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Carrapiço-Seabra C, De Lazzari M, Ameziane A, van Rhoon GC, Dobšícek Trefná H, Curto S. Application of the ESHO-QA guidelines for determining the performance of the LCA superficial hyperthermia heating system. Int J Hyperthermia 2023; 40:2272578. [PMID: 37879635 DOI: 10.1080/02656736.2023.2272578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/15/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE This study aimed to assess the quality of the lucite cone applicator (LCA), the standard applicator for superficial hyperthermia at the Erasmus MC Cancer Institute, using the most recent quality assurance guidelines, thus verifying their feasibility. MATERIALS AND METHODS The assessment was conducted on each of the six LCAs available for clinical treatments. The temperature distribution was evaluated using an infrared camera across different layers of a fat-muscle mimicking phantom. The maximum temperature increase, thermal effective penetration depth (TEPD), and thermal effective field size (TEFS) were used as quality metrics. The experimental results were validated through comparison with simulated results, using a canonical phantom model and a realistic phantom model segmented from CT imaging. RESULTS A maximum temperature increase above 6 °C at 2 cm depth in the fat-muscle phantom for all the experiments was found. A mean negative difference between simulated and experimental data was of 1.3 °C when using the canonical phantom model. This value decreased to a mean negative difference of 0.4 °C when using the realistic model. Simulated and measured TEPD showed good agreement for both in silico scenarios, while discrepancies were present for TEFS. CONCLUSIONS The LCAs passed all QA guidelines requirements for superficial hyperthermia delivery when used singularly or in an array configuration. A further characterization of parameters such as antenna efficiency and heat transfer coefficients would be beneficial for translating experimental results to simulated values. Implementing the QA guidelines was time-consuming and demanding, requiring careful preparation and correct setup of antenna elements.
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Affiliation(s)
- Carolina Carrapiço-Seabra
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mattia De Lazzari
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Abdelali Ameziane
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Gerard C van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Radiation Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | - Hana Dobšícek Trefná
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
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De Lazzari M, Ström A, Farina L, Silva NP, Curto S, Trefná HD. Ethylcellulose-stabilized fat-tissue phantom for quality assurance in clinical hyperthermia. Int J Hyperthermia 2023; 40:2207797. [PMID: 37196995 DOI: 10.1080/02656736.2023.2207797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Phantoms accurately mimicking the electromagnetic and thermal properties of human tissues are essential for the development, characterization, and quality assurance (QA) of clinically used equipment for Hyperthermia Treatment (HT). Currently, a viable recipe for a fat equivalent phantom is not available, mainly due to challenges in the fabrication process and fast deterioration. MATERIALS AND METHODS We propose to employ a glycerol-in-oil emulsion stabilized with ethylcellulose to develop a fat-mimicking material. The dielectric, rheological, and thermal properties of the phantom have been assessed by state-of-the-art measurement techniques. The full-size phantom was then verified in compliance with QA guidelines for superficial HT, both numerically and experimentally, considering the properties variability. RESULTS Dielectric and thermal properties were proven equivalent to fat tissue, with an acceptable variability, in the 8 MHz to 1 GHz range. The rheology measurements highlighted enhanced mechanical stability over a large temperature range. Both numerical and experimental evaluations proved the suitability of the phantom for QA procedures. The impact of the dielectric property variations on the temperature distribution has been numerically proven to be limited (around 5%), even if higher for capacitive devices (up to 20%). CONCLUSIONS The proposed fat-mimicking phantom is a good candidate for hyperthermia technology assessment processes, adequately representing both dielectric and thermal properties of the human fat tissue while maintaining structural stability even at elevated temperatures. However, further experimental investigations on capacitive heating devices are necessary to better assess the impact of the low electrical conductivity values on the thermal distribution.
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Affiliation(s)
- Mattia De Lazzari
- Biomedical Electromagnetics, Electrical Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Anna Ström
- Applied Chemistry, Chemistry and Chemical Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Laura Farina
- Translational Medical Device Lab, University of Galway, Galway, Ireland
| | - Nuno P Silva
- Translational Medical Device Lab, University of Galway, Galway, Ireland
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Hana Dobšíček Trefná
- Biomedical Electromagnetics, Electrical Engineering, Chalmers University of Technology, Göteborg, Sweden
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Androulakis I, Sumser K, Machielse MND, Koppert L, Jager A, Nout R, Franckena M, van Rhoon GC, Curto S. Patient-derived breast model repository, a tool for hyperthermia treatment planning and applicator design. Int J Hyperthermia 2022; 39:1213-1221. [DOI: 10.1080/02656736.2022.2121862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Ioannis Androulakis
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Kemal Sumser
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Melanie N. D. Machielse
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Linetta Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Remi Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - Gerard C. van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
- Department of Radiation Science and Technology, Delft University of Technology, Delft, The Netherlands
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
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VilasBoas-Ribeiro I, Nouwens SAN, Curto S, Jager BD, Franckena M, van Rhoon GC, Heemels WPMH, Paulides MM. POD-Kalman filtering for improving noninvasive 3D temperature monitoring in MR-guided hyperthermia. Med Phys 2022; 49:4955-4970. [PMID: 35717578 PMCID: PMC9545729 DOI: 10.1002/mp.15811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 12/21/2022] Open
Abstract
Background During resonance frequency (RF) hyperthermia treatment, the temperature of the tumor tissue is elevated to the range of 39–44°C. Accurate temperature monitoring is essential to guide treatments and ensure precise heat delivery and treatment quality. Magnetic resonance (MR) thermometry is currently the only clinical method to measure temperature noninvasively in a volume during treatment. However, several studies have shown that this approach is not always sufficiently accurate for thermal dosimetry in areas with motion, such as the pelvic region. Model‐based temperature estimation is a promising approach to correct and supplement 3D online temperature estimation in regions where MR thermometry is unreliable or cannot be measured. However, complete 3D temperature modeling of the pelvic region is too complex for online usage. Purpose This study aimed to evaluate the use of proper orthogonal decomposition (POD) model reduction combined with Kalman filtering to improve temperature estimation using MR thermometry. Furthermore, we assessed the benefit of this method using data from hyperthermia treatment where there were limited and unreliable MR thermometry measurements. Methods The performance of POD–Kalman filtering was evaluated in several heating experiments and for data from patients treated for locally advanced cervical cancer. For each method, we evaluated the mean absolute error (MAE) concerning the temperature measurements acquired by the thermal probes, and we assessed the reproducibility and consistency using the standard deviation of error (SDE). Furthermore, three patient groups were defined according to susceptibility artifacts caused by the level of intestinal gas motion to assess if the POD–Kalman filtering could compensate for missing and unreliable MR thermometry measurements. Results First, we showed that this method is beneficial and reproducible in phantom experiments. Second, we demonstrated that the combined method improved the match between temperature prediction and temperature acquired by intraluminal thermometry for patients treated for locally advanced cervical cancer. Considering all patients, the POD–Kalman filter improved MAE by 43% (filtered MR thermometry = 1.29°C, POD–Kalman filtered temperature = 0.74°C). Moreover, the SDE was improved by 47% (filtered MR thermometry = 1.16°C, POD–Kalman filtered temperature = 0.61°C). Specifically, the POD–Kalman filter reduced the MAE by approximately 60% in patients whose MR thermometry was unreliable because of the great amount of susceptibilities caused by the high level of intestinal gas motion. Conclusions We showed that the POD–Kalman filter significantly improved the accuracy of temperature monitoring compared to MR thermometry in heating experiments and hyperthermia treatments. The results demonstrated that POD–Kalman filtering can improve thermal dosimetry during RF hyperthermia treatment, especially when MR thermometry is inaccurate.
