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Like Google Maps for the liver, this solution helps clinicians navigate one of the body’s most complex organs

Interventional radiologist’s study5 suggests a higher rate of liver tumor response when pairing embolization with tumor feeding vessel detection software

While the heart and brain are often deemed the most important organs in the human body, the liver is a true workhorse, performing more than 500 major bodily functions, including breaking down food, protecting the body from toxins, and filtering blood1.

But across the world, this organ is on life support as liver cancer and mortality rates rapidly rise – between 1990 and 2015, liver cancer incidence increased by 75 percent worldwide.2 To combat this, more doctors are turning to interventional oncology to treat the cancer.3

Unlike traditional cancer treatments like chemotherapy, radiation or surgery, interventional oncology is minimally-invasive. Doctors use image guided surgical navigation systems – like GE’s Discovery IGS 7 – to take a special X-ray called a Cone-Beam CT. The Cone-Beam CT produces 3D images of the anatomy and helps clinicians identify the vessels that could be feeding the tumor, so they can inject chemotherapy drugs and/or embolize the tumor. The goal is treatment of the cancer with no further evidence of the disease.

“Complete tumor response is correlated with survival.” Dr. François Cornelis*, Head of the Interventional Oncology Department at Tenon Hospital, Sorbonne University, explains. “It has also been shown that a partial treatment can trigger disease progression by selecting cell profiles that will be more aggressive in the future.”

Minimally-invasive, highly targeted treatment methods have many patient benefits, but they are not easy. Interventional oncologists and radiologists face many challenges during the procedure, including navigating the liver’s complex vasculature, detecting tumor-feeding vessels and determining which injection points will deliver therapies to diseased liver tissue while avoiding the healthy tissue.

For years, one of the major producers of interventional technology, GE Healthcare has gathered input from interventional radiologists across the world to understand what tools they need to navigate the liver more confidently. With that feedback, its engineers developed Liver ASSIST4, a solution that helps interventionalists identify tumor feeding vessels.

Dr. François Cornelis recently studied5 how using Cone-Beam CT with solution like Liver ASSIST4 impacts hepatocellular carcinoma response.

“What is clear, and it has been demonstrated in our study, is that Cone-Beam CT associated with Liver ASSIST is correlated to more complete tumor response rates,” Dr. Cornelis explained. “Even the expert will benefit from Liver ASSIST. It can be compared to an airplane on-board computer which does all the work during take-off and landing. This dimension of simulation and assistance is actually what we ultimately need.
The engineers continue to evolve this solution with feedback from interventionalists, and recently unveiled Liver ASSIST V.I.4, which equips clinicians with a dynamic simulation tool, so they can plan their injection points and simulate different injection trajectories in complex, minimally-invasive liver embolization procedures.

Liver ASSIST V.I. leverages data pulled from cone beam CT images and with the power of applied intelligence, provides a nearly-instant characterization of the liver vasculature, highlighting the vessels traveling to the vicinity of the tumors.

“This should help save time in our review and analysis of the CBCT data.” Dr. Thierry de Baere*, Interventional Radiologist at Gustave Roussy Cancer Center Grand Paris, France, explained. “It will help more precisely define where to position the tip of the catheter, which means we can expect better treatment of the tumor.”

As interventional oncology becomes more common and evolves into another pillar of oncology6, guidance solutions like Liver ASSIST V.I. will become a valuable tool for clinicians as they work to improve patient outcomes and the management of liver cancer.

“Experts often feel they do not need such tools to reach optimal treatment,” Dr. Cornelis said. “But I consider we should have outcome predictors and reproducibility across patients and operators. We have reached such a level of technicality in our minimally invasive procedures, that we need these tools.”

 

 

  1. https://www.hopkinsmedicine.org/healthlibrary/conditions/liver_biliary_and_pancreatic_disorders/liver_anatomy_and_functions_85,P00676
  2. https://www.cancertodaymag.org/Pages/Spring2018/Liver-Cancer-on-the-Rise.aspx
  3. Kwan SW1, Kerlan RK Jr, Sunshine JH. Utilization of interventional oncology treatments in the United States. J Vasc Interv Radiol. 2010 Jul;21(7):1054-60.
  4. Liver ASSIST solution is a previous version of Liver ASSIST V.I solution.
    Liver ASSIST V.I solution includes Hepatic VCAR and FlightPlan for Liver that can be used independently. It also requires an AW workstation with Volume Viewer and Volume Viewer Innova. These applications are sold separately. Not available in all markets outside the United States.
  5. Cornelis et al. Hepatic Arterial Embolization Using Cone Beam CT with Tumor Feeding Vessel Detection Software: Impact on Hepatocellular Carcinoma Response. Cardiovasc. Intervent. Radiol. 2017. The Statements described here are Dr. François Cornelis’ professional opinions.
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131521/

*Dr. Cornelis and Dr. De Baere are paid consultants of GE Healthcare. The statements described here are their professional opinions.