Tailor-Made Radiation Therapy in Cancer Treatment

Radiation therapy is one of the most essential elements in cancer treatment. But properly planning radiation therapy is a highly complex task. Fraunhofer mathematicians have joined an alliance with medical physicists and physicians to improve the therapy planning process. In doing so they have helped improve patient‘s chances of recovery.

Professor Karl-Heinz Küfer was amazed when he saw for the first time how radiation therapy for cancer patients was planned: »The processes physicians and physicists used in jointly planning radiation therapy reminded me of looking for objects in a dark room, groping around and then trying again,« recalls Küfer, a mathematician at the Fraunhofer Institute for Industrial Mathematics ITWM in Kaiserslautern, Germany. He recognizedthe potential for improvement and got together with physicians, physicists and information scientists to develop an alternative solution. The result was an interactive and easy-to-operate software product. It shortens the duration of radiation therapy planning, makes finding a good balance between therapy potentials and possible side-effects easier and ultimately increases the patient‘s chances of recovery.Every year in Germany approximately 483,000 people are diagnosed with cancer, with 222,000 cases ending fatally. This makes cancer Germany‘s second most common cause of death. Radiation therapy is used to treat more than half the cases. The radiation used damages cell DNA and thus inhibits their cell division or results directly in the death of the cell.

The objective of the therapy is to kill tumor cells while protecting healthy tissue. In the past the physician formulated his wishes and the radiation physicist turned these demands into a therapy plan. If the physician wasn‘t satisfied with the results, the physicist did follow-up work. Gradually the optimum solution was found. »The new thing about the mathematical approach is that from the very beginning a variety of solutions is calculated; the physician can then choose the best solution for the patient,« explains Professor Jürgen Debus, radio-oncologist at Heidelberg University Hospital, who tested the developed software in clinical use. In order to improve the process, Fraunhoferresearchers Karl-Heinz Küfer, Dr. Michael Bortz, Dr. Alexander Scherrer, Dr. Philipp Süss and Dr. Katrin Teichert considered therapy planning as a multi-criterion optimization task, in this case a balanced compromise involving around ten to fifteen in part contradictory planning goals. »The principle of the Pareto solution is a better concept here than the previous trial-and-error strategy,« Karl-Heinz Küfer emphasizes. Such a solution which cannot be improved in terms of all criteria simultaneously. When one criterion improves, another criterion has to worsen in compensation. In the case of radiation therapy this means that if the tumor is to receive a higher dose of radioactivity, the surrounding tissue will be damaged more severely.

The software was developed under the leadership of the ITWM together with the German Cancer Research Center, Heidelberg University Hospital and Massachusetts General Hospital in a Harvard Medical School researchpartnership. »With the new planning system the tumor can be better brought under control, since we can irradiate the tumor with a higher dose. This means the probability of permanently eradicating the tumor is also higher, and at the same time we can protect normal tissue which we might not have been able to protect at all inthe past,« remarks Professor Thomas Bortfeld, who in 2011 put the multi-criterion optimization approach to clinical use at Massachusetts General Hospital in Boston for the first time, together with RaySearch Laboratories.

With additional licensing through world market leader Varian Medical Systems startingin 2016, the technology will in the future be available at over 20,000 therapy planning stations around the world.

Development of the interactive multi-criterion radiation therapy planning system earned the Fraunhofer researchers Karl-Heinz Küfer, Michael Bortz, Alexander Scherrer, Philipp Süss and Katrin Teichert and their research partners Thomas Bortfeld, Jürgen Debus, Wolfgang Schlegel and Christian Thieke the Stifterverband for German Science‘s 2016 award. The jury specifically recognized »the broad viability of the method in treating thewidespread illness of cancer as well as the relevance to international markets.

More information can be found from Fraunhofer website by following this link.

Presentation video by Fraunhofer: Tailor-Made Radiation Therapy / Copyright Fraunhofer

Stanford engineers design a home urine test that could scan for diseases

Invented to test blood sugar in 1956, the standard dipstick test is now a paper strip with 10 square pads. Dipped in a sample, each pad changes color to screen for the presence of a different disease-indicating chemical. After waiting the appropriate amount of time, a medical professional – or, increasingly, an automated system – compares the pad shades to a color reference chart for results.

Considering the dipstick as a given, Bowden and Smith, the engineers, designed a system to overcome three main potential errors in a home test: lighting, volume control and timing.

As a color-based test, the dipstick needs consistent lighting conditions. The same color can look different depending on its background, so the engineers created a black box that covers the dipstick. Its flat, interlocking parts make it easy to mail, store and assemble. They also tackled volume control.

To fix this, the engineers designed a multi-layered system to load urine onto the dipstick. A dropper squeezes urine into a hole in the first layer, filling up a channel in the second layer and ten square holes in the third layer. When the third layer is inserted into the black box, some clever engineering ensures that a uniform volume of urine is deposited on each of the ten pads on the dipstick at just the right time.

Finally, a smartphone is placed on top of the black box with the video camera focused on the dipstick inside the box. Custom software reads video from the smartphone and controls the timing and color analysis.

To perform the test a person would load the urine and then push the third layer into the box. When the third layer hits the back of the box, it signals the phone to begin the video recording at the precise moment when the urine is deposited on the pads.