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Affiliation(s)
- Iva VilasBoas-Ribeiro
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sven A N Nouwens
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Bram de Jager
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Gerard C van Rhoon
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Radiation Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - W P M H Heemels
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Margarethus M Paulides
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Care and Cure Research Lab (EM-4C&C) of the Electromagnetics Group, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Said Camilleri J, Farrugia L, Curto S, Rodrigues DB, Farina L, Caruana Dingli G, Bonello J, Farhat I, Sammut CV. Review of Thermal and Physiological Properties of Human Breast Tissue. Sensors (Basel) 2022; 22:s22103894. [PMID: 35632302 PMCID: PMC9143271 DOI: 10.3390/s22103894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023]
Abstract
Electromagnetic thermal therapies for cancer treatment, such as microwave hyperthermia, aim to heat up a targeted tumour site to temperatures within 40 and 44 °C. Computational simulations used to investigate such heating systems employ the Pennes’ bioheat equation to model the heat exchange within the tissue, which accounts for several tissue properties: density, specific heat capacity, thermal conductivity, metabolic heat generation rate, and blood perfusion rate. We present a review of these thermal and physiological properties relevant for hyperthermia treatments of breast including fibroglandular breast, fatty breast, and breast tumours. The data included in this review were obtained from both experimental measurement studies and estimated properties of human breast tissues. The latter were used in computational studies of breast thermal treatments. The measurement methods, where available, are discussed together with the estimations and approximations considered for values where measurements were unavailable. The review concludes that measurement data for the thermal and physiological properties of breast and tumour tissue are limited. Fibroglandular and fatty breast tissue properties are often approximated from those of generic muscle or fat tissue. Tumour tissue properties are mostly obtained from approximating equations or assumed to be the same as those of glandular tissue. We also present a set of reliable data, which can be used for more accurate modelling and simulation studies to better treat breast cancer using thermal therapies.
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Affiliation(s)
- Jeantide Said Camilleri
- Department of Physics, Faculty of Science, University of Malta, MSD 2080 Msida, Malta; (L.F.); (J.B.); (I.F.); (C.V.S.)
- Correspondence:
| | - Lourdes Farrugia
- Department of Physics, Faculty of Science, University of Malta, MSD 2080 Msida, Malta; (L.F.); (J.B.); (I.F.); (C.V.S.)
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands;
| | - Dario B. Rodrigues
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Laura Farina
- Translational Medical Device Lab, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | | | - Julian Bonello
- Department of Physics, Faculty of Science, University of Malta, MSD 2080 Msida, Malta; (L.F.); (J.B.); (I.F.); (C.V.S.)
| | - Iman Farhat
- Department of Physics, Faculty of Science, University of Malta, MSD 2080 Msida, Malta; (L.F.); (J.B.); (I.F.); (C.V.S.)
| | - Charles V. Sammut
- Department of Physics, Faculty of Science, University of Malta, MSD 2080 Msida, Malta; (L.F.); (J.B.); (I.F.); (C.V.S.)
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Seabra C, Curto S, van Rhoon G. PO-1465 Factors influencing hyperthermia in vivo thermal dosimetry, a systematic review. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03429-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seabra C, VilasBoas-Ribeiro I, Sumser K, Curto S, van Rhoon G. PD-0902 First commissioning tests of the BSD2000-3D Universal Arch MR-compatible hyperthermia device. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02981-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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8
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Curto S, Androulakis J, Machielse M, Sumser K, Paulides M, Franckena M, Koppert L, Jager A, Van Rhoon G. PO-1192 Treatment planning for thermotherapy as adjuvant strategy to breast cancer preoperative radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03156-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Paulides MM, Rodrigues DB, Bellizzi GG, Sumser K, Curto S, Neufeld E, Montanaro H, Kok HP, Dobsicek Trefna H. ESHO benchmarks for computational modeling and optimization in hyperthermia therapy. Int J Hyperthermia 2021; 38:1425-1442. [PMID: 34581246 DOI: 10.1080/02656736.2021.1979254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The success of cancer hyperthermia (HT) treatments is strongly dependent on the temperatures achieved in the tumor and healthy tissues as it correlates with treatment efficacy and safety, respectively. Hyperthermia treatment planning (HTP) simulations have become pivotal for treatment optimization due to the possibility for pretreatment planning, optimization and decision making, as well as real-time treatment guidance. MATERIALS AND METHODS The same computational methods deployed in HTP are also used for in silico studies. These are of great relevance for the development of new HT devices and treatment approaches. To aid this work, 3 D patient models have been recently developed and made available for the HT community. Unfortunately, there is no consensus regarding tissue properties, simulation settings, and benchmark applicators, which significantly influence the clinical relevance of computational outcomes. RESULTS AND DISCUSSION Herein, we propose a comprehensive set of applicator benchmarks, efficacy and safety optimization algorithms, simulation settings and clinical parameters, to establish benchmarks for method comparison and code verification, to provide guidance, and in view of the 2021 ESHO Grand Challenge (Details on the ESHO grand challenge on HTP will be provided at https://www.esho.info/). CONCLUSION We aim to establish guidelines to promote standardization within the hyperthermia community such that novel approaches can quickly prove their benefit as quickly as possible in clinically relevant simulation scenarios. This paper is primarily focused on radiofrequency and microwave hyperthermia but, since 3 D simulation studies on heating with ultrasound are now a reality, guidance as well as a benchmark for ultrasound-based hyperthermia are also included.
