NEMA Goes to Washington to Promote Role of Imaging in Cancer Outcomes
FDA Approved: FDA Clears Siemens? Megavoltage Cone Beam Imaging Package
Running the Numbers
New Research Method Shows Promise for Pancreatic Cancer Treatment
Siemens and Cleveland Clinic Sign Software Licensing Agreement
Product Showcase: Brachytherapy System Plans Treatment On the Fly

NEMA Goes to Washington to Promote Role of Imaging in Cancer Outcomes

Advancements in medical-imaging technology are complementing the work of oncologists, improving health outcomes for cancer patients, and benefiting economic productivity, according to experts at a recent Capitol Hill briefing.

The event—moderated by Mike Rogers (R-Mich), chair of the House of Representatives Cancer Care Working Group, and hosted by US Oncology (Houston) and the National Electrical Manufacturers Association (NEMA of Rosslyn, Va)—underscored the growing national awareness that medical imaging, when combined with pharmaceutical therapies and highly skilled physicians, can diagnose and treat cancer earlier and more precisely, giving patients a better chance of survival and helping them avoid costly and taxing surgeries.

“A comprehensive approach to cancer diagnosis and treatment has a tremendous impact on patients across the entire nation,” Rogers said. “With emerging research continually pointing to imaging as a crucial part of that care continuum, ensuring that all Americans can access quality imaging services is absolutely essential.”

Roy A. Beveridge, MD, oncologist at Inova Fairfax Hospital (Fairfax, Va), added, “Imaging is allowing physicians today to treat patients in ways never thought possible. Today’s imaging allows us to unobtrusively screen, diagnose, and stage cancers; precisely guide treatment to preserve healthy surrounding tissue; and even determine if a given treatment is working.”

A new white paper, titled “Medical Imaging in Cancer Care: Charting the Progress,” (downloadable as a pdf) was published as a summary of the event. The paper looks at how innovation in cancer diagnosis and treatment improves health and economic productivity.

FDA Approved

FDA Clears Siemens? Megavoltage Cone Beam Imaging Package

The US Food and Drug Administration (FDA of Rockville, Md) has granted Siemens Medical Solutions (Malvern, Pa) 510(k) clearance for its MVision megavoltage cone beam (MVCB) imaging package. MVision is the newest addition to the company’s portfolio of adaptive radiation therapy solutions and is currently commercially available worldwide.

This image of the prostate was acquired with the MVision MVCB imaging package from Siemens Medical.

MVision is a volumetric in-line target imaging solution and the next step in image-guided radiation therapy (IGRT). Designed to work with Siemens Medical’s linear accelerators, the system is a commercial implementation of cone beam technology that uses a standard radiotherapy treatment beam. MVision makes it possible for the megavoltage source used for treatment to also create a 3-D image of the patient, enabling clinicians to “see inside” the patient at the most appropriate moment. It does not require an independent imaging source for IGRT.

Designed to complement a clinic’s oncology workflow, MVision integrates and automates all processes. With a few steps, therapists can calculate 3-D offsets, send them to the treatment couch to compensate for daily variations, and safely deliver therapy.

Running the Numbers

87% of patients in a study with low-risk prostate cancer who received brachytherapy showed no signs of recurrence 10 years later. Authors conclude that the decline of PSA following brachytherapy with low-dose-rate isotopes can be protracted. Absolute PSA and PFS curves merge, and are comparable at 10 years.

Source: Grimm PD, Blasko JC, Sylvester JE, et al. 10-year biochemical (prostate-specific antigen) control of prostate cancer with 125-I brachytherapy. Int J Radiation Oncology Biol Phys. 2001;51:31?40.

New Research Method Shows Promise for Pancreatic Cancer Treatment

Xenogen Corp (Alameda, Calif) has announced that researchers have successfully imaged the spontaneous development of bioluminescent tumors in the pancreas and bladder of mice using the company’s proprietary optical-imaging technologies. According to the company, these findings further validate the role of Xenogen’s IVIS in vivo optical-imaging system, tumor cell lines, and transgenic mouse models in cancer research.

“There is a pressing need to develop better treatments for pancreatic cancer because of its clinical challenges and poor prognosis,” said Scott K. Lyons, PhD, senior scientist in oncology at Xenogen. “Our findings could make it easier and more cost efficient for researchers to develop effective treatments for pancreatic cancer.”

