Thermophysiological responses of human volunteers to whole body RF exposure at 220 MHz

Temperatures in Pigs During 3 T MRI Temperatures, Heart Rates, and Breathing Rates of Pigs During RF Power Deposition in a 3 T (128 MHz) Body Coil

Exposure to radiofrequency (RF) power deposition during magnetic resonance imaging (MRI) induces elevated body-tissue temperatures and may cause changes in heart and breathing rates, disturbing thermoregulation. Eleven temperature sensors were placed in muscle tissue and one sensor in the rectum (measured in 10 cm depth) of 20 free-breathing anesthetized pigs to verify temperature curves during RF exposure. Tissue temperatures and heart and breathing rates were measured before, during, and after RF exposure. Pigs were placed into a 60-cm diameter whole-body resonator of a 3 T MRI system. Nineteen anesthetized pigs were divided into four RF exposure groups: sham (0 W/kg), low-exposure (2.7 W/kg, mean exposure time 56 min), moderate-exposure (4.8 W/kg, mean exposure time 31 min), and high-exposure (4.4 W/kg, mean exposure time 61 min). One pig was exposed to a whole-body specific absorption rate (wbSAR) of 11.4 W/kg (extreme-exposure). Hotspot temperatures, measured by sensor 2, increased by mean 5.0 ± 0.9°C, min 3.9; max 6.3 (low), 7.0 ± 2.3°C, min 4.6; max 9.9 (moderate), and 9.2 ± 4.4°C, min 6.1, max 17.9 (high) compared with 0.3 ± 0.3°C in the sham-exposure group (min 0.1, max 0.6). Four time-temperature curves were identified: sinusoidal, parabolic, plateau, and linear. These curve shapes did not correlate with RF intensity, rectal temperature, breathing rate, or heart rate. In all pigs, rectal temperatures increased (2.1 ± 0.9°C) during and even after RF exposure, while hotspot temperatures decreased after exposure. When rectal temperature increased by 1°C, hotspot temperature increased up to 42.8°C within 37 min (low-exposure) or up to 43.8°C within 24 min (high-exposure). Global wbSAR did not correlate with maximum hotspot. Bioelectromagnetics. 2021;42:37-50. © 2020 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.

Noninvasive radiofrequency treatment effect on mitochondria in pancreatic cancer cells

BACKGROUND

The development of novel therapeutic approaches for cancer therapy is important, especially for tumors that have poor response or develop resistance to standard chemotherapy and radiation. We discovered that noninvasive radiofrequency (RF) fields can affect cancer cells but not normal cells, inhibit progression of tumors in mice, and enhance the anticancer effects of chemotherapy. However, it remains unclear what physiological and molecular mechanisms this treatment induces inside cells. Here, we studied the effect of RF treatment on mitochondria in human pancreatic cancer cells.

METHODS

The morphology of mitochondria in cells was studied via electron microscopy. The alteration of mitochondrial membrane potential (Δψ) was accessed using a Mitotracker probe. The respiratory activity of mitochondria was evaluated by analyzing changes in oxygen consumption rates determined with a Mito Stress Test Kit. The production of intracellular reactive oxygen species was performed using flow cytometry. The colocalization of mitochondria and autophagosome markers in cells was performed using fluorescence immunostaining and confocal microscopy analysis.

RESULTS

RF fields treatment changed the morphology of mitochondria in cancer cells, altered polarization of the mitochondrial membrane, substantially impaired mitochondrial respiration, and increased reactive oxygen species production, indicating RF-induced stress on the mitochondria. We also observed frequent colocalization of the autophagosome marker LC3B with the mitochondrial marker Tom20 inside cancer cells after RF exposure, indicating the presence of mitochondria in the autophagosomes. This suggests that RF-induced stress can damage mitochondria and induce elimination of damaged organelles via autophagy.

CONCLUSION

RF treatment impaired the function of mitochondria in cancer cells. Therefore, mitochondria can represent one of the targets of the RF treatment.

