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MRI-Guided Cancer Surgery

esults because kidney cancer is so devastating. Most patients cannot withstand surgery and do not benefit from chemotherapy. They are usually given six months to live.

"So for these patients, we have set the clock back," Lewin said. "And they can go back to work in a day or so with a minimum of discomfort."

Until recently, MRI was used only for diagnosis. Now doctors in a handful of medical centers around the country are experimenting with the imaging technology as a tool in the operating room.

The Case Western group, funded in part by a $736,000 Whitaker Foundation grant, is apparently the first to use an MRI-guided radio-frequency probe to destroy abdominal tumors.

"A handful of groups have looked at radio-frequency ablation for tumors," Lewin said. "For the most part, this has been done with ultrasound or CT to place a probe in a patient using an amount of energy that is expected to treat the tumor. Then they follow up with some kind of imaging to see if it was successful.

"In our protocol, we can interactively vary the energy and position of the probe with MRI guidance and monitor cell death as it happens," he said. "We can also guard against damaging vital structures."

The procedure relies on a Siemens open MRI machine coupled with a high-resolution, shielded LCD monitor. Duerks group has rewritten the software that drives the machine so it can make images more rapidly. As a result, the image acquisition rate has risen from one frame every two minutes to one per second.

The addition of a three-camera array allows doctors to follow the precise position of the radio-frequency probe in three-dimensional space. "We can track the exact location of the tip of the probe and see whats behind it as well," Duerk said.

The group hopes to begin a Phase II clinical trial for efficacy as early as next fall.


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Contact: Frank Blanchard
fb@whitaker.org
703-528-2430
Whitaker Foundation
15-Apr-1997


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