These mice have been imaged with the IVIS imaging system from Xenogen, a real-time, in vivo biophotonic system that noninvasively assesses the spread and growth of tumors in real time.

In the past, these types of transgenic pancreatic tumor models have been difficult to work with because the exact timing for tumor progression was estimated based on the animal’s age. Consequently, researchers have had difficulty knowing when to initiate treatment, how to best schedule treatment, or if the treatment was having an effect prior to the study’s conclusion.

Aided by Xenogen’s IVIS imaging system, researchers can use these transgenic mice to noninvasively assess the spread and growth of the tumors in the pancreas in real time. This provides researchers with additional insight into how the tumors spread and grow. It also can tell them how effective a potential drug or treatment might be and what potential side effects are associated with specific targets.

Xenogen expects the technology to be commercialized in mid-2006 and drug companies to use the model as a preclinical development tool in early 2007.

Siemens and Cleveland Clinic Sign Software Licensing Agreement

Siemens Medical Solutions (Malvern, Pa) and The Cleveland Clinic have signed a licensing agreement for the marketing of reconstruction and calibration software developed by clinic researchers. Providing clearer images at a higher resolution than traditional single- or multi-pinhole collimators, the single photon emission computed tomography (SPECT) solution could allow researchers to quickly and accurately image new diagnostic and therapeutic compounds in preclinical studies. In addition to marketing the software, Siemens Medical expects to release a new multi-pinhole solution based on the clinic’s technology.

“Accuracy and efficiency are imperative in this arena, and with this new reconstruction and calibration technology, Siemens will deliver the highest-quality multi-pinhole SPECT solution to its customers,” said Michael Reitermann, president of the molecular imaging division at Siemens Medical.

With multi-pinhole reconstruction and calibration software, developed by Frank DiFilippo, PhD, of the clinic’s department of molecular and functional imaging, researchers could produce high-resolution images with more specificity in less time than with traditional collimators, which can take up to an hour to complete. Collimators filter streams of gamma rays to create images of radiopharmaceutical distribution, similar to how cameras collect rays of light to create photographs. The new software permits the accurate use of multiple pinholes, increasing the detector’s sensitivity to the gamma-ray stream and reducing the time needed to acquire images.

Additionally, the new software addresses an important challenge associated with multi-pinhole collimators. With each added pinhole, the complexity of the detector geometry increases, amplifying the importance of accurate calibration.

“Such accurate calibration is an enabling factor for high-resolution image reconstruction,” DiFilippo said. “This development accounts for the complete scanner geometry to a high degree of precision. Researchers can select a different multi-pinhole collimator configuration for each study and calibrate the scanner with a simple automated process. This new method can increase the versatility of preclinical scanners and provide higher-quality images than traditional calibration methods.”

Product Showcase

Brachytherapy System Plans Treatment On the Fly

New from Varian Medical Systems (Palo Alto, Calif) is Vitesse 2.0, a real-time ultrasound-based brachytherapy treatment planning system. According to the company, the system speeds up prostate cancer treatments and potentially reduces patients’ in-hospital time by enabling clinicians to complete two brachytherapy procedures per day on a patient. With Vitesse 2.0, clinicians can develop treatment plans that show the locations of radiation sources and dose distribution, using ultrasound images generated in the operating room rather than moving the patient to another room with a CT scanner for x-ray images.

Varian Medical?s Vitesse system makes it possible to see the placement of HDR brachytherapy needles within a volumetric ultrasound image.

Because the system offers real-time imaging, clinicians can plan needle locations, monitor and adjust the positions as the needles are inserted, identify the final needle position in the patient, and export the entire data set to Varian Medical’s BrachyVision 3-D planning system. Then, the plan for the high-dose-rate (HDR) prostate procedure can be completed, and the patient can be treated.

Vitesse 2.0 has been adopted by several cancer clinics, including Long Beach Memorial Medical Center (Long Beach, Calif), Springfield Regional Cancer Center (Springfield, Ohio), and Virginia Commonwealth University Hospital (Richmond, Va). “It’s a breakthrough in prostate brachytherapy treatments, because you can give two treatments on the first day, and the patient only needs to stay in the hospital for one night rather than two,” said Anil Sharma, chief medical physicist at Long Beach Memorial. “That means a happy patient, a happy hospital, and a more cost-efficient procedure.”

For more information, visit www.varian.com or call (650) 493-4000.