Children and adults exposed to electromagnetic fields at the ICNIRP reference levels: theoretical assessment of the induced peak temperature increase

Design and Assessment of a Novel Biconical Human-Sized Alternating Magnetic Field Coil for MNP Hyperthermia Treatment of Deep-Seated Cancer

Magnetic nanoparticle (MNP) hyperthermia therapy is a treatment technique that can be used alone or as an adjunct to radiation and/or chemotherapies for killing cancer cells. During treatment, MNPs absorb a part of electromagnetic field (EMF) energy and generate localized heat when subjected to an alternating magnetic field (AMF). The MNP-absorbed EMF energy, which is characterized by a specific absorption rate (SAR), is directly proportional to AMF frequency and the magnitude of transmitting currents in the coil. Furthermore, the AMF penetrates inside tissue and induces eddy currents in electrically conducting tissues, which are proportional to the electric field (J = σE). The eddy currents produce Joule heating (<J·E> = 0.5·σ·E2) in the normal tissue, the rate of energy transfer to the charge carriers from the applied electric fields. This Joule heating contains only the electric field because the magnetic field is always perpendicular to the velocity of the conduction charges, i.e., it does not produce work on moving charge. Like the SAR due to MNP, the electric field produced by the AMF coil is directly proportional to AMF frequency and the magnitude of transmitting currents in the coil. As a result, the Joule heating is directly proportional to the square of the frequency and transmitter current magnitude. Due to the fast decay of magnetic fields from an AMF coil over distance, MNP hyperthermia treatment of deep-seated tumors requires high-magnitude transmitting currents in the coil for clinically achievable MNP distributions in the tumor. This inevitably produces significant Joule heating in the normal tissue and becomes more complicated for a standard MNP hyperthermia approach for deep-seated tumors, such as pancreatic, prostate, liver, lung, ovarian, kidney, and colorectal cancers. This paper presents a novel human-sized AMF coil and MNP hyperthermia system design for safely and effectively treating deep-seated cancers. The proposed design utilizes the spatial distribution of electric and magnetic fields of circular coils. Namely, it first minimizes the SAR due to eddy currents in the normal tissue by moving the conductors away from the tissue (i.e., increasing coils’ radii), and second, it increases the magnetic field at the targeted area (z = 0) due to elevated coils (|z| > 0) by increasing the radius of the elevated coils (|z| > 0). This approach is a promising alternative aimed at overcoming the limitation of standard MNP hyperthermia for deep-seated cancers by taking advantage of the transmitter coil’s electric and magnetic field distributions in the human body for maximizing AMF in tumor regions and avoiding damage to normal tissue. The human-sized coil’s AMF, MNP activation, and eddy current distribution characteristics are investigated for safe and effective treatment of deep-seated tumors using numerical models. Namely, computational results such as AMF, Joule heating SAR, and temperature distributions are presented for a full-body, 3D human model. The SAR and temperature distributions clearly show that the proposed human-sized AMF coil can provide clinically relevant AMF to the region occupied by deep-seated cancers for the application of MNP hyperthermia therapy while causing less Joule heating in the normal tissues than commonly used AMF techniques.

Antenna Arrangement in UWB Helmet Brain Applicators for Deep Microwave Hyperthermia

Deep microwave hyperthermia applicators are typically designed as narrow-band conformal antenna arrays with equally spaced elements, arranged in one or more rings. This solution, while adequate for most body regions, might be sub-optimal for brain treatments. The introduction of ultra-wide-band semi-spherical applicators, with elements arranged around the head and not necessarily aligned, has the potential to enhance the selective thermal dose delivery in this challenging anatomical region. However, the additional degrees of freedom in this design make the problem non-trivial. We address this by treating the antenna arrangement as a global SAR-based optimization process aiming at maximizing target coverage and hot-spot suppression in a given patient. To enable the quick evaluation of a certain arrangement, we propose a novel E-field interpolation technique which calculates the field generated by an antenna at any location around the scalp from a limited number of initial simulations. We evaluate the approximation error against full array simulations. We demonstrate the design technique in the optimization of a helmet applicator for the treatment of a medulloblastoma in a paediatric patient. The optimized applicator achieves 0.3 °C higher T90 than a conventional ring applicator with the same number of elements.

