3D Image Guidance Tool Designed to Visualize, Target, and Treat Tumor Lesions

A live three-dimensional (3D) image guidance application optimizes tumor embolization procedures on interventional X-ray systems.

Philips Healthcare (Best, The Netherlands) reported on the launch of EmboGuide, its latest technology in interventional oncology, to treat difficult-to-reach tumors or tumors in patients who are deemed unsuitable for surgery. EmboGuide is a live 3D image guidance tool that supports the increasing number of minimally invasive procedures. It is designed to be used with Philips’ interventional X-ray system to perform tumor embolization procedures. Such procedures involve blocking the arteries feeding a tumor to deprive it of nutrients and oxygen. They require the insertion of a catheter, which must be guided to the tumor site with the aid of live image-guidance.

Developed in collaboration with leading clinicians and partners such as BTG (Eclépens, Switzerland), a developer of interventional oncology systems, EmboGuide addresses the need for an enhanced 3D imaging system to make interventional oncology procedures more effective and easier to perform, and ultimately enhance patient outcomes. It provides interventional radiologists with the ability to visualize and characterize tumor lesions and plan and perform interventional procedures.

“Interventional oncology is a fast growing field that offers clinicians a viable treatment option for patients who are not suitable for surgical tumor removal,” said Gene Saragnese, CEO imaging systems at Philips Healthcare. “Together with our partners, we will leverage our combined expertise in image-guided interventions and therapies to accelerate this transformation from surgical procedures to minimally invasive treatments in oncology.”

A specific example of a tumor embolization procedure is transarterial chemo-embolization (TACE), used for palliative treatment of liver tumors. It involves simultaneous local administration of chemotherapy and beads that block the arteries feeding the liver tumor. “We can only treat what we see, yet the embolization of all blood vessels that feed the liver tumor lesion is key for an effective TACE procedure,” said Shiro Miyayama, MD, from the department of diagnostic radiology, Fukuiken Saisekai Hospital (Japan). “EmboGuide’s live 3D image guidance helps to improve the technical success of the procedure, as it can automatically identify the small tumor-feeders that are difficult to detect with conventional 2D angiographic imaging methods.”

The visualization feature of the EmboGuide utilizes the ultra-low X-ray dose settings of Philips’ AlluraClarity interventional X-ray system and the fast, high quality imaging of the abdomen of XperCT Dual. XperCT Dual’s enhanced imaging technique—multiphase cone beam CT—offers excellent 3D images of lesions, with detection accuracy that is superior to traditional 2D angiographic imaging. It offers clinicians better imaging of the treatment targets for optimized decision-making while performing the procedure. XperCT Dual has been found to be comparable to magnetic resonance imaging (MRI), which is considered to be the “gold standard.”

The reach feature of the EmboGuide helps to define the tumor lesions and features automatic identification of blood vessels that feed the lesions. It detects more than twice as many tumor feeding arteries compared to traditional imaging techniques, such as digital subtraction angiography (DSA). This allows interventional radiologists to optimize the catheter locations for embolization and plan a route to them. During the administration of the embolization agent, EmboGuide accurately superimposes the planning information onto the interventional X-ray system’s live images to monitor the treatment progress and determine its endpoint.

“In the treatment of intermediate HCC, the integrated use of our embolic device with image guidance is vital for successful treatment,” said Mike Motion, BTG general manager, interventional oncology. “As a leader in interventional oncology, we invest to improve the safety and efficacy of the procedure. Partnering with Philips has strengthened our ability to further develop this cohesive approach using DC Bead and Philips’ EmboGuide with the ultimate objective of advancing interventional oncology.”

The launch of EmboGuide is a result of Philips’ global investment in Healthcare R&D, which amounted to a total of EUR 780 million in 2013. It highlights Philips’ focus on interventional oncology—a rapidly developing market with a compound annual growth rate of approximately 15%.

Philips’ EmboGuide was presented at the Asia-Pacific Congress of Cardiovascular and Interventional Radiology (APCCVIR), held in Singapore from May 15-18, 2014. At the Congress, Dr. Miyayama shared his experiences with EmboGuide in a scientific presentation.

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