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

Abstract

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.more » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [2]; ;  [5];  [6];  [5];  [1];  [1];  [2];  [6]
  1. Department of Radiation Oncology, Sunnybrook Health Sciences Centre and the University of Toronto, Toronto, Ontario (Canada)
  2. (Canada)
  3. Clinical Sites Research Program, Philips Research, Cambridge, Massachusetts (United States)
  4. Thunder Bay Regional Research Institute, Thunder Bay, Ontario (Canada)
  5. MR Therapy, Philips Healthcare, Vantaa (Finland)
  6. Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario (Canada)
Publication Date:
OSTI Identifier:
22648744
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 4; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CHEMOTHERAPY; ETHICAL ASPECTS; EVALUATION; HYPERTHERMIA; NEOPLASMS; PERFORMANCE; RADIOTHERAPY; RECTUM; SWINE; TEMPERATURE MEASUREMENT

Citation Formats

Chu, William, E-mail: William.Chu@sunnybrook.ca, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Staruch, Robert M., Pichardo, Samuel, Physics and Electrical Engineering, Lakehead University, Thunder Bay, Ontario, Tillander, Matti, Köhler, Max O., Huang, Yuexi, Ylihautala, Mika, McGuffin, Merrylee, Czarnota, Gregory, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, and Hynynen, Kullervo. Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.03.019.
Chu, William, E-mail: William.Chu@sunnybrook.ca, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Staruch, Robert M., Pichardo, Samuel, Physics and Electrical Engineering, Lakehead University, Thunder Bay, Ontario, Tillander, Matti, Köhler, Max O., Huang, Yuexi, Ylihautala, Mika, McGuffin, Merrylee, Czarnota, Gregory, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, & Hynynen, Kullervo. Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation. United States. doi:10.1016/J.IJROBP.2016.03.019.
Chu, William, E-mail: William.Chu@sunnybrook.ca, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Staruch, Robert M., Pichardo, Samuel, Physics and Electrical Engineering, Lakehead University, Thunder Bay, Ontario, Tillander, Matti, Köhler, Max O., Huang, Yuexi, Ylihautala, Mika, McGuffin, Merrylee, Czarnota, Gregory, Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, and Hynynen, Kullervo. Fri . "Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation". United States. doi:10.1016/J.IJROBP.2016.03.019.
@article{osti_22648744,
title = {Magnetic Resonance–Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation},
author = {Chu, William, E-mail: William.Chu@sunnybrook.ca and Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario and Staruch, Robert M. and Pichardo, Samuel and Physics and Electrical Engineering, Lakehead University, Thunder Bay, Ontario and Tillander, Matti and Köhler, Max O. and Huang, Yuexi and Ylihautala, Mika and McGuffin, Merrylee and Czarnota, Gregory and Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario and Hynynen, Kullervo},
abstractNote = {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.},
doi = {10.1016/J.IJROBP.2016.03.019},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 95,
place = {United States},
year = {Fri Jul 15 00:00:00 EDT 2016},
month = {Fri Jul 15 00:00:00 EDT 2016}
}