Category: Other, Miscellaneous
Introduction & Objective : The treatment of a specific area and the right patient selection for targeted therapy remains today a technical and clinical challenge. The work presented here proposes a solution to ensure appropriate patient management and optimal targeted treatment. The preclinical and the pilot study of this new tool are presented here.
The system of KOELIS is composed of a cartographer that follows the patient from the diagnosis’ phase to post-treatment follow-up. It allows for target characterization and precise definition of the treatment planning based on multimodal diagnostic information. Transrectal ultrasound is used with an approach similar to the biopsy approach, involving the guidance of a 18G applicator that delivers a controlled amount of energy (microwave) to the heart of the tumor. In vitro validation is performed via 123 measurements on 4 animal tissues (turkey, beef liver, pork loin, pork liver) in order to confirm the repeatability, the precision and the sensitivity of the treatment according to various parameters. A multivariate linear regression associated with a logarithmic model, as well as a backward model selection procedure areexploited for this purpose.A preliminary in vivo investigation is presented. The treatment is performed on a patient before prostatectomy (transabdominal). The treated area measured by macroscopic analysis is compared to the in vitro abacus.
A low sensitivity to the tissue kind is measured (RMS error of 2.12 mm on the small axis of the ellipse). A predictive abacus is established with pork loin results with a RMS error of 0.6 mm on the small axis. The first-in-human result is an elliptical ablation of 25*20*15 mm (predicted dimensions from the in vitro abacus : 25.3*15.2*15.2 mm).
Preliminary results suggest that the proposed navigation system and energy provide a localized, safe, accurate and affordable treatment, meeting the requirements of targeted therapy. Clinical investigations are in progress to validate these results. This system, together with a proper patient selection and target characterization, is a first step towards outpatient needle-based treatment of prostate cancer.
Roland van Velthoven– Urologist, Uro-Science & Consulting sprl, Brussels, Belgium
Eric Gaudard– Research Manager, Koelis, Meylan, Rhone-Alpes, France
Antoine Leroy– CEO, Koelis, Meylan, Rhone-Alpes, France
Patrick Henri– Marketing Director, Koelis, Meylan, Rhone-Alpes, France
Uro-Science & Consulting sprl
Brussels, Not Applicable, Belgium