Autophagy and enhanced chemosensitivity in experimental pancreatic cancers induced by noninvasive radiofrequency field treatment

BACKGROUND

Patients with pancreatic ductal adenocarcinoma (PDAC) have limited therapeutic options and poor response to the standard gemcitabine (GCB)-based chemotherapy. In the current study, the authors investigated the feasibility of noninvasive short-wave radiofrequency (RF) electric fields to improve the cytotoxic effect of GCB on PDAC cells and determined its mechanism of action.

METHODS

The cytotoxicity of RF alone and in combination with GCB was studied in vitro on normal pancreatic human pancreatic ductal epithelial cells and different PDAC cell lines by flow cytometry, and in vivo on ectopic and orthotopic human PDAC xenograft models in mice. The mechanism of RF activity was studied by Western blot analysis and immunohistochemistry. Toxicity was determined by histopathology.

RESULTS

Exposure of different PDAC cells to 13.56-megahertz radio waves resulted in a substantial cytotoxic effect, which was accompanied by the induction of autophagy but not apoptosis. These effects of RF were found to be absent in normal cells. Excessive numbers of autophagosomes in cancer cells persisted 24 to 48 hours after RF exposure and then declined. The addition of a subtoxic dose of GCB to RF treatment inhibited the recovery of cancer cells from the RF-induced autophagy and enhanced the cytotoxic effect of the latter on cancer cells. The treatment of PDAC in situ in mice with the combination of noninvasive RF and GCB was found to have a superior antitumor effect compared with the use of RF or GCB alone, yet there was no evidence of systemic toxicity.

CONCLUSIONS

Noninvasive RF treatment induced autophagy but not apoptosis in cancer cells and demonstrated potential as an enhancer of chemotherapy for treating patients with pancreatic cancer without toxicity to normal cells.

In vivo anti-cancer efficacy of magnetite nanocrystal--based system using locoregional hyperthermia combined with 5-fluorouracil chemotherapy

We present an approach for synchronizing hyperthermia and thermal-responsive local drug release. The targeting probe has a magnetite nanocrystal (Fe₃O₄@PSMA) core and a polynucleotide shell that carries 5-fluorouracil (5-FU) and anti-human epidermal growth factor receptor 2 (anti-HER2) antibody for cancer cell-specific targeting. The targeting nanocrystals play as an important role to relay the externally delivered radiofrequency energy for tumor hyperthermia. Locoregional heat then triggers a drug release from the oligonucleotide carrier as it directly damages tumor cells. Cell viability assays and pathological examinations show that this synchronization is significantly more efficacious in both in vitro and in vivo models than hyperthermia or chemotherapy alone. Prominent tumor remission in vivo was achieved through radiofrequency synchronization of hyperthermia and chemotherapy after the nanoparticle had been intravenously injected.

MRI-based multiscale model for electromagnetic analysis in the human head with implanted DBS

Deep brain stimulation (DBS) is an established procedure for the treatment of movement and affective disorders. Patients with DBS may benefit from magnetic resonance imaging (MRI) to evaluate injuries or comorbidities. However, the MRI radio-frequency (RF) energy may cause excessive tissue heating particularly near the electrode. This paper studies how the accuracy of numerical modeling of the RF field inside a DBS patient varies with spatial resolution and corresponding anatomical detail of the volume surrounding the electrodes. A multiscale model (MS) was created by an atlas-based segmentation using a 1 mm³ head model (mRes) refined in the basal ganglia by a 200 μm² ex-vivo dataset. Four DBS electrodes targeting the left globus pallidus internus were modeled. Electromagnetic simulations at 128 MHz showed that the peak of the electric field of the MS doubled (18.7 kV/m versus 9.33 kV/m) and shifted 6.4 mm compared to the mRes model. Additionally, the MS had a sixfold increase over the mRes model in peak-specific absorption rate (SAR of 43.9 kW/kg versus 7 kW/kg). The results suggest that submillimetric resolution and improved anatomical detail in the model may increase the accuracy of computed electric field and local SAR around the tip of the implant.

