Effective Estimation and Computer Control of Minimum Tumour Temperature During Conductive Interstitial Hyperthermia

The goal of heat therapy in the treatment of malignant disease is to raise the temperature of all neoplastic tissue to a cytotoxic temperature for a predetermined period of time. This seemingly simple task has proved difficult in-vivo, in part because of nonuniform power absorption and in part because of nonhomogeneous and time varying tumour blood flow. We have addressed this difficulty first by utilizing the conceptually simple technique of conductive interstitial hyperthermia, in which the tumour is warmed by multiple, electrically heated catheters, and second by implementing on-line conu·ol of minimum tumour temperatures near each catheter, estimated on the basis of the steadystate ratio of catheter power to catheter temperature rise. This report presents an analysis of the accuracy, precision, and stability of the on-line minimum temperature estimation/conu·ol technique for 22 patients who received 31 separate courses of conductive interstitial hyperthermia for the treatment of malignant brain tumours, and in whom temperature was monitored independently by 12 to 16 independent sensors per patient. In all patients, the technique was found to accurately and precisely estimate and control the local minimum temperatures. Comparison of measured and estimated temperatures revealed a mean difference of 0.0 ±0.4 °C for those sensors within 1.0 mm of the expected location for minimum temperatures. This technique, therefore, offers an attractive method for controlling hyperthermia therapy -- even in the presence of time varying local blood flow

Accuracy and precision of computer-simulated tissue temperatures in individual human intracranial tumours treated with interstitial hyperthermia

Accurate knowledge of tissue temperature is necessary for effective delivery of clinical hyperthermia in the treatment of malignant tumours. This report compares computer-predicted versus measured intratumoral temperatures in 11 human subjects with intracranial tumours, treated with a conceptually simple \u27conductive\u27 interstitial hyperthermia system. Interstitial hyperthermia was achieved by the use of parallel arrays of implanted, electrically heated catheters. The tissue was warmed by thermal conduction and blood convection. Simulation of intratumoral temperatures was achieved by solving a modified bioheat transfer equation on a digital computer using a finite difference method. Comparison of intratumoral temperatures from simulations and measured values differed by about ± 0.75 oC. Further analysis of computed temperature distributions between catheters revealed a rapidly computable relationship between the local minimum tumour temperature and nearby catheter power and temperature that accounts for effects of varying blood flow. These findings suggest that \u27on-line\u27 prediction and control of local minimum tumour temperatures are feasible with the conductive interstitial technique

Evidence of changes in regional blood perfusion in human intracranial tumours during conductive interstitial hyperthermia

Human intracranial tumours were treated using local heat therapy produced by surgically implanted catheters containing local resistive heating elements. Changes in local tumor blood flow were assessed indirectly from an algorithm based on the bioheat transfer equation. The algorithm used the ratio of catheter power to catheter temperature rise to estimate regional blood perfusion. Local heat therapy produced consistent reductions in local apparent perfusion. Changes in apparent regional perfusion occurred in intriguing patterns that gave clues to possible vascular events of therapeutic significance

Theoretical Basis for Controlling Minimal Tumor Temperature During Interstitial Conductive Heat Therapy

This paper describes simulation of steady-state intratumoral temperatures achieved by a simple modality of local heat therapy: interstitial treatment with parallel arrays of warmed, conductive heating elements. During “conductive heating” power is directly deposited only in the interstitial probes. Adjacent tissue is warmed by heat conduction. Simulations of interstitial conductive heating involved solution of the bioheat transfer equation on a digital computer using a finite difference model of the treated tissue. The simulations suggest that when the complete temperature distributions for conductive interstitial hyperthermia are examined in detail, substantial uniformity of the temperature distributions is evident. Except for a thin sleeve of tissue surrounding each heating element, a broad, flat central valley of temperature elevation is achieved, with a well defined minimum temperature, very close to modal and median tissue temperatures. Because probes are inserted directly in tumor tissue, the thin sleeve of overheated tissue would not be expected to cause normal tissue complications. The temperature of the heated probes must be continuously controlled and increased in the face of increased blood flow in order to maintain minimum tumor temperature. However, correction for changes in blood flow is possible by adjusting probe temperature according to a feedback control scheme, in which power dissipation from each probe is the sensed input variable. Conductive interstitial heating with continually controlled probe temperature deserves investigation as a technique for local hyperthermia therapy

Moving Your Sons to Safety: Galls Containing Male Fig Wasps Expand into the Centre of Figs, Away From Enemies

Figs are the inflorescences of fig trees (Ficus spp., Moraceae). They are shaped like a hollow ball, lined on their inner surface by numerous tiny female flowers. Pollination is carried out by host-specific fig wasps (Agaonidae). Female pollinators enter the figs through a narrow entrance gate and once inside can walk around on a platform generated by the stigmas of the flowers. They lay their eggs into the ovules, via the stigmas and styles, and also gall the flowers, causing the ovules to expand and their pedicels to elongate. A single pollinator larva develops in each galled ovule. Numerous species of non-pollinating fig wasps (NPFW, belonging to other families of Chalcidoidea) also make use of galled ovules in the figs. Some initiate galls, others make use of pollinator-generated galls, killing pollinator larvae. Most NPFW oviposit from the outside of figs, making peripherally-located pollinator larvae more prone to attack. Style length variation is high among monoecious Ficus spp. and pollinators mainly oviposit into more centrally-located ovules, with shorter styles. Style length variation is lower in male (wasp-producing) figs of dioecious Ficus spp., making ovules equally vulnerable to attack by NPFW at the time that pollinators oviposit

Design and evaluation of closed-loop feedback control of minimum temperatures in human intracranial tumors treated with interstitial hyperthermia

The dynamic nature of blood flow during hyperthermia therapy has made the control of minimum tumor temperature a difficult task. This paper presents initial studies of a novel approach to closed-loop control of local minimum tissue temperatures utilizing a newly developed estimation algorithm for use with conductive interstitial heating systems. The local minimum tumor temperature is explicitly estimated from the power required to maintain each member of an array of electrically heated catheters at a known temperature, in conjunction with a new bioheat equation-based algorithm to predict the ‘droop’ or fractional decline in tissue temperature between heated catheters. A closed loop controller utilizes the estimated minimum temperature near each catheter as a feedback parameter, which reflects variations in local blood flow. In response the controller alters delivered power to each catheter to compensate for changes in blood flow. The validity and stability of this estimation/control scheme were tested in computer simulations and in closed-loop control of nine patient treatments. The average estimation error from patient data analysis of 21 sites at which temperature was independently measured (three per patient) was 0.0 oC, with a standard deviation of 0.8 oC. These results suggest that estimation of local minimum temperature and feedback control of power delivery can be employed effectively during conductive interstitial heat therapy of intracranial tumors in man