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Elekta-Philips Win MD Anderson Center for MRI Device Test

Elekta AB and Royal Philips Electronics NV won their first hospital contract to test a new type of radiation therapy machine designed to increase the accuracy of treatment and reduce the need for surgery.

The University of Texas MD Anderson Cancer Center will test the machine, which uses magnetic resonance imaging during treatment to keep the radiation focused on the tumor, the companies said today in a statement. Stockholm-based Elekta and Amsterdam-based Philips plan other collaboration agreements with hospitals, which must purchase or lease the equipment.

Radiation therapy uses a high-energy beam of X-rays that passes through the patient’s body to kill cancer cells. The beam is highly susceptible to magnetic fields, so MRI is typically done before treatment to map out where cancer cells are and where the beam should be aimed. The new machine is designed to allow MRI to be done during treatment so the beam can be repositioned in real-time should the target shift as the patient breathes or moves.

“Historically, putting the two technologies together has been a crazy idea” because the magnets would cause the energy beam to bend, Kevin Brown, Elekta’s head of scientific research, said in an interview.

The companies created a special magnet that accommodates the presence of radiation nearby. The electron beam streams through a “null” space between the magnetic fields, Brown said. He declined to specify how much the machine will cost because it’s still in development and not yet for sale.

1999 Concept

The idea to combine MRI with radiation-treatment technology was first proposed in 1999 by Jan Lagendijk, a radiation oncology physicist at University Medical Centre Utrecht in the Netherlands, where the new machine is being tested. With real-time imaging, the beam can be refocused should the target area change, such as a lung tumor that moves when the patient breathes.

“It’s dancing around, not just in millimeters but centimeters,” Lagendijk said in an interview. “A kidney moves up to 6 centimeters when you breathe.”

The machine can target therapies within 1 millimeter of accuracy to minimize the amount of healthy tissue radiated near cancer cells, he said. The radiation dose can be increased to make a highly-targeted, personalized treatment with the aim of negating the need for surgery in some cases, he said.

‘Gold Standard’

“MRI is the gold-standard modality for imaging soft tissues, and MR imaging of the cancer during radiation therapy could provide the health care team the ability to optimize treatment while reducing toxicity,” Steven J. Frank, an associate professor of radiation oncology and director of advanced technologies at MD Anderson, said in the statement.

Elekta and Philips used the MRI component of the prototype on healthy volunteers and tested the radiation treatment on fluid plastic models to make sure the beam hits its target and is as potent as traditional radiotherapy.

A different imaging technology, known as computed tomography, or CT scanning, has been combined with radiation therapy for treatment of tumors in bones, Lagendijk said. A CT scan uses multiple X-ray beams to capture an image of the body. MRI is “superior” for looking at soft tissue, particularly tumors of the rectum, esophagus and kidneys, which are hard to treat due to low visibility with CT, Lagendijk said.

Curing Role

Radiotherapy is becoming more sophisticated, and 40 percent of cancer patients who are cured now receive it as part of their treatment, Henry Scowcroft, science information manager at Cancer Research U.K., said in an e-mail.

“It will be intriguing to see to how well the device performs as the consortium develops the technology, and whether it will lead to real improvements in cancer care,” Scowcroft said.

Once enough hospitals are on board, the companies will request regulatory approval for testing the machine on cancer patients, Elekta’s Brown said. Marco van Vulpen, Lagendijk’s colleague and principal investigator, is designing clinical trials for patients with tumors in the kidney, pancreas and prostate. Installation of the machines should start next year, Lagendijk said.

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