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Affiliation(s)
- Margarethus M Paulides
- Electromagnetics for Care & Cure Laboratory (EM4C&C), Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Radiotherapy, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Dario B Rodrigues
- Hyperthermia Therapy Program, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Gennaro G Bellizzi
- Department of Radiotherapy, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Kemal Sumser
- Department of Radiotherapy, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Sergio Curto
- Department of Radiotherapy, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Esra Neufeld
- Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland
| | - Hazael Montanaro
- Foundation for Research on Information Technologies in Society (IT'IS), Zurich, Switzerland.,Laboratory for Acoustics/Noise control, Swiss Federal Laboratories for Materials Science and Technology (EMPA), Dubendorf, Switzerland
| | - H Petra Kok
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Hana Dobsicek Trefna
- Biomedical Electromagnetics Group, Department of Electrical Engineering, Chalmers University of Technology, Göteborg, Sweden
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Priester MI, Curto S, van Rhoon GC, ten Hagen TLM. External Basic Hyperthermia Devices for Preclinical Studies in Small Animals. Cancers (Basel) 2021; 13:cancers13184628. [PMID: 34572855 PMCID: PMC8470307 DOI: 10.3390/cancers13184628] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary The application of mild hyperthermia can be beneficial for solid tumor treatment by induction of sublethal effects on a tissue- and cellular level. When designing a hyperthermia experiment, several factors should be taken into consideration. In this review, multiple elementary hyperthermia devices are described in detail to aid standardization of treatment design. Abstract Preclinical studies have shown that application of mild hyperthermia (40–43 °C) is a promising adjuvant to solid tumor treatment. To improve preclinical testing, enhance reproducibility, and allow comparison of the obtained results, it is crucial to have standardization of the available methods. Reproducibility of methods in and between research groups on the same techniques is crucial to have a better prediction of the clinical outcome and to improve new treatment strategies (for instance with heat-sensitive nanoparticles). Here we provide a preclinically oriented review on the use and applicability of basic hyperthermia systems available for solid tumor thermal treatment in small animals. The complexity of these techniques ranges from a simple, low-cost water bath approach, irradiation with light or lasers, to advanced ultrasound and capacitive heating devices.
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Affiliation(s)
- Marjolein I. Priester
- Laboratory of Experimental Oncology, Department of Pathology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands;
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.)
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.)
| | - Gerard C. van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.)
| | - Timo L. M. ten Hagen
- Laboratory of Experimental Oncology, Department of Pathology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands;
- Correspondence:
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van Rhoon G, Paulides M, Curto S. SP-0341 Clinical heating techniques, thermometry and quality assurance. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08559-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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VilasBoas-Ribeiro I, Curto S, van Rhoon GC, Franckena M, Paulides MM. MR Thermometry Accuracy and Prospective Imaging-Based Patient Selection in MR-Guided Hyperthermia Treatment for Locally Advanced Cervical Cancer. Cancers (Basel) 2021; 13:cancers13143503. [PMID: 34298716 PMCID: PMC8303939 DOI: 10.3390/cancers13143503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Monitoring and controlling the temperature distribution combined with precise energy delivery are key components for hyperthermia treatment success. Magnetic resonance (MR) imaging is used clinically to monitor the temperature of the treated volume non-invasively. However, there are no comprehensive systematic studies on MR thermometry accuracy during deep pelvic hyperthermia, and the few investigational studies suffer from a high probability of bias due to lacking objective criteria for data inclusion. This study presents the first systematic analysis and defines an imaging-based criterion for prospective patient selection to standardize clinical MR thermometry accuracy assessments. Abstract The efficacy of a hyperthermia treatment depends on the delivery of well-controlled heating; hence, accurate temperature monitoring is essential for ensuring effective treatment. For deep pelvic hyperthermia, there are no comprehensive and systematic reports on MR thermometry. Moreover, data inclusion generally lacks objective selection criteria leading to a high probability of bias when comparing results. Herein, we studied whether imaging-based data inclusion predicts accuracy and could serve as a tool for prospective patient selection. The accuracy of the MR thermometry in patients with locally advanced cervical cancer was benchmarked against intraluminal temperature. We found that gastrointestinal air motion at the start of the treatment, quantified by the Jaccard similarity coefficient, was a good predictor for MR thermometry accuracy. The results for the group that was selected for low gastrointestinal air motion improved compared to the results for all patients by 50% (accuracy), 26% (precision), and 80% (bias). We found an average MR thermometry accuracy of 2.0 °C when all patients were considered and 1.0 °C for the selected group. These results serve as the basis for comprehensive benchmarking of novel technologies. The Jaccard similarity coefficient also has good potential to prospectively determine in which patients the MR thermometry will be valuable.
