Transcript Ablatherm PowerPoint Presentation

The HIFU Treatment
www.debenedetti1547.org
for Localized Prostate Cancer
HIFU
Technology
History
ABLATHERM®
Device
Ablatherm®
Treatment
INTEGRATED IMAGING
Exit
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HIFU
Technology
History
ABLATHERM®
Device
Treatment
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ablatherm® HIFU : step by step
The device
The probe
Robotized
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Placement
Scanning
3D imaging
Planning
Firing phase
Ultrasound
Final aspect
End
Ultrasound Waves Generation
Physical Principle
Treatment Description
Plane transducer
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Ultrasound waves emission by
transducer electro-mechanical
vibrations
Acoustical pressure
Tissue motion
Tissue heating
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+
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Focused Ultrasound Waves
Physical Principle
HIFU
Technology
Treatment Description
Focused transducer
Emitting ultrasound waves
History
ABLATHERM®
Device
Acoustical pressure
Treatment
Tissue heating
Over 85°C
Tissue Lesion Formation
Physical Principle
Treatment Description
Thermal effects
Temperature Simulation
HIFU
Technology
History
INSERM U 557
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HIC Technology
HIFU INDUCED CAVITATION
ABLATHERM®
Device
Treatment
Cavitation effects
+
Time exposure
Thermal Dose Simulation
INSERM U 557
=
Tissue lesion
Local Increase of Tissue Temperature
Physical Principle
Treatment Description
Two different approaches to reach the destruction threshold :
HIFU
Temp.
Technology
CANCER
Temp.
BPH
History
ABLATHERM®
HIFU
Device
HYPERTHERMIA
Treatment
Time
High Temperature (>85 °C)
 Short Time (< 5 Sec.)

Time
Low Temperature (< 45 °C)
 Long Duration (>1 Hr)

Transducer Positioning
Physical Principle
Treatment Description
Precise lesion positioning
with dynamic focusing
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Sparing of
surrounding tissue
Lesion Distribution within the Prostate
Physical Principle
HIFU
Technology
History
Treatment Description
• Each shot consists of
a burst of ultrasound
waves with a duration
of 5 seconds
ABLATHERM®
Device
Treatment
• The focal volume is
very small: 19-24 mm
in length by 1.7 mm in
diameter
Lesion Distribution within the Prostate
Physical Principle
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Treatment Description
Lesion Distribution within the Prostate
Physical Principle
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Treatment Description
The firing head moves until the
whole targeted volume is treated
History of the Ablatherm® Project
• 1989:
Preliminary experiments on rats kidneys
and technology development
HIFU
• 1990:
Cancer treatment - feasibility: Dunning tumors
• 1991:
Endorectal approach - feasibility: canine prostate
ABLATHERM®
• 1993:
Treatment efficacy - evaluation: PCa
Device
• 1995:
Device safety improvements
Treatment
• 1996:
European Multicentric Study
Technology
History
• 2000:
Mark Ablatherm® Maxis
• 2005:
Mark Ablatherm® Integrated Imaging
CE Mark Ablatherm®
Marked January 2000
HIFU
Technology
History
ABLATHERM®
Device
Treatment
In excess 9000 treatments in 100 sites in Europe
HIFU
Technology
2000
History
ABLATHERM®
Device
Treatment
1000
Patients treated with Ablatherm every year
Ablatherm® HIFU
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Device Description
General Description
Probe
Command
Module
HIFU
Technology
History
Treatment
Module
Electronics
User Interface
and safeties
Probe
Module
Imaging
and Firing
System
RF Power
ABLATHERM®
Motors
Device
Cooling
Treatment
+ Disposable
Computer
Patient Support
Endorectal Probe
Endorectal Probe
General Description
Probe
2 functions, 2 transducers
integrated in ONE probe
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Imaging
Real-time ultrasound imaging.
7.5 MHz high-definition image.
Electronic array technology.
Treatment
A 3 MHz transducer.
Dynamic positioning with respect to rectal wall.
Wide opening.
Integrated imaging
General Description
Probe
2 different transducers with an
Integrated imaging 7.5 MHz probe
HIFU
Technology
History
ABLATHERM®
Device
Treatment
High resolution
imaging system
Imaging & Treating Simultaneously
General Description
Probe
Imaging
HIFU
Technology
History
ABLATHERM®
From a transversal real-time image,
the 7.5 MHz electronic ultrasound
transducer can provide
an accurate 3D reconstruction
of the treatment area.
Device
Treatment
Firing
High-energy ultrasound waves are
focused through the rectal wall to
the targeted prostate area.
Indications
Summary
Positioning
Treatment
Candidate for RPP
HIFU
Technology
History
ABLATHERM®
Device
Treatment
EBRT failure
Recurrence after
previous HIFU
Main Steps of a Treatment
Summary
Positioning
Treatment
• Probe preparation (Ablapak® disposable)
HIFU
Technology
History
ABLATHERM®
Device
Treatment
• Patient installation (Immobilization)
• Prostate localization (Apex identification)
- Longitudinal imaging
- Transversal imaging
• Treatment (Safety controls)
• Patient removal
• Probe cleaning and disinfection
Patient Installation (Immobilization)
Summary
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Positioning
Patient
positioned in
right lateral
decubitus
position
Treatment
Patient Installation (Immobilization)
Summary
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Positioning
Treatment
Patient
movement
detector
Prostate localization (1)
Summary
Positioning
Probe insertion
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Treatment
Intra-rectal positioning
Prostate localization (2)
Summary
Positioning
Probe insertion
Treatment
Robotized movements
HIFU
Technology
History
ABLATHERM®
Device
Treatment
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Prostate localization (3)
Summary
Positioning
Treatment
Automatic imaging phase
HIFU
Technology
History
ABLATHERM®
Device
Treatment
3D reconstruction
Prostate localization (4)
Summary
Positioning
Treatment
Automatic imaging phase
3D reconstruction
HIFU
Technology
History
ABLATHERM®
Device
Treatment
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Treatment (planning)
Summary
Positioning
Treatment
Treatment area programming
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Firing phase
Treatment (planning)
Summary
Positioning
Treatment
Treatment area programming
HIFU
Technology
History
ABLATHERM®
Device
Treatment
Firing phase
Treatment (planning)
Summary
Positioning
Treatment
Treatment area programming
Firing phase
HIFU
Technology
History
ABLATHERM®
Device
Treatment
If the video doesn’t start automatically click on the window
Treatment (planning)
Summary
Positioning
Treatment
Treatment area programming
Firing phase
HIFU
Technology
History
ABLATHERM®
Device
Treatment
If the video doesn’t start automatically click on the window
Treatment (Safety Controls)
Summary
HIFU
Positioning
Treatment
Main safety features
Technology
• Power / Firing sequence
• Probe position
• Patient movement
• Rectum position
• Temperature
History
ABLATHERM®
Device
Treatment
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