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Focal laser ablation of prostate cancer: definition, needs, and future. Adv Urol 2012; 2012:589160. [PMID: 22666240 PMCID: PMC3362007 DOI: 10.1155/2012/589160] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 01/13/2023] Open
Abstract
Current challenges and innovations in prostate cancer management concern the development of focal therapies that allow the treatment of only the cancer areas sparing the rest of the gland to minimize the potential morbidity. Among these techniques, focal laser ablation (FLA) appears as a potential candidate to reach the goal of focusing energy delivery on the identified targets. The aim of this study is to perform an up-to-date review of this new therapeutic modality. Relevant literature was identified using MEDLINE database with no language restrictions (entries: focal therapy, laser interstitial thermotherapy, prostate cancer, FLA) and by cross-referencing from previously identified studies. Precision, real-time monitoring, MRI compatibility, and low cost of integrated system are principal advantages of FLA. Feasibility and safety of this technique have been reported in phase I assays. FLA might eventually prove to be a middle ground between active surveillance and radical treatment. In conclusion, FLA may have found a role in the management of prostate cancer. However, further trials are required to demonstrate the oncologic effectiveness in the long term.
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Carpentier A, Chauvet D, Reina V, Beccaria K, Leclerq D, McNichols RJ, Gowda A, Cornu P, Delattre JY. MR-guided laser-induced thermal therapy (LITT) for recurrent glioblastomas. Lasers Surg Med 2012; 44:361-8. [DOI: 10.1002/lsm.22025] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2012] [Indexed: 11/10/2022]
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Fuentes D, Yung J, Hazle JD, Weinberg JS, Stafford RJ. Kalman filtered MR temperature imaging for laser induced thermal therapies. IEEE TRANSACTIONS ON MEDICAL IMAGING 2012; 31:984-94. [PMID: 22203706 PMCID: PMC3873725 DOI: 10.1109/tmi.2011.2181185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The feasibility of using a stochastic form of Pennes bioheat model within a 3-D finite element based Kalman filter (KF) algorithm is critically evaluated for the ability to provide temperature field estimates in the event of magnetic resonance temperature imaging (MRTI) data loss during laser induced thermal therapy (LITT). The ability to recover missing MRTI data was analyzed by systematically removing spatiotemporal information from a clinical MR-guided LITT procedure in human brain and comparing predictions in these regions to the original measurements. Performance was quantitatively evaluated in terms of a dimensionless L(2) (RMS) norm of the temperature error weighted by acquisition uncertainty. During periods of no data corruption, observed error histories demonstrate that the Kalman algorithm does not alter the high quality temperature measurement provided by MR thermal imaging. The KF-MRTI implementation considered is seen to predict the bioheat transfer with RMS error < 4 for a short period of time, ∆t < 10 s, until the data corruption subsides. In its present form, the KF-MRTI method currently fails to compensate for consecutive for consecutive time periods of data loss ∆t > 10 sec.
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Affiliation(s)
- D. Fuentes
- The University of Texas M.D Anderson Cancer Center, Department of Imaging Physics, Houston TX 77030, USA
| | - J. Yung
- The University of Texas M.D Anderson Cancer Center, Department of Imaging Physics, Houston TX 77030, USA
| | - J. D. Hazle
- The University of Texas M.D Anderson Cancer Center, Department of Imaging Physics, Houston TX 77030, USA
| | - J. S. Weinberg
- The University of Texas M.D Anderson Cancer Center, Department of Neurosurgery, Houston TX 77030, USA
| | - R. J. Stafford
- The University of Texas M.D Anderson Cancer Center, Department of Imaging Physics, Houston TX 77030, USA
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Rahmathulla G, Recinos PF, Valerio JE, Chao S, Barnett GH. Laser Interstitial Thermal Therapy for Focal Cerebral Radiation Necrosis: A Case Report and Literature Review. Stereotact Funct Neurosurg 2012; 90:192-200. [DOI: 10.1159/000338251] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 02/28/2012] [Indexed: 11/19/2022]
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Taylor BA, Elliott AM, Hwang KP, Shetty A, Hazle JD, Stafford RJ. Measurement of temperature dependent changes in bone marrow using a rapid chemical shift imaging technique. J Magn Reson Imaging 2011; 33:1128-35. [PMID: 21509871 DOI: 10.1002/jmri.22537] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE To provide quantitative temperature monitoring for thermal therapies in bone marrow by measuring temperature-dependent signal changes in the bone marrow of ex vivo canine femurs heated with a 980-nm laser at 1.5T and 3.0T. MATERIALS AND METHODS Using a multi-gradient echo (≤ 16) acquisition and signal modeling with the Stieglitz-McBride algorithm, the temperature sensitivity coefficients (TSC, ppm/°C) of water and multiple lipid components' proton resonance frequency (PRF) values are measured at high spatiotemporal resolutions (1.6 × 1.6 × 4 mm(3) , ≤ 5 seconds). Responses in R(2) * and amplitudes of each peak were also measured as a function of temperature simultaneously. RESULTS Calibrations demonstrate that lipid signal may be used to compensate for B(0) errors to provide accurate temperature readings (<1.0°C). Over a temperature range of 17.2-57.2°C, the TSCs after correction to a bulk methylene reference are -0.87 × 10(-2) ± 4.7 × 10(-4) ppm/°C and -0.87 × 10(-2) ± 4.0 × 10(-4) ppm/°C for 1.5T and 3.0T, respectively. CONCLUSION Overall, we demonstrate that accurate and precise temperature measurements can be made in bone marrow. In addition, the relationship of R(2) * and signal amplitudes with respect to temperature are shown to differ significantly where conformal changes are predicted by Arrhenius rate model analysis.
