Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant A.; Juang, Titania; Scott, Serena J.; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I.

doi:10.1117/12.876401

Cited by 18 publications

(25 citation statements)

References 6 publications

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“…1,2 For maximum clinical benefit, uniform temperature profiles are desired within target volumes for 30 -60 min duration, with minimum temperature greater than 40 o C and 6 -10 min cumulative thermal dose at 43 o C. [3][4][5] Administering hyperthermia to tumors situated deep inside the body presents significant clinical challenges such as, selective energy deposition within the tumor while thermally sparing surrounding structures, and sufficient thermometry for reliable treatment monitoring. 6 These difficulties are also associated with hyperthermia delivery to focal tumors in prostate and other organs inside the pelvic cavity.…”

Section: Introductionmentioning

confidence: 99%

“…Devices designed for prostate hyperthermia include interstitial linear array applicators with tubular ultrasound transducers 5,7 and endorectal ultrasound (ERUS) phased arrays [8][9][10] used in combination with radiation therapy. Currently, MR guided high intensity focused ultrasound (HIFU) systems are being increasingly utilized for noninvasive or minimally-invasive thermal ablation of soft tissue tumors in multiple organ sites.…”

Section: Introductionmentioning

confidence: 99%

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Targeted hyperthermia in prostate with an MR-guided endorectal ultrasound phased array: patient specific modeling and preliminary experiments

et al. 2013

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Feasibility of hyperthermia delivery to the prostate with a commercially available MR-guided endorectal ultrasound (ERUS) phased array ablation system (ExAblate 2100, Insightec, LTD) was assessed through computer simulations and ex vivo experiments.The simulations included a 3D FEM-based biothermal model, and acoustic field calculations for the ExAblate phased array (2.3 MHz, 2.3×4.0 cm 2 ) using the rectangular radiator method. Array beamforming strategies were investigated to deliver 30-min hyperthermia (>41 o C) to focal regions of prostate cancer, identified from MR images in representative patient cases. Constraints on power densities, sonication durations and switching speeds imposed by ExAblate hardware and software were incorporated in the models. T>41 o C was calculated in 14-19 cm 3 for sonications with planar or diverging beam patterns at 0.9-1.2 W/cm 2 , and in 3-10 cm 3 for curvilinear (cylindrical) or multifocus beam patterns at 1.5-3.3 W/cm 2 , potentially useful for treating focal disease in a single posterior quadrant.Preliminary experiments included beamformed sonications in tissue mimicking phantom material under MRI-based temperature monitoring at 3T (GRE TE=7.0 ms, TR=15 ms, BW=10.5 kHz, FOV=15 cm, matrix 128x128, FA=40º). MR-temperature rises of 2-6 o C were induced in a phantom with the ExAblate array, consistent with calculated values and lower power settings (~0.86 W/cm 2 , 3 min.).Conformable hyperthermia may be delivered by tailoring power deposition along the array length and angular expanse. MRgERUS HIFU systems can be controlled for continuous hyperthermia in prostate to augment radiotherapy and drug delivery. [FUS Foundation, NIH R01 122276, 111981].

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Targeted hyperthermia in prostate with an MR-guided endorectal ultrasound phased array: patient specific modeling and preliminary experiments

et al. 2013

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“…Thermotherapy significantly improves the efficacy of chemoradiotherapy and reduces its side effects so is often used in clinical practice. 7 Common methods of heating include hot water, 8,9 ultrasound, 10 and microwaves. 11 Kong et al were the first to study the effect of thermotherapy on carrier extravasation, 12 concluding that thermotherapy can improve the extravasation of liposomes.…”

Section: Introductionmentioning

confidence: 99%

Improved Efficacy of Liposomal Doxorubicin Treatment of Superficial Tumors by Thermotherapy

Xiong

An-wei

Gong

et al. 2015

Technol Cancer Res Treat

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“…62 Furthermore, in the in vivo setting we considered applicators consisting of 3 and 4 tubular ultrasound transducers in a linear array, similar in configurations as applied for hyperthermia with HDR brachytherapy. 63 We also included some simulations to approximate application of elevated power levels, where tissue temperatures in excess of 100…”

Section: Iid Bioacoustic-thermal Modelmentioning

confidence: 99%

Multiple applicator hepatic ablation with interstitial ultrasound devices: Theoretical and experimental investigation

et al. 2012

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Purpose: To evaluate multiple applicator implant configurations of interstitial ultrasound devices for large volume ablation of liver tumors. Methods: A 3D bioacoustic-thermal model using the finite element method was implemented to assess multiple applicator implant configurations for thermal ablation with interstitial ultrasound energy. Interstitial applicators consist of linear arrays of up to four 10 mm-long tubular ultrasound transducers, each under separate and dynamic power control, enclosed within a water-cooled delivery catheter (2.4 mm OD). The authors considered parallel implants with two and three applicators (clustered configuration), spaced 2-3 cm apart, to simulate open surgical placement. In addition, the authors considered two applicator implants with applicators converging and diverging at angles of ∼20• , 30• , and 45• to simulate percutaneous placement. Heating experiments (10-15 min) were performed and compared against simulations employing the same experimental parameters. To estimate the performance of parallel, multiple applicator configurations in an in vivo setting, simulations were performed taking into account a range of blood perfusion levels (0, 5, 12, and 15 kg m −3 s −1 ) that may occur in tumors of varying vascularity. The impact of tailoring the power supplied to individual transducer elements along the length of applicators is explored for applicators inserted in non-parallel (converging and diverging) configurations. Thermal dose (t 43 > 240 min) and temperature thresholds (T > 52• C) were used to define the ablation zones, with dynamic changes to tissue acoustic and thermal properties incorporated within the model. Results: Experiments in ex vivo bovine liver yielded ablation zones ranging between 4.0-5.6 cm × 3.2-4.9 cm, in cross section. Ablation zone dimensions predicted by simulations with similar parameters to the experiments were in close agreement (within 5 mm). Simulations of in vivo heating showed that 15 min heating and interapplicator spacing less than 3 cm are required to obtain contiguous, complete ablation zones. The ability to create complete ablation zone profiles for nonparallel implants was illustrated by tailoring applied power levels along the length of applicators. Conclusions: Parallel implants consisting of three interstitial ultrasound applicators in a triangular configuration yield complete ablation zones measuring up to 6.2 cm × 5.7 cm after 15 min heating. At larger interapplicator spacing, the level of blood perfusion in the tumor may yield indentations along the periphery of the ablation zone. Tailoring applied power along the length of the applicator can accommodate for nonparallel implants, without compromising safety.

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Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

Cited by 18 publications

References 6 publications

Targeted hyperthermia in prostate with an MR-guided endorectal ultrasound phased array: patient specific modeling and preliminary experiments

Targeted hyperthermia in prostate with an MR-guided endorectal ultrasound phased array: patient specific modeling and preliminary experiments

Improved Efficacy of Liposomal Doxorubicin Treatment of Superficial Tumors by Thermotherapy

Multiple applicator hepatic ablation with interstitial ultrasound devices: Theoretical and experimental investigation

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