Design and Evaluation of a Hybrid Radiofrequency Applicator for Magnetic Resonance Imaging and RF Induced Hyperthermia: Electromagnetic Field Simulations up to 14.0 Tesla and Proof-of-Concept at 7.0 Tesla

This work demonstrates the feasibility of a hybrid radiofrequency (RF) applicator that supports magnetic resonance (MR) imaging and MR controlled targeted RF heating at ultrahigh magnetic fields (B₀≥7.0T). For this purpose a virtual and an experimental configuration of an 8-channel transmit/receive (TX/RX) hybrid RF applicator was designed. For TX/RX bow tie antenna electric dipoles were employed. Electromagnetic field simulations (EMF) were performed to study RF heating versus RF wavelength (frequency range: 64 MHz (1.5T) to 600 MHz (14.0T)). The experimental version of the applicator was implemented at B₀ = 7.0T. The applicators feasibility for targeted RF heating was evaluated in EMF simulations and in phantom studies. Temperature co-simulations were conducted in phantoms and in a human voxel model. Our results demonstrate that higher frequencies afford a reduction in the size of specific absorption rate (SAR) hotspots. At 7T (298 MHz) the hybrid applicator yielded a 50% iso-contour SAR (iso-SAR-50%) hotspot with a diameter of 43 mm. At 600 MHz an iso-SAR-50% hotspot of 26 mm in diameter was observed. RF power deposition per RF input power was found to increase with B₀ which makes targeted RF heating more efficient at higher frequencies. The applicator was capable of generating deep-seated temperature hotspots in phantoms. The feasibility of 2D steering of a SAR/temperature hotspot to a target location was demonstrated by the induction of a focal temperature increase (ΔT = 8.1 K) in an off-center region of the phantom. Temperature simulations in the human brain performed at 298 MHz showed a maximum temperature increase to 48.6C for a deep-seated hotspot in the brain with a size of (19×23×32)mm³ iso-temperature-90%. The hybrid applicator provided imaging capabilities that facilitate high spatial resolution brain MRI. To conclude, this study outlines the technical underpinnings and demonstrates the basic feasibility of an 8-channel hybrid TX/RX applicator that supports MR imaging, MR thermometry and targeted RF heating in one device.     

Development and evaluation of a multi-applicator system of endocavitary radiothermotherapy of gynecologic tumors

An applicator system for the radiothermotherapy of gynecological tumors has been developed. The concept is based on combining high-dose rate afterloading therapy with local hyperthermia (27.12 MHz). The main applicator, the rf-gamma applicator consists of a guide tube for the gamma source, an electrode system and a cooling system. Isodoses and isotherms can be adapted to the individual anatomical-pathological situation presenting. For therapy planning the interaction between the applicators and the perfused tissue was investigated in a theoretical FEM model. In the first step, the SAR-function in the vicinity of the rf-applicator was determined by means of a 2D FEM calculation. In a second step, the 3D temperature fields was determined using linear shape functions. The results of these calculations showed that in every case the hot spots shifted from the applicator surface into the depths of the tissue. With the aid of an infrared camera and a split phantom the calculations were examined in a homogeneous non-perfused tissue model. Thermometry confirmed the accuracy of the results obtained. The radiothermotherapy system described here was tested in animal experiments, and is presently being used in a clinical pilot study.     

Comparison between beta radiation dose distribution due to LDR and HDR ocular brachytherapy applicators using GATE Monte Carlo platform

Eye applicators with 90Sr/90Y and 106Ru/106Rh beta-ray sources are generally used in brachytherapy for the treatment of eye diseases as uveal melanoma. Whenever, radiation is used in treatment, dosimetry is essential. However, knowledge of the exact dose distribution is a critical decision-making to the outcome of the treatment. The Monte Carlo technique provides a powerful tool for calculation of the dose and dose distributions which helps to predict and determine the doses from different shapes of various types of eye applicators more accurately. The aim of this work consisted in using the Monte Carlo GATE platform to calculate the 3D dose distribution on a mathematical model of the human eye according to international recommendations. Mathematical models were developed for four ophthalmic applicators, two HDR 90Sr applicators SIA.20 and SIA.6, and two LDR 106Ru applicators, a concave CCB model and a flat CCB model. In present work, considering a heterogeneous eye phantom and the chosen tumor, obtained results with the use of GATE for mean doses distributions in a phantom and according to international recommendations show a discrepancy with respect to those specified by the manufacturers. The QC of dosimetric parameters shows that contrarily to the other applicators, the SIA.20 applicator is consistent with recommendations. The GATE platform show that the SIA.20 applicator present better results, namely the dose delivered to critical structures were lower compared to those obtained for the other applicators, and the SIA.6 applicator, simulated with MCNPX generates higher lens doses than those generated by GATE.     

