MR Image Guided Hyperthermia Gerhard Sennewald PhD, Munich, Germany Kazakh Medical Diagnostic Forum “Technological Innovations in radiology & functional.

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Presentation transcript:

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

Agenda  BSD 20003D Deep Regional Hyperthermia  BSD 20003D-MR Image Guided Hyperthermia  SigmaHyperPlan / SigmaVision

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

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

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

BSD-2000 System Family BSD D/MR System: 3 Rings with 8 Antenna each MRI Image Guided Thermometry BSD 2000 Basic System BSD D System

8 Antennas in 4 pairs Functional Principle: Regional Hyperthermia

Sigma 60 Applicator: 8 Antenna Array surrounding the Patient BSD 2000 Concept: Antenna Arrays

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

Lamp phantom Regional Hyperthermia

BSD D Hyperthermia Treatment Suite

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

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

MR Image Guided Hyperthermia

Dockable Patient Cart & 70 cm Bore

Thermometry – MR Controlled Hyperthermia

Hyperthermia MRI Diagnostics MR Hyperthermia Treatment Suite

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

The new user-friendly software for MR-Thermometry

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

MR Guided Pediatric Hyperthermia Wessalowski et al.: The Lancet Oncology 2013 on Germ Cell Tumors Department of Pediatric Oncology UMS Düsseldorf - Germany Wessalowski et al. Lancet Oncol. 2013

MR Guided Pediatric Hyperthermia Wessalowski et al. Lancet Oncol. 2013

MR Guided Pediatric Hyperthermia Applicators of Various Sizes Optimize Pediatric Treatments Wessalowski et al. Lancet Oncol. 2013

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

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

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

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

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

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

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

The Atzelsberg Clinical Trial Circle 42 O. Ott: Rectal Cancer HyRec Trial - Treatment Schedule - Trial is Recruting Recurrent & Locally Advanced Rectal Cancer Week d2 d9 d23 d30 d 1-14d 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 RESECTIONRESECTION d2 d9 d23 d30 d5 d12 d26 d33 d16 d19 Ott OJ et al., 2009 Required Cases n =59

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

Thank you!

MR Guided Hyperthermia in Soft Tissue Sarcomas