Application of an artificial intelligence segmentation for deep hyperthermia treatment planning in the pelvic region

During a microwave hyperthermia oncology treatment, the target region temperature is elevated to the temperatures of 40–44 °C, which improves the therapeutic effect of a standard radiotherapy and/or chemotherapy treatments. Amplitudes and phases of antenna input signals in the phased array setup surrounding the 3D patient model are optimised with respect to maximise the energy deposition in the target region. In this study, we successfully integrated an automatic artificial intelligence segmentation routine, used for patient-specific 3D model generation, into the hyperthermia treatment planning process. This allows us to apply more realistic patient 3D model for the online hyperthermia guidance including detailed retrospective analyses of the overall treatment quality, possibly leading to a widespread clinical use of the hyperthermia treatment planning

Assessment of the thermal tissue models for the head and neck hyperthermia treatment planning

Purpose: To compare different thermal tissue models for head and neck hyperthermia treatment planning, and to assess the results using predicted and measured applied power data from clinical treatments. Methods: Three commonly used temperature models from literature were analysed: “constant baseline”, “constant thermal stress” and “temperature dependent”. Power and phase data of 93 treatments of 20 head and neck patients treated with the HYPERcollar3D applicator were used. The impact on predicted median temperature T50 inside the target region was analysed with maximum allowed temperature of 44 °C in healthy tissue. The robustness of predicted T50 for the three models against the influence of blood perfusion, thermal conductivity and the assumed hotspot temperature level was analysed. Results: We found an average predicted T50 of 41.0 ± 1.3 °C (constant baseline model), 39.9 ± 1.1 °C (constant thermal stress model) and 41.7 ± 1.1 °C (temperature dependent model). The constant thermal stress model resulted in the best agreement between the predicted power (P = 132.7 ± 45.9 W) and the average power measured during the hyperthermia treatments (P = 129.1 ± 83.0 W). Conclusion: The temperature dependent model predicts an unrealistically high T50. The power values for the constant thermal stress model, after scaling simulated maximum temperatures to 44 °C, matched best to the average measured powers. We consider this model to be the most appropriate for temperature predictions using the HYPERcollar3D applicator, however further studies are necessary for developing of robust temperature model for tissues during heat stress.</p

Computational electromagnetic modeling is key in objective control of hyperthermia

\u3cp\u3eConfining treatment to the tumor to improve therapeutic outcome and reduce toxicity, is a hot issue in cancer research. Hyperthermia is recognized as a strong sensitizer for radiotherapy and chemotherapy enhancing tumor control without increasing toxicity. Today's electromagnetic hyperthermia systems heat large tissue volumes with limited ability to selectively heat the tumor. Fortunately, tremendous improvements in 3-dimensional electromagnetic &amp; temperature modelling provide an exciting opportunity to design advanced multi-element electromagnetic applicator systems. Together with feedback control using MR non-invasive thermometry and smart E-field sensors, this paves the way for selective tumor heating and potentially prescription of a thermal dose.\u3c/p\u3

Microwave Hyperthermia of Brain Tumors: A 2D Assessment Parametric Numerical Study

Due to the clinically proven benefit of hyperthermia treatments if added to standard cancer therapies for various tumor sites and the recent development of non-invasive temperature measurements using magnetic resonance systems, the hyperthermia community is convinced that it is a time when even patients with brain tumors could benefit from regional microwave hyperthermia, even if they are the subject of a treatment to a vital organ. The purpose of this study was to numerically analyze the ability to achieve a therapeutically relevant constructive superposition of electromagnetic (EM) waves in the treatment of hyperthermia targets within the brain. We evaluated the effect of the target size and position, operating frequency, and the number of antenna elements forming the phased array applicator on the treatment quality. In total, 10 anatomically realistic 2D human head models were considered, in which 10 circular hyperthermia targets with diameters of 20, 25, and 30 mm were examined. Additionally, applicators with 8, 12, 16, and 24 antenna elements and operating frequencies of 434, 650, 915, and 1150 MHz, respectively, were analyzed. For all scenarios considered (4800 combinations), the EM field distributions of individual antenna elements were calculated and treatment planning was performed. Their quality was evaluated using parameters applied in clinical practice, i.e., target coverage (TC) and the target to hot-spot quotient (THQ). The 12-antenna phased array system operating at 434 MHz was the best candidate among all tested systems for HT treatments of glioblastoma tumors. The 12 antenna elements met all the requirements to cover the entire target area; an additional increase in the number of antenna elements did not have a significant effect on the treatment quality

Microwave Catheter Navigation System for the Radiofrequency Liver Ablation

Thermal ablation is a well-known method used in interventional radiology to treat cancer. The treatment success is closely related to the exact catheter location in the treated area. Current navigation methods are based mostly on ultrasound or computed tomography. This work explores the possibility of tracking the catheter position during ablation treatment of hepatocellular carcinomas (HCC) using an ultra-wideband (UWB) antenna array and microwave radar imaging based on the “Delay and Sum” (DAS) algorithm. The feasibility was first numerically studied on a simple homogeneous liver model. A heterogeneous anthropomorphic 3D model of the treated region consisting of the main organs within the treated area was then used. Various standard radiofrequency ablation (RFA) catheters were placed virtually in the heterogeneous model. The location and orientation of the antenna elements of the developed imaging system and the applied frequency band were studied. Subsequently, an experimental setup consisting of a 3D printed homogeneous anthropomorphic model, eight UWB dipole antennas, and catheters was created and used in a series of measurements. The average accuracy determining the catheter position from simulated and experimental data was 3.88 ± 0.19 and 6.13 ± 0.66 mm, which are close to the accuracy of clinical navigation systems

Waveguide-based applicators for superficial hyperthermia treatment:is tuning really required?

