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Abstract #1829

Initial Experience with Volumetric MRI-Guided High-Intensity Focused Ultrasound Ablation in Breast Cancer Patients

Laura Merckel1, Roel Deckers2, Thijs van Dalen3, Max Khler4, Gerald Schubert4, Joost van Gorp5, Paul Vaessen6, Willem Mali1, Chrit T.W. Moonen2, Lambertus W. Bartels2, Maurice A.A.J. van den Bosch1

1Radiology, Univeristy Medical Center Utrecht, Utrecht, Netherlands; 2Images Sciences Institute, Univeristy Medical Center Utrecht, Utrecht, Netherlands; 3Surgery, Diakonessenhuis, Utrecht, Netherlands; 4Philips Heathcare, Vantaa, Finland; 5Pathology, Diakonessenhuis, Utrecht, Netherlands; 6Anesthesia, University Medical Center Utrecht, Utrecht, Netherlands

Our initial experiences with a dedicated MR-HIFU breast platform using a lateral and volumetric ablation technique are presented. In total, 10 breast cancer patients will be included. The study is performed according to a treat-and-resect protocol. In the first patient, it was difficult to perform a sonication due to problems with patient positioning and movement. In the second patient, three sonications were performed, causing tissue necrosis in the tumor observed during histopathological analysis. The PRFS-based optimized MR thermometry sequence had a temporal standard deviation of 1.86C after applying the multibaseline method to correct for temperature errors induced by respiration.

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Keywords

ablated ablation ablations able abort according accurate acoustic adoption alternative although anesthesia anterior appears applying around assess best biopsy breast cancer cause caused clinical close comparable conscious consists correction dedicated designed deviation diameter difficulties dose duration dynamic dynamics efficacy element enhanced enough errors evaluated experienced feasible female field fluctuations focused frequency gadolinium gorp guided hampered hours included induced initial injection inside intensity international invasive just lateral laura leading least limited location look medical medicine minutes modules molecular moment movement muscle necrosis needle novel ongoing optimized pain part patient patients peak pectoral peters picture placed planning platform position positioning power practice predicted preliminary promising prone prospective protocol proven reach reached redness remaining resection respiration safety scanner sciences sedation separate several skin slices staging staining studies subsequent supported surgery surgical symposium system table target technically temperature temporal thermal thermometry tissue transducers translational treatment trial tumor ultrasound volumetric volunteers water watt week writing yellow