Technology teamup targets liver cancer

Western has teamed up with the Centre for Imaging Technology Commercialization (CIMTEC) and Claron Technology Inc. in developing hardware and original software modules in the treatment of liver cancer across the globe.

Combined into an image-guided oncology therapy system, this collaborative project has the potential to impact liver cancer treatment in India, North Asia and part of Europe, where access to CT (computed tomography) and MR (magnetic resonance) scanners is extremely limited, said Western professor and CIMTEC director Aaron Fenster.

“The big advantage is that highly accurate ablations can be performed in a procedure suite, as opposed to a CT scanner, making them more accessible, faster and much cheaper,” he said.

Hepatocellular carcinoma (HCC), the most common type of liver cancer, is the fifth most commonly diagnosed malignancy and the third most frequent cause of cancer related deaths worldwide. Incidence is particularly high in Asia and sub-Saharan Africa due to the large number of cases of hepatitis B and C on those continents. Both hepatitis B and C are complicated by cirrhosis of the liver, which is the greatest risk factor for HCC.

Minimally invasive techniques, such as radio frequency and microwave ablation of malignant tissue in the liver, is a rapidly expanding research field and treatment tool for patients who are not candidates for surgical resection or transplant. In some cases this acts as a bridge to liver transplantation.

Due to low complication rates, faster recovery times and reported survival rates comparable to resection, the indications for these minimally invasive procedures are continually increasing. However, these methods have a higher local recurrence rate than surgical resection, mostly due to the limitations of conventional ultrasound image-guidance.

CIMTEC’s work on 3D ultrasound-guided focal liver tumour ablation was born out of a project funded through the Ontario Institute for Cancer Research, who had been addressing the limitations of conventional 2D ultrasound imaging. The new system will increase the accuracy of identifying and localizing a tumour and reduce, perhaps even eliminate the need for intra-operative CT imaging.

The prototype system showed positive results during testing in the clinic of Western professor and London Health Science Centre interventional radiologist Dr. Nirmal Kakani. At the same time, Perfint Healthcare, located in India, was looking for an ultrasound-based solution to liver cancer treatment. With the reputation of Robarts Research Institute as a world-leader in the development of 3D ultrasound guided interventions, they became aware of the work and contacted Fenster. Perfint Healthcare will assist with the distribution of the therapy system.