Intervención en OncologíaImage-guided solutions for interventional oncology

The term interventional oncology describes a variety of minimally invasive, image-guided tumor therapies. The most widely practiced procedures fall into two categories: transcatheter therapies and ablative therapies.

Transcatheter therapies such as TACE and SIRT are catheter-based tumor treatments. Ablative therapies such as radiofrequency ablation (RFA) generally involve the destruction of the lesion via a percutaneously placed needle.
 

"syngo DynaCT provides more clinical information for planning, guidance and therapy control during TACE ."
Dr. Bernhard Meyer, Charité Berlin, Germany

Imaging Support
TACE involves the embolization of the tumor feeding vessels with embolic particles. Our advanced applications provide excellent support during this transcather procedure. 

 
Image-guided solutions for TACE:

"With its excellent image quality Large Volume syngo DynaCT enhances the identification of tumor feeding vessels or aberrant vessels, which leads to improved planning of embolizational procedures like SIRT."
Dr. T. Jakobs, University of Munich, Germany

"syngo iGuide increases my confidence during needle procedures. Besides, it speeds up the workflow."
Dr. David Lacey, Iowa Methodist Medical Center, USA

Imaging Support
RFA treatment requires accurate needle placement for successful tumor ablation. 3D guidance tools provide significant imaging support for needle navigation.

Image-guided solutions for RFA:

Interventional oncology procedures depend on highly sophisticated imaging applications – during all phases of the tumor treatment workflow. Siemens has a portfolio of unique, cutting-edge interventional imaging applications that are ideally suited for interventional oncology.

Providing cross-sectional soft tissue images directly in the interventional suite, syngo DynaCT is a formidable support tool for all stages of the minimally invasive procedure.

Advantages

• Supports selective injection through precise identification of tumor-feeding vessels
• Offers immediate information on procedure status
• Virtually eliminates the need for patient transfers to the CT suite
• Reduces total procedure time
• Minimizes the risk of complications
• Leads to procedural changes in 50% of TACE procedures (results of a study published in European Radiology March '09 by Dr. Meyer, University of Berlin, Charité, Germany, and Prof. Dr. Wacker; Johns Hopkins Hospital, Baltimore, USA)

A unique feature of our revolutionary Artis® zeego® multiaxis imaging system, Large Volume syngo DynaCT provides an extended field of view for superb intervention planning, feeding-vessel identification and results verification.

Advantages

• Its field of view (up to 47 cm in diameter) is comparable to CT coverage
• Complete coverage of the abdominal and thoracic organs (liver, lungs) and vessels¹

syngo DynaPBV Body is a 3D functional imaging application that provides physiological information directly in the interventional lab.

The software indicates the distribution of blood in lesions and surrounding tissue by means of color-coded cross-sectional blood volume maps. Based on this blood volume information, physicians can evaluate changes in perfusion caused by treatment or biological processes. 

The new syngo Embolization Guidance is a software for advanced embolization planning and guidance. A vessel tree of tumor feeding vessels can be overlaid with live-fluoroscopy images, simplifying catheter navigation for any embolization procedure independent of body region.

For liver embolization our easy one-click workflow automatically detects tumor-feeding vessels for targeted embolization - supporting you in performing efficient and safe treatment.

Advantages 

• Automatic feeder detection for complete embolization of liver tumors
• One-click solution for fast and easy liver embolization planning even right at tableside
• Efficient and standardized procedure planning for increased quality of care
• State-of-the-art treatment offering for enhanced reputation

Enables previous CT, MR or PET CT images to be fused with high-contrast angio 3D or syngo DynaCT datasets. syngo Fusion Package displays relevant diagnostic data at a glance, thereby significantly supporting interventional oncology workflows.

Advantages

• Fuses existing diagnostic data (e.g. PET CT) with syngo DynaCT images
• Overlays acquired data with live fluoroscopy image*
• Allows needle path planning on datasets fused with e.g. MR, CT, PET CT
• Provides additional information such as tumor activity directly in the interventional suite
• Provides full anatomical information for puncture procedures or embolization procedures

^{* syngo 3D Roadmap required}

syngo iFlow provides the visualization of a Digital Subtraction Angiography (DSA) run in one color-coded image, all at the press of a button. The colors represent the time of maximum opacification in each single pixel.

Now with the 3rd generation of syngo iFlow, it is possible to calculate and display flow curves for single pixel markers. Furthermore, it provides tools to evaluate the inflow and outflow of contrast in dedicated pixels or in regions of interest that enable viewing the blood flow parameters of a user defined region (circular, rectangular or any individual shape), such as time to maximal opacification or area under curve. syngo iFlow provides a greater understanding of the contrast flow within the pathology, greater ease in visualizing the outcome of a procedure and assists the clinician in image review.

Advantages

• Easily visualize flow characteristics and identify regions with blood flow anomalies
• Confirm treatment results by comparing blood flow in selected regions pre- and post- intervention
• Demonstrate the vascularization pattern of tumors
• Enhance the dominating feeders of vascular malformations.
• No dedicated acquisition protocol required - syngo iFlow postprocessing works on any DSA at any frame rate

A superb needle guidance application that supports real-time, integrated needle navigation in the interventional suite in three easy steps – that’s syngo Needle Guidance.

With its intuitive workflow, syngo Needle Guidance makes needle procedure planning easy and convenient. The Siemens detector features a unique integrated cross-hair laser light that aids facilitation of skin entry point selection, and saves dose.

Advantages

• Excellent needle guidance in three easy steps
• Integrated fusion of control scan acquisitions
• Needle path planning on datasets fused with MR, CT and PET CT
• Better patient access – an important factor especially for: obese patients, complex needle positioning, steep angulations
• Improved patient comfort through continuous monitoring

"With the installation of Artis zeego, we are now able to offer interventional oncological procedures to patients with more advanced and difficult diseases – in areas where we have not treated them before. As a result of this, we can expand both our experiences and our services."

Prof. Dr. Vogl, Head of Diagnostic and Interventional Radiology, University of Frankfurt, Germany
Read more in the interview with Prof. Dr. Vogl in our Customer Magazine

^{(AXIOM Innovations, Issue No. 10, November 2009)}

Our image-guided solution portfolio provides a solid foundation for a viable interventional oncology program, andfor broad-based savings in general. It creates value in a number of ways:

Improved resource planning
Applications such as syngo DynaCT can improve resource planning through better allocation of individual procedures for the appropriate room. Moving needle procedures from the CT to the interventional suite, for example, frees up the CT room for conducting other diagnostic examinations.

Significantly faster procedures
syngo DynaCT can speed up chemoembolization and SIRT procedures by eliminating the need for patient transfers to a CT system – both before and after the procedure. Overall procedure time can thereby be reduced by as much as 40%*, as studies have shown.

Enhanced interventional offering
Expanding an interventional radiology program to include interventional oncology procedures offers medical facilities the attractive prospect of increasing their case mix and patient base – not to mention, added revenues.

Equipped for the future
Designed for hybrid utilization, the systems of the Artis zee family enable clinics to quickly adapt to new imaging scenarios in the future as their needs change.

Life
Our customer care program Life covers a series of service offerings that help customers get the most
out of their Siemens investment – over the entire life cycle of the product. Proactive services such as our Guardian Program are designed to secure a high level of system availability.