Enabling individualized therapy through nanotechnology

Individualized medicine is the healthcare strategy that rebukes the idiomatic dogma of 'losing sight of the forest for the trees'. We are entering a new era of healthcare where it is no longer acceptable to develop and market a drug that is effective for only 80% of the patient population. The emergence of "-omic" technologies (e.g. genomics, transcriptomics, proteomics, metabolomics) and advances in systems biology are magnifying the deficiencies of standardized therapy, which often provide little treatment latitude for accommodating patient physiologic idiosyncrasies. A personalized approach to medicine is not a novel concept. Ever since the scientific community began unraveling the mysteries of the genome, the promise of discarding generic treatment regimens in favor of patient-specific therapies became more feasible and realistic. One of the major scientific impediments of this movement towards personalized medicine has been the need for technological enablement. Nanotechnology is projected to play a critical role in patient-specific therapy; however, this transition will depend heavily upon the evolutionary development of a systems biology approach to clinical medicine based upon "-omic" technology analysis and integration. This manuscript provides a forward looking assessment of the promise of nanomedicine as it pertains to individualized medicine and establishes a technology "snapshot" of the current state of nano-based products over a vast array of clinical indications and range of patient specificity. Other issues such as market driven hurdles and regulatory compliance reform are anticipated to "self-correct" in accordance to scientific advancement and healthcare demand. These peripheral, non-scientific concerns are not addressed at length in this manuscript; however they do exist, and their impact to the paradigm shifting healthcare transformation towards individualized medicine will be critical for its success.

Use of nanoparticles for targeted, noninvasive thermal destruction of malignant cells

Shortwave (MHz range) radiofrequency (RF) energy is nonionizing, penetrates deeply into biological tissues with no adverse side effects, and heats metallic nanoparticles efficiently. Targeted delivery of these nanoparticles to cancer cells should result in hyperthermic cytotoxicity upon exposure to a focused, noninvasive RF field. We have demonstrated that gold nanoparticles conjugated with cetuximab (C225) are quickly internalized by Panc-1 (pancreatic adenocarcinoma) and Difi (colorectal adenocarcinoma) cancer cells overexpressing epidermal growth factor receptor (EGFR). Panc-1 or Difi cells treated with naked gold nanoparticles or nonspecific IgG-conjugated gold nanoparticles demonstrated minimal intracellular uptake of gold nanoparticles by transmission electron microscopy (TEM). In contrast, there were dense concentrations of cytoplasmic vesicles containing gold nanoparticles following treatment with cetuximab-conjugated gold nanoparticles. Exposure of cells to a noninvasive RF field produced nearly 100% cytotoxicity in cells treated with the cetuximab-conjugated gold nanoparticles, but significantly lower levels of cytotoxicity in the two control groups (p < 0.00012). Treatment of a breast cancer cell line (CAMA-1) that does not express EGFR with cetuximab-conjugated gold nanoparticles produced no enhanced cytotoxicity following treatment in the RF field. Conjugation of cancer cell-directed targeting agents to gold nanoparticles may represent an effective and cancer-specific therapy to treat numerous types of human malignant disease using noninvasive RF hyperthermia.

Reminiscences of a journeyman scientist: studies of thermoregulation in non-human primates and humans

After graduating from Mount Holyoke College in 1948 where I majored in experimental psychology I worked at the College for 2 years with the Johns Hopkins Thermophysiological Unit. My graduate work later at the University of Wisconsin, centering on sensory psychology, culminated in my 1955 PhD thesis on human dark adaptation. I continued work in sensory psychology later with Neal Miller at Yale and then moved to the John B. Pierce Foundation--a Yale affiliate--where I began the studies of thermoregulation that constitute the center of my scientific career. Those studies were largely--later wholly--conducted using microwave energy as a thermal load and were thus published in Bioelectromagnetics even as I played an active role in the Bioelectromagnetics Society. In the beginning this work was centered on the responses of Squirrel Monkeys to thermal loads. Later, serving as Senior Scientist at the Air Force Research Laboratory at San Antonio, I completed an extensive analysis of thermal regulation in humans. I consider this work of special note inasmuch as the extraordinary human thermoregulatory ability was surely among the attributes that were paramount in initially separating humans from the other anthropoid primates.