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Affiliation(s)
- Iva VilasBoas-Ribeiro
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Correspondence:
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
| | - Gerard C. van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Department of Radiation Science and Technology, Faculty of Applied Sciences, Delft University of Technology, 2629 JB Delft, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
| | - Margarethus M. Paulides
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Center for Care and Cure Technologies Eindhoven (C3Te), Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
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Bellizzi GG, Sumser K, VilasBoas-Ribeiro I, Curto S, Drizdal T, van Rhoon GC, Franckena M, Paulides MM. Standardization of patient modeling in hyperthermia simulation studies: introducing the Erasmus Virtual Patient Repository. Int J Hyperthermia 2021; 37:608-616. [PMID: 32515240 DOI: 10.1080/02656736.2020.1772996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose: Thermal dose-effect relations have demonstrated that clinical effectiveness of hyperthermia would benefit from more controlled heating of the tumor. Hyperthermia treatment planning (HTP) is a potent tool to study strategies enabling target conformal heating, but its accuracy is affected by patient modeling approximations. Homogeneous phantoms models are being used that do not match the body shape of patients in treatment position and often have unrealistic target volumes. As a consequence, simulation accuracy is affected, and performance comparisons are difficult. The aim of this study is to provide the first step toward standardization of HTP simulation studies in terms of patient modeling by introducing the Erasmus Virtual Patient Repository (EVPR): a virtual patient model database.Methods: Four patients with a tumor in the head and neck or the pelvis region were selected, and corresponding models were created using a clinical segmentation procedure. Using the Erasmus University Medical Center standard procedure, HTP was applied to these models and compared to HTP for commonly used surrogate models.Results: Although this study was aimed at presenting the EVPR database, our study illustrates that there is a non-negligible difference in the predicted SAR patterns between patient models and homogeneous phantom-based surrogate models. We further demonstrate the difference between actual and simplified target volumes being used today.Conclusion: Our study describes the EVPR for the research community as a first step toward standardization of hyperthermia simulation studies.
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Affiliation(s)
- Gennaro G Bellizzi
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kemal Sumser
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Iva VilasBoas-Ribeiro
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sergio Curto
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tomas Drizdal
- Department of Biomedical Technology, Czech Technical University in Prague, Prague, Czech Republic
| | - Gerard C van Rhoon
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Martine Franckena
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Margarethus M Paulides
- Hyperthermia Unit, Department of Radiation Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Adibzadeh F, Sumser K, Curto S, Yeo DTB, Shishegar AA, Paulides MM. Systematic review of pre-clinical and clinical devices for magnetic resonance-guided radiofrequency hyperthermia. Int J Hyperthermia 2020; 37:15-27. [PMID: 31918599 DOI: 10.1080/02656736.2019.1705404] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Clinical trials have demonstrated the therapeutic benefits of adding radiofrequency (RF) hyperthermia (HT) as an adjuvant to radio- and chemotherapy. However, maximum utilization of these benefits is hampered by the current inability to maintain the temperature within the desired range. RF HT treatment quality is usually monitored by invasive temperature sensors, which provide limited data sampling and are prone to infection risks. Magnetic resonance (MR) temperature imaging has been developed to overcome these hurdles by allowing noninvasive 3D temperature monitoring in the target and normal tissues. To exploit this feature, several approaches for inserting the RF heating devices into the MR scanner have been proposed over the years. In this review, we summarize the status quo in MR-guided RF HT devices and analyze trends in these hybrid hardware configurations. In addition, we discuss the various approaches, extract best practices and identify gaps regarding the experimental validation procedures for MR - RF HT, aimed at converging to a common standard in this process.
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Affiliation(s)
- Fatemeh Adibzadeh
- Department of Radiation Oncology, Erasmus MC - Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Electrical Engineering, Technical University of Sharif, Tehran, Iran
| | - Kemal Sumser
- Department of Radiation Oncology, Erasmus MC - Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sergio Curto
- Department of Radiation Oncology, Erasmus MC - Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Amir A Shishegar
- Department of Electrical Engineering, Technical University of Sharif, Tehran, Iran
| | - Margarethus M Paulides
- Department of Radiation Oncology, Erasmus MC - Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Electrical Engineering, Technical University of Eindhoven, Eindhoven, The Netherlands
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15
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Trujillo M, Prakash P, Faridi P, Radosevic A, Curto S, Burdio F, Berjano E. How large is the periablational zone after radiofrequency and microwave ablation? Computer-based comparative study of two currently used clinical devices. Int J Hyperthermia 2020; 37:1131-1138. [PMID: 32996794 PMCID: PMC7714001 DOI: 10.1080/02656736.2020.1823022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose: To compare the size of the coagulation (CZ) and periablational (PZ) zones created with two commercially available devices in clinical use for radiofrequency (RFA) and microwave ablation (MWA), respectively. Methods: Computer models were used to simulate RFA with a 3-cm Cool-tip applicator and MWA with an Amica-Gen applicator. The Arrhenius model was used to compute the damage index (Ω). CZ was considered when Ω> 4.6 (>99% of damaged cells). Regions with 0.6<Ω< 2.1 were considered as the PZ (tissue that has undergone moderate sub-ablative hyperthermia). The ratio of PZ volume to CZ volume (PZ/CZ) was regarded as a measure of performance, since a low value implies achieving a large CZ while keeping the PZ small. Results: Ten-min RFA (51 W) created smaller periablational zones than 10-min MWA (11.3 cm3 vs. 17.2 22.9 cm3, for 60 100 W MWA, respectively). Prolonging duration from 5 to 10 min increased the PZ in MWA more than in RFA (2.7 cm3 for RFA vs. 8.3–11.9 cm3 for 60–100 W MWA, respectively). PZ/CZ for RFA were relatively high (65–69%), regardless of ablation time, while those for MWA were highly dependent on the duration (increase of up to 25% between 5 and 10 min) and on the applied power (smaller values as power was raised, 102% for 60 W vs. 81% for 100 W, both for 10 min). The lowest PZ/CZ across all settings was 56%, obtained with 100 W-5 min MWA. Conclusions: Although RFA creates smaller periablational zones than MWA, 100 W-5 min MWA provides the lowest PZ/CZ.
