Rationale for using invasive thermometry for regional hyperthermia of pelvic tumors

Wust, Peter; Gellermann, Johanna; Harder, Christian; Tilly, Wolfgang; Rau, Beate; Dinges, Stefan; Schlag, Peter M.; Budach, Volker; Félix, R.

doi:10.1016/s0360-3016(98)00165-5

Cited by 75 publications

(57 citation statements)

References 26 publications

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“…The time curves of mean MR temperatures over f80 minutes are in accordance with typical directly recorded temperature-time curves (see Fig. 2) well known from invasive or minimal-invasive thermometry in regional hyperthermia (3,42). In the majority (11 of 15 heat sessions) we found a transition of the mean MR-temperature of the tumor into a plateau with a thermal relaxation time of 15 to 20 minutes.…”

Section: Resultssupporting

confidence: 88%

Noninvasive Magnetic Resonance Thermography of Recurrent Rectal Carcinoma in a 1.5 Tesla Hybrid System

Gellermann¹,

Wlodarczyk²,

Hildebrandt³

et al. 2005

Cancer Research

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To implement noninvasive thermometry, we installed a hybrid system consisting of a radiofrequency multiantenna applicator (SIGMA-Eye) for deep hyperthermia (BSD-2000/3D) integrated into the gantry of a 1.5 Tesla magnetic resonance (MR) tomograph Symphony. This system can record MR data during radiofrequency heating and is suitable for application and evaluation of methods for MR thermography. In 15 patients with preirradiated pelvic rectal recurrences, we acquired phase data sets (25 slices) every 10 to 15 minutes over the treatment time (60-90 minutes) using gradient echo sequences (echo time = 20 ms), transformed the phase differences to MR temperatures, and fused the color-coded MR-temperature distributions with anatomic T1-weighted MR data sets. We could generate one complete series of MR data sets per patient with satisfactory quality for further analysis. In fat, muscle, water bolus, prostate, bladder, and tumor, we delineated regions of interest (ROI), used the fat ROI for drift correction by transforming these regions to a phase shift zero, and evaluated the MR-temperature frequency distributions. Mean MR temperatures (T MR ), maximum T MR , full width half maximum (FWHM), and other descriptors of tumors and normal tissues were noninvasively derived and their dependencies outlined. In 8 of 15 patients, direct temperature measurements in reference points were available. We correlated the tumor MR temperatures with direct measurements, clinical response, and tumor features (volume and location), and found reasonable trends and correlations. Therefore, the mean T MR of the tumor might be useful as a variable to evaluate the quality and effectivity of heat treatments, and consequently as optimization variable. Feasibility of noninvasive MR thermography for regional hyperthermia has been shown and should be further investigated. (Cancer Res 2005; 65(13): 5872-80)

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Section: Resultssupporting

confidence: 88%

Noninvasive Magnetic Resonance Thermography of Recurrent Rectal Carcinoma in a 1.5 Tesla Hybrid System

Gellermann¹,

Wlodarczyk²,

Hildebrandt³

et al. 2005

Cancer Research

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“…9,10 However, invasive thermometry-although it is regarded as the gold standard by many clinicians-not only requires the intratumoral placement of thermistors but also suffers from severe limitations regarding the integrity of the thermometric information obtained, which may be incomplete. 11,12 It has been demonstrated that minimally invasive thermometry using specified reference points or tracks in the rectum, vagina, or urethra is equivalent to invasive measurements in pelvic tumors 13,14 ; however, currently, no minimally invasive technique is available for the surveillance of extremity tumors. Therefore, the successful implementation of noninvasive thermometry (NIT) would be helpful, particularly for regional hyperthermia in patients with STS.…”

Section: Resultsmentioning

confidence: 99%

Noninvasive magnetic resonance thermography of soft tissue sarcomas during regional hyperthermia

Gellermann

Hildebrandt

Issels³

et al. 2006

Cancer

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BACKGROUND The objective of this study was to evaluate noninvasive magnetic resonance (MR) thermography for the monitoring of regional hyperthermia (RHT) in patients with soft tissue sarcomas of the lower extremities and pelvis. METHODS Noninvasive MR monitoring during RHT was performed in 9 patients who had high‐risk soft tissue sarcomas of the lower extremities or pelvis during neoadjuvant chemotherapy plus RHT in the scope of the European Organization for Research and Treatment of Cancer 62961/European Society for Hyperthermic Oncology RHT‐95 study. Anatomic and temperature‐sensitive data sets were acquired every 10 minutes before and during RHT (using gradient‐echo‐sequences with variable echo times). MR temperature distributions were derived from the phase differences by using the proton‐resonance frequency shift method. A phase convolution setting phase shifts to zero in the fat tissue was performed as a drift correction. The mean MR temperatures in the tumor and muscles and the index temperatures (e.g., T90, which covers 90% of the target volume) and thermal doses were determined and compared with pathohistologic responses and direct temperature measurements if available. RESULTS Thirty of 72 MR‐thermography data sets (>40% of heat sessions) were evaluable. A significant correlation was observed between pathohistologic response (defined as a necrosis rate ≥90%) and standardized thermal parameters, such as thermal dose cumulative equivalent minutes at 43°C to 90% of the target volume (T90) (P = .050), mean T90 (P = .048), or T50 (P = .050). The correlation of 13 conventional temperature measurements performed in selected patients and sessions invasively in the tumor or noninvasively in rectum and bladder revealed an excellent correlation with MR temperatures (R2 = .96). CONCLUSIONS Noninvasive MR thermography of soft tissue sarcoma was feasible and suitable for validating the quality of heating during RHT. Cancer 2006. © 2006 American Cancer Society.

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“…In a pilot study of 4 patients, a close correlation between fibre-optic temperature measurements and corrected MR-thermometry measurements was observed (23). In Europe such MR-based non-invasive thermometry during regional heating with the BSD heating device is currently under investigation in Munich and Berlin (19,24). The spatial resolution is about 1 cm 3 and the thermal resolution 0.5°C (25).…”

Section: Experimental Backgroundmentioning

confidence: 85%

“…It should be underlined that they placed pelvic catheters by a transgluteal, CT-guided technique, and left the catheters in situ for the whole treatment period. Using a similar transgluteal technique for most patients, the Berlin Group reported that 19% of catheters had to be removed because of side effects such as local inflammation, pain or abscess formation when used for deep-seated tumours (19). In 300 patients with 1 491 deep-heating sessions from the Duke University in the USA, the complication incidence was 11%, of which 4% of patients were scored as serious (12).…”

Section: Experimental Backgroundmentioning

confidence: 99%

Status of Clinical Hyperthermia

Dahl

Dalene²,

Bc³

et al. 1999

Acta Oncologica

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Rationale for using invasive thermometry for regional hyperthermia of pelvic tumors

Cited by 75 publications

References 26 publications

Noninvasive Magnetic Resonance Thermography of Recurrent Rectal Carcinoma in a 1.5 Tesla Hybrid System

Noninvasive Magnetic Resonance Thermography of Recurrent Rectal Carcinoma in a 1.5 Tesla Hybrid System

Noninvasive magnetic resonance thermography of soft tissue sarcomas during regional hyperthermia

Status of Clinical Hyperthermia

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