Timing is critical to the analysis. Pads have readout times ranging from 30 seconds to 2 minutes. Once the two minutes are up, the person can transfer the recording to a software program on their computer. For each pad, it pulls out the frames from the correct time and reads out the results.

Detailed coverage can be found from Stanford website following this link.

FDA Approves MRI Spinal Cord Stimulator from Boston Scientific

Boston Scientific announced the launch of the Precision Montage MRI Spinal Cord Stimulator (SCS) System after receiving approval from the U.S. Food and Drug Administration. The Precision Montage System offers customized relief to patients with chronic pain while also enabling safe access to full body magnetic resonance imaging (MRI) in a 1.5 Tesla environment when conditions of use are met.

More than 100 million Americans suffer from chronic pain, which can have a devastating impact on quality of life. Patients with pain sometimes experience a fluctuation in location, type and intensity of pain throughout the day or over time. The Precision Montage MRI SCS System allows patients to undergo a full-body MRI while benefiting from the pain relief of MultiWave Technology. MultiWave Technology enables delivery of multiple waveforms, including burst and higher rates, intended to help respond to changes in pain over time. In an analysis of registry information from 800 patients, it was determined that 72 percent used multiple waveforms to customize their therapy and optimize pain relief.

A press release can be found from Boston Scientific website by following this link.

FDA Approves Stand-alone 3D Screening With Siemens Tomosynthesis Platform

Siemens Healthineers has announced that the Food and Drug Administration (FDA) has approved the use of 3D-only screening mammography utilizing the company’s Mammomat Inspiration with Tomosynthesis Option digital mammography system. The Siemens system is the first and only 3D digital breast tomosynthesis (DBT) platform to be approved by the FDA as a stand-alone screening and diagnostic system; all other mammography systems on the market require a combination of 2D and 3D examinations.

FDA approval of the 3D-only application follows a pivotal reader study in which participating radiologists demonstrated their ability to increase cancer detection at a lower radiation dose than combined 2D and DBT. In the study, radiologists decreased average recall rates by an average of 19 percent without the need for a 2D image.

“Siemens is proud to announce the availability of 3D-only screening with our Mammomat Inspiration with Tomosynthesis Option digital mammography system,” said Martin Silverman, Vice President of X-ray Products at Siemens Healthineers. “Although this is the first breast tomosynthesis solution on the market to demonstrate statistically superior results to 2D as a stand-alone breast exam, we know many providers will continue using 3D tomosynthesis as an adjunct to 2D screenings. Those providers who use our platform, however, will do so with confidence, knowing our 3D is a proven stand-alone option.”

Siemens’ Tomosynthesis Only Option is available on the company’s Mammomat Inspiration and Mammomat Inspiration Prime Edition digital mammography systems.

Johnson & Johnson and HP to Enhance 3D Printing Technologies

Johnson & Johnson announced a collaboration between Johnson & Johnson Services, Inc. and a subsidiary of HP Inc. The collaboration is focused on using 3D printing technologies to create better health care outcomes at reduced costs. Working together, the companies plan to combine their scientific, clinical, material science and technological expertise, and deep insights to develop products and solutions which can be manufactured quickly and customized to the needs of an individual patient or consumer.

In the near-term, the collaboration will focus on personalization of instrumentation and software for patient-specific healthcare devices. It is anticipated that 3D printing technology will lead to innovation in areas such as orthopaedics, eye health and consumer products, among others.

“The intersection of technology and health care is spurring innovation that will have a profound impact on patients and consumers all over the world,” said Sandra Peterson, Group Worldwide Chairman, Johnson & Johnson. “Combined with advances in data mining and software, 3D printing could enable distributed manufacturing models and patient-specific products, therapies and solutions that deliver better outcomes, better economics and improved global accessibility. This collaboration with HP Inc. exemplifies our commitment to harnessing new technology to improve outcomes and reduce costs across the health continuum.”

“Advances in 3D printing technology have the potential to break historical paradigms of health care delivery in ways that are not feasible in traditional manufacturing processes,” said Stephen Nigro, president of HP’s 3D printing business. “Together with Johnson & Johnson we have the potential to create opportunities and innovations in health care to improve patients’ lives that neither company could develop alone.”

A press release can be found from J & J website following this link.

Siemens enters field of molecular services for oncology

Siemens Healthineers has expanded its diagnostics portfolio with the acquisition of NEO New Oncology AG, Cologne, Germany. The company’s cancer genome diagnostic platform NEO(1) will support pathologists and oncologists with comprehensive molecular information to help select targeted cancer therapies. NEO New Oncology is developing molecular profiling assays based on NGS (Next Generation Sequencing), both for tissue specimens and body liquids. This includes NEOliquid, a liquid biopsy test for the analysis of genomic profiles of solid tumors from a simple blood sample. NEO New Oncology’s high quality 3rd generation hybrid capture technology allows for the analysis of circulating tumor DNA with high accuracy.

The acquisition of NEO New Oncology provides Siemens Healthineers an entry point into NGS-based genomic testing and expands its capabilities in precision medicine and companion diagnostics. Furthermore, Siemens Healthineers establishes a business prospect in the field of molecular services, with the plan to provide testing and enablement services to physicians, hospitals and laboratories, including access to the latest medical knowledge and technologies.

A press release can be found from Siemens website by following this link.