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Affiliation(s)
- Macarena Trujillo
- BioMIT, Department of Applied Mathematics, Universitat Politècnica de València, Valencia, Spain
| | - Punit Prakash
- Mike Wiegers Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | - Pegah Faridi
- Mike Wiegers Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS, USA
| | | | - Sergio Curto
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
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16
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Curto S, Mulder HT, Aklan B, Mils O, Schmidt M, Lamprecht U, Peller M, Wessalowski R, Lindner LH, Fietkau R, Zips D, van Holthe N, Franckena M, Paulides MM, van Rhoon GC. A multi-institution study: comparison of the heating patterns of five different MR-guided deep hyperthermia systems using an anthropomorphic phantom. Int J Hyperthermia 2020; 37:1103-1115. [DOI: 10.1080/02656736.2020.1810331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sergio Curto
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Hendrik Thijmen Mulder
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Bassim Aklan
- Department of Internal Medicine III, Ludwig-Maximilians University Hospital, Munich, Germany
| | - Oliver Mils
- Department of Pediatric Hematology, Oncology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Manfred Schmidt
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Ulf Lamprecht
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Michael Peller
- Department of Radiology, Ludwig-Maximilians University Hospital, Munich, Germany
| | - Ruediger Wessalowski
- Department of Pediatric Hematology, Oncology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Lars H. Lindner
- Department of Internal Medicine III, Ludwig-Maximilians University Hospital, Munich, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Daniel Zips
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Netteke van Holthe
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Martine Franckena
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Margarethus M. Paulides
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Gerard C. van Rhoon
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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Paulides M, Dobsicek Trefna H, Curto S, Rodrigues D. Recent technological advancements in radiofrequency- andmicrowave-mediated hyperthermia for enhancing drug delivery. Adv Drug Deliv Rev 2020; 163-164:3-18. [PMID: 32229271 DOI: 10.1016/j.addr.2020.03.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/23/2022]
Abstract
Hyperthermia therapy is a potent enhancer of chemotherapy and radiotherapy. In particular, microwave (MW) and radiofrequency (RF) hyperthermia devices provide a variety of heating approaches that can treat most cancers regardless the size. This review introduces the physics of MW/RF hyperthermia, the current state-of-the-art systems for both localized and regional heating, and recent advancements in hyperthermia treatment guidance using real-time computational simulations and magnetic resonance thermometry. Clinical trials involving RF/MW hyperthermia as adjuvant for chemotherapy are also presented per anatomical site. These studies favor the use of adjuvant hyperthermia since it significantly improves curative and palliative clinical outcomes. The main challenge of hyperthermia is the distribution of state-of-the-art heating systems. Nevertheless, we anticipate that recent technology advances will expand the use of hyperthermia to chemotherapy centers for enhanced drug delivery. These new technologies hold great promise not only for (image-guided) perfusion modulation and sensitization for cytotoxic drugs, but also for local delivery of various compounds using thermosensitive liposomes.
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Mulder HT, Curto S, Paulides MM, Franckena M, van Rhoon GC. Systematic quality assurance of the BSD2000-3D MR-compatible hyperthermia applicator performance using MR temperature imaging. Int J Hyperthermia 2018; 35:305-313. [PMID: 30204006 DOI: 10.1080/02656736.2018.1497209] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Radiofrequency (RF) mild hyperthermia (40 °C-44 °C for 60 minutes) is an effective adjuvant treatment for several types of cancer. To ensure treatment efficacy, quality assurance (QA) is necessary. This study presents the first systematic 3D characterisation of the heating performance of the commonly used Pyrexar BSD2000-3D MR-compatible hyperthermia applicator using magnetic resonance temperature imaging (MRTI). METHODS A reproducibly positioned phantom was heated with a power of 1000 watts during the 12.4 min needed to measure eight temperature distributions using MRTI. The target heating location was systematically varied between experiments. We analysed focus shape characteristics, steering accuracy, focus deformation due to steering, presence of off-target heating and reproducibility. RESULTS The mean maximum temperature increase was 5.9 ± 0.4 °C. The mean full width half maximum (FWHM) was 14.4 ± 0.5 cm in the XY plane and 24.5 ± 0.8 cm in Z-direction. The mean steering error was 0.4 ± 0.2 cm. The focus shape slightly varied between experiments, depending on steering distance in Y-direction. Off-target heating was not detected. Reproducibility of the focus amplitude and shape was determined by comparing the mean deviation from the mean temperature in the central slice was 0.3 ± 0.2 °C. CONCLUSION The Pyrexar BSD2000-3D MR-compatible applicator provides robust and reproducible heating. The upper boundary of the 95% confidence interval of the spatial steering accuracy is 0.9 cm, i.e. sufficient to fulfil the criterion of ≤0.2 °C temperature variation due to positioning errors as defined by Canters et al.
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Affiliation(s)
- Hendrik Thijmen Mulder
- a Radiation Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam , The Netherlands
| | - Sergio Curto
- a Radiation Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam , The Netherlands
| | | | - Martine Franckena
- a Radiation Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam , The Netherlands
| | - Gerard C van Rhoon
- a Radiation Oncology, Erasmus Medical Centre Cancer Institute , Rotterdam , The Netherlands
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Curto S, Faridi P, Shrestha TB, Pyle M, Maurmann L, Troyer D, Bossmann SH, Prakash P. An integrated platform for small-animal hyperthermia investigations under ultra-high-field MRI guidance. Int J Hyperthermia 2017; 34:341-351. [PMID: 28728442 DOI: 10.1080/02656736.2017.1339126] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Integrating small-animal experimental hyperthermia instrumentation with magnetic resonance imaging (MRI) affords real-time monitoring of spatial temperature profiles. This study reports on the development and preliminary in vivo characterisation of a 2.45 GHz microwave hyperthermia system for pre-clinical small animal investigations, integrated within a 14 T ultra-high-field MRI scanner. MATERIALS AND METHODS The presented system incorporates a 3.5 mm (OD) directional microwave hyperthermia antenna, positioned adjacent to the small-animal target, radiating microwave energy for localised heating of subcutaneous tumours. The applicator is integrated within the 30 mm bore of the MRI system. 3D electromagnetic and biothermal simulations were implemented to characterise hyperthermia profiles from the directional microwave antenna. Experiments in tissue mimicking phantoms were performed to assess hyperthermia profiles and validate MR thermometry against fibre-optic temperature measurements. The feasibility of delivering in vivo hyperthermia exposures to subcutaneous 4T1 tumours in experimental mice under simultaneous MR thermometry guidance was assessed. RESULTS Simulations and experiments in tissue mimicking phantoms demonstrated the feasibility of heating 21-982 mm3 targets with 8-12 W input power. Minimal susceptibility and electrical artefacts introduced by the hyperthermia applicator were observed on MR imaging. MR thermometry was in excellent agreement with fibre-optic temperatures measurements (max. discrepancy ≤0.6 °C). Heating experiments with the reported system demonstrated the feasibility of heating subcutaneous tumours in vivo with simultaneous MR thermometry. CONCLUSIONS A platform for small-animal hyperthermia investigations under ultra-high-field MR thermometry was developed and applied to heating subcutaneous tumours in vivo.
