Temperature monitoring utilising thermoacoustic signals during pulsed microwave thermotherapy: A feasibility study

A Preclinical System Prototype for Focused Microwave Breast Hyperthermia Guided by Compressive Thermoacoustic Tomography

OBJECTIVE

As a newly developed technique, focused microwave breast hyperthermia (FMBH) can provide accurate and cost-effective treatment of breast tumors with low side effect. A clinically feasible FMBH system requires a guidance technique to monitor the microwave power distribution in the breast. Compressive thermoacoustic tomography (CTT) is a suitable guidance approach for FMBH, which is more cost-effective than MRI. However, no experimental validation based on a realized FMBH-CTT system has been reported, which greatly hinders the further advancement of this novel approach.

METHODS

We developed a preclinical system prototype for the FMBH-CTT technique, containing a microwave phased antenna array, a microwave source, an ultrasound transducer array and associated data acquisition module.

RESULTS

Experimental results employing homogeneous and inhomogeneous breast-mimicking phantoms demonstrate that the CTT technique can offer reliable guidance for the entire process of the FMBH. In addition, small phase noises do not deteriorate the overall performance of the system prototype.

CONCLUSION

The realized preclinical FMBH-CTT system prototype is capable for noninvasive, accurate and low-side-effect breast tumor treatment with effective guidance.

SIGNIFICANCE

The experimentally validated FMBH-CTT system prototype provides a feasible paradigm for CTT guided FMBH, establishes a practical platform for future improvement of this technique, and paves the way for potential clinical translation.

Emerging photoacoustic and thermoacoustic imaging technologies for detecting primary and metastatic cancer and guiding therapy

In recent years, there has been a progressive trend towards less invasive technologies for detecting metastatic cancer and guiding therapy with the goal of lower morbidity, better outcomes, and superior cosmetic appearance than traditional methods. This mini-review examines three emerging noninvasive hybrid technologies for detecting primary cancer, metastasis and guiding thermal therapy. Real-time thermoacoustic imaging and thermometry potentially provides valuable and critical feedback for guiding focused microwave ablation therapy. Label-free photoacoustic monitoring of cancer cells is a promising clinical diagnostic and theranostic tool for detecting metastatic disease and monitoring the response to therapy. Finally, immunologically targeted gold nanoparticles combined with photoacoustic imaging is able to detect lymph node micrometastasis in mouse models of breast cancer. These emerging techniques have the potential to improve the decision to biopsy, provide more accurate prognosis, and enhance the efficacy of therapy for early and late stage cancers.

Real-Time Volumetric Thermoacoustic Imaging and Thermometry Using a 1.5-D Ultrasound Array

Noninvasive thermal therapies for the treatment of breast cancer depend on accurate monitoring of tissue temperature to optimize treatment and ensure safety. This work describes a real-time system for 3-D thermoacoustic imaging and thermometry (TAI-TAT) for tracking temperature in tissue samples during heating. The study combines a 2.7-GHz microwave pulse generator with a custom 1.5-D 0.6 MHz ultrasound array for generating and detecting TA signals. The system is tested and validated on slabs of biological tissue and saline gel during heating. Calibration curves for relating the TA signal to temperature were calculated in saline gel (3.40%/°C), muscle (1.73%/°C), and fat (1.15%/°C), respectively. The calibrations were used to produce real-time, volumetric temperature maps at ~3-s intervals with a spatial resolution of approximately 3 mm. TAT temperature changes within a region of interest were compared to adjacent thermocouples with a mean error of 17.3%, 13.2%, and 20.4% for muscle, gel, and fat, respectively. The TAT algorithm was also able to simultaneously track temperatures in different tissues. With further development, noninvasive TAI-TAT may prove to be a valuable method for accurate and real-time feedback during breast cancer ablation therapy.

Multi-physics modeling of thermoacoustic pulse generation and propagation during pulsed microwave ablation of tissue

Microwave-induced thermoacoustic (TA) imaging is a potential alternative to conventional real-time imaging methods for monitoring microwave ablation (MWA). In this study, we develop a multi-physics model for the generation and propagation of microwave-induced TA signals during pulsed MWA. Our model couples electromagnetics, heat transfer, and acoustics physics. We compare simulation and experimental results for a pulsed MWA system wherein a coaxial MWA antenna is used to heat water. The simulated and experimentally measured TA signals for this configuration are in good qualitative agreement. This multi-physics modeling tool is valuable for understanding the fundamentals of TA signal generation and propagation from within an evolving ablation zone.

Real-time 3D thermoacoustic imaging and thermometry using a self-calibration technique

Thermoacoustic (TA) imaging is a modality where pulsed microwaves are used to generate ultrasound waves in tissue, which are highly correlated with temperature. This study uses a self-calibration approach to improve the estimation of temperature using 3D real-time TA thermometry in porcine tissue during localized heating. The self-calibration method estimated temperatures at eight embedded thermocouple locations with a normalized root-mean-square error of 3.25±2.08%. The results demonstrate that the method has the suitable accuracy and resolution to provide feedback control for breast cancer ablation therapy.

