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MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany

MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany Kazakh Medical Diagnostic Forum “ T echnological Innovations in radiology & functional diagnosis “ Astana, Kazakhstan , September 23 & 24 , 2014. Agenda. Agenda. BSD 2000 •3D Deep Regional Hyperthermia

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MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany

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  1. MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany KazakhMedical Diagnostic Forum “Technological Innovations in radiology& functionaldiagnosis“ Astana, Kazakhstan, September 23 & 24, 2014

  2. Agenda Agenda • BSD 2000•3D Deep Regional Hyperthermia • BSD 2000•3D-MR Image Guided Hyperthermia • SigmaHyperPlan / SigmaVision

  3. Regional Hyperthermia Upper (front ) plate Antennas Lower (back ) plate Antennas capacitive systems radiative multi antenna systems Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.

  4. Regional Hyperthermia capacitive systems radiative multi antenna systems Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.

  5. Regional Hyperthermia Direction of the E-Fields capacitivesystems radiative multi antenna systems Image courtesy of Dughiero et al. Image courtesy of Gellermann et al.

  6. BSD-2000 System Family BSD 2000 Basic System • BSD-2000-3D/MRSystem: • 3 Rings with 8 Antenna each • MRI Image Guided Thermometry BSD 2000 3D System

  7. Regional Hyperthermia Functional Principle: 8 Antennas in 4 pairs

  8. BSD 2000 Concept: Antenna Arrays • Sigma60Applicator: • 8 AntennaArray surrounding the Patient

  9. BSD 2000 3D Applicator 24 Antennae in 3 Rings of 8 Antennas each

  10. Lamp phantom Regional Hyperthermia

  11. BSD 2000 3D Hyperthermia Treatment Suite

  12. BSD-2000 Clinical Indications: • Pancreas • Abdominal • Prostate • Pelvic • Lung • etc…. • Cervix • Rectal • Bladder • Sarcoma

  13. Temperature Monitoring • Invasive Thermometry • Intratumoral • Min. Invasive Thermometry • Intraluminal • Image Guided Thermometry • MRI-Thermometry

  14. MR Image Guided Hyperthermia

  15. MR Image Guided Hyperthermia

  16. MR Image Guided Hyperthermia

  17. MR Image Guided Hyperthermia Dockable Patient Cart & 70 cm Bore

  18. Thermometry – MR Controlled Hyperthermia

  19. MR Hyperthermia Treatment Suite MRI Diagnostics Hyperthermia

  20. MR Imaging Compatible Applicators • Sigma 30 MR • 8 antennae • 4 channels • 1 antenna ring • 27 x 25 cm long • 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

  21. The new user-friendly software for MR-Thermometry

  22. Color overlaytodisplaythetemperaturechanges Total andDifference PRFS Timelinefeaturetomonitorthechronologicalsequenceofthetreatment T90 temperaturecalculation Timelinedocumentationforeachstep Thermometry

  23. MR Guided PediatricHyperthermia Wessalowski et al.: The Lancet Oncology 2013 on GermCell Tumors Department ofPediatricOncology UMS Düsseldorf - Germany Wessalowski et al. Lancet Oncol. 2013

  24. MR Guided PediatricHyperthermia Wessalowski et al. Lancet Oncol. 2013

  25. MR Guided PediatricHyperthermia ApplicatorsofVarious Sizes OptimizePediatric Treatments Wessalowski et al. Lancet Oncol. 2013

  26. MR Guided PediatricHyperthermia Pediatric Abdominal Treatment in Sigma 40 Applicator Wessalowski et al. Lancet Oncol. 2013

  27. MR Guided PediatricHyperthermia CombiningHyperthermia & Chemo forRecurrentGermCell Tumors: • 44 Patients, All Non-Respondersto Standard Chemo Treatment, Treated in HyperPei Protocol Resulting in 25 Completeand 14 Partial Remissions Wessalowski et al. Lancet Oncol. 2013

  28. MR Guided PediatricHyperthermia Editorial T. Olson in „The Lancet Oncology“ 2013: Hyperthermia in PediatricGermCell Tumors – a New Treatment Standard ? Wessalowski et al. Lancet Oncol. 2013

  29. The Atzelsberg Clinical Trial Circle Ott OJ et al., 2009

  30. The Atzelsberg Clinical Trial Circle Ott OJ et al., 2009

  31. The Atzelsberg Clinical Trial Circle Ott OJ et al., 2009

  32. The Atzelsberg Clinical Trial Circle • Development of Guidelines and Clinical Trials Ott OJ et al., 2009

  33. RESECTION Radiotherapy PTV: depending on former Tx Dose: 45 Gy d 1-14 d 22-35 5-FU CIV (250 mg/m²/d) d2 d9 d23 d30 Oxaliplatin Bolus (50 mg/m²/d) d2 d5 d9 d12 d16 d19 d23 d26 d30 d33 Deep Regional Hyperthermia 1 2 3 4 5 6 Week The Atzelsberg Clinical Trial Circle O. Ott: RectalCancerHyRec Trial - Treatment Schedule - Trial isRecruting Recurrent & LocallyAdvancedRectalCancer Required Cases n =59 Ott OJ et al., 2009

  34. The Atzelsberg Clinical Trial Circle R.D.Issels MD PhD: Randomized Phase III Trial on Postoperative PancreasCancer

  35. Thank you!

  36. MR Guided Hyperthermia in Soft Tissue Sarcomas

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