails/1.jpg)
MR Image Guided Hyperthermia
Gerhard Sennewald PhD, Munich, Germany Kazakh Medical Diagnostic Forum “Technological Innovations in radiology & functional diagnosis“Astana, Kazakhstan, September 23 & 24, 2014
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Agenda
Agenda
BSD 2000•3D Deep Regional HyperthermiaBSD 2000•3D-MR Image Guided Hyperthermia SigmaHyperPlan / SigmaVision
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capacitive systems radiative multi antenna systems
Regional Hyperthermia
Upper (front ) plate
Lower (back ) plate
Antennas
Antennas
Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.
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capacitive systems
Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.
Regional Hyperthermia
radiative multi antenna systems
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Direction of the E-Fields
capacitive systems
Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.
Regional Hyperthermia
radiative multi antenna systems
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BSD-2000 System Family
BSD-2000-3D/MR System:
• 3 Rings with 8 Antenna each• MRI Image Guided Thermometry
BSD 2000 Basic System
BSD 2000 3D System
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8 Antennas in 4 pairs
Functional Principle:
Regional Hyperthermia
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Sigma 60 Applicator: • 8 Antenna Array surrounding the Patient
BSD 2000 Concept: Antenna Arrays
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24 Antennae in
3 Rings of 8 Antennas each
BSD 2000 3D Applicator
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Lamp phantom
Regional Hyperthermia
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BSD 2000 3D Hyperthermia Treatment Suite
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• Cervix• Rectal• Bladder• Sarcoma
BSD-2000 Clinical Indications:
• Pancreas• Abdominal• Prostate• Pelvic • Lung• etc….
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Temperature Monitoring
• Invasive Thermometry– Intratumoral
• Min. Invasive Thermometry– Intraluminal
• Image Guided Thermometry– MRI-Thermometry
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MR Image Guided Hyperthermia
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MR Image Guided Hyperthermia
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MR Image Guided Hyperthermia
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MR Image Guided HyperthermiaDockable Patient Cart & 70 cm Bore
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Thermometry – MR Controlled Hyperthermia
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Hyperthermia MRI Diagnostics
MR Hyperthermia Treatment Suite
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MR Imaging Compatible Applicators
Sigma Eye MR:
• 24 antennae• 12 channels• 3 antenna rings• 37 x 54 x 48 cm long
Sigma 40 MR:
• 16 antennae• 8 channels• 2 antenna rings• 42 x 38 cm long
Sigma 30 MR
• 8 antennae• 4 channels• 1 antenna ring• 27 x 25 cm long
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The new user-friendly software for MR-Thermometry
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• Color overlay to display the temperature changes
• Total and Difference PRFS • Timeline feature to monitor the chronological
sequence of the treatment• T90 temperature calculation• Timeline documentation for each step
Thermometry
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MR Guided Pediatric Hyperthermia
Wessalowski et al.: The Lancet Oncology 2013 on Germ Cell TumorsDepartment of Pediatric Oncology UMS Düsseldorf - Germany
Wessalowski et al. Lancet Oncol. 2013
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MR Guided Pediatric Hyperthermia
Wessalowski et al. Lancet Oncol. 2013
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MR Guided Pediatric Hyperthermia
Applicators of Various Sizes Optimize Pediatric Treatments
Wessalowski et al. Lancet Oncol. 2013
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MR Guided Pediatric Hyperthermia
Pediatric Abdominal Treatment in Sigma 40 Applicator
Wessalowski et al. Lancet Oncol. 2013
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MR Guided Pediatric Hyperthermia
• 44 Patients, All Non-Responders to Standard Chemo Treatment, Treated in HyperPei Protocol Resulting in 25 Complete and 14 Partial Remissions
Combining Hyperthermia & Chemo for Recurrent Germ Cell Tumors:
Wessalowski et al. Lancet Oncol. 2013
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MR Guided Pediatric Hyperthermia
Editorial T. Olson in „The Lancet Oncology“ 2013:Hyperthermia in Pediatric Germ Cell Tumors – a New Treatment Standard ?
Wessalowski et al. Lancet Oncol. 2013
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The Atzelsberg Clinical Trial Circle
Ott OJ et al., 2009
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The Atzelsberg Clinical Trial Circle
Ott OJ et al., 2009
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The Atzelsberg Clinical Trial Circle
Ott OJ et al., 2009
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The Atzelsberg Clinical Trial Circle
• Development of Guidelines and Clinical Trials
Ott OJ et al., 2009
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The Atzelsberg Clinical Trial Circle
42
O. Ott: Rectal Cancer HyRec Trial - Treatment Schedule - Trial is RecrutingRecurrent & Locally Advanced Rectal Cancer
1 2 3 4 5 6
Week
d2 d9 d23 d30
d 1-14 d 22-35
Radiotherapy PTV: depending on former Tx Dose: 45 Gy
5-FU CIV (250 mg/m²/d)
Oxaliplatin Bolus (50 mg/m²/d)
Deep Regional Hyperthermia
R
E
S
E
C
T
I
O
N
d2 d9 d23 d30 d5 d12 d26 d33 d16 d19
Ott OJ et al., 2009
Required Cases n =59
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The Atzelsberg Clinical Trial Circle
R.D.Issels MD PhD: Randomized Phase III Trial on Postoperative Pancreas Cancer
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Thank you!
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MR Guided Hyperthermia in Soft Tissue Sarcomas