Using a Conformal Water Bolus to Adjust Heating Patterns of Microwave Waveguide Applicators

Background: Hyperthermia, i.e., raising tissue temperature to 40-45°C for 60 min, has been demonstrated to increase the effectiveness of radiation and chemotherapy for cancer. Although multi-element conformal heat applicators are under development to provide more adjustable heating of contoured anatomy, to date the most often used applicator to heat superficial disease is the simple microwave waveguide. With only a single power input, the operator must be resourceful to adjust heat treatment to accommodate variable size and shape tumors spreading across contoured anatomy. Methods: We used multiphysics simulation software that couples electromagnetic, thermal and fluid dynamics physics to simulate heating patterns in superficial tumors from commercially available microwave waveguide applicators. Temperature distributions were calculated inside homogenous muscle and layered skin-fat-muscle-tumor-bone tissue loads for a typical range of applicator coupling configurations and size of waterbolus. Variable thickness waterbolus was simulated as necessary to accommodate contoured anatomy. Physical models of several treatment configurations were constructed for comparison of simulation results with experimental specific absorption rate (SAR) measurements in homogenous muscle phantom. Results: Accuracy of the simulation model was confirmed with experimental SAR measurements of three unique applicator setups. Simulations demonstrated the ability to generate a wide range of power deposition patterns with commercially available waveguide antennas by controllably varying size and thickness of the waterbolus layer. Conclusion: Heating characteristics of 915 MHz waveguide antennas can be varied over a wide range by controlled adjustment of microwave power, coupling configuration, and waterbolus lateral size and thickness. The uniformity of thermal dose delivered to superficial tumors can be improved by cyclic switching of waterbolus thickness during treatment to proactively shift heat peaks and nulls around under the aperture, thereby reducing patient pain while increasing minimum thermal dose by end of treatment. © (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE)

Locoregional hyperthermia of deep-seated tumours applied with capacitive and radiative systems. A simulation study

Background: Locoregional hyperthermia is applied to deep-seated tumours in the pelvic region. Two very different heating techniques are often applied: capacitive and radiative heating. In this paper, numerical simulations are applied to compare the performance of both techniques in heating of deep-seated tumours. Methods: Phantom simulations were performed for small (30 × 20 × 50 cm 3 ) and large (45 × 30 × 50 cm 3 ), homogeneous fatless and inhomogeneous fat-muscle, tissue-equivalent phantoms with a central or eccentric target region. Radiative heating was simulated with the 70 MHz AMC-4 system and capacitive heating was simulated at 13.56 MHz. Simulations were performed for small fatless, small (i.e. fat layer typically 3 cm) patients with cervix, prostate, bladder and rectum cancer. Temperature distributions were simulated using constant hyperthermic-level perfusion values with tissue constraints of 44 °C and compared for both heating techniques. Results: For the small homogeneous phantom, similar target heating was predicted with radiative and capacitive heating. For the large homogeneous phantom, most effective target heating was predicted with capacitive heating. For inhomogeneous phantoms, hot spots in the fat layer limit adequate capacitive heating, and simulated target temperatures with radiative heating were 2–4 °C higher. Patient simulations predicted therapeutic target temperatures with capacitive heating for fatless patients, but radiative heating was more robust for all tumour sites and patient sizes, yielding target temperatures 1–3 °C higher than those predicted for capacitive heating. Conclusion: Generally, radiative locoregional heating yields more favourable simulated temperature distributions for deep-seated pelvic tumours, compared with capacitive heating. Therapeutic temperatures are predicted for capacitive heating in patients with (almost) no fat

In-Silico Hyperthermia Performance of a Near-Field Patch Antenna at Various Positions on a Human Body Model

A compact patch applicator designed to enhance targeted energy coupling at 434 MHz is a key enabler for sensitizing temperature increments in body regions containing superficial tumours. A detailed FDTD body model is used to explore simulated RF coupling and temperature increments for typical clinical conditions. The antenna impedance matching, specific absorption rate and thermal distribution parameters are evaluated to identify applied performance outcomes. The analysis reveals physiological-RF coupling patterns for an optimised closely-coupled single element applicator

Target-specific multiphysics modeling for thermal medicine applications

Dissertation to obtain the degree of Doctor of Philosophy in Biomedical EngineeringThis thesis addresses thermal medicine applications on murine bladder hyperthermia and brain temperature monitoring. The two main objectives are interconnected by the key physics in thermal medicine: heat transfer. The first goal is to develop an analytical solution to characterize the heat transfer in a multi-layer perfused tissue. This analytical solution accounts for important thermoregulation mechanisms and is essential to understand the fundamentals underlying the physical and biological processes associated with heat transfer in living tissues. The second objective is the development of target-specific models that are too complex to be solved by analytical methods. Thus, the software for image segmentation and model simulation is based on numerical methods and is used to optimize non-invasive microwave antennas for specific targets. Two examples are explored using antennas in the passive mode (probe) and active mode (applicator). The passive antenna consists of a microwave radiometric sensor developed for rapid non-invasive feedback of critically important brain temperature. Its design parameters are optimized using a power-based algorithm. To demonstrate performance of the device, we build a realistic model of the human head with separate temperaturecontrolled brain and scalp regions. The sensor is able to track brain temperature with 0.4 °C accuracy in a 4.5 hour long experiment where brain temperature is varied in a 37 °C, 27 °C and 37 °C cycle. In the second study, a microwave applicator with an integrated cooling system is used to develop a new electro-thermo-fluid (multiphysics) model for murine bladder hyperthermia studies. The therapy procedure uses a temperature-based optimization algorithm to maintain the bladder at a desired therapeutic level while sparing remaining tissues from dangerous temperatures. This model shows that temperature dependent biological properties and the effects of anesthesia must be accounted to capture the absolute and transient temperature fields within murine tissues. The good agreement between simulation and experimental results demonstrates that this multiphysics model can be used to predict internal temperatures during murine hyperthermia studies