Impact of Number of Segmented Tissues on SAR Prediction Accuracy in Deep Pelvic Hyperthermia Treatment Planning

Simple Summary

Hyperthermia treatment planning is the process of optimizing treatment quality using pre-treatment simulations. Although it has become a powerful tool, prediction accuracy is strongly dependent on the patient model. For deep hyperthermia in the pelvis, it is common that only four tissue categories are discriminated (bone, fat, muscle-like, and tumor). For the head and neck region, more tissues have been shown to be required for good prediction accuracy. Delineating is a labor-intensive and difficult process. Hence, it is important to find the optimum between accuracy and labor, but for deep pelvic hyperthermia, there are no published studies showing the impact of the number of tissues. We studied the trade-off between the segmentation detail needed and segmentation feasibility. Our findings indicate that including high water content tissues can impact simulation accuracy. Although our results, in general, underline the suitability of our current clinical protocol, they help to prioritize improvements for specific cases.

Abstract

In hyperthermia, the general opinion is that pre-treatment optimization of treatment settings requires a patient-specific model. For deep pelvic hyperthermia treatment planning (HTP), tissue models comprising four tissue categories are currently discriminated. For head and neck HTP, we found that more tissues are required for increasing accuracy. In this work, we evaluated the impact of the number of segmented tissues on the predicted specific absorption rate (SAR) for the pelvic region. Highly detailed anatomical models of five healthy volunteers were selected from a virtual database. For each model, seven lists with varying levels of segmentation detail were defined and used as an input for a modeling study. SAR changes were quantified using the change in target-to-hotspot-quotient and maximum SAR relative differences, with respect to the most detailed patient model. The main finding of this study was that the inclusion of high water content tissues in the segmentation may result in a clinically relevant impact on the SAR distribution and on the predicted hyperthermia treatment quality when considering our pre-established thresholds. In general, our results underline the current clinical segmentation protocol and help to prioritize any improvements.

Modeling Tissue Heating From Exposure to Radiofrequency Energy and Relevance of Tissue Heating to Exposure Limits: Heating Factor

This review/commentary addresses recent thermal and electromagnetic modeling studies that use image-based anthropomorphic human models to establish the local absorption of radiofrequency energy and the resulting increase in temperature in the body. The frequency range of present interest is from 100 MHz through the transition frequency (where the basic restrictions in exposure guidelines change from specific absorption rate to incident power density, which occurs at 3-10 GHz depending on the guideline). Several detailed thermal modeling studies are reviewed to compare a recently introduced dosimetric quantity, the heating factor, across different exposure conditions as related to the peak temperature rise in tissue that would be permitted by limits for local body exposure. The present review suggests that the heating factor is a robust quantity that is useful for normalizing exposures across different simulation models. Limitations include lack of information about the location in the body where peak absorption and peak temperature increases occur in each exposure scenario, which are needed for careful assessment of potential hazards. To the limited extent that comparisons are possible, the thermal model (which is based on Pennes' bioheat equation) agrees reasonably well with experimental data, notwithstanding the lack of theoretical rigor of the model and uncertainties in the model parameters. In particular, the blood flow parameter is both variable with physiological condition and largely determines the steady state temperature rise. We suggest an approach to define exposure limits above and below the transition frequency (the frequency at which the basic restriction changes from specific absorption rate to incident power density) to provide consistent levels of protection against thermal hazards. More research is needed to better validate the model and to improve thermal dosimetry in general. While modeling studies have considered the effects of variation in thickness of tissue layers, the effects of normal physiological variation in tissue blood flow have been relatively unexplored.

Desktop exposure system and dosimetry for small scale in vivo radiofrequency exposure experiments

This paper describes a new approach to the risk assessment of exposure from wireless network devices, including an exposure setup and dosimetric assessment for in vivo studies. A novel desktop reverberation chamber has been developed for well-controlled exposure of mice for up to 24 h per day to address the biological impact of human exposure scenarios by wireless networks. The carrier frequency of 2.45 GHz corresponds to one of the major bands used in data communication networks and is modulated by various modulation schemes, including Global System for Mobile Communications (GSM), Universal Mobile Telecommunications System (UMTS), Radio Frequency Identification (RFID), and wireless local area network, etc. The system has been designed to enable exposures of whole-body averaged specific absorption rate (SAR) of up to 15 W/kg for six mice of an average weight of 25 g or of up to 320 V/m incident time-averaged fields under loaded conditions without distortion of the signal. The dosimetry for whole-body SAR and organ-averaged SAR of the exposed mice, with analysis of uncertainty and variation analysis, is assessed. The experimental dosimetry based on temperature measurement agrees well with the numerical dosimetry, with a very good SAR uniformity of 0.4 dB in the chamber. Furthermore, a thermal analysis and measurements were performed to provide better understanding of the temperature load and distribution in the mice during exposure.

