The 34th Annual Meeting of the European Society for Hyperthermic Oncology (ESHO) was held September 14–17, 2022, in Gothenburg, Sweden.
Topics discussed included:
- Measuring temperature during exposure to high-intensity focused ultrasound (HIFU)
- Developing a HIFU transducer-based system for hyperthermia
- Combining hyperthermia and radiotherapy on a preclinical glioblastoma model
- Delivering liposomal cisplatin using MR-HIFU hyperthermia
- Optimizing combined thermal ablation and high dose radiotherapy for dose reduction and tumor control
- Using Fractionated MR-HIFU hyperthermia in the pancreas of a large animal model
- Using an in vitro system with spheroids for focused ultrasound hyperthermia (and radiotherapy) studies
- Studying the impact of sequence-dependent drift characteristics on PRFS thermometry
- Using hyperthermia-activated intravenous liposomal-vitamin C plus microbubbles for sonoporation in bulky tumors
Nine abstracts and posters that may be of interest to the focused ultrasound community are listed below.
Intercomparison of temperature measurements during ultrasound exposure by R. Baêsso, A. Ivory, G. Dündar, D. Bingöl, N. Hossain, S. Pozzi, B. Karaböce, B. Caccia, V. Wilkens, and P. Miloro from National Physical Laboratory, Teddington, United Kingdom; İstanbul University, Physics Department, Istanbul, Turkey; Physikalisch-Technische Bundesanstalt, Braunschweig, Germany; Istituto Superiore di Sanità, Rome, Italy; and TUBITAK Ulusal Metroloji Enstitüsü (UME), Gebze, Turkey. Ultrasound-based therapies continue to develop and show promise as noninvasive tools for cancer treatments. High-intensity focused ultrasound (HIFU) can be used for both thermal ablation and hyperthermia. However, measuring the temperature during HIFU exposure can be quite challenging if the final aim is to measure it accurately.
Development and implementation of a HIFU transducer–based system for a closed-loop controlled focused hyperthermia treatment by A. Ivory, R. Baêsso, F. Saba, A. Spinelli, P. Miloro, and G. Durando from National Physical Laboratory, Teddington, United Kingdom; INRIM, Torino, Italy; and OSR, Milan, Italy. The ability to maintain a specific temperature in a target region is key to any hyperthermia delivery system, to achieve the desired effects, ensure necrosis is not induced (due to increased temperatures consistent with thermal ablation) or healthy tissue treated (requiring sufficient treatment localization to avoid sensitizing healthy tissue).
Combination of ultrasounds, hyperthermia, and radiotherapy on a preclinical glioblastoma model by G. Durando, F. Vurro, F. Saba, P. Miloro, A. Ivory, R. Baêsso, and A. Spinelli from the Italian Metrological Institute, Turin, Italy; San Raffaele Scientific Institute, Experimental Imaging Centre, Milan, Italy; and the National Physical Laboratory, Teddington, United Kingdom. Glioblastoma (GBM) is one of the most malignant brain tumours, with a short life expectancy and an elevated mortality because of the lack of effective therapies and, thus, innovative treatments need to be developed. In this work a combined ultrasounds (US) hyperthermia (HT) with radiotherapy (RT) using a preclinical GMB model has been investigated.
Liposomal drug delivery of cisplatin using MR-HIFU hyperthermia in a large animal model by L. Sebeke, J. D. Castillo Gomez, E. Heijman, P. Rademann, A. Simon, S. Ekdawi, S. Vlachakis, D. Toker, B. Mink, C. Schubert-Quecke, S. Y. Yeo, P. Schmidt, M. Hossann, L. Lindner, and H. Grüll from the University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany; University of Cologne, Faculty of Mathematics and Natural Sciences, Department of Chemistry, Cologne, Germany; Philips Research Eindhoven, Eindhoven, Netherlands; University of Cologne, Faculty of Medicine and University Hospital Cologne, Experimental Medicine, Cologne, Germany; Profound Medical GmbH, Hamburg, Germany; Thermosome GmbH, Planegg, Germany; and LMU Klinikum München, Munich, Germany. Hyperthermia-induced local release of cytotoxic drugs from thermosensitive liposomes (TSLs) is an effective way to increase their therapeutic window. For clinical translation of this concept, we performed a series of swine studies using a novel formulation of cisplatin (CisPt) in phosphatidyldiglycerol (DPPG2)-TSLs in combination with magnetic resonance guided high intensity focused ultrasound (MR-HIFU)-mediated hyperthermia.
