Technique, research and benefits

Interfacetechnology/clinical/SHS/public health : case study interventional radiology

>> Jean Palussière

Radiology in oncology or so called interventional oncology is now considered by certain as the fourth oncological discipline, alongside surgical, radiation, and medical oncology. This makes it particularly dynamic and it is important for interventional radiologists to stay on top of technological developments. During the last ten years the therapeutic part of Interventional Oncology has rapidly grown in different fields such as thermal ablation and local drug delivery. Thermal ablation, which allows to treat tumors with temperature modifications, has known an increasing development during the last 10 years to treat metastases and primary tumors. In particular, they offer an alternative to patients contraindicated or refusing surgery. The main advantages are the low invasiveness with a high level of tolerance, and a low rate of complications and also the repeatability in patients whose disease may be chronic. Since 2004 we have applied these thermal ablation techniques to breast cancer with interesting results for patients in the elderly. We are now preparing the development of a non invasive ablative technique based on focused ultrasounds guided by MRI. MRI guided Focused Ultrasound is one of the primary areas of research of the Translational Research and Advanced Imaging Laboratory (TRAIL) University of Bordeaux.

For the last 10 years, a team of researchers at the University of Utah, under the direction of Dennis L. Parker, have been developing MRI guided FUS technology. In collaboration with Image Guided Therapy of Pessac, and with funding from the National Institutes of Health, they have developed a breast-specific MRI guided FUS system and are now at a point where the system could be applied to subjects at the University of Bordeaux. Through this partnership, we hope to develop this pioneering endeavour and to improve the treatment of breast cancer.

>> Nicolas Grenier

Radiology (IR) is a growing field, mainly in oncology. It is minimally invasive, preserving body integrity, with less side-effects and has also a real economic impact due to : short recovery, ambulatory patient care and maintaining the patient in his social environment with less days off.

IR has also an advantage being based on many technical innovations and investments by companies is high in this field. It allows combination of strategies such as identification of specific targets using molecular imaging (another growing field), development of focal therapies and combination with new medical targeted therapies and nanotechnologies for local drug delivery or local onset of biological effects (gene expression…).

Unfortunately, IR is also slowered in its deployment essentially due to problems of funding innovation by our regulation authorities, but also due to some lack in organization of evaluation of clinical and economic impacts of such innovations by the involved scientific societies.

As an example, this presentation will show how, by using a combination of strategies of innovations, we have been tried, for the last 7 years, to develop a specific targeting of prostatic cancer in order to offer new focal therapies.

Cette présentation a été donnée dans le cadre du ScientificBRIO Day 2 organisé annuellement par le SIRIC BRIO et qui a pour but de réunirtous les acteurs du SIRIC BRIO et plus largement de la cancérologie à Bordeaux.