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siemens healthineers asco 2020

ASCO 2021
Enabling the Pathways of Cancer CareShaping the future of oncology

A leap in cancer care. A leap in impact.

Siemens Healthineers and Varian share a vision for shaping the future of healthcare and creating a world without fear of cancer. 

siemens healthineers asco 2021

Siemens Healthineers and Varian are now combining their strengths by taking a leap in cancer care, and a leap in the impact on healthcare overall to accelerate the path from diagnosis to survivorship in one joint step. United by a common goal to ensure every patient receives the right treatment at the right time, we want oncologists, physicians and clinicians to be as supported as possible to take on the challenges caused by cancer.

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 

Treating late-stage cancer is extremely challenging. However, treatment, e.g. for lung caner can be significantly more effective if the disease is detected earlier in stage I or II, before the onset of symptoms when the disease is still localized. This emphasizes the benefit to establish screening programs for earlier detection.

Lung Cancer Therapy
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.

Discover our solutions for screening and early detection

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.

Discover our solutions for diagnosis and staging in cancer:

Therapy decision 

In 2020 we officially presented our first CE-marked clinical decision support pathway – AI-Pathway Companion Prostate Cancer5. We are now expanding the portfolio of oncology pathways with the introduction of the AI-Pathway Companion Lung Cancer. The solution, focused on non-small cell lung cancer, enables personalized and standardized decision-making along the lung cancer pathway6.

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

AI-Pathway Companion supports key challenges in diagnosis and treatment of non-small cell lung cancer by …7,8   

AI-Pathway Companion
… providing the ability to have a quick snapshot overview

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

New ways in surgical lung cancer care

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.

1

Not available for sale in the U.S. Product availability may vary from country to country and is subject to varying regulatory requirements.

2

Sanyal AJ, et a. Hepatology. 2019 Apr 16. doi: 10.1002/hep.30664. [Epub ahead of print].

3

Casal et al. Cone beam computed tomography-guided thin/ultrathin bronchoscopy for diagnosis of peripheral lung nodules: a prospective pilot study. J Thorac Dis 2018

4

Avasarala et al. Multidimensional Precision Hybrid Mobile 2D/3D C-Arm Assisted Biopsy of Peripheral Lung Nodules. J Bronchol Intervent Pulmonol 2020

5

AI-Pathway Companion applications are not commercially available in all countries. Their future availability cannot be guaranteed.

6

AI-Pathway Companion Lung Cancer is under development and not commercially available. The future availability cannot be ensured.

7

AI-Pathway Companion Lung Cancer is under development and not commercially available. The future availability cannot be ensured.

8

AI-Pathway Companion applications are not commercially available in all countries. Their future availability cannot be guaranteed.

9

This function is supported by AI-Pathway Companion Connector.

10

Prerequisite: “All data is available as required per guideline.” Feature dependent on quality of input data.

11

Kudo M, Lencioni R, Marrero JA, et al. Regional differences in sorafenib-treated patients with hepatocellular carcinoma: GIDEON observational study. Liver Int. 2016;36(8):1196-1205. doi:10.1111/liv.13096

12

Kudo, M. (2018). Management of Hepatocellular Carcinoma in Japan as a World-Leading Model. Liver Cancer, 7(2), 134–147. https://doi.org/10.1159/000484619

13

Vera R, González-Flores E, Rubio C, et al. Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM. Clin Transl Oncol. 2020;22(5):647-662. doi:10.1007/s12094-019-02182-z

14

Rice SL, Bale R, Breen DJ, et al. The Management of Colorectal Cancer Liver Metastases: The Interventional Radiology Viewpoint. Int J Radiat Oncol. 2019;103(3):537-539. doi:10.1016/j.ijrobp.2018.08.069

15

Putzer D, Schullian P, Braunwarth E, et al. Integrating interventional oncology in the treatment of liver tumors. Eur Surg - Acta Chir Austriaca. 2018;50(3):117-124. doi:10.1007/s10353-018-0521-5

16

Lucatelli P, Corona M, Argirò R, et al. Impact of 3D Rotational Angiography on Liver Embolization Procedures: Review of Technique and Applications. Cardiovasc Intervent Radiol. 2015;38(3):523-535. doi:10.1007/s00270-014-1023-x Bapst B, Lagadec M, Breguet R, Vilgrain V, Ronot M. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol. 2016;39(1):8-20. doi:10.1007/s00270-015-1180-Odisio BC, Simoneau E, Holmes AA, Conrad CH, Vauthey J-N. Fast-Track Two-Stage Hepatectomy Using a Hybrid Interventional Radiology/Operating Suite as Alternative Option to Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy Procedure. J Am Coll Surg. 2018;227(2):e5-e10. doi:10.1016/j.jamcollsurg.2018.04.027

Bale R, Laimer G, Schullian P, et al. Minimal ablative margin (MAM) assessment with image fusion: an independent predictor for local tumor progression in hepatocellular carcinoma after stereotactic radiofrequency ablation. Eur Radi. Published online 2020. doi:10.1007/s00330-019-06609-7