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Affiliation(s)
- Sergio Curto
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
| | - Pegah Faridi
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
| | - Tej B Shrestha
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Marla Pyle
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Leila Maurmann
- c Department of Chemistry , Kansas State University , Manhattan , KS , USA
| | - Deryl Troyer
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Stefan H Bossmann
- c Department of Chemistry , Kansas State University , Manhattan , KS , USA
| | - Punit Prakash
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
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Sebek J, Curto S, Eaton-Evans J, Bouchier-Hayes J, Ruvio G, Ganta C, Beard W, Buttar N, Song LWK, Prakash P. Feasibility Assessment of Microwave Ablation for Treating Esophageal Varices. J Med Device 2017. [DOI: 10.1115/1.4037187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Esophageal varices are a significant complication of portal hypertension. Endoscopic variceal ligation (EVL) is one of the clinical standards for treating these varices and preventing their hemorrhage. Limitations of EVL include the risk of stricture formation and postband ulcer bleeding due to the damage caused to the esophageal mucosa, as well as the need for multiple endoscopic treatment sessions to eradicate the varices. The goal of this study is to develop a device and evaluate the technical feasibility of microwave ablation to seal esophageal varices, while preventing thermal damage to the surface mucosal tissue. A microwave applicator with a directional radiation pattern was developed for endoscopic ablation of esophageal varices. Electromagnetic and bioheat transfer computational models were employed to optimize the design of the microwave applicator and evaluate energy delivery strategies for this application. Experiments in ex vivo and in vivo tissue were employed to verify simulation results. Simulations predicted enhanced heating performance of the antenna using an angled monopole radiating element. Further, simulations indicate that while the endoscopic cap attenuated electric fields in tissue, it also enhanced surface cooling of tissue, increasing the likelihood of preserving mucosal tissue. Experiments in ex vivo tissue indicated the feasibility of sealing veins with 77 W microwave power delivered for 30 s. In vivo experiments demonstrated the ability to seal veins, while preserving surface tissue. This study demonstrated the technical feasibility of microwave thermal ablation for treating esophageal varices using a 2.45 GHz water-cooled directional microwave applicator.
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Affiliation(s)
- Jan Sebek
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS 66506; Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, Praha 6 166 27, Czech Republic e-mail:
| | - Sergio Curto
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS 66506 e-mail:
| | - Jimmy Eaton-Evans
- School of Engineering and Informatics, NUIG, Galway H91 TK33, Ireland e-mail:
| | | | - Giuseppe Ruvio
- School of Engineering and Informatics, NUIG, Galway H91 TK33, Ireland e-mail:
| | - Chanran Ganta
- Department of Diagnostic Medicine and Pathobiology, Kansas State University, 1800 Denison Avenue, Manhattan, KS 66506 e-mail:
| | - Warren Beard
- Department of Clinical Sciences, Kansas State University, 1800 Denison Avenue, Manhattan, KS 66506 e-mail:
| | - Navtej Buttar
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905 e-mail:
| | - Louis Wong Kee Song
- Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905 e-mail:
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, KS 66506 e-mail:
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McWilliams BT, Wang H, Binns VJ, Curto S, Bossmann SH, Prakash P. Experimental Investigation of Magnetic Nanoparticle-Enhanced Microwave Hyperthermia. J Funct Biomater 2017; 8:E21. [PMID: 28640198 PMCID: PMC5618272 DOI: 10.3390/jfb8030021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/07/2017] [Accepted: 06/12/2017] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to evaluate microwave heating enhancements offered by iron/iron oxide nanoparticles dispersed within tissue-mimicking media for improving efficacy of microwave thermal therapy. The following dopamine-coated magnetic nanoparticles (MNPs) were considered: 10 and 20 nm diameter spherical core/shell Fe/Fe₃O₄, 20 nm edge-length cubic Fe₃O₄, and 45 nm edge-length/10 nm height hexagonal Fe₃O₄. Microwave heating enhancements were experimentally measured with MNPs dissolved in an agar phantom, placed within a rectangular waveguide. Effects of MNP concentration (2.5-20 mg/mL) and microwave frequency (2.0, 2.45 and 2.6 GHz) were evaluated. Further tests with 10 and 20 nm diameter spherical MNPs dispersed within a two-compartment tissue-mimicking phantom were performed with an interstitial dipole antenna radiating 15 W power at 2.45 GHz. Microwave heating of 5 mg/mL MNP-agar phantom mixtures with 10 and 20 nm spherical, and hexagonal MNPs in a waveguide yielded heating rates of 0.78 ± 0.02 °C/s, 0.72 ± 0.01 °C/s and 0.51 ± 0.03 °C/s, respectively, compared to 0.5 ± 0.1 °C/s for control. Greater heating enhancements were observed at 2.0 GHz compared to 2.45 and 2.6 GHz. Heating experiments in two-compartment phantoms with an interstitial dipole antenna demonstrated potential for extending the radial extent of therapeutic heating with 10 and 20 nm diameter spherical MNPs, compared to homogeneous phantoms (i.e., without MNPs). Of the MNPs considered in this study, spherical Fe/Fe₃O₄ nanoparticles offer the greatest heating enhancement when exposed to microwave radiation. These nanoparticles show strong potential for enhancing the rate of heating and radial extent of heating during microwave hyperthermia and ablation procedures.