\u3cp\u3eWaveguide-based applicators are used for hyperthermia treatment of superficial tumors, e.g. chest wall recurrences. During superficial hyperthermia treatment (SHT), the patient is in the near field of these antennas, so its radiating properties may vary. To maximize the transfer power from generators towards treatment area, waveguide-based applicators usually feature means for tuning the applicators. The purpose of this study was to investigate whether waveguide-based applicators for SHT really require such tuning. Hereto, we designed and optimized a waveguide lucite applicator at 434 MHz, applying a muscle phantom and a layered (skin, fat and muscle) phantom to mimic the patient.Applicator performance was measured for different water bolus temperatures and temperatures of the water circulating the applicator by studying impedance matching. S\u3csub\u3e11\u3c/sub\u3e ≤ -15 dB was measured for nine locations at the skin of a volunteer and three different water bolus temperatures.We conclude that tuning of waveguidebased applicators is not required when the applicator is properly designed.\u3c/p\u3

Hyperthermia and the need to monitor temperature

\u3cp\u3eExtensive biologic research has shown that adjuvant thermal therapy, i.e. heating tumors to 40-43°C, is a promising approach to increase the efficacy of existing radio- and chemotherapy protocols. The fact that in clinical trials, hyperthermia has shown not to increase toxicity is a major drive to invest in developing innovative devices and applicators to deliver thermal therapies. Moreover, the recent demonstrated ability of hyperthermia to decrease the repair of DNA double strand breaks provides a gateway to new treatments strategies involving hyperthermia and in combination with temperature sensitive drug carriers hyperthermia can be used for triggered local drug delivery.\u3c/p\u3

Reconstruction of applicator positions from multiple-view images for accurate superficial hyperthermia treatment planning

\u3cp\u3eIn the current clinical practice, prior to superficial hyperthermia treatments (HT), temperature probes are placed in tissue to document a thermal dose. To investigate whether the painful procedure of catheter placement can be replaced by superficial HT planning, we study if the specific absorption rate (SAR) coverage is predictive for treatment outcome. An absolute requirement for such a study is the accurate reconstruction of the applicator setup. The purpose of this study was to investigate the feasibility of the applicator setup reconstruction from multiple-view images. The accuracy of the multiple-view reconstruction method has been assessed for two experimental setups using six lucite cone applicators (LCAs) representing the largest array applied at our clinic and also the most difficult scenario for the reconstruction. For the two experimental setups and 112 distances, the mean difference between photogrametry reconstructed and manually measured distances was 0.25 ± 0.79 mm (mean±1 standard deviation). By a parameter study of translation T (mm) and rotation R (°) of LCAs, we showed that these inaccuracies are clinically acceptable, i.e. they are either from ±1.02 mm error in translation or ±0.48° in rotation, or combinations expressed by 4.35R(2) + 0.97T(2) = 1. We anticipate that such small errors will not have a relevant influence on the SAR distribution in the treated region. The clinical applicability of the procedure is shown on a patient with a breast cancer recurrence treated with reirradiation plus superficial hyperthermia using the six-LCA array. The total reconstruction procedure of six LCAs from a set of ten photos currently takes around 1.5 h. We conclude that the reconstruction of superficial HT setup from multiple-view images is feasible and only minor errors are found that will have a negligible influence on treatment planning quality.\u3c/p\u3

Hyperthermia treatment planning guided applicator selection for sub-superficial head and neck tumors heating

\u3cp\u3ePURPOSE: In this study, we investigated the differences in hyperthermia treatment (HT) quality between treatments applied with different hyperthermia systems for sub-superficial tumours in the head and neck (H&amp;N) region.\u3c/p\u3e\u3cp\u3eMATERIALS AND METHODS: In 24 patients, with a clinical target volume (CTV) extending up to 6 cm from the surface, we retrospectively analysed the predicted HT quality achievable by two planar applicator arrays or one phased-array hyperthermia system. Hereto, we calculated and compared the specific absorption rate (SAR) and temperature distribution coverage of the CTV and gross tumour volume (GTV) for the Lucite cone applicator (LCA: planar), current sheet applicator (CSA: planar) and the HYPERcollar (phased-array).\u3c/p\u3e\u3cp\u3eRESULTS: The HYPERcollar provides better SAR coverage than planar applicators if the target region is fully enclosed by its applicator frame. For targets extending outside the HYPERcollar frame, sufficient SAR coverage (25% target coverage, i.e. TC25 ≥ 75%) can still be achieved using the LCA when the target is fully under the LCA aperture and not deeper than 50 mm from the patient surface.\u3c/p\u3e\u3cp\u3eCONCLUSION: Simulations predict that the HYPERcollar (hence also its successor the HYPERcollar3D) is to be preferred over planar applicators such as LCA and current sheet applicator in sub-superficial tumours in the H&amp;N region when used within specifications.\u3c/p\u3