FDTD analysis of a noninvasive hyperthermia system for brain tumors

ABSTRACT: BACKGROUND: Hyperthermia is considered one of the new therapeutic modalities for cancer treatment and is based on the difference in thermal sensitivity between healthy tissues and tumors. During hyperthermia treatment, the temperature of the tumor is raised to 40--4[DEGREE SIGN]C for a definite period resulting in the destruction of cancer cells. This paper investigates design, modeling and simulation of a new non-invasive hyperthermia applicator system capable of effectively heating deep seated as well as superficial brain tumors using inexpensive, simple, and easy to fabricate components without harming surrounding healthy brain tissues. METHODS: The proposed hyperthermia applicator system is composed of an air filled partial half ellipsoidal chamber, a patch antenna, and a head model with an embedded tumor at an arbitrary location. The irradiating antenna is placed at one of the foci of the hyperthermia chamber while the center of the brain tumor is placed at the other focus. The finite difference time domain (FDTD) method is used to compute both the SAR patterns and the temperature distribution in three different head models due to two different patch antennas at a frequency of 915 MHz. RESULTS: The obtained results suggest that by using the proposed noninvasive hyperthermia system it is feasible to achieve sufficient and focused energy deposition and temperature rise to therapeutic values in deep seated as well as superficial brain tumors without harming surrounding healthy tissue. CONCLUSIONS: The proposed noninvasive hyperthermia system proved suitable for raising the temperature in tumors embedded in the brain to therapeutic values by carefully selecting the systems components. The operator of the system only needs to place the center of the brain tumor at a pre-specified location and excite the antenna at a single frequency of 915 MHz. Our study may provide a basis for a clinical applicator prototype capable of heating brain tumors.     

Analysis of electromagnetic heating patterns inside a cryopreserved organ

Computer analysis of the induced electromagnetic field and heating distribution inside cryopreserved organs subjected to electromagnetic illumination at frequencies of 84 MHz 434 MHz and 2.45 GHz were carried out using a spherical model for the organ, with special reference to heating in a single-mode resonant cavity. The interaction between the frequency of the incident field and the size and dielectric properties of the sample was investigated. It is shown that uniform heating of organs is likely to be achieved at lower frequencies, as might be expected. However, the ratio between the power penetration depth for plane waves and the size of the organ is not a sufficient basis on which to judge quantitatively the uniformity of the power absorption. Hot or cold spots can occur within the organ even when this ratio is greater than unity; the wavelength in the material is also an important factor. The results from this study indicate that the use of a resonant cavity as a heating applicator has advantages over plane-wave illumination. A sharp upper limit can be set to the frequency suitable for rapid and uniform heating of a given organ.     

Electromagnetic heating of tissue-equivalent phantoms with thin,insulating partitions

The electromagnetic power absorption in tissue-equivalent phantoms that are used for evaluation of diathermy and hyperthermia applicators is analyzed for the purpose of determining the effect of an insulating partition that is frequently used to facilitate separation of the phantom for thermographic analysis of heating distributions. An analysis that is based on the plane wave spectrum decomposition of the electromagnetic field is applied to a simplified model of the medium. The simplified model is valid whenever the insulating partition does not significantly alter the fields in the medium. The curves that are presented indicate that thin partitions do not significantly alter the power absorption for most situations of therapeutic interest. Data on the effects of partition thickness and electrical parameters are presented for microwave and radiofrequencies of interest for diathermy and hyperthermia.     