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Affiliation(s)
- Brogan T McWilliams
- Department of Electrical and Computer Engineering, Kansas State University, 3078 Engineering Hall, Manhattan, KS 66506, USA.
| | - Hongwang Wang
- Department of Chemistry, Kansas State University, 213 CBC Building, Manhattan, KS 66506, USA.
| | - Valerie J Binns
- Department of Electrical and Computer Engineering, Kansas State University, 3078 Engineering Hall, Manhattan, KS 66506, USA.
| | - Sergio Curto
- Department of Electrical and Computer Engineering, Kansas State University, 3078 Engineering Hall, Manhattan, KS 66506, USA.
| | - Stefan H Bossmann
- Department of Chemistry, Kansas State University, 213 CBC Building, Manhattan, KS 66506, USA.
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, 3078 Engineering Hall, Manhattan, KS 66506, USA.
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Curto S, Garcia-Miquel A, Suh M, Vidal N, Lopez-Villegas JM, Prakash P. Design and characterisation of a phased antenna array for intact breast hyperthermia. Int J Hyperthermia 2017; 34:250-260. [PMID: 28605946 DOI: 10.1080/02656736.2017.1337935] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Currently available hyperthermia technology is not well suited to treating cancer malignancies in the intact breast. This study investigates a microwave applicator incorporating multiple patch antennas, with the goal of facilitating controllable power deposition profiles for treating lesions at diverse locations within the intact breast. MATERIALS AND METHODS A 3D-computational model was implemented to assess power deposition profiles with 915 MHz applicators incorporating a hemispheric groundplane and configurations of 2, 4, 8, 12, 16 and 20 antennas. Hemispheric breast models of 90 mm and 150 mm diameter were considered, where cuboid target volumes of 10 mm edge length (1 cm3) and 30 mm edge length (27 cm3) were positioned at the centre of the breast, and also located 15 mm from the chest wall. The average power absorption (αPA) ratio expressed as the ratio of the PA in the target volume and in the full breast was evaluated. A 4-antenna proof-of-concept array was fabricated and experimentally evaluated. RESULTS Computational models identified an optimal inter-antenna spacing of 22.5° along the applicator circumference. Applicators with 8 and 12 antennas excited with constant phase presented the highest αPA at centrally located and deep-seated targets, respectively. Experimental measurements with a 4-antenna proof-of-concept array illustrated the potential for electrically steering power deposition profiles by adjusting the relative phase of the signal at antenna inputs. CONCLUSIONS Computational models and experimental results suggest that the proposed applicator may have potential for delivering conformal thermal therapy in the intact breast.
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Affiliation(s)
- Sergio Curto
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA.,b Department of Radiation Oncology , Erasmus MC Cancer Institute , Rotterdam , The Netherlands
| | | | - Minyoung Suh
- d Department of Textile and Apparel, Technology and Management, College of Textiles , North Carolina State University , Raleigh , NC , USA
| | - Neus Vidal
- c Electronics Department , University of Barcelona , Barcelona , Spain
| | | | - Punit Prakash
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
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Curto S, Taj-Eldin M, Fairchild D, Prakash P. Microwave ablation at 915 MHz vs 2.45 GHz: A theoretical and experimental investigation. Med Phys 2016; 42:6152-61. [PMID: 26520708 DOI: 10.1118/1.4931959] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The relationship between microwave ablation system operating frequency and ablation performance is not currently well understood. The objective of this study was to comparatively assess the differences in microwave ablation at 915 MHz and 2.45 GHz. METHODS Analytical expressions for electromagnetic radiation from point sources were used to compare power deposition at the two frequencies of interest. A 3D electromagnetic-thermal bioheat transfer solver was implemented with the finite element method to characterize power deposition and thermal ablation with asymmetrical insulated dipole antennas (single-antenna and dual-antenna synchronous arrays). Simulation results were validated against experiments in ex vivo tissue. RESULTS Theoretical, computational, and experimental results indicated greater power deposition and larger diameter ablation zones when using a single insulated microwave antenna at 2.45 GHz; experimentally, 32±4.1 mm and 36.3±1.0 mm for 5 and 10 min, respectively, at 2.45 GHz, compared to 24±1.7 mm and 29.5±0.6 mm at 915 MHz, with 30 W forward power at the antenna input port. In experiments, faster heating was observed at locations 5 mm (0.91 vs 0.49 °C/s) and 10 mm (0.28 vs 0.15 °C/s) from the antenna operating at 2.45 GHz. Larger ablation zones were observed with dual-antenna arrays at 2.45 GHz; however, the differences were less pronounced than for single antennas. CONCLUSIONS Single- and dual-antenna arrays systems operating at 2.45 GHz yield larger ablation zone due to greater power deposition in proximity to the antenna, as well as greater role of thermal conduction.