Combined thermal ablation and high dose radiotherapy: Optimizing for dose reduction and tumor control by R. Griffin from the University of Arkansas for Medical Sciences, Radiation Oncology, Little Rock, AR, United States. The field of radiation oncology continues to advance in the application of high dose, low fraction number regimens, with many noted improvements in response rates. At the same time, the field of thermal medicine has advanced with the advent of image-guided (MRI or Ultrasound) thermal ablation (HIFU, RF, etc.) as well as various interventional oncology approaches. As technologies advance, the use of MRI or ultrasound to assist in radiotherapy or thermal therapy treatment planning suggests that a single treatment room may be possible for image guided high dose radiation and thermal ablation.
Fractionated MR-HIFU hyperthermia in the pancreas of a large animal model by S. Berger, L. Sebeke, E. Heijman, J. Lindemeyer, P. Rademann, A. Simon, and H. Grüll from the University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany; University of Cologne, Faculty of Mathematics and Natural Sciences, Department of Chemistry, Cologne, Germany; Philips Research Eindhoven, Eindhoven, Netherlands; and University Hospital of Cologne, Experimental Medicine, Cologne, Germany. Several clinical studies using ultrasound-guided high-intensity focused ultrasound (HIFU) for thermal ablation of pancreatic cancer have shown to improve local control and alleviate pain. Preclinical studies showed that hyperthermia-mediated drug delivery with temperature sensitive liposomes prior to ablation allows treatment of the tumor rim adding additional therapeutic efficacy. As a step towards this combination therapy, we investigate the application of hyperthermia in the pancreas of landrace pigs using MR-guided HIFU.
An in vitro system for focused ultrasound hyperthermia (and radiotherapy) studies using spheroids by I. Rivens, P. Mouratidis, D. Andres Bautista, R. Symonds-Taylor, N. Jiménez, F. Camarena, and G. Ter Haar from the Institute of Cancer Research, Centre for Cancer Imaging, Sutton, United Kingdom; and Universitat Politècnica de València, Instituto de Instrumentación para Imagen Molecular – CSIC, Valencia, Spain. Ultrasound can be used for clinical hyperthermia. In vitro studies are challenging as acoustic interactions in 2D cell suspensions are not representative of those in vivo. The lack of absorption in culture medium means acoustically induced thermal effects are absent. A system for ultrasound (US) hyperthermia studies (+/- radiotherapy (RT)) of 3D in vitro models with thermal dosimetric control has been built with the aim of improving prediction of in vivo outcomes.
The impact of sequence-dependent drift characteristics on PRFS thermometry by S. Berger, J. Lindemeyer, and H. Grüll from the University of Cologne, Faculty of Medicine; University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany; and University of Cologne, Faculty of Mathematics and Natural Sciences, Department of Chemistry, Cologne, Germany. MR thermometry allows for noninvasive temperature feedback of hyperthermia treatments, using for example, MR-HIFU. The widely used PRFS thermometry is phase-based and therefore sensitive to phase errors. A known source of such artifacts lies in the MR scanners’ magnetic field drifting over time. Especially MRI sequences with high gradient duty cycles, such as echo-planar imaging (EPI), used in rapid thermometry, are strongly affected. This phase drift evolves spatially heterogenous over time and is dependent on gradient utilization, therefore also on slicing direction.
Hyperthermia-activated intravenous liposomal-vitamin C plus microbubbles sonoporation in bulky tumors: Proof of concept study by J. Vidal-Jove, M. Velat, E. Deltor, P. Del Castillo, and F. Barrachina from the Comprehensive Tumor Center Barcelona, Institut Khuab for Interventional Oncology, Barcelona, Spain; and Farmacia Barrachina, Formulacion, Tavernes, Spain. Deep Local Hyperthermia (DLH) is a procedure useful at obtaining cancer control with a synergistic approach. It has proven efficacy activating liposomes as strategy to better concentrate compounds inside tumors. Microbubbles Sonoporation (MS) increases vascular and cellular membrane permeability. Intravenous Liposomal Vitamin C (LVC) has antitumor effects as an adjuvant cancer treatment.