Design of Site-Specific Microwave Phased Array Hyperthermia Applicators Using 434 MHz Reduced Cavity-Backed Patch Antenna

Cancers of the neck, breast, and lower extremities are common malignancies diagnosed in India with a higher incidence of advanced-stage disease. Phased array (PA) applicators reported for hyperthermia treatment (HT) of the breast have small focal region and high cross-coupling, and those reported for lower extremities provide regional heating and limited steering. In this study, we present the numerical design of site-specific PA applicators for HT of large solid tumors in the neck, breast, and lower extremities using a miniaturized 434 MHz cavity-backed water-loaded patch antenna. The fabricated antenna has 38 × 36 mm² aperture, more than 90% power coupling, 25 MHz bandwidth, and good agreement between simulated and measured specific absorption rate (SAR) in phantom. The site-specific applicators demonstrated less power reflection (<−17.9 dB) and cross-coupling (<−26.8 dB) for 5 mm inter-ring spacing. SAR indicators for 64 cc tumor at varying locations in simplified layered three-dimensional (3D) tissue models of the neck, breast, and leg showed average power absorption ratio (aPA_ratio) ≥ 3.16, target to hotspot quotient (THQ) ≥ 0.57, 25% iso-SAR coverage (TC₂₅) ≥ 81%, and 50% iso-SAR coverage (TC₅₀) ≥51.8%. Simulation results of site-specific applicators for 3D inhomogeneous patient models showed aPA_ratio ≥ 5.98, THQ ≥ 0.9, TC₅₀ ≥ 86%, and 100% TC₂₅ for all sites. It is concluded that the 434 MHz miniaturized cavity-backed patch antenna can be used to develop high-density PA applicators with 12–24 antennas for HT of large solid tumors (≥4 cm) in the neck, breast, and lower extremities with 3D steering ability and less cross-coupling (≤−26.8 dB). © 2020 Bioelectromagnetics Society     

Thresholds of cat cochlear nucleus neurons to microwave pulses

Action potentials of neurons in cat dorsal and posteroventral cochlear nuclei were recorded extracellularly with glass microelectrodes while the head of the cat was exposed to microwave pulses at 915 MHz using a diathermy applicator. Response thresholds to acoustic tones, acoustic clicks, and microwave pulses were determined for auditory units with characteristic frequencies (CFs) from 278 Hz to 39.2 kHz. Tests with pulsatile stimuli were performed for durations of 20-700 mus, principally 20, 70, and 200 mus. Brainstem midline specific absorption rate (SAR) threshold was as small as 11.1 mW/g per pulse, and specific absorption (SA) threshold was a small as 0.6 muJ/g per pulse. Microwave thresholds were generally lower for CF less than 9 kHz, as were most acoustic thresholds. However, microwave threshold was only weakly related to click threshold and CF-tone threshold of each unit.     

Coupled field analysis of heat flow in the near field of a microwave applicator for tumor ablation

Microwave tumor ablation (MTA) offers a new approach for the treatment of hepatic neoplastic disease. Reliable and accurate information regarding the heat distribution inside biological tissue subjected to microwave thermal ablation is important for the efficient design of microwave applicators and for optimizing experiments, which aim to assess the effects of therapeutic treatments. Currently there are a variety of computational methods based on different vascular structures in tissue, which aim to model heat distribution during ablation. This paper presents results obtained from two such computational models for temperature distributions produced by a clinical 2.45 GHz MTA applicator immersed in unperfused ex vivo bovine liver, and compares them with measured results from a corresponding ex vivo experiment. The computational methods used to model the temperature distribution in tissue caused by the insertion of a 5.6 mm diameter "wandlike" microwave applicator are the Green's function method and the finite element method (FEM), both of which provide solutions of the heat diffusion partial differential equation. The results obtained from the coupled field simulations are shown to be in good agreement with a simplified analysis based on the bio-heat equation and with ex vivo measurements of the heat distribution produced by the clinical MTA applicator.     

Comparative study of shortwave heating patterns in phantoms with polyethylene and silk partitions

Specific absorption rate (SAR) and effective depths of heating patterns induced by a shortwave, pancake diathermy applicator in fat-muscle phantom are measured. Midplane partitions of polyethylene and silk screen with and without contact chemicals are used. Thermographically obtained SAR data show nearly the same value for silk-screen partitions with and without contact chemicals and slightly lower values with polyethylene partitions, provided that the partition midplanes are tightly pressed against each other. Thermometry data indicate that for low-power exposures the major error in thermographic measurements obtained after termination of heating is due to thermal diffusion and not evaporative cooling in the opened midplane of the phantom.     