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Affiliation(s)
- Brian A Taylor
- Department of Imaging Physics, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA
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Xi G, Mania-Farnell B, Rajaram V, Mayanil CS, Soares MB, Tomita T, Goldman S. Efficacy of interstitial continuous vincristine infusion in a bioluminescent rodent intracranial tumor model. J Neurooncol 2011; 106:261-70. [PMID: 21842443 DOI: 10.1007/s11060-011-0680-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 07/30/2011] [Indexed: 12/24/2022]
Abstract
Interstitial chemotherapeutic drug infusion can bypass the blood-brain barrier, and provide high regional drug concentrations without systemic exposure. However, toxicity and efficacy for drugs administered via interstitial continuous (i.c.) infusion have not been characterized. In the current study, vincristine (VIN) was infused into the right frontal lobes of healthy Fisher 344 rats at 30, 45, 60, and 120 μg/ml over a period of 7 days at 1 μl/h, using an Alzet osmotic pump to evaluate toxicity. C6 rat glioblastoma cells transduced with a luciferase gene were inoculated into the right frontal lobe of a second group of rats. VIN was administered to tumor bearing rats via i.c. infusion 7 days later and tumor growth was monitored by bioluminescence intensity (BLI) to assess VIN efficacy, intravenous (i.v.) drug administration was used as a comparison drug delivery method. The results suggested that VIN toxicity is dose-dependent. Efficacy studies showed increased BLI, which correlates with histopathological tumor size, in saline-infused and i.v.-treated tumor-bearing rats. These rats survived an average of 28 ± 0.85 days and 33 ± 1.38 days, respectively. Both groups had large tumors at the time of death. Animals treated with VIN via i.c. infusion survived until day 90, the observation endpoint for this study. This was significantly longer than average survival times in the previous two groups. These results demonstrate that VIN via i.c. infusion is effective in reducing C6 glioblastoma tumors and prolonging rodent survival time compared to i.v. injection and suggest that chemotherapeutic drug administration via i.c. infusion may be a promising strategy for treating malignant brain tumors.
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Affiliation(s)
- Guifa Xi
- Neurosurgical Department, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Sherman JH, Hoes K, Marcus J, Komotar RJ, Brennan CW, Gutin PH. Neurosurgery for Brain Tumors: Update on Recent Technical Advances. Curr Neurol Neurosci Rep 2011; 11:313-9. [DOI: 10.1007/s11910-011-0188-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
The advanced imaging techniques outlined in this article are only slowly establishing their place in surgical practice. Even a low risk of false information is unacceptable in neurosurgery, thus decision-making is necessarily conservative. As more validation studies and greater experience accrue, surgeons are becoming more comfortable weighing the quality of information from functional imaging studies. Advanced imaging information is highly complementary to established surgical "good practice" such as anatomic planning, awake craniotomy, and electrocortical stimulation; its greatest impact is perhaps on how neurosurgery is planned and discussed before the patient is ever brought to the operating room. Access to functional magnetic resonance (MR) imaging, diffusion tractography, and intraoperative MR imaging can influence neurosurgical decisions before, during, and after surgery. However, the widespread adoption of these techniques in neurosurgical practice remains limited by the lack of standardized methods, the need for validation across institutions, and the unclear cost-effectiveness particularly for intraoperative MR imaging. Before advanced imaging results can be used therapeutically, it is incumbent on the neurosurgeon and neuroradiologist to develop a working understanding of each technique's strengths and weaknesses, positive and negative predictive values, and modes of failure. This content presents several imaging methods that are increasingly used in neurosurgical planning. As these techniques are progressively applied to surgery, radiologists, medical physicists, neuroscientists, and engineers will be necessary partners with the treating neurosurgeon to bridge the gap between the experimental and the therapeutic.
