EM based cancer treatment exist in various forms including widely applied techniques such as RF (and MW) ablation, highly promising but not yet well established treatments such as hyperthermia as well as novel, experimental approaches such as pulsed/modulated field based treatments. These treatments are often combined with radio- or chemotherapy and can contribute dramatically to improving the treatment outcome. IT’IS is committed to further enhance these treatments by studying the underlying mechanisms as well as developing novel devices, software and quality assurance tools.

 

Research Objectives

The objectives of EM Cancer Treatment Research at IT’IS Foundation are to:

• develop numerical tools to model EM based cancer treatment (hyperthermia, RF and MW ablation) on a macroscopic and microscopic level
• develop hyperthermia and ablation treatment planning tools
• develop novel devices for EM based cancer treatment (hyperthermia - applicators, ablation catheters) and simulation tools that support the development and improvement of devices
• build exposure setups to investigate the impact of pulsed and modulated fields on cells and organisms
• develop EM and temperature measurement equipment as well as phantoms for quality assurance purposes

The objectives are addressed by active collaboration with leading clinical, industrial and university research groups as well as regulatory agencies and standardization bodies. Of particular relevance is the close collaboration with the Daniel den Hoed cancer center of the EMC in Rotterdam. (NIELS, more here?)

 

Past Achievements

IT’IS Foundation together with its partners have made important contributions in EM cancer treatment:

• development of a novel phased array RF applicator for the head & neck area capable of delivering focused energy to one or multiple target sites in a highly controlled manner
• development of monitoring and control technology for the delivered field of specific applicators
• development of a magnetic field applicator for magnetic nanoparticle based hyperthermia (the nanoparticles are embedded in bone cement and used to treat bone cancer patients)
• development of exposure setups and experiments to investigate the effect of modulated EM pulses on cancer cells (w/wo simultaneous treatment with photodynamic medicine)
• investigation of electroporation using strong (pulsed) EM field on a whole-body, tissue, cellular and subcellular level using dedicated numerical tools
• modeling of tumor growth and treatment with heat combined with chemotherapy considering cell proliferation, apopthosis and killing, angiogenesis, signaling molecules, nutrients, heat and mechanical stress...
• development of a platform for hyperthermia treatment planning able to perform sophisticated, detailed treatment planning
• investigation of the suitability of high performance computing in hyperthermia treatment planning (cluster parallelization, GPU and CELL B.E. acceleration)
• development of an advanced segmentation tool for medical image data, able to generate detailed anatomical models based on commonly available CT or MRI data
• development of a superior thermal solver for temperature induced heating of living tissue with sophisticated perfusion modeling, thermoregulation support, body-core heating…
• development and implementation of an advanced perfusion model, considering tissue inhomogeneity and anisotropy, discrete vessels, effective thermal conductivity, convective flow (laminar and complex), temperature induced perfusion changes, time varying and temperature dependent metabolic heat generation…
• development of novel numerical techniques for accurate and fast thermal simulation thin structures (metal wires and leads, vessels, water-cooled ablation catheters) and curved surfaces
• development of routines to determine thermal dose distributions and induced tissue damage
• development of novel antenna steering parameter optimization routines for phased array applicators capable of providing improved treatment parameters considering patient feedback as well as sensor measurements and of optimizing multiple (often conflicting) goals at the same time
• development of novel optimization techniques (e.g., binary tree based probability density estimation variant of genetic optimization)
• development of methodology to measure the EM field generated by hyperthermia applicators and to compare the measurements with simulations
• development of tissue simulating media, sensors and phantoms for quality assurance purposes
• characterization of multiple commercial and experimental hyperthermia applicators
• investigation of RF ablation and RF surgery and the impact of nearby vessels as well as water cooling of the ablation catheter (in addition to numerical and experimental investigation of High Intensity Focused Ultrasound ablation)

The success of the research activities of the IT'IS Foundation led to the spin-off company Zurich Med Tech (ZMT) founded in 2006 by leading scientists of the IT'IS Foundation.  A treatment planning system is now being commercialized and a clinical prototype for head and neck hyperthermia treatments is being developed. ZMT has expanded its efforts in computational life sciences and MRI safety testing of implants. The latter activities have had considerable impact on the development of international standards.

Research Challenges

IT’IS remains committed to investigating the promising EM based cancer treatments.

Examples of current projects are:

• development of a new generation of the head&neck applicator
• development of novel device strategies for focused  RF ablation in the brain
• conduction of clinical study on the efficacy of hyperthermia treatment planning
• investigation of the suitability of multigoal optimization approaches in hyperthermia treatment planning
• conduction of experiments to investigate the effect of modulated EM pulses on cancer cells w/wo simultaneous treatment with photodynamic medicine
• development of equipment for dosimetry and quality assurance in hyperthermia
• improvement of segmentation tool for the generation of patient specific models
• extension of our tumor growth and treatment models to include parameters such as interstitial fluid pressure
• development of (sub-)cell models to study the impact of high fields particularly on the cell membrane (e.g., electroporation)