siemens healthineers asco 2020

ASCO 2021
Enabling the Pathways of Cancer Care
Shaping the future of oncology

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Trends & Challenges  

While the number of cancer cases is projected to raise, trends such as patient awareness, screening, early diagnosis and new treatments drive increased survivorship.

For care providers these trends can add new challenges along the care pathway for cancer patients.

Trends & Challenges
Trends & Challenges
pathway for cancer patients

Screening & Early detection 

ASCO 2021

Image Courtesy of Klinikum Nürnberg, Nuremberg, Germany

"Lung cancer screening programs could lead to a stage shift"

Success of screening or early detection programs also depends on their accessibility for a broad population. As an example, low dose lung cancer screening with CT that can help limit the imaging dose to potentially healthy participants. In liver cancer, the ELF test1 can improve patient care by identifying NAFLD patients and stratifying those at risk of progressing to cirrhosis and LREs2 and ultrasound liver elastography can act as an easily accessible tool for quantifying and staging liver fibrosis.

The large number of images created during screening programs often brings a growing workload for radiologist.

AI based solutions, like AI-Rad Companion Chest CT, help to reduce the burden of basic repetitive tasks and may increase diagnostic precision when interpreting medical images.​ With its deep learning algorithms, AI-Rad Companion automatically highlights abnormalities, segments anatomies, and compares results to reference values.

Diagnosis & Staging 

Screening and early detection efforts can only lead to benefits if the rest of the pathway adapts. That means the accurate diagnosis and staging of very small lesions often found in early stage patients.

Lung Cancer

Precise lung cancer staging of lymph node involvement and distant metastases determines the prognosis and is the foundation of adequate therapy selection. For example, modern digital PET-CT systems offer high temporal and spatial resolution and can help to better evaluate small lung lesion(s).

Often endobronchial biopsy is an important next step to determine malignancy. However, despite procedural advances, the diagnostic yield remains low.3 A study conducted by Avasarala et al. (2020) demonstrated that mobile 3D imaging may help to achieve high targeting rates with reasonable cost.4

Liver Cancer

Imaging builds the backbone of diagnosing hepatocellular carcinoma - one of the most common forms of liver cancer. Ultrasound offers a great accessibility for surveillance of at-risk populations. When it comes to diagnosis, cross-secional imaging with CT or MRI can deliver dynamic, contrast-enhanced imaging of the liver over multiple phases of enhancement.

Patient cooperation and proper contrast timing are key for successful dynamic contrast enhanced imaging with MRI. Patients typically are required to perform multiple breath-holds for optimal image quality. Radiographers need to manage the complex timing of contrast agent and image acquisition to scan during the clinically relevant phases. Siemens Healthineers unique technologies make this complex exam easy for the technologists and patients alike. Compressed Sensing GRASP-VIBE allows dynamic contrast enhanced imaging to be performed in one push-button scan, under free-breathing.

Therapy decision 

Through our growing portfolio of oncology pathways, our mission remains clear: to facilitate diagnosis and therapeutic decisions with a clear goal of improving patient outcomes.

Our AI-Pathway Companions:

  • enable advanced oncology care through smart integration of disease-specific, longitudinal data for comprehensive and contextualized decision-making
  • facilitate accessibility and adherence to evidence-based standards of care to provide transparency and clinical excellence in oncology
  • empower patient-centered care by leveraging personalized and intelligent insights for well-informed shared decision-making

Treatment Planning & Treatment 

Early-stage patients require a different mix of treatments, often a shift towards minimally invasive curative treatments is observed.

Patients with longer survival are also likely to require repeated treatments for recurrences – an important reason to use minimally-invasive tissue-sparing techniques such as ablation or super-selective chemo-embolization that preserve options for future procedures.11, 12

In the case of the liver, only a minority of patients is candidate for a curative intent treatment, whether it is in the form of surgical resection, ablation or ultra-selective TACE. When early detection is increased, most options are available, and then the selection of the ideal therapy can be done on the basis of the patient characteristics and preferences. Image guidance is needed for ablation and embolization, while image-guided treatments like TACE, ablation, portal embolization or double venous deprivation can increase the number of patients candidates for surgical resection.13, 14, 15

Having access to the latest technologies with software assistance can help improving the outcomes and reducing the number of repeated treatments.16

Sophisticated image guidance enables minimally invasive and highly precise interventions on lungs. Surgeons at the Houston Methodist Medical Center perform iVATS procedures in their Hybrid OR.

Follow-up

After completion of the therapy, a systematic follow-up for the early detection of e.g. lung cancer relapse should always be part of the patient’s workup and is described in the corresponding guidelines. 

Enabling patients to manage their health during follow-up and survivorship is essential in achieving improved outcomes. For clinicians, the health data patients provide during follow-up can offer insights into the effectiveness of diagnosis, therapy decision and treatment.

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