Cryoablation of Early Invasive Ductal Breast Cancer With MRI Confirmation Shows Promising Clinical Benefits, According to Study Presented at RSNA
Researcher Says, Sanarus' Visica 2(TM) Treatment System May Offer Same Therapeutic Benefits as Lumpectomy with Improved Cosmesis and Lower Costs
CHICAGO, Dec. 5 /PRNewswire/ -- Early clinical experience with the FDA
cleared Visica 2(TM) Treatment System from Sanarus Medical confirms the
effectiveness of ultrasound guided cryoablation to completely eradicate
small, unifocal Invasive Ductal Breast Cancer (IDC). Initial data from this
multi-center study was presented at the 94th Scientific Assembly and Annual
Meeting of the Radiological Society of North America (RSNA), November 29 -
December 5, 2008.
The study, "New Findings on Contrast-enhanced Magnetic Resonance
Imaging, the "Black Hole" and "Cryohalo" are Markers for the Efficacy of
Ultrasound-guided Cryoablation of Small Unifocal Invasive Ductal Breast
Cancer," presented by Gary Levine, MD, Director of Breast Imaging at Hoag
Breast Care Center in Newport Beach, Calif., was designed to evaluate the
ability of breast contrast enhanced MRI to assess the effectiveness of
ultrasound guided cryoablation for the local treatment of small, unifocal IDC.
"With a large body of evidence demonstrating the ability of cryoablation
to destroy cancerous and noncancerous tumors of the liver, prostate, kidney
and breast, the gating factor for the treatment of breast cancer tumors was
the ability to visualize the extent of the tumor in advance and confirm target
destruction post-procedure," said Dr. Levine. "We are very encouraged that
our preliminary results demonstrate that in selected early IDC breast cancers,
cryoablation with MRI confirmation may offer the same therapeutic benefit as
lumpectomy with less morbidity, improved cosmesis and less cost."
Patients with newly diagnosed IDC underwent an "early" pre-ablation CEMRI
to establish its MR enhancement pattern. Ultrasound-guided cryoablation was
then performed using a Visica Treatment System to ablate the malignant tumor
and a margin of surrounding tissue. A "delayed" CEMRI was performed
approximately four weeks post-ablation followed by a standard surgical
lumpectomy. The early and delayed CEMRI findings were correlated with the
surgical histopathology. In all 15 cases, the post-ablation MRI's showed no
suspicious contrast enhancement remaining at the targeted tumor site and
histopathology confirmed complete tumor kill within the intended ablation
zone. In three cases histopathology confirmed residual DCIS and/or small
satellite lesions outside the cryoablation zone.
At delayed CEMRI, previously unreported characteristic and reproducible
findings of signal void on post-contrast subtraction images ("black hole")
correlates with an area of coagulation necrosis at the cryoablation site and a
surrounding uniform thin rim enhancement ("cryohalo") corresponds to a zone of
inflammation at the cryoablation margin.
"Lack of residual suspicious enhancement on post-cryoablation CEMRI
appears to correlate with complete tumor kill within the targeted ablation
zone. We believe the novel MR findings termed "black hole" and "cryohalo"
serve as markers for successful ablation, giving us a noninvasive and
reproducible method to verify clinical results," added Dr. Levine.
The study conducted by Dr. Levine and Steven Poplack, MD, Co-Director of
Breast Imaging at Dartmouth Hitchcock Medical Center is similar to the
National Cancer Institute (NCI) funded clinical trial recently initiated by
the American College of Surgeons Oncology Group (ACOSOG). Titled, "A Phase II
Trial Exploring the Success of Cryoablation Therapy in the Treatment of
Invasive Breast Carcinoma," the ACOSOG study will also evaluate cryoablation
as well as the ability of MRI to evaluate post-cryoablation efficacy. The
Visica 2 System was selected as the exclusive cryoablation technology to be
utilized in the ACOSOG study.
Cryoablation is a minimally invasive non-surgical procedure that uses
extreme cold to destroy tumors. The Sanarus Visica System has predominately
been used in the cryoablation of non-cancerous tumors called fibroadenomas
since its initial FDA market clearance in March of 2002. This office-based
procedure, which usually takes less than 20 minutes, involves placing a small
needle into the center of the fibroadenoma using ultrasound guidance and
subsequently freezing and killing the tumor. The safety and efficacy of
cryoablation have been well established in over 2,000 fibroadenomas that have
been treated with the System to date.
This study was presented at RSNA as part of the Breast Imaging
(Interventional) Session, #SST01-05, Friday, December 5 at 11:10am in Room
E253CD:
New Findings on Contrast-enhanced Magnetic Resonance Imaging (CEMRI),
the "Black Hole" and "Cryohalo" are Markers for the Efficacy of Ultrasound
(US)-guided Cryoablation of Small (less than or equal to 15mm) Unifocal
Invasive Ductal Breast Cancer
GLevine, FSHeinemann, Hoag Breast Care Center, Newport Beach, CA;
SPoplack, RBarth, WWells, Dartmouth Hitchcock Medical Center, Lebanon, NH
About Sanarus Medical
Sanarus Medical is based in Pleasanton, Calif., and is focused on
providing patients and physicians with minimally invasive, office-based breast
care management solutions from diagnosis to treatment. Using cryoablation
technology, Sanarus has developed proprietary technologies to provide breast
surgeons and radiologists with a comprehensive and minimally invasive way to
diagnose and treat breast patients. The Sanarus technologies change the way
that patients are managed, from an operating room-based, surgically intensive
care pathway to a more comfortable, cost effective, office-based care pathway.
The company's Website is http://www.sanarus.com.