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Abd-El-Barr MM, Rahman M, Rao G. Investigational therapies for brain metastases. Neurosurg Clin N Am 2010; 22:87-96, vii. [PMID: 21109153 DOI: 10.1016/j.nec.2010.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Contrary to the incidence of primary cancers, the incidence of brain metastasis has been increasing. This increase is likely because of the effects of an aging population, improved neuroimaging surveillance, and better control of systemic cancer, allowing time for brain metastasis to occur. Unlike systemic cancers, for which chemotherapy is the mainstay of treatment, the therapeutic strategies available to treat brain metastasis have traditionally been limited to surgical resection, whole brain radiation therapy, or stereotactic radiosurgery, either individually or in combination. It is important to put the treatment in the context of the prognosis for patients with brain metastases.
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Affiliation(s)
- Muhammad M Abd-El-Barr
- Department of Neurosurgery, University of Florida, Box 100265, Gainesville, FL 32610, USA
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Fuentes D, Feng Y, Elliott A, Shetty A, McNichols RJ, Oden JT, Stafford RJ. Adaptive real-time bioheat transfer models for computer-driven MR-guided laser induced thermal therapy. IEEE Trans Biomed Eng 2010; 57:1024-30. [PMID: 20142153 DOI: 10.1109/tbme.2009.2037733] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The treatment times of laser induced thermal therapies (LITT) guided by computational prediction are determined by the convergence behavior of partial differential equation (PDE)-constrained optimization problems. In this paper, we investigate the convergence behavior of a bioheat transfer constrained calibration problem to assess the feasibility of applying to real-time patient specific data. The calibration techniques utilize multiplanar thermal images obtained from the nondestructive in vivo heating of canine prostate. The calibration techniques attempt to adaptively recover the biothermal heterogeneities within the tissue on a patient-specific level and results in a formidable PDE constrained optimization problem to be solved in real time. A comprehensive calibration study is performed with both homogeneous and spatially heterogeneous biothermal model parameters with and without constitutive nonlinearities. Initial results presented here indicate that the calibration problems involving the inverse solution of thousands of model parameters can converge to a solution within three minutes and decrease the [see text for symbol](L) (2) (2) ((0, T; L) (2) ((Omega))) norm of the difference between computational prediction and the measured temperature values to a patient-specific regime.
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Affiliation(s)
- David Fuentes
- Department of Imaging Physics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
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Martin AJ, Starr PA, Larson PS. Software requirements for interventional MR in restorative and functional neurosurgery. Neurosurg Clin N Am 2009; 20:179-86. [PMID: 19555880 DOI: 10.1016/j.nec.2009.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Interventional MRI (iMRI) holds great promise for optimally guiding and monitoring restorative and functional neurosurgical procedures. This technology has already been used to guide ablative therapies and insert deep brain stimulation electrodes, and many future applications are envisioned. An optimized software interface is crucial for efficiently integrating the imaging data acquired during these procedures. MR systems are largely dedicated to image prescription and acquisition, whereas neuronavigation systems typically operate with previously acquired static data. An optimal software interface for iMRI requires fusion of many of the capabilities offered by these individual devices and further requires the development of tools to handle the integration and presentation of dynamically updated data.
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Affiliation(s)
- Alastair J Martin
- Department of Radiology and Biomedical Imaging, University of California San Francisco, Box 0628, Room L-310, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
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MR imaging-guided cryoablation of metastatic brain tumours: initial experience in six patients. Eur Radiol 2009; 20:404-9. [PMID: 19697040 DOI: 10.1007/s00330-009-1554-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 06/24/2009] [Accepted: 07/05/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective was to evaluate the initial experience and safety of magnetic resonance imaging (MRI)-guided transcranial cryoablation in cystic metastatic brain tumours. MATERIAL AND METHODS Seven cystic metastatic brain tumours in six patients were treated with cryoablation. The approval from the local ethics committee and individual patient consent were acquired before the study. Before the procedure the tumours were detected with conventional CT or MRI. The procedure was performed under local anaesthesia and conscious sedation. A 0.23-T open MRI system with optical tracking was used for procedural planning, instrument guidance and procedural monitoring of the ice ball formation. An MR-compatible, argon-based cryoablation system was used. The schedule of follow-up imaging ranged from 12 days to 12 months. RESULTS Seven treatment sessions were performed. All the cryoprobes were successfully inserted into the target with one pass. All the patients tolerated the procedure well without experiencing any neurological deficits during the treatment phase or during the immediate post-treatment period. One patient died 12 days after cryoablation. CONCLUSION MR-guided and monitored metastasis brain tumour cryoablation is technically feasible and may represent an alternative treatment in selected patients.
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Viard R. Présentation des différentes avancées techniques en imagerie interventionnelle par résonance magnétique. Ing Rech Biomed 2009. [DOI: 10.1016/j.irbm.2008.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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