Thermographic studies of phantom and canine kidneys thawed by microwave radiation

Whole organs, such as kidneys, must be thawed quickly and uniformly to prevent damage during thawing due to excessive heating. Electromagnetic heating with microwaves thaws the kidneys quickly but frequently produces "hot spots" with heat damage. To study heat damage, phantom gelatin kidneys with different dielectric constants and canine kidneys perfused with 12.5% glycerol, ethylene glycol, or dimethyl sulfoxide before freezing were microwave thawed, and the interior temperature was measured by thermography. Phantom kidneys were thawed free standing and canine kidneys were either free standing or packed in a gel mixture. Both phantom and canine kidneys were split symmetrically and separated with a sheet of Styrofoam to facilitate immediate separation and evaluation of the halves after thawing (approximately 3 sec). All the phantoms, regardless of dielectric properties, had areas less than 0 degrees C or greater than 37 degrees C after thawing. The free-standing canine kidneys and the gel-packed ethylene glycol-perfused kidneys had frozen areas (less than 0 degrees C) and hot spots (greater than 37 degrees C). However, glycerol- and dimethyl sulfoxide-perfused kidneys packed in gel before thawing had no areas less than 0 degrees C or greater than 37 degrees C. Altering the geometry from a "kidney shape" to a cylindrical shape with increased volume improved the uniformity of thawing and was more effective than altering the dielectric constant over the range evaluated.     

Development of a single mode electromagnetic resonant cavity for rewarming of cryopreserved biomaterials

An electromagnetic (EM) heating system is developed to achieve the rapid and uniform warming of cryopreserved biomaterials. Using the heating system, a rectangular resonant cavity is excited in TE101 mode at frequencies near 434 MHz. In experiments, a spherical phantom of biomaterial with a diameter of 36 mm is placed at the center of the cavity. The phantom is first cooled down to about -80 degrees C within the cavity and then thawed by EM absorption. Results show that EM warming can produce much higher warming rate than conventional water-bath warming method. The spatial temperature distribution in the phantom during EM warming is also more uniform than that during the water-bath warming.     

Monte Carlo simulation and measurement of radiation leakage from applicators used in external electron radiotherapy

External electron radiotherapy is performed using a cone or applicator to collimate the beam. However, because of a trade-off between collimation and scattering/bremsstrahlung X-ray production, applicators generate a small amount of secondary radiation (leakage). We investigate the peripheral dose outside the radiation field of a Varian-type applicator. The dose and fluence outside the radiation field were analyzed in a detailed Monte Carlo simulation. The differences between the calculation results and data measured in a water phantom in an ionization chamber were less than ±1% in regions more than 3 mm below the surface of the phantom and at the depth of dose maximum. The calculated fluence was analyzed inside and outside the radiation field on a plane just above the water phantom surface. Changing the electron energy affected the off-axis fluence distribution outside the radiation field; however, the size of the applicator had little effect on this distribution. For each energy, the distributions outside the radiation field were similar to the dose distribution at shallow depths in the water phantom. The effect of secondary electrons generation by photon transmission through the alloy making up the lowest scraper was largest in the region from the field edge to directly below the cutout and at higher beam energies. The results of the Monte Carlo simulation confirm that the peripheral dose outside the field is significantly affected by radiation scattered or transmitted from the applicator, and the effect increases with the electron energy.     

3D-printed applicators for high dose rate brachytherapy: Dosimetric assessment at different infill percentage

PurposeDosimetric assessment of high dose rate (HDR) brachytherapy applicators, printed in 3D with acrylonitrile butadiene styrene (ABS) at different infill percentage.Materials and methodsA low-cost, desktop, 3D printer (Hamlet 3DX100, Hamlet, Dublin, IE) was used for manufacturing simple HDR applicators, reproducing typical geometries in brachytherapy: cylindrical (common in vaginal treatment) and flat configurations (generally used to treat superficial lesions). Printer accuracy was investigated through physical measurements. The dosimetric consequences of varying the applicator’s density by tuning the printing infill percentage were analysed experimentally by measuring depth dose profiles and superficial dose distribution with Gafchromic EBT3 films (International Specialty Products, Wayne, NJ). Dose distributions were compared to those obtained with a commercial superficial applicator.ResultsMeasured printing accuracy was within 0.5 mm. Dose attenuation was not sensitive to the density of the material. Surface dose distribution comparison of the 3D printed flat applicators with respect to the commercial superficial applicator showed an overall passing rate greater than 94% for gamma analysis with 3% dose difference criteria, 3 mm distance-to-agreement criteria and 10% dose threshold.ConclusionLow-cost 3D printers are a promising solution for the customization of the HDR brachytherapy applicators. However, further assessment of 3D printing techniques and regulatory materials approval are required for clinical application.     