Feasibility of future epidemiological studies on possible health effects of mobile phone base stations

The increasing deployment of mobile communication base stations led to an increasing demand for epidemiological studies on possible health effects of radio frequency emissions. The methodological challenges of such studies have been critically evaluated by a panel of scientists in the fields of radiofrequency engineering/dosimetry and epidemiology. Strengths and weaknesses of previous studies have been identified. Dosimetric concepts and crucial aspects in exposure assessment were evaluated in terms of epidemiological studies on different types of outcomes. We conclude that in principle base station epidemiological studies are feasible. However, the exposure contributions from all relevant radio frequency sources have to be taken into account. The applied exposure assessment method should be piloted and validated. Short to medium term effects on physiology or health related quality of life are best investigated by cohort studies. For long term effects, groups with a potential for high exposure need to first be identified; for immediate effect, human laboratory studies are the preferred approach.

Role of blood flow on RF exposure induced skin temperature elevations in rabbit ears

In this in vivo study, we measured local temperature changes in rabbit pinnae, which were evoked by radiofrequency (RF) exposure for 20 min at localized SAR levels of 0 (sham exposure), 2.3, 10.0, and 34.3 W/kg over 1.0 g rabbit ear tissue. The effects of RF exposures on skin temperature were measured under normal blood flow and without blood flow in the ear. The results showed: (1) physiological blood flow clearly modified RF induced thermal elevation in the pinna as blood flow significantly suppressed temperature increases even at 34.3 W/kg; (2) under normal blood flow conditions, exposures at 2.3 and 10.0 W/kg, approximating existing safety limits for the general public (2 W/kg) and occupational exposure (10 W/kg), did not induce significant temperature rises in the rabbit ear. However, 2.3 W/kg induced local skin temperature elevation under no blood flow conditions. Our results demonstrate that the physiological effects of blood flow should be considered when extrapolating modeling data to living animals, and particular caution is needed when interpreting the results of modeling studies that do not include blood flow.

Worst Case Temperature Rise in a One-Dimensional Tissue Model Exposed to Radiofrequency Radiation

This paper investigates the temperature rise in a 1-D layered tissue model, which is irradiated with nonionizing radiation. Of the numerous tissue configurations that correspond to realistic body trunk and limb representations, only those are examined which maximize the averaged specific absorption rate (SAR). The results show that the old IEEE standard on safety was more conservative in terms of temperature rise than the Non-Ionizing Radiation Protection guidelines. They also indicate that the removal of heat exchange from the skin surface can induce a significant temperature rise in it, which is, however, mostly due to imposing the adiabatic conditions themselves, rather than the electromagnetic energy absorption.

Radio frequency electromagnetic fields: mild hyperthermia and safety standards

This chapter is a short review of literature that serves as the basis for current safe exposure recommendations by ICNIRP (International Commission on Non-Ionizing Radiation Protection, 1998). and the IEEE C95.1 (IEEE Standard for Safety Levels with Respect to Human Exposure to Radio Frequency Electromagnetic Fields, 3 kHz to 300 GHz, 2005) for exposure to radio frequency electromagnetic radiation (RF-EMF). Covered here are topics on dosimetry, thermoregulatory responses, behavioral responses, and how these have been used to derive safe exposure limits for humans to RF-EMF. Energy in this portion of the electromagnetic spectrum, 3 kHz-300 GHz, can be uniquely absorbed and is different from ionizing radiation both in dosimetry and effects. The deposition of thermalizing energy deep in the body by exposure to RF-EMF fields provides a unique exception to the energy flows normally encountered by humans. Behavioral effects of RF-EMF exposure range from detection to complete cessation of trained behaviors. RF-EMF is detectable and can in most cases, presumably by thermal mechanisms, support aversion and disruption or complete cessation (work stoppage) of behavior. Safety standards are based on behavioral responses by laboratory animals to RF-EMF, enhanced by careful studies of human thermoregulatory responses at four specific RF frequencies, thereby providing a conservative level of protection from RF-EMF for humans.