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Affiliation(s)
- Sergio Curto
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506
| | - Mohammed Taj-Eldin
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506
| | - Dillon Fairchild
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas 66506
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Affiliation(s)
- Jan Sebek
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
- Department of Circuit Theory, Czech Technical University, Prague, Czech Republic
| | - Sergio Curto
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
| | - Radoslav Bortel
- Department of Circuit Theory, Czech Technical University, Prague, Czech Republic
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas, USA
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Abstract
PURPOSE Currently available microwave hyperthermia systems for breast cancer treatment do not conform to the intact breast and provide limited control of heating patterns, thereby hindering an effective treatment. A compact patch antenna with a flared groundplane that may be integrated within a wearable hyperthermia system for the treatment of the intact breast disease is proposed. MATERIALS AND METHODS A 3D simulation-based approach was employed to optimise the antenna design with the objective of maximising the hyperthermia treatment volume (41 °C iso-therm) while maintaining good impedance matching. The optimised antenna design was fabricated and experimentally evaluated with ex vivo tissue measurements. RESULTS The optimised compact antenna yielded a -10 dB bandwidth of 90 MHz centred at 915 MHz, and was capable of creating hyperthermia treatment volumes up to 14.4 cm(3) (31 mm × 28 mm × 32 mm) with an input power of 15 W. Experimentally measured reflection coefficient and transient temperature profiles were in good agreement with simulated profiles. Variations of + 50% in blood perfusion yielded variations in the treatment volume up to 11.5%. When compared to an antenna with a similar patch element employing a conventional rectangular groundplane, the antenna with flared groundplane afforded 22.3% reduction in required power levels to reach the same temperature, and yielded 2.4 times larger treatment volumes. CONCLUSION The proposed patch antenna with a flared groundplane may be integrated within a wearable applicator for hyperthermia treatment of intact breast targets and has the potential to improve efficiency, increase patient comfort, and ultimately clinical outcomes.
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Affiliation(s)
- Sergio Curto
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , Kansas , USA
| | - Punit Prakash
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , Kansas , USA
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McWilliams BT, Schnell EE, Curto S, Fahrbach TM, Prakash P. A Directional Interstitial Antenna for Microwave Tissue Ablation: Theoretical and Experimental Investigation. IEEE Trans Biomed Eng 2015; 62:2144-50. [DOI: 10.1109/tbme.2015.2413672] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Curto S, Ramasamy M, Suh M, Prakash P. Design and analysis of a conformal patch antenna for a wearable breast hyperthermia treatment system. ACTA ACUST UNITED AC 2015. [DOI: 10.1117/12.2079718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Ronveaux O, Arrieta F, Curto S, Laurani H, Danovaro-Holliday MC. Assessment of the quality of immunization data produced by the national individual registration system in Uruguay, 2006. Rev Panam Salud Publica 2009; 26:153-60. [PMID: 19814895 DOI: 10.1590/s1020-49892009000800008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The nominal registration system of Uruguay's national immunization program (NIP) tracks administered vaccines on a paper form filled out after each vaccination and collated into a national database, thus allowing for individual follow-up. This study performed a comprehensive assessment of the quality of Uruguay's immunization data in November 2006 to evaluate the validity of the information and to confirm the high national immunization coverage reported by the program. METHODS The research team analyzed the concordance of the operational-level numerators (infant immunization data from 18 public and private vaccination centers in six country departments) with department- and national-level data, and compared the national-level (NIP) infant denominators with other official sources. A standardized questionnaire was used to evaluate system performance at the operational (vaccination center), department, and national level. Rapid house-to-house monitoring was conducted to generate additional coverage estimates. RESULTS Numerator accuracy throughout the data flow was 100%, and national-level denominators appeared to be exhaustive. Overall system performance was excellent (proper archiving and recording of form data, sufficient supply of forms, timely flow of information, adequate defaulter tracing practices and computer system security). The main weaknesses were the degree of data analysis and feedback to peripheral levels. House-to-house monitoring showed high overall immunization coverage (97%). CONCLUSION Uruguay's NIP registration system produces remarkably reliable information, ensuring valid measurement of immunization coverage. In addition, by allowing for monitoring of each child's current vaccination status, it facilitates management of interventions designed to reduce vaccination default and thus helps achieve the country's high level of coverage.
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Abstract
Between 1979 and 1994, epidemiological surveillance of meningitides in Uruguay showed a progressive increase in suppurative meningitides due mainly to Neisseria meningitidis and Haemophilus influenzae type b (Hib). The cases were concentrated in children under 5; however, among the cases caused by Hib, 70% affected children from 1 to 11 months old. Facing this situation, the Ministry of Public Health resolved, as of August 1994, to include the Hib vaccine in the country's Expanded Program on Immunization, which has been in place since 1982. The Hib vaccination is done without charge and is obligatory for all children under 5 years of age. It is done using the following series of vaccinations: a) three doses, given at 2, 4, and 6 months, with a booster dose at age 1; b) children from 7 to 11 months old receive two doses two months apart and a booster dose a year later; and c) a single dose for children 12 months to 4 years old. Between August and December 1994 a coverage rate of 76.6% was reached among children between 2 months and 4 years old, and the coverage has remained above 80% in the new cohorts. In Uruguay, this vaccination strategy had a spectacular impact on morbidity and mortality due to meningitides caused by Hib. One of the results was that the incidence of 15.6 per 100,000 registered in children under 5 in the prevaccination years declined to 0.03 per 100,000 in 1996.
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Affiliation(s)
- G Ruocco
- Ministerio de Salud Pública, División de Epidemiología, Montevideo, Uruguay
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Bisset NG, Bruhn JG, Curto S, Holmstedt B, Nyman U, Zenk MH. Was opium known in 18th dynasty ancient Egypt? An examination of materials from the tomb of the chief royal architect Kha. J Ethnopharmacol 1994; 41:99-114. [PMID: 8170167 DOI: 10.1016/0378-8741(94)90064-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Examination by microscopy, thin-layer chromatography, gas-liquid chromatography alone and combined with mass spectrometry, and radioimmunoassay methods of materials from the tomb of the ancient Egyptian chief royal architect Kha, who is believed to have died about 1405 BC, has shown that there is no morphine--and hence no opium--present. This finding casts doubt on the results of an earlier analysis. Tropane alkaloids are likewise absent. The significance of the present findings for the history of the opium poppy, Papaver somniferum L., in the eastern Mediterranean region is discussed. Evidence (chemical, botanical, artefactual, and linguistic) for the supposed presence of the opium poppy and opium in Egypt in the Late Bronze Age is briefly reviewed. These considerations and the negative outcome of the present analyses mean that the earlier reported finding can no longer be accepted as evidence.
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Affiliation(s)
- N G Bisset
- Chelsea Department of Pharmacy, King's College London, University of London, UK
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