Interference of programmed electromagnetic stimulation with pacemakers and automatic implantable cardioverter defibrillators

A commercially available magnetic therapy system, designed for clinical application as well as for private use without medical supervision, was examined with respect to its potential for causing electromagnetic interference with implantable pacemakers (PMs) and automatic implantable cardioverter defibrillators (AICDs). A sample of 15 PMs and 5 AICDs were experimentally investigated. Each of the implants was realistically positioned in a homogeneous, electrically passive torso phantom and exposed to the magnetic fields of the system's applicators (whole body mat, cushion, and bar applicator). The detection thresholds of the implants were programmed to maximum sensitivity and both unipolar as well as bipolar electrode configurations were considered. The evaluation of possible interferences was derived from the internal event storages and pacing statistics recorded by the implants during exposure. Any "heart activity" recorded by the implants during exposure was interpreted as a potential interference, because the implant obviously misinterpreted the external interference signal as a physiological signal. Only cases without any recorded "heart activity" and with nominal pacing rates (as expected from the program parameter settings) of the implants were rated as "interference-free." Exposure to the whole body mat (peak magnetic induction up to 265 microT) did not show an influence on PMs and AICD in any case. The cushion applicator at the highest field intensity (peak magnetic induction up to 360 microT) led to atrial sensing defects in four PM models with unipolar electrode configuration. Under bipolar electrode configuration no disturbances occurred. The bar applicator led to sensing problems and consecutively reduced pacing rates in all tested PM models under unipolar electrode configuration and maximum field intensity (peak magnetic induction up to 980 microT). Bipolar electrode configuration resolved the problem. The investigated AICDs did not show malfunctions under any investigated condition. In conclusion, the examined PEMF therapy system did not interfere with the investigated implantable cardiac devices with bipolar electrode configuration. However, unipolar electrode configuration in pacemakers seems to be potentially hazardous during application of the examined PEMF therapy system.     

Exposure of non‐target tissues in medical diathermy

With different prevalence in different regions, radio frequency (RF) electromagnetic fields (EMF) are widely used for therapeutic tissue heating. Although short‐wave diathermy (27.12 MHz) is the most popular treatment modality, quantitative data on patient's exposure have been lacking. By numerical simulation with the numerical anatomical model NORMAN, intracorporal distributions of specific absorption rates (SAR) were investigated for different treatment scenarios and applicators. Quantitative data are provided for exposures of target treatment areas as well as for vulnerable regions such as the eye lenses, central nervous system, and testes. Different applicators and distances were investigated. Capacitive and inductive applicators exhibit quite a different heating efficiency. It could be shown that for the same output power therapeutic heat deposition can vary by almost one order of magnitude. By mimicking therapist's practice to use patient's heat perception as an indicator for output power setting, numerical data were elaborated demonstrating that muscle tissue exposures may be several times higher for inductive than for capacitive applicators. Presented quantitative data serve as a guide for power adjustment preventing relevant overexposures without compromising therapy; they also provide a basis for estimating target tissue heat load and developing therapeutic guidelines. Bioelectromagnetics 31:12–19, 2010. © 2009 Wiley‐Liss, Inc.     

Effect of Microwaves on Escherichia coli and Bacillus subtilis

Suspensions of Escherichia coli and Bacillus subtilis spores were exposed to conventional thermal and microwave energy at 2,450 MHz. The degrees of inactivation by the different energy sources were compared quantitatively. During the transient heating period by microwave energy, approximately a 6 log cycle reduction in viability was encountered for E. coli. This reduction was nearly identical to what is expected for the same time-temperature exposure to conventional heating. Heating of B. subtilis spores by conventional and microwave energy was also carried out at 100 C, in ice and for transient heating. The degree of inactivation by microwave energy was again identical to that by conventional heating. In conclusion, inactivation of E. coli and B. subtilis by exposure to microwaves is solely due to the thermal energy, and there is no per se effect of microwaves.     