EEG/(f)MRI measurements at 7 Tesla using a new EEG cap (“InkCap”)

We aimed at improving the signal-to-noise ratio (SNR) of electroencephalography (EEG) during magnetic resonance imaging (MRI) by introducing a new EEG cap ("InkCap") based on conductive ink technology. The InkCap was tested with temperature measurements on an electrically conductive phantom head and during structural and functional MRI (fMRI) recordings in 11 healthy human volunteers at 7 T. Combined EEG/fMRI measurements were conducted to study the interaction between the two modalities. The EEG recordings with the InkCap demonstrated up to a five-fold average decrease in signal variance during echo-planar imaging, with respect to a cap made of standard carbon fiber leads. During concurrent EEG/fMRI measurements in human volunteers, alpha oscillations were clearly detected at 7 T. Minimal artifacts were present in the T2* and high-resolution structural MR images of the brain parenchyma. Our results show that the InkCap technology considerably improves the quality of both EEG and (f)MRI during concurrent measurements even at 7 T.

On the effect of resistive EEG electrodes and leads during 7 T MRI: simulation and temperature measurement studies

The purpose of the study was to assess the effects of electrodes and leads on electromagnetic field and specific absorption rate (SAR) distributions during simultaneous electroencephalography (EEG) and 7-T MRI. Two different approaches were evaluated and compared to the case without electrodes: (a) the use of different EEG lead resistivity and (b) the use of a radiofrequency (RF) resistor on the lead near the EEG electrode. These configurations are commonly used in research and clinical settings. Electromagnetic field and SAR distributions generated by the transmit RF coil were evaluated using finite difference time domain simulations on an anatomically accurate head model. The spatiotemporal changes of temperature were estimated with the heat equation. Temperature changes during turbo spin echo sequences were also measured using a custom-made phantom: the conductive head mannequin anthropomorphic (CHEMA). The results of this study showed that the SAR and temperature distributions in CHEMA (a) increased when using low resistive leads, with respect to the no-electrode case; (b) were affected by the resistivity of the EEG leads, with carbon fiber leads performing better than standard copper leads; and (c) were not affected by the use of an RF resistor between the EEG electrode and the lead.

Empirical and theoretical dosimetry in support of whole body radio frequency (RF) exposure in seated human volunteers at 220 MHz

This study reports the dosimetry performed to support an experiment that measured physiological responses of seated volunteer human subjects exposed to 220 MHz fields. Exposures were performed in an anechoic chamber which was designed to provide uniform fields for frequencies of 100 MHz or greater. A vertical half-wave dipole with a 90 degrees reflector was used to optimize the field at the subject's location. The vertically polarized E field was incident on the dorsal side of the phantoms and human volunteers. The dosimetry plan required measurement of stationary probe drift, field strengths as a function of distance, electric and magnetic field maps at 200, 225, and 250 cm from the dipole antenna, and specific absorption rate (SAR) measurements using a human phantom, as well as theoretical predictions of SAR with the finite difference time domain (FDTD) method. A NBS (National Bureau of Standards, now NIST, National Institute of Standards and Technology, Boulder, CO) 10 cm loop antenna was positioned 150 cm to the right, 100 cm above and 60 cm behind the subject (toward the transmitting antenna) and was read prior to each subject's exposure and at 5 min intervals during all RF exposures. Transmitter stability was determined by measuring plate voltage, plate current, screen voltage and grid voltage for the driver and final amplifiers before and at 5 min intervals throughout the RF exposures. These dosimetry measurements assured accurate and consistent exposures. FDTD calculations were used to determine SAR distribution in a seated human subject. This study reports the necessary dosimetry to precisely control exposure levels for studies of the physiological consequences of human volunteer exposures to 220 MHz.