Does exposure to environmental radiofrequency electromagnetic fields cause cognitive and behavioral effects in 10-year-old boys?

The relationship between exposure to electromagnetic fields from non-ionizing radiation and adverse human health effects remains controversial. We aimed to explore the association of environmental radiofrequency-electromagnetic fields (RF-EMFs) exposure with neurobehavioral function of children. A subsample of 123 boys belonging to the Environment and Childhood cohort from Granada (Spain), recruited at birth from 2000 through 2002, were evaluated at the age of 9-11 years. Spot electric field measurements within the 100 kHz to 6 GHz frequency range, expressed as both root mean-square (S(RMS) and maximum power density (S(MAX)) magnitudes, were performed in the immediate surrounds of childreńs dwellings. Neurocognitive and behavioral functions were assessed with a comprehensive battery of tests. Multivariate linear and logistic regression models were used, adjusting for potential confounders. All measurements were lower than reference guideline limits, with median S(RMS) and S(MAX) values of 285.94 and 2759.68 μW/m(2), respectively. Most of the cognitive and behavioral parameters did not show any effect, but children living in higher RF exposure areas (above median S(RMS) levels) had lower scores for verbal expression/comprehension and higher scores for internalizing and total problems, and obsessive-compulsive and post-traumatic stress disorders, in comparison to those living in areas with lower exposure. These associations were stronger when S(MAX) values were considered. Although some of our results may suggest that low-level environmental RF-EMF exposure has a negative impact on cognitive and/or behavior development in children; given limitations in the study design and that the majority of neurobehavioral functioning tasks were not affected, definitive conclusions cannot be drawn.

Anthropogenic Radio-Frequency Electromagnetic Fields Elicit Neuropathic Pain in an Amputation Model

Anecdotal and clinical reports have suggested that radio-frequency electromagnetic fields (RF EMFs) may serve as a trigger for neuropathic pain. However, these reports have been widely disregarded, as the epidemiological effects of electromagnetic fields have not been systematically proven, and are highly controversial. Here, we demonstrate that anthropogenic RF EMFs elicit post-neurotomy pain in a tibial neuroma transposition model. Behavioral assays indicate a persistent and significant pain response to RF EMFs when compared to SHAM surgery groups. Laser thermometry revealed a transient skin temperature increase during stimulation. Furthermore, immunofluorescence revealed an increased expression of temperature sensitive cation channels (TRPV4) in the neuroma bulb, suggesting that RF EMF-induced pain may be due to cytokine-mediated channel dysregulation and hypersensitization, leading to thermal allodynia. Additional behavioral assays were performed using an infrared heating lamp in place of the RF stimulus. While thermally-induced pain responses were observed, the response frequency and progression did not recapitulate the RF EMF effects. In vitro calcium imaging experiments demonstrated that our RF EMF stimulus is sufficient to directly contribute to the depolarization of dissociated sensory neurons. Furthermore, the perfusion of inflammatory cytokine TNF-α resulted in a significantly higher percentage of active sensory neurons during RF EMF stimulation. These results substantiate patient reports of RF EMF-pain, in the case of peripheral nerve injury, while confirming the public and scientific consensus that anthropogenic RF EMFs engender no adverse sensory effects in the general population.

Absence of acute ocular damage in humans after prolonged exposure to intense RF EMF