Review of strategies for MRI based reconstruction of endocavitary and interstitial applicators in brachytherapy of cervical cancer

Brachytherapy plays an essential role in the curative intent management of locally advanced cervical cancer. The introduction of the magnetic resonance (MR) as a preferred image modality and the development of new type of applicators with interstitial components have further improved its benefits.The aim of this work is to review the current status of one important aspect in the cervix cancer brachytherapy procedure, namely catheter reconstruction.MR compatible intracavitary and interstitial applicators are described. Considerations about the use of MR imaging (MRI) regarding appropriate strategies for applicator reconstruction, technical requirements, MR sequences, patient preparation and applicator commissioning are included.It is recommendable to perform the reconstruction process in the same image study employed by the physician for contouring, that is, T2 weighted (T2W) sequences. Nevertheless, a clear identification of the source path inside the catheters and the applicators is a challenge when using exclusively T2W sequences. For the intracavitary component of the implant, sometimes the catheters may be filled with some substance that produces a high intensity signal on MRI. However, this strategy is not feasible for plastic tubes or titanium needles, which, moreover, induce magnetic susceptibility artifacts. In these situations, the use of applicator libraries available in the treatment planning system (TPS) is useful, since they not only include accurate geometrical models of the intracavitary applicators, but also recent developments have made possible the implementation of the interstitial component. Another strategy to improve the reconstruction process is based on the incorporation of MR markers, such as small pellets, to be used as anchor points.Many institutions employ computed tomography (CT) as a supporting image modality. The registration of CT and MR image sets should be carefully performed, and its uncertainty previously assessed. Besides, an important research work is being carried out regarding the use of ultrasound and electromagnetic tracking technologies.     

Thermal inactivation of Listeria monocytogenes during a process simulating temperatures achieved during microwave heating

Conventional heating was used to expose cells of Listeria monocytogenes , either in broth or in situ on chicken skin, to the mean times and temperatures that are achieved during a 28 min period of microwave cooking of a whole chicken. Heating L. monocytogenes by this method in culture broth resulted in a reduction in viable cell numbers by a factor of greater than 10⁶ upon reaching 70°C. Simulated microwave cooking of L. monocytogenes in situ , on chicken skin, resulted in more variability in the numbers of survivors. Heating for the full cook time of 28 min, however, resulted in a mean measured temperature of 85°C and no surviving listerias were detected. This indicated a reduction in viable numbers of greater than 10⁶. To reduce temperature variation, cells were heated on skin in a submerged system in which exposure to 70°C for 2 min resulted in a reduction in viable cell numbers of all strains of listerias tested of between 10⁶ and 10⁸. These results show that when a temperature of 70°C is reached and maintained for at least 2 min throughout a food there is a substantial reduction in the numbers of L. monocytogenes . The survival of this organism during microwave heating when temperatures of over 70°C are reported is probably due to uneven heating by microwave ovens resulting in the presence of cold spots in the product. The heat resistance of L. monocytogenes is comparable with that of many other non-sporing mesophilic bacteria.     

Brain temperature measurements in rats: a comparison of microwave and ambient temperature exposures

In an effort to understand microwave heating better, regional brain and core temperatures of rats exposed to microwave radiation (2450 MHz) or elevated air temperatures were measured in two studies. In general, we have found no substantial evidence for temperature differentials, or "hot spots," in the brain of these animals. In the first study, after a 30-min exposure, no temperature differences between brain regions either after microwave or ambient air exposure were found. However, a highly significant correlation between brain and core temperatures was found and this correlation was the same for both microwave and ambient air heating. In the second study, time-temperature profiles were measured in rats exposed to either 30 mW/cm2 or 36.2 degrees C. In this study, the 30-min exposure period was divided into seven intervals and the change in temperature during each period was analyzed. Only the cortex showed significantly different heating rates between the air heating and microwave heating; however, this difference disappeared after the initial 5 min of exposure.