Feasibility of concurrent treatment with the scanning ultrasound reflector linear array system (SURLAS) and the helical tomotherapy system

Peñagarícano, José; Moros, Eduardo G.; Novák, Petr; Yan, Yulong; Corry, Peter M.

doi:10.1080/02656730801929923

Cited by 8 publications

(14 citation statements)

References 44 publications

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“…The main conclusion from the treatment planning study was that simultaneous treatment with the SURLAS and HT IMRT/IGRT is feasible as demonstrated by the clinically acceptable radiation treatment plans generated [66]. Likewise, the main conclusion of the experimental study was that the delivered (measured) and planned radiation dose distributions were in excellent agreement when the SURLAS applicator was positioned as it was planned.…”

Section: The Surlas: a Device Developed For Simultaneous Thermoradiotmentioning

confidence: 99%

“…Our first working hypothesis was that IMRT can produce clinically acceptable dose distributions on a recurrent breast cancer tumor while that same tumor receives ultrasound hyperthermia using the SURLAS. To test this hypothesis two research projects were initiated: a radiation treatment planning study to compute dose distributions in recurrent breast cancer PTVs with the SURLAS applicator in place [66]; and an experimental study, where a radiation treatment plan was computed and delivered to a phantom with the SURLAS applicator on top of the phantom simulating a clinical setup, to evaluate the effects of the presence and potential misplacement of the SURLAS applicator on measured dose distributions [67]. …”

Section: The Surlas: a Device Developed For Simultaneous Thermoradiotmentioning

confidence: 99%

“…Moreover, the MVCT images could be also used to verify the position of the SURLAS applicator with respect to the patient and from treatment to treatment. All these ideas were tested successfully [66, 67]. …”

Section: The Surlas: a Device Developed For Simultaneous Thermoradiotmentioning

confidence: 99%

See 2 more Smart Citations

Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Moros

Peñagarícano

Novák

et al. 2010

International Journal of Hyperthermia

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This paper reviews systems and techniques to deliver simultaneous thermoradiotherapy of breast cancer. It first covers the clinical implementation of simultaneous delivery of superficial (microwave or ultrasound) hyperthermia and external photon beam radiotherapy, first using a Co-60 teletherapy unit and later medical linear accelerators. The parallel development and related studies of the SURLAS, an advanced system specifically designed and developed for simultaneous thermoradiotherapy, follows. The performance characteristics of the SURLAS are reviewed and power limitation problems at high acoustic frequencies (> 3MHz) are discussed along with potential solutions. Next, the feasibility of simultaneous SURLAS hyperthermia and IMRT/IGRT is established based on published and newly presented studies. Finally, based on the encouraging clinical results thus far, it is concluded that new trials employing the latest technologies are warranted along with further developments in treatment planning. Keywordsbreast; cancer; chest wall; heat; hyperthermia; radiation therapy; radiotherapy; radiosensitization; recurrence; thermoradiotherapy; simultaneous; ultrasound; intensity modulated Hyperthermia and CancerConventional hyperthermia in cancer therapy can be defined as the elevation of tissue temperatures to 41~43°C for more than 30 minutes. Hyperthermia is typically used as an adjunct therapy to radiotherapy and/or chemotherapy [1][2][3][4][5]. Many well-conducted clinical trials, including phase III multi-institutional trials following quality assurance guidelines, have shown that hyperthermia can significantly increase both local tumor control rates and duration of local control in tumors that recur or persist after surgery, radiotherapy and/or chemotherapy [6][7][8][9]. Furthermore, hyperthermia has been shown beneficial in the treatment of residual microscopic disease in the management of local-regional breast cancer [10], in the treatment of soft tissue sarcomas preoperatively with radiation [11], and in the treatment of deep pelvic tumors [12,13]. A significant survival benefit was also reported when hyperthermia was combined with brachytherapy in the treatment of glioblastoma multiforme [14] and with external beam radiotherapy in the treatment of recurrent head and neck cancer [15]. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptIn fact, when clinical trials have been conducted under widely accepted quality assurance guidelines-which implies matching the heating technology to the target site along with the implementation of a reasonable thermometry strategy-radiotherapy plus hyperthermia has always resulted in statistically better outcomes than radiotherapy alone [16]. Thermoradiotherapy of Breast CancerPatients with persistent and/or recurrent breast cancer and chest wall tumors have significantly benefited when hyperthermia has been added to their radiotherapy and/or chemotherapy regimens [17][18][19][20][21][22][23][24][25][26]. One of the physical reasons for the success of hyp...