The eye is considered to be a critical organ when determining safety standards for radio frequency (RF) radiation. Experimental data obtained using animals showed that RF heating of the eye, particularly over a specific threshold, can induce cataracts. During the treatment of cancer in the head and neck by hyperthermia, the eyes receive a considerable dose of RF radiation due to stray radiation from the prolonged (60 min) and intense exposure at 434 MHz of this region. In the current study, we verified the exposure guidelines for humans by determining the association between the electromagnetic and thermal dose in the eyes with the reported ocular effects. We performed a simulation study to retrospectively assess the specific absorption rate (SAR) and temperature increase in the eyes of 16 selected patients (encompassing a total of 74 treatment sessions) whose treatment involved high power delivery as well as a minimal distance between the tumor site and the eye. Our results show that the basic restrictions on the peak 10 g spatial-averaged SAR (10 W kg(-1)) and peak tissue temperature increase (1 °C) are exceeded by up to 10.4 and 4.6 times, on average, and by at least 6.2 and 1.8 times when considering the lower limit of the 95% confidence interval. Evaluation of the acute effects according to patients' feedback (all patients), the common toxicity criteria scores (all patients) and an ophthalmology investigation (one patient with the highest exposure) revealed no indication of any serious acute ocular effect, even though the eyes were exposed to high electromagnetic fields, leading to a high thermal dose. We also found that, although there is a strong correlation (R (2) =  0.88) between the predicted induced SAR and temperature in the eye, there are large uncertainties regarding the temperature-SAR relationship. Given this large uncertainty (129%) compared with the uncertainty of 3D temperature simulations (61%), we recommend using temperature simulations as a dosimetric measure in electromagnetic exposure risk assessments.

Quantification of RF-exposure of the fetus using anatomical CAD-models in three different gestational stages

This study analyzes the exposure of pregnant women and their fetuses in three different gestational stages to electromagnetic radiation in the radio frequency range in the near- and the far-field using numerical modeling. For far-field exposure, the power density at which the basic restriction for the whole body SAR is reached is calculated for both the mother and the fetus at whole body resonance and at frequencies between 450 MHz and 2,450 MHz. The near-field exposure is assessed at 450 MHz, 900 MHz, and 2,450 MHz using half wavelength dipoles as generic sources located at different locations around the abdomen of the mother. For the investigated cases, the exposure of the mother is always below or on the order of magnitude of the basic restriction for exposure at the reference level. When applying the reference levels for the general public, the fetus is sufficiently shielded by the mother. However, the basic restrictions for general public exposure can be exceeded in the fetus when the mother is exposed at reference levels for occupational conditions. For plane wave exposure at occupational levels, the whole body SAR in the fetus can exceed the basic restrictions for the general population by at least 1.8 dB, and in the near-field of professional devices, the 10 g SAR can be non-compliant with the product standard for the general public by > 3.5 dB.

Significant RF-EMF and thermal levels observed in a computational model of a person with a tibial plate for grounded 40 MHz exposure

Using numerical modeling, a worst-case scenario is considered when a person with a metallic implant is exposed to a radiofrequency (RF) electromagnetic field (EMF). An adult male standing on a conductive ground plane was exposed to a 40 MHz vertically polarized plane wave field, close to whole-body resonance where maximal induced current flows are expected in the legs. A metal plate (50-300 mm long) was attached to the tibia in the left leg. The findings from this study re-emphasize the need to ensure compliance with limb current reference levels for exposures near whole-body resonance, and not just rely on compliance with ambient electric (E) and magnetic (H) field reference levels. Moreover, we emphasize this recommendation for someone with a tibial plate, as failure to comply may result in significant tissue damage (increases in the localized temperature of 5-10 °C were suggested by the modeling for an incident E-field of 61.4 V/m root mean square (rms)). It was determined that the occupational reference level for limb current (100 mA rms), as stipulated in the 1998 guidelines of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), is satisfied if the plane wave incident E-field levels are no more than 29.8 V/m rms without an implant and 23.4 V/m rms for the model with a 300 mm implant.

A measurement and modeling study of temperature in living and fixed tissue during and after radiofrequency exposure

Fluorescent intensity of the dye Rhodamine-B (Rho-B) decreases with increasing temperature. We show that in fresh rat brain tissue samples in a custom-made radiofrequency (RF) tissue exposure device, temperature rise due to RF radiation as measured by absorbed dye correlates well with temperature measured nearby by fiber optic probes. Estimates of rate of initial temperature rise (using both probe measurement and the dye method) accord well with estimates of local specific energy absorption rate (SAR). We also modeled the temperature characteristics of the exposure device using combined electromagnetic and finite-difference thermal modeling. Although there are some differences in the rate of cooling following cessation of RF exposure, there is reasonable agreement between modeling and both probe measurement and dye estimation of temperature. The dye method also permits measurement of regional temperature rise (due to RF). There is no clear evidence of local differential RF absorption, but further refinement of the method may be needed to fully clarify this issue.