Non-Invasive Remote Temperature Monitoring Using Microwave-Induced Thermoacoustic Imaging

Non-invasive temperature monitoring of tissue at depth in real-time is critical to hyperthermia therapies such as high-intensity focused ultrasound. Knowledge of temperature allows for monitoring treatment as well as providing real-time feedback to adjust deposited power in order to maintain safe and effective temperatures. Microwave-induced thermoacoustic (TA) imaging, which combines the conductivity/dielectric contrast of microwave imaging with the resolution of ultrasound, shows potential for estimating temperature non-invasively in real-time by indirectly measuring the temperature dependent parameters from reconstructed images. In this work, we study the temperature dependent behavior of the generated pressure in the TA effect and experimentally demonstrate simultaneous imaging and temperature monitoring using TA imaging. The proof-of-concept experiments demonstrate millimeter spatial resolution while achieving degree-level accuracy.

Nonlinear Thermoacoustic Imaging Based on Temperature-Dependent Thermoelastic Response

In this paper, a novel nonlinear thermoacoustic imaging (NTAI) system is developed based on the temperature-dependent thermoelastic response under microwave irradiation. Specifically, we consider the high-pulse repetition frequency (HPRF) microwave regime, where the tissue temperature increases after microwave irradiation. In this circumstance, the temperature-dependent thermodynamic parameters of the tissue change; thus, the influence of absorbed microwave energy on the thermoacoustic (TA) amplitude is reflected in the change of thermodynamic parameters. Hence, this temperature dependence yields a nonlinear relationship between the TA amplitude and the absorbed microwave energy in the HPRF regime. In this paper, we obtain the nonlinear coefficient as a new parameter to distinguish biological tissues by performing differential measurements in the NTAI system. We further experimentally extract the nonlinear coefficient in phantom and ex vivo mouse, revealing the feasibility of applications in biological tissues identification with high contrast.

Thermoacoustic contrast of prostate cancer due to heating by very high frequency irradiation

Applying the thermoacoustic (TA) effect to diagnostic imaging was first proposed in the 1980s. The object under test is irradiated by high-power pulses of electromagnetic energy, which heat tissue and cause thermal expansion. Outgoing TA pressure pulses are detected by ultrasound transducers and reconstructed to provide images of the object. The TA contrast mechanism is strongly dependent upon the frequency of the irradiating electromagnetic pulse. When very high frequency (VHF) electromagnetic irradiation is utilized, TA signal production is driven by ionic content. Prostatic fluids contain high levels of ionic metabolites, including citrate, zinc, calcium, and magnesium. Healthy prostate glands produce more ionic metabolites than diseased glands. VHF pulses are therefore expected to generate stronger TA signal in healthy prostate glands than in diseased glands. A benchtop system for performing ex vivo TA computed tomography with VHF energy is described and images are presented. The system utilizes irradiation pulses of 700 ns duration exceeding 20 kW power. Reconstructions frequently visualize anatomic landmarks such as the urethra and verumontanum. TA reconstructions from three freshly excised human prostate glands with little, moderate, and severe cancerous involvement are compared with histology. TA signal strength is negatively correlated with percent cancerous involvement in this small sample size. For the 45 regions of interest analyzed, a reconstruction value of 0.4 mV provides 100% sensitivity but only 29% specificity. This sample size is far too small to draw sweeping conclusions, but the results warrant a larger volume study including comparison of TA images to the gold standard, histology.

Photoacoustic thermography of tissue

Photoacoustic (PA) techniques can measure temperature in biological tissues because PA signal amplitude is sensitive to tissue temperature. So far, temperature-measuring PA techniques have focused on sensing of temperature changes at a single position. In this work, we photoacoustically measured spatial distribution of temperature in deep tissue. By monitoring the temperature at a single position using a thermocouple, the relationship between the PA signal amplitude and the actual temperature was determined. The relationship was then used to translate a PA image into a temperature map. This study showed that it is possible to calibrate the system for the temperature range of hyperthermia using single-point measurements over a smaller temperature range. Our experimental results showed a precision of -0.8±0.4°C (mean±standard error) in temperature measurement, and a spatial resolution as fine as 1.0 mm. PA techniques can be potentially applied to monitor temperature distribution deep in tissue during hyperthermia treatment of cancer.

4-D photoacoustic tomography

Photoacoustic tomography (PAT) offers three-dimensional (3D) structural and functional imaging of living biological tissue with label-free, optical absorption contrast. These attributes lend PAT imaging to a wide variety of applications in clinical medicine and preclinical research. Despite advances in live animal imaging with PAT, there is still a need for 3D imaging at centimeter depths in real-time. We report the development of four dimensional (4D) PAT, which integrates time resolutions with 3D spatial resolution, obtained using spherical arrays of ultrasonic detectors. The 4D PAT technique generates motion pictures of imaged tissue, enabling real time tracking of dynamic physiological and pathological processes at hundred micrometer-millisecond resolutions. The 4D PAT technique is used here to image needle-based drug delivery and pharmacokinetics. We also use this technique to monitor 1) fast hemodynamic changes during inter-ictal epileptic seizures and 2) temperature variations during tumor thermal therapy.