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Section: The Surlas: a Device Developed For Simultaneous Thermoradiotmentioning

confidence: 99%

Section: The Surlas: a Device Developed For Simultaneous Thermoradiotmentioning

confidence: 99%

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Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Moros

Peñagarícano

Novák

et al. 2010

International Journal of Hyperthermia

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“…Methods for heating superficial tissue disease have been reviewed previously (16–19). While ultrasound (US) systems can be focused precisely to small targets at depth(13) and have shown the ability to smear uniform heating across larger regions of the body(14) even simultaneously with external beam radiotherapy (15–17), most ultrasound systems have difficulty heating contoured anatomy and tissue overlying shallow depth bone.…”

Section: Introductionmentioning

confidence: 99%

Conformal microwave array (CMA) applicators for hyperthermia of diffuse chest wall recurrence

Stauffer

Maccarini

Arunachalam

et al. 2010

International Journal of Hyperthermia

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Purpose This article summarizes the evolution of microwave array applicators for heating large area chestwall disease as an adjuvant to external beam radiation, systemic chemotherapy, and potentially simultaneous brachytherapy. Methods Current devices used for thermotherapy of chestwall recurrence are reviewed. The largest conformal array applicator to date is evaluated in four studies: i) ability to conform to the torso is demonstrated with a CT scan of a torso phantom and MR scan of the conformal waterbolus component on a mastectomy patient; ii) Specific Absorption Rate (SAR) and temperature distributions are calculated with electromagnetic and thermal simulation software for a mastectomy patient; iii). SAR patterns are measured with a scanning SAR probe in liquid muscle phantom for a buried coplanar waveguide CMA; and iv) heating patterns and patient tolerance of CMA applicators are characterized in a clinical pilot study with 13 patients. Results CT and MR scans demonstrate excellent conformity of CMA applicators to contoured anatomy. Simulations demonstrate effective control of heating over contoured anatomy. Measurements confirm effective coverage of large treatment areas with no gaps. In 42 hyperthermia treatments, CMA applicators provided well-tolerated effective heating of up to 500cm2 regions, achieving target temperatures of Tmin=41.4±0.7°C, T90=42.1±0.6°C, Tave=42.8±0.6°C, and Tmax=44.3±0.8°C as measured in an average of 90 points per treatment. Summary The CMA applicator is an effective thermal therapy device for heating large-area superficial disease such as diffuse chestwall recurrence. It is able to cover over three times the treatment area of conventional hyperthermia devices while conforming to typical body contours.

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“…[3][4][5][6][7][8][9][10][11][12][13] Noninvasive thermal ablation may enhance the efficacy of ionizing radiation therapy and chemotherapy, and potentially reduce the need for surgery, and thus it has the potential to provide significant outcome improvements and lower morbidity rates in this and other high-risk patient populations. 6,[14][15][16] The SonoKnife, a new concept for a noninvasive (externally applied), scan-able, high intensity linefocused ultrasound thermal therapy system, was conceived for thermal ablation of advanced (persistent or recurrent) superficial head and neck tumors and positive lymph nodes that are located not more than 5 cm from the skin and are not larger than 3 cm in diameter.…”

Section: Introductionmentioning

confidence: 99%

SonoKnife: Feasibility of a line‐focused ultrasound device for thermal ablation therapy

et al. 2011

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Purpose: To evaluate the feasibility of line-focused ultrasound for thermal ablation of superficially located tumors. Methods: A SonoKnife is a cylindrical-section ultrasound transducer designed to radiate from its concave surface. This geometry generates a line-focus or acoustic edge. The motivation for this approach was the noninvasive thermal ablation of advanced head and neck tumors and positive neck nodes in reasonable treatment times. Line-focusing may offer advantages over the common point-focusing of spherically curved radiators such as faster coverage of a target volume by scanning of the acoustic edge. In this paper, The authors report studies using numerical models and phantom and ex vivo experiments using a SonoKnife prototype. Results: Acoustic edges were generated by cylindrical-section single-element ultrasound transducers numerically, and by the prototype experimentally. Numerically, simulations were performed to characterize the acoustic edge for basic design parameters: transducer dimensions, line-focus depth, frequency, and coupling thickness. The dimensions of the acoustic edge as a function of these parameters were determined. In addition, a step-scanning simulation produced a large thermal lesion in a reasonable treatment time. Experimentally, pressure distributions measured in degassed water agreed well with acoustic simulations, and sonication experiments in gel phantoms and ex vivo porcine liver samples produced lesions similar to those predicted with acoustic and thermal models. Conclusions: Results support the feasibility of noninvasive thermal ablation with a SonoKnife.

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Feasibility of concurrent treatment with the scanning ultrasound reflector linear array system (SURLAS) and the helical tomotherapy system

Cited by 8 publications

References 44 publications

Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer

Conformal microwave array (CMA) applicators for hyperthermia of diffuse chest wall recurrence

SonoKnife: Feasibility of a line‐focused ultrasound device for thermal ablation therapy

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