ROCHESTER, Minn. — Looking to the future, radiologists at Mayo Clinic in Rochester saw an opportunity to bring several disparate tools together into a unified space to serve complementary roles in sophisticated, minimally invasive cancer treatments.

The Hybrid Procedural Suite was designed primarily to advance the evolving practice of tumor ablation — a needle-based treatment that destroys cancerous or otherwise abnormal tissue. Ablation is used to target cancer in locations such as the kidneys, liver, lung and prostate, as well as soft tissues and bones. The Hybrid Procedural Suite brings together CT, fluoroscopy and ultrasound in one room, with MRI procedural capabilities in an adjoining room. In the near future, a third room will be constructed to add a dual-source CT scanner.

"The driving force is really to improve outcomes for patients," says Matthew Callstrom, M.D., Ph.D., chair of the Midwest Department of Radiology, adding that combining these technologies will allow for more objective measurement of the success of these procedures, and provide opportunities for the approach to be standardized and improved.
"Right now, I'd say the world operates along the lines of using tools that are not designed specifically for use in ablation. You find workarounds and try to do the best you can with the tools that you have," Dr. Callstrom says. "We need a standard approach to treatment and to drive toward very predictable outcomes."

Procedural suites are nothing new. The hybrid piece is, though — specifically bringing fluoroscopy into the CT suite and allowing for these tools to be combined with MRI, Dr. Callstrom says. "This sort of integrated solution is only offered in a few centers across the world. The way we're trying to do it is unique, with a full solution-based strategy. The ultimate goal is to drive patient outcomes so that the treatment they get at Mayo Clinic is better than anywhere in the world."

As part of the collaboration to build this new suite, the Department of Radiology worked closely with anesthesiologists, urologists, medical oncologists, neurologists, neurosurgeons, orthopedic surgeons, radiation oncologists, physicists and outside experts to develop solutions that would help physicians perform each complex procedure, and plan for and assess progress during and after the procedure.

"We've designed a room with CT and fluoroscopy together, which allows us to, for example, place devices off axis in the spine or pelvis because those structures are not aligned in the axial plane," he says. "Also, if monitoring a procedure with MRI is the best approach, we've worked with Philips to develop a transfer system to go from CT into the MRI suite because those two rooms are adjacent and separated by a door. The barriers to using the right imaging modality at the right phase of treatment have been markedly reduced."

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