Radiofrequency applicator concepts for thermal magnetic resonance of brain tumors at 297 MHz (7.0 Tesla)

PURPOSE: Thermal intervention is a potent sensitizer of cells to chemo- and radiotherapy in cancer treatment. Glioblastoma multiforme (GBM) is a potential clinical target, given the cancer's aggressive nature and resistance to current treatment options. The annular phased array (APA) technique employing electromagnetic waves in the radiofrequency (RF) range allows for localized temperature increase in deep seated target volumes (TVs). Reports on clinical applications of the APA technique in the brain are still missing. Ultrahigh field magnetic resonance (MR) employs higher frequencies than conventional MR and has potential to provide focal temperature manipulation, high resolution imaging and noninvasive temperature monitoring using an integrated RF applicator (ThermalMR). This work examines the applicability of RF applicator concepts for ThermalMR of brain tumors at 297 MHz (7.0 Tesla). METHODS: Electromagnetic field (EMF) simulations are performed for clinically realistic data based on GBM patients. Two algorithms are used for specific RF energy absorption rate based thermal intervention planning for small and large TVs in the brain, aiming at maximum RF power deposition or RF power uniformity in the TV for 10 RF applicator designs. RESULTS: For both TVs , the power optimization outperformed the uniformity optimization. The best results for the small TV are obtained for the 16 element interleaved RF applicator using an elliptical antenna arrangement with water bolus. The two row elliptical RF applicator yielded the best result for the large TV. DISCUSSION: This work investigates the capacity of ThermalMR to achieve targeted thermal interventions in model systems resembling human brain tissue and brain tumors

A phased array applicator based on open ridged-waveguide antenna for microwave hyperthermia

Radiative hyperthermia is a clinically applied cancer treatment modality where antenna design is crucial to achieving therapeutic goals. Serving as the building block of a phased-array configuration, antennas are typically arranged in a cylindrical or elliptical array called applicator. This short communication proposes an elliptical phased array applicator based on a compact, UWB design from the category of double-ridged horn antennas customized for hyperthermia systems. The performance of the antenna, named open ridged-waveguide, has been experimentally assessed based on the quality metrics of the hyperthermic community. The proposed design achieves an ultra-wideband range of operation from 400 to 800 MHz with an aperture size of 3 by 4 cm. Moreover, thanks to the shielding provided by the metallic housing, the design proves good isolation better than -30 dB throughout the band. The power deposition capability of the proposed applicator followed by the thermal analysis is also investigated for a realistic headand neck patient model. The results indicate very good quality metrics achieved in the treatment planning of the patient

Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Purpose. To assess the feasibility of adding hyperthermia to an original method of organ-preserving brachytherapy treatment for locally advanced head and neck tumors. Methods and materials. The method involves organ-preserving tumor resection and adjunctive high-dose-rate (HDR) brachytherapy delivered via afterloading catheters. These catheters are embedded in a polymeric implant prepared intraoperatively to fill the resection cavity, allowing precise computer planning of dose distribution in the surrounding at-risk tumor bed tissue. Theoretical and experimental analyzes address the feasibility of heating the tumor bed implant by coupling energy from a 100 kHz magnetic field applied externally into ferromagnetic particles, which are uniformly distributed within the implant. The goal is to combine adjuvant hyperthermia (40 °C–45 °C) to at-risk tissue within 5 mm of the resection cavity for thermal enhancement of radiation and chemotherapy response. Results. A five-year relapse free survival rate of 95.8% was obtained for a select group of 48 male patients with T3N0M0 larynx tumors, when combining organ-preserving surgery with HDR brachytherapy from a tumor bed implant. Anticipating the need for additional treatment in patients with more advanced disease, a theoretical analysis demonstrates the ability to heat at-risk tissue up to 10 mm from the surface of an implant filled with magnetically coupled ferromagnetic balls. Using a laboratory induction heating system, it takes just over 2 min to increase the target tissue temperature by 10 °C using a 19% volume fraction of ferromagnetic spheres in a 2 cm diameter silicone implant. Conclusion. The promising clinical results of a 48 patient pilot study demonstrate the feasibility of a new organ sparing treatment for laryngeal cancer. Anticipating the need for additional therapy, theoretical estimations of potential implant heating are confirmed with laboratory experiments, preparing the way for future implementation of a thermobrachytherapy implant approach for organ-sparing treatment of locally advanced laryngeal cancer