Daniel Neuman

Phantom and animal tissues for modelling the electrical properties of human liver

The dielectric properties of human liver were characterized over the frequency range of 0.3-3 GHz for freshly excised tissue samples of primary hepatocellular carcinoma, metastatic colorectal carcinoma, and normal liver tissues resected from the tumour margin. On average, the dielectric constant (^9; r ) of freshly excised human liver tumour was 12% higher than that of surrounding normal liver, and the electrical conductivity (`3;) of tumour was 24% higher. In order to establish suitable tissue models for human liver, the electrical properties were compared to measurements of homogenous phantom mixtures, in vitro bovine liver, and in vivo canine and porcine liver tissues. The data demonstrate that there are several animal tissues that can be used to model the average dielectric properties of human liver reasonably accurately, and use of the most readily available bovine liver appears well-justified, even when stored for up to 10 days in a refrigerator. Additionally, the dielectric properties of in vitro liver remained stable over a large temperature range, with `3; rising only 1.1%/°C in porcine liver (15-37°C) and 2.0%/°C in bovine liver (10-90°C), and ^9; r decreasing Ͱ4;0.2%/°C in both tissues. This effort identifies homogeneous solid and liquid phantom models and several heterogeneous in vitro tissues that adequately model the dielectric properties of human liver tumours for use in quantitative studies of microwave power deposition in liver.

Dual-mode antenna design for microwave heating and noninvasive thermometry of superficial tissue disease

Hyperthermia therapy of superficial skin disease has proven clinically useful, but current heating equipment is somewhat clumsy and technically inadequate for many patients. The present effort describes a dual-purpose, conformal microwave applicator that is fabricated from thin, flexible, multilayer printed circuit board (PCB) material to facilitate heating of surface areas overlaying contoured anatomy. Preliminary studies document the Feasibility of combining Archimedean spiral microstrip antennas, located concentrically within the central region of square dual concentric conductor (DCC) annular slot antennas. The motivation is to achieve homogeneous tissue heating simultaneously with noninvasive thermometry by radiometric sensing of blackbody radiation from the target tissue under the applicator. Results demonstrate that the two antennas have complimentary regions of influence. The DCC ring antenna structure produces a peripherally enhanced power deposition pattern with peaks in the outer corners of the aperture and a broad minimum around 50% of maximum centrally. In contrast, the Archimedean spiral radiates (or receives) energy predominantly along the boresight axis of the spiral, thus confining the region of influence to tissue located within the central broad minimum of the DCC pattern. Analysis of the temperature-dependent radiometer signal (brightness temperature) showed linear correlation of radiometer output with test Load temperature using either the spiral or DCC structure as the receive antenna. The radiometric performance of the broadband Archimedean antenna was superior compared to the DCC, providing improved temperature resolution (0.1/spl deg/C-0.2/spl deg/C) and signal sensitivity (0.3/spl deg/C-0.8/spl deg/C//spl deg/C) at all four 500 MHz integration bandwidths tested within the frequency range from 1.2 to 3.0 GHz.

SAR pattern perturbations from resonance effects in water bolus layers used with superficial microwave hyperthermia applicators

This study examines the effect of various thickness water bolus coupling layers on the SAR (Specific Absorption Rate) patterns from Dual Concentric Conductor (DCC) based Conformal Microwave Array (CMA) superficial hyperthermia applicators. Previous theory has suggested that water bolus coupling layers can be considered as a dielectric resonator; therefore, it is possible for the impinging electric field to stimulate volume oscillations and surface wave oscillations inside the water bolus. These spurious oscillations will destructively or constructively interact with the impinging electric field to cause a perturbation of the applicator SAR pattern. An experiment was designed which consisted of mapping the electric field produced by a four element DCC CMA applicator in liquid muscle phantom at depths of 5 and 10mm in front of four different thickness water boli; 0 (no bolus) 4, 9 and 13mm. Using the Finite Difference Time Domain (FDTD) method, SAR distributions were calculated for similar test cases. It was found that for water bolus thicknesses of 9mm or greater, there is a marked perturbation of both experimental and theoretical SAR distributions. It is believed that this perturbation is experimental confirmation of the volume and surface wave oscillation theory described by previous investigators.

Evaluation of a dual-arm Archimedean spiral array for microwave hyperthermia

Purpose: This effort describes a third-party performance evaluation of a novel, commercial, dual-armed Archimedean spiral array hyperthermia applicator. The applicator is analysed for its ability to couple efficiently into muscle equivalent phantom loads, operate over a broad bandwidth to help accommodate variable tissue properties and generate predictable and repeatable SAR contours that are adaptable to clinically probable disease shapes. Materials and methods: Characterization of the applicator includes E-field and return-loss measurements in liquid muscle tissue-equivalent phantom, as well as comparison of ‘treatment-planning’ simulations of several possible array SAR patterns with measured SAR from non-coherently driven spiral array antennae. Results: The applicator demonstrates a reasonably low return loss over a large bandwidth and the ability to generate a very uniform heating pattern. Ability to adjust SAR contours spatially to fit specific shapes is also demonstrated. Conclusions: This device should prove a welcome addition to a currently limited set of superficial heating applicators to provide controllable heating of superficial tissue disease.

