Performance analysis of a dedicated breast MR-HIFU system for tumor ablation in breast cancer patients

Deckers, Roel; Merckel, Laura G.; Schubert, G.; Köhler, Max O.; Knuttel, Floortje M.; Mali, Willem P.Th.M.; Moonen, Chrit; Bosch, Maurice A.A.J. van den; Bartels, Lambertus W.

doi:10.1088/0031-9155/60/14/5527

Cited by 43 publications

(45 citation statements)

References 40 publications

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“…As HIFU begins to increasingly be used in the clinic for the treatment of other cancers (breast 18, 28 , liver 29, 30 , pancreas 31, 32 ), so does the potential capability of the combination therapy shown here. HS-targeting can be used in cancers of the liver and breast where the same HS receptors can be targeted 33, 34 .…”

Section: Discussionmentioning

confidence: 96%

“…The experimental setup is shown in axial (Fig 1A) and coronal (Fig 1B) orientations in Figure 1. Susceptibility effects due to ultrasound transducer motion were mitigated using an atlas-based reconstruction 18 where approximately 50 baseline library images were acquired with the transducer moving along the pre-defined trajectory (Fig 1C) multiple times without firing the ultrasound. During sonication, the current MR phase measurement was subtracted from the baseline library phase image that was most similar in a least squared difference sense.…”

Section: Methodsmentioning

confidence: 99%

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Enhanced efficacy of combination heat shock targeted polymer therapeutics with high intensity focused ultrasound

Frazier

Payne

Dillon

et al. 2017

Nanomedicine: Nanotechnology, Biology and Medicine

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Combination of polymer therapeutics and hyperthermia has been shown to enhance accumulation in selectively heated tumor tissue. The additional use of heat shock (HS)-targeting towards tumor tissues can further enhance accumulation and retention, and improve therapeutic outcomes. In this work, high intensity focused ultrasound (HIFU) was used to generate hyperthermia in prostate tumor tissue. Upregulation of the cell surface HS receptor glucose regulated protein 78 kDa (GRP78) was observed after treatment with HIFU hyperthermia which was then targeted by specific HS-targeting peptides. We used the peptide sequence WDLAWMFRLPVG attached to the side chains of water-soluble N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers containing docetaxel (DOC) conjugated via a lysosomally degradable linker. It was shown that HIFU-mediated HS-targeted copolymer-DOC conjugates improved treatment efficacy in a murine prostate tumor xenograft model. These results show that the use of HIFU hyperthermia in combination with HS-targeted polymer-drug conjugates has potential to improve therapeutic outcomes in prostate cancer treatment.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Enhanced efficacy of combination heat shock targeted polymer therapeutics with high intensity focused ultrasound

Frazier

Payne

Dillon

et al. 2017

Nanomedicine: Nanotechnology, Biology and Medicine

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show abstract

“…58 MR-HIFU treatment of breast cancer is now in development as tumor necrosis of up to 100% has been reported. 59,60 Here, thermal-induced changes of vascular permeability for targeted drug delivery by HIFU might offer further interesting therapeutic opportunities.…”

Section: Discussionmentioning

confidence: 99%

MR-guided high-intensity focused ultrasound treatment of uterine fibroids

Wiggermann¹,

Beldoch²,

Hoellen³

et al. 2016

RRFU

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Uterine fibroids are benign, encapsulated uterine tumors, representing the most common reason for hysterectomy in premenopausal women. High-intensity focused ultrasound (HIFU; also known as focused ultrasound surgery) is a noninvasive technique leading to tissue heating in a centered focus, inducing a thermal tissue necrosis. Magnetic resonance-guided HIFU (MR-HIFU; also know as MR-guided focused ultrasound surgery) allows to allocate the uterine fibroids as well as to evaluate whether these are accessible for HIFU treatment. Further advantages are MR-based real-time temperature mapping and immediate evaluation of postprocedure therapeutic success by MR imaging. These advantages minimize the patient risk and make the treatment more effective. MR-HIFU is a uterus conserving, low pain-to-painless, and noninvasive treatment option. Here, we review its medical and economic advance to surgical procedures due to the low complication rates combined with proven symptom relief and the enhancement of the quality of life.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13] While most feasibility studies to date have been performed with a vertically propagating transducer, some designs use laterally mounted configurations.…”

Section: Introductionmentioning

confidence: 99%

“…1, [13][14][15][16] Laterally positioned transducers avoid striking important structures such as the heart, lungs, and ribs in the far field of the beam path when targeting a tumor in the breast, thus reducing reflections and undesired heating in healthy tissues.…”

Section: Introductionmentioning

confidence: 99%

Phase aberration simulation study of MRgFUS breast treatments

et al. 2016

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Purpose: This simulation study evaluates the effects of phase aberration in breast MR-guided focused ultrasound (MRgFUS) ablation treatments performed with a phased-array transducer positioned laterally to the breast. A quantification of these effects in terms of thermal dose delivery and the potential benefits of phase correction is demonstrated in four heterogeneous breast numerical models. Methods: To evaluate the effects of varying breast tissue properties on the quality of the focus, four female volunteers with confirmed benign fibroadenomas were imaged using 3T MRI. These images were segmented into numerical models with six tissue types, with each tissue type assigned standard acoustic properties from the literature. Simulations for a single-plane 16-point raster-scan treatment trajectory centered in a fibroadenoma in each modeled breast were performed for a breast-specific MRgFUS system. At each of the 16 points, pressure patterns both with and without applying a phase correction technique were determined with the hybrid-angular spectrum method. Corrected phase patterns were obtained using a simulation-based phase aberration correction technique to adjust each element's transmit phase to obtain maximized constructive interference at the desired focus. Thermal simulations were performed for both the corrected and uncorrected pressure patterns using a finite-difference implementation of the Pennes bioheat equation. The effect of phase correction was evaluated through comparison of thermal dose accumulation both within and outside a defined treatment volume. Treatment results using corrected and uncorrected phase aberration simulations were compared by evaluating the power required to achieve a 20• C temperature rise at the first treatment location. The extent of the volumes that received a minimum thermal dose of 240 CEM at 43• C inside the intended treatment volume as well as the volume in the remaining breast tissues was also evaluated in the form of a dose volume ratio (DVR), a DVR percent change between corrected and uncorrected phases, and an additional metric that measured phase spread. Results: With phase aberration correction applied, there was an improvement in the focus for all breast anatomies as quantified by a reduction in power required (13%-102%) to reach 20• C when compared to uncorrected simulations. Also, the DVR percent change increased by 5%-77% in seven out of eight cases, indicating an improvement to the treatment as measured by a reduction in thermal dose deposited to the nontreatment tissues. Breast compositions with a higher degree of heterogeneity along the ultrasound beam path showed greater reductions in thermal dose delivered outside of the treatment volume with correction applied than beam trajectories that propagated through more homogeneous breast compositions. An increasing linear trend was observed between the DVR percent change and the phase-spread metric (R 2 = 0.68). Conclusions: These results indicate that performing phase aberration correction for breast MRgFUS treatme...

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Performance analysis of a dedicated breast MR-HIFU system for tumor ablation in breast cancer patients

Cited by 43 publications

References 40 publications

Enhanced efficacy of combination heat shock targeted polymer therapeutics with high intensity focused ultrasound

Enhanced efficacy of combination heat shock targeted polymer therapeutics with high intensity focused ultrasound

MR-guided high-intensity focused ultrasound treatment of uterine fibroids

Phase aberration simulation study of MRgFUS breast treatments

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