Estimate of the fetal temperature increase due to UHF RFID exposure

Exposure from electromagnetic (EM) devices has increased during the last decades due to the rapid development of new technologies. Among them, radiofrequency identification (RFID) applications are used in almost every aspect of everyday life, which could expose people unselectively. This scenario could pose potential risks for certain groups of general population, such as pregnant women, who are more sensitive to thermal effects produced by EM exposure. In this paper, the temperature rise at the steady state in two pregnant women models exposed to UHF RFID has been assessed. Results show that heating of tissues is far from the threshold of biological effects indicated by radiation protection guidelines.

Stochastic method for determination of the organ-specific averaged SAR in realistic environments at 950 MHz

The organ-specific averaged specific absorption rate (SARosa ) in a heterogeneous human body phantom, the Virtual Family Boy, is determined for the first time in five realistic electromagnetic environments at the Global System for Mobile Communications downlink frequency of 950 MHz. We propose two methods based upon a fixed set of finite-difference time-domain (FDTD) simulations for generating cumulative distribution functions for the SARosa in a certain environment: an accurate vectorial cell-wise spline interpolation with an average error lower than 1.8%, and a faster scalar linear interpolation with a maximal average error of 14.3%. These errors are dependent on the angular steps chosen for the FDTD simulations. However, it is demonstrated that both methods provide the same shape of the cumulative distribution function for the studied organs in the considered environments. The SARosa depends on the considered organ and the environment. Two factors influencing the SARosa are investigated for the first time: conductivity over the density ratio of an organ, and the distance of the organ's center of gravity to the body's surface and exterior of the phantom. A non-linear regression with our model provides a correlation of 0.80. The SARosa due to single plane-wave exposure is also investigated; a worst-case single plane-wave exposure is determined for all studied organs and has been compared with realistic SARosa values. There is no fixed worst-case polarization for all organs, and a single plane-wave exposure condition that exceeds 91% of the SARosa values in a certain environment can always be found for the studied organs.

Simulation techniques in hyperthermia treatment planning

Abstract Clinical trials have shown that hyperthermia (HT), i.e. an increase of tissue temperature to 39-44 °C, significantly enhance radiotherapy and chemotherapy effectiveness [1]. Driven by the developments in computational techniques and computing power, personalised hyperthermia treatment planning (HTP) has matured and has become a powerful tool for optimising treatment quality. Electromagnetic, ultrasound, and thermal simulations using realistic clinical set-ups are now being performed to achieve patient-specific treatment optimisation. In addition, extensive studies aimed to properly implement novel HT tools and techniques, and to assess the quality of HT, are becoming more common. In this paper, we review the simulation tools and techniques developed for clinical hyperthermia, and evaluate their current status on the path from 'model' to 'clinic'. In addition, we illustrate the major techniques employed for validation and optimisation. HTP has become an essential tool for improvement, control, and assessment of HT treatment quality. As such, it plays a pivotal role in the quest to establish HT as an efficacious addition to multi-modality treatment of cancer.

CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

OBJECTIVE

To define thresholds of safe local temperature increases for MR equipment that exposes patients to radiofrequency fields of high intensities for long duration. These MR systems induce heterogeneous energy absorption patterns inside the body and can create localised hotspots with a risk of overheating.

METHODS

The MRI + EUREKA research consortium organised a "Thermal Workshop on RF Hotspots". The available literature on thresholds for thermal damage and the validity of the thermal dose (TD) model were discussed.

RESULTS/CONCLUSIONS

The following global TD threshold guidelines for safe use of MR are proposed: 1. All persons: maximum local temperature of any tissue limited to 39 °C 2. Persons with compromised thermoregulation AND (a) Uncontrolled conditions: maximum local temperature limited to 39 °C (b) Controlled conditions: TD < 2 CEM43°C 3. Persons with uncompromised thermoregulation AND (a) Uncontrolled conditions: TD < 2 CEM43°C (b) Controlled conditions: TD < 9 CEM43°C The following definitions are applied: Controlled conditions A medical doctor or a dedicated trained person can respond instantly to heat-induced physiological stress Compromised thermoregulation All persons with impaired systemic or reduced local thermoregulation

KEY POINTS

• Standard MRI can cause local heating by radiofrequency absorption. • Monitoring thermal dose (in units of CEM43°C) can control risk during MRI. • 9 CEM43°C seems an acceptable thermal dose threshold for most patients. • For skin, muscle, fat and bone,16 CEM43°C is likely acceptable.

Thermal tissue damage model analyzed for different whole-body SAR and scan durations for standard MR body coils

PURPOSE

This article investigates the safety of radiofrequency induced local thermal hotspots within a 1.5T body coil by assessing the transient local peak temperatures as a function of exposure level and local thermoregulation in four anatomical human models in different Z-positions.

METHODS

To quantize the effective thermal stress of the tissues, the thermal dose model cumulative equivalent minutes at 43°C was employed, allowing the prediction of thermal tissue damage risk and the identification of potentially hazardous MR scan-scenarios. The numerical results were validated by B1 (+) - and skin temperature measurements.

RESULTS

At continuous 4 W/kg whole-body exposure, peak tissue temperatures of up to 42.8°C were computed for the thermoregulated model (60°C in nonregulated case). When applying cumulative equivalent minutes at 43°C damage thresholds of 15 min (muscle, skin, fat, and bone) and 2 min (other), possible tissue damage cannot be excluded after 25 min for the thermoregulated model (4 min in nonregulated).

CONCLUSION

The results are found to be consistent with the history of safe use in MR scanning, but not with current safety guidelines. For future safety concepts, we suggest to use thermal dose models instead of temperatures or SAR. Special safety concerns for patients with impaired thermoregulation (e.g., the elderly, diabetics) should be addressed.

Dominant factors affecting temperature rise in simulations of human thermoregulation during RF exposure

Numerical models of the human thermoregulatory system can be used together with realistic voxel models of the human anatomy to simulate the body temperature increases caused by the power absorption from radio-frequency electromagnetic fields. In this paper, the Pennes bioheat equation with a thermoregulatory model is used for calculating local peak temperatures as well as the body-core-temperature elevation in a realistic human body model for grounded plane-wave exposures at frequencies 39, 800 and 2400 MHz. The electromagnetic power loss is solved by the finite-difference time-domain (FDTD) method, and the discretized bioheat equation is solved by the geometric multigrid method. Human thermoregulatory models contain numerous thermophysiological and computational parameters--some of which may be subject to considerable uncertainty--that affect the simulated core and local temperature elevations. The goal of this paper is to find how greatly the computed temperature is influenced by changes in various modelling parameters, such as the skin blood flow rate, models for vasodilation and sweating, and clothing and air movement. The results show that the peak temperature rises are most strongly affected by the modelling of tissue blood flow and its temperature dependence, and mostly unaffected by the central control mechanism for vasodilation and sweating. Almost the opposite is true for the body-core-temperature rise, which is however typically greatly lower than the peak temperature rise. It also seems that ignoring the thermoregulation and the blood temperature increase is a good approximation when the local 10 g averaged specific absorption rate is smaller than 10 W kg(-1).

Local SAR enhancements in anatomically correct children and adult models as a function of position within 1.5 T MR body coil

Usage of magnetic resonance imaging (MRI) is continuously increasing due to its excellent soft-tissue contrast and improving diagnostic values. MRI also has the advantage that it operates without ionizing radiation. The main safety concerns are torque, acceleration by the static field, nerve stimulation by the gradient fields, and tissue heating by the radio-frequency (RF) fields. This paper investigates if children and fetuses are at higher risks than adults when the current RF regulations are applied. We analyzed and compared local absorption hotspots, i.e., the peak spatial specific absorption rate averaged over any 10 g (psSAR10g) for five adults, three children of ages 5, 11 and 14 years, and 1 pregnant female (36 weeks' gestation) in 10 different Z-positions (head to calves). In the First Level Operating Mode (4 W/kg whole-body averaged exposure), the psSAR10g values found for adults were as large as 60 W/kg in the trunk and 104 W/kg in the extremities. The corresponding values for children were 43 and 58 W/kg, respectively, and 14 W/kg for the unborn child. Modeling of worst case anatomical RF loops can substantially increase the psSAR10g values, i.e., by factor >>2. The results suggest that local exposure for children and fetuses is smaller than for adults (15-75%), i.e., no special considerations for children and the unborn child are needed regarding psSAR10g due to RF. However, the local thermal load of the unborn may be significantly increased due to the high exposure average (up to 4 W/kg) of the non-perfused amniotic fluid.