Multilayer conformal applicator for microwave heating and brachytherapy treatment of superficial tissue disease

Purpose: The purpose of this study was to construct and perform preliminary functionality evaluations of a multilayer conformal applicator with provisions for thermal monitoring, tight conformity and simultaneous microwave heating and brachytherapy treatment of large-area contoured surfaces. Materials and methods: The multilayer conformal applicator consists of thermal monitoring catheters for fibre-optic monitoring of skin temperatures, a waterbolus, a PCB microwave antenna array, a dielectric spacer for brachytherapy considerations, brachytherapy catheters for delivering HDR radiation and an inflatable air bladder for improving conformity to contoured surfaces. The applicator also includes an elastic attachment structure to hold the applicator securely in place on the patient. The conformity of the applicator to irregular surfaces was evaluated through CT imaging of the applicator fitted onto a life-sized human torso phantom. The fluid flow dynamics of the waterbolus, which impact the effectiveness of temperature control, were evaluated with thermometry during a 19°C step change temperature of the circulating water. Results: CT imaging showed improved conformity to the torso phantom surface following the application of gentle inward pressure from inflating the outer air bladder. Only a small number of 1–5 mm sized air gaps separated the conformal applicator and tissue surface. Thermometry testing of the bolus fluid flow dynamics demonstrated temperature uniformity within ±0.82°C across a 19 × 34 × 0.6 cm area bolus and ±0.85°C across a large 42 × 32 × 0.6 cm area bolus. Conclusion: CT scans of the applicator confirmed that the applicator conforms well to complex body contours and should maintain good conformity and positional stability even when worn on a mobile patient. Thermometry testing of two different waterbolus geometries demonstrated that uniform circulation and temperature control can be maintained throughout large, complex bolus shapes.

Progress on system for applying simultaneous heat and brachytherapy to large-area surface disease (Invited Paper)

Laboratory experiments have shown that thermal enhancement of radiation response increases substantially for higher thermal dose (approaching 100 CEM43) and when hyperthermia and radiation are delivered simultaneously. Unfortunately, equipment capable of delivering uniform doses of heat and radiation simultaneously has not been available to test the clinical potential of this approach. We present recent progress on the clinical implementation of a system that combines the uniform heating capabilities of flexible printed circuit board microwave array applicators with an array of brachytherapy catheters held a fixed distance from the skin for uniform radiation of tissue <1.5 cm deep with a scanning high dose rate (HDR) brachytherapy source. The system is based on the Combination Applicator which consists of an array of up to 32 Dual Concentric Conductor (DCC) apertures driven at 915 MHz for heating tissue, coupled with an array of 1 cm spaced catheters for HDR therapy. Efforts to optimize the clinical interface and move from rectangular to more complex shape applicators that accommodate the entire disease in a larger number of patients are described. Improvements to the system for powering and controlling the applicator are also described. Radiation dosimetry and experimental performance results of a prototype 15 x 15 cm dual-purpose applicator demonstrate dose distributions with good homogeneity under large contoured surfaces typical of diffuse chestwall recurrence of breast carcinoma. Investigations of potential interaction between heat and brachytherapy components of a Combination Applicator demonstrate no perceptible perturbation of the heating field from an HDR source or leadwire, no perceptible effect of a scanning HDR source on fiberoptic thermometry, and <0.5% variation of radiation dose delivered through the CMA applicator. By applying heat and radiation simultaneously for maximum synergism of modalities, this dual therapy system should expand the number of patients that can benefit from effective thermoradiotherapy treatments.

Dual-mode antenna array for microwave heating and noninvasive thermometry of superficial tissue disease

Hyperthermia therapy of superficial skin disease has proven clinically useful, but current heating equipment is clumsy and technically inadequate for many patients. The present effort describes a dual purpose multielement conformal array microwave applicator that is fabricated from flexible printed circuit board (PCB) material to facilitate heating of large surface areas overlying contoured anatomy. Preliminary studies document the feasibility of combining concentric spiral microstrip antennas within multilayer PCB material in order to achieve tissue heating simultaneously with non-invasive thermometry by radiometric sensing of blackbody radiation from the target tissue under the applicator. Results demonstrate that superficial tissue regions may be heated uniformly above 50% of SARmax out to the periphery of 915 MHz conformal array applicators made from arrays of Dual Concentric Conductor apertures. Finally the data clearly demonstrate that separate complimentary antenna structures may be combined together in thin and lightweight conformal arrays to provide heating simultaneously with microwave radiometry based temperature monitoring of superficial tissue.

Construction of a Conformal Water Bolus Vest Applicator for Hyperthermia Treatment of Superficial Skin Cancer

Large area chestwall recurrence of breast carcinoma can be treated with moderate temperature hyperthermia in combination with radiation or chemotherapy. For diffuse chestwall disease, hyperthermia is best delivered with a conformal microwave array (CMA) applicator using a temperature-controlled water bolus designed specifically to fit complex contours and maintain contact with the tissue surface to prevent air gaps which distort the microwave power deposition pattern. In order to maintain the desired temperature range of 41-45 ° C during local hyperthermia treatments, it is necessary to have an effective fluid flow system to serve as a buffer and prevent overheating of skin, which can lead to small blisters or, in rare cases, deeper burns. The fluid flow dynamics of a vest shaped open water bag design is evaluated with thermometry during a step temperature change of circulating water. The data confirm the feasibility of uniform circulation and temperature control throughout complex bolus shapes. This water bolus design should improve temperature uniformity of current treatments for superficial tissue disease.

Optimization of a dual concentric conductor antenna for superficial hyperthermia applications

Dual concentric conductor antennas (DCCs) have been proposed as effective radiators for microwave hyperthermia applications, due to simplicity of construction from flexible printed circuit board (PCB) material. With proper design, the power deposition (SAR) pattern is uniform across the DCC. The effect of a single antenna can be combined in conformal nonphased arrays to form a region of nearly flat temperature distribution over a large area down to 1-1.5 cm depth. In the past, DCC antenna performance was analyzed using in-house FDTD software. Recently available electromagnetic simulation software provides reduced simulation time, increased accuracy and a user friendly interface with the ability to sweep design parameters to achieve critical optimization goals. More detail on antenna loading conditions provides enhanced design accuracy by accounting for second order effects neglected in previous modