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Rotterdam, Netherlands

Fortunati V.,Erasmus University Rotterdam | Verhaart R.F.,Hyperthermia Unit | Van Der Lijn F.,Erasmus University Rotterdam | Niessen W.J.,Erasmus University Rotterdam | And 4 more authors.
Proceedings - International Symposium on Biomedical Imaging | Year: 2012

Outcome optimization of hyperthermia tumor treatment in the head and neck requires accurate hyperthermia treatment planning. Hyperthermia treatment planning is based on tissue segmentation for 3D patient model generation. We present here an automatic atlas-based segmentation algorithm for the organs at risk from CT images of the head and neck. To overcome the large anatomical variability, atlas registration and intensity-based classification were combined. A cost function composed of an intensity energy term, a spatial prior energy term based on the atlas registration and a regularization term is globally minimized using graph cut. The method was evaluated by measuring Dice similarity coefficient, mean and Hausdorff surface distances with respect to manual delineation. Overall a high correspondence was found with Dice similarity coefficient higher than 0.86 and a mean distance lower than the voxel resolution. © 2012 IEEE. Source

Linthorst M.,Hyperthermia Unit | Van Geel A.N.,The Surgical Center | Baartman E.A.,Erasmus Daniel Den Hoed Cancer Center | Oei S.B.,Bernard Verbeeten Institute | And 3 more authors.
Strahlentherapie und Onkologie | Year: 2013

Purpose: Radiation-induced angiosarcoma (RAS) of the chest wall/breast has a poor prognosis due to the high percentage of local failures. The efficacy and side effects of re-irradiation plus hyperthermia (reRT + HT) treatment alone or in combination with surgery were assessed in RAS patients. Patients and methods: RAS was diagnosed in 23 breast cancer patients and 1 patient with melanoma. These patients had previously undergone breast conserving therapy (BCT, n = 18), mastectomy with irradiation (n=5) or axillary lymph node dissection with irradiation (n = 1). Treatment consisted of surgery followed by reRT + HT (n = 8), reRT + HT followed by surgery (n = 3) or reRT + HT alone (n = 13). Patients received a mean radiation dose of 35 Gy (32-54 Gy) and 3-6 hyperthermia treatments (mean 4). Hyperthermia was given once or twice a week following radiotherapy (RT). Results: The median latency interval between previous radiation and diagnosis of RAS was 106 months (range 45-212 months). Following reRT + HT, the complete response (CR) rate was 56 %. In the subgroup of patients receiving surgery, the 3-month, 1- and 3-year actuarial local control (LC) rates were 91, 46 and 46 %, respectively. In the subgroup of patients without surgery, the rates were 54, 32 and 22 %, respectively. Late grade 4 RT toxicity was seen in 2 patients. Conclusion: The present study shows that reRT + HT treatment - either alone or combined with surgery - improves LC rates in patients with RAS. © 2013 Urban & Vogel. Zusammenfassung: Ziel: Das strahleninduzierte Angiosarkom (RAS, "radiation-induced angiosarcoma") der Brustwand hat wegen des hohen Anteils an lokalem Versagen eine schlechte Prognose. Die Wirksamkeit und Nebenwirkungen von Rebestrahlung und Hyperthermie (ReRT + HT) allein oder in Kombination mit vorhergehender oder nachfolgender Operation wurden bei Patienten mit einem RAS der Brustwand überprüft Patienten und Methoden: RAS wurde bei 23 Patientinnen mit Brustkrebs und bei einer Patientin mit malignem Melanom, nach früherer brusterhaltender Brustkrebstherapie (n=18), Mastektomie mit Bestrahlung (n=5) und axillärer Lymphknotendissektion mit Bestrahlung (n=1) diagnostiziert. Die Behandlung des RAS bestand aus Chirurgie gefolgt von ReRT + HT (n=8), ReRT + HT gefolgt von Chirurgie (n=3) oder ReRT + HT allein (n=13). Die Patienten wurden mit einer Strahlendosis von 32-54 Gy behandelt (durchschnittlich 35 Gy) und 3-6 Hyperthermiebehandlungen (durchschnittlich 4). Die Hyperthermie wurde 1-mal oder 2-mal pro Woche nach der Bestrahlung gegeben. Ergebnisse: Das durchschnittliche Latenzzeitintervall zwischen ehemaliger Bestrahlung und RAS-Diagnose betrug 106 Monate (Bereich 45-212 Monate). Nach ReRT + HT lag die komplette Remission (CR) bei 56%. In der Untergruppe von Patienten mit Chirurgie lagen die 3-Monats-, 1- und 3-Jahres-Lokalkontrollraten (LC) bei 91%, 46% und 46%. In der Untergruppe von Patienten ohne Operation waren dies 54%, 32% und 22%. Eine Grad-4-Spättoxizität zeigte sich bei 2 Patienten. Schlussfolgerung: Die vorliegende Studie zeigt, dass ReRT + HT entweder allein oder in Kombination mit Chirurgie zu einer verbesserten LC-Rate bei Patienten mit RAS führt. © 2013 Urban & Vogel. Source

Numan W.C.M.,Hyperthermia Unit | Hofstetter L.W.,General Electric | Kotek G.,Hyperthermia Unit | Bakker J.F.,Hyperthermia Unit | And 5 more authors.
International Journal of Hyperthermia | Year: 2014

Magnetic resonance thermometry (MRT) offers non-invasive temperature imaging and can greatly contribute to the effectiveness of head and neck hyperthermia. We therefore wish to redesign the HYPERcollar head and neck hyperthermia applicator for simultaneous radio frequency (RF) heating and magnetic resonance thermometry. In this work we tested the feasibility of this goal through an exploratory experiment, in which we used a minimally modified applicator prototype to heat a neck model phantom and used an MR scanner to measure its temperature distribution. We identified several distorting factors of our current applicator design and experimental methods to be addressed during development of a fully MR compatible applicator. To allow MR imaging of the electromagnetically shielded inside of the applicator, only the lower half of the HYPERcollar prototype was used. Two of its antennas radiated a microwave signal (150W, 434MHz) for 11min into the phantom, creating a high gradient temperature profile (ΔTmax=5.35°C). Thermal distributions were measured sequentially, using drift corrected proton resonance frequency shift-based MRT. Measurement accuracy was assessed using optical probe thermometry and found to be about 0.4°C (0.1-0.7°C). Thermal distribution size and shape were verified by thermal simulations and found to have a good correlation (r2=0.76). © 2014 Informa UK Ltd. Source

Paulides M.M.,Hyperthermia Unit | Stauffer P.R.,Duke University | Neufeld E.,Foundation for Research on Information Technologies in Society | MacCarini P.F.,Duke University | And 5 more authors.
International Journal of Hyperthermia | Year: 2013

Clinical trials have shown that hyperthermia (HT), i.e. an increase of tissue temperature to 39-44 °C, significantly enhance radiotherapy and chemotherapy effectiveness [1]. Driven by the developments in computational techniques and computing power, personalised hyperthermia treatment planning (HTP) has matured and has become a powerful tool for optimising treatment quality. Electromagnetic, ultrasound, and thermal simulations using realistic clinical set-ups are now being performed to achieve patient-specific treatment optimisation. In addition, extensive studies aimed to properly implement novel HT tools and techniques, and to assess the quality of HT, are becoming more common. In this paper, we review the simulation tools and techniques developed for clinical hyperthermia, and evaluate their current status on the path from 'model' to 'clinic'. In addition, we illustrate the major techniques employed for validation and optimisation. HTP has become an essential tool for improvement, control, and assessment of HT treatment quality. As such, it plays a pivotal role in the quest to establish HT as an efficacious addition to multi-modality treatment of cancer. © 2013 Informa UK Ltd. All rights reserved. Source

De Bruijne M.,Hyperthermia Unit | Van Der Zee J.,Hyperthermia Unit | Ameziane A.,Hyperthermia Unit | Van Rhoon G.C.,Hyperthermia Unit
International Journal of Hyperthermia | Year: 2011

Steering of multi-element heating arrays for superficial hyperthermia (SHT) can be a challenge in the clinic. This is because the technician has to deal with a multiple-input multiple-output system, varying tissue dynamics, and often sparse tissue temperature data. In addition, patient feedback needs to be taken into account. Effective management of the steering task determines the quality of heating. Systematic evaluation is an effective tool to control the quality of treatments. The purpose of this manuscript is to report on a treatment evaluation flow developed for SHT at the Erasmus MC. This flow is used to secure the quality of steering as well as to stimulate general quality awareness in the hyperthermia team. All treatments are evaluated in a multidisciplinary discussion. Tools and methods were developed to enable effective and efficient evaluations. The treatment evaluation sheet is a compact and intuitive representation of power and temperature data. Trend lines and a temperature-depth plot allow a quick analysis of the steering parameters and the heating profile within the target volume. In addition, the principal statistics of applicator power, water bolus and tissue temperature values are given. Power steering data includes the number of switch-off events, interruption time and the number of steering actions. A list of basic checks and reference values for clinical data support further the treatment evaluation. These tools and the systematic treatment evaluations they facilitate, ultimately lead to consistent performance and fine tuning of the set-up and steering strategy for each individual patient. © 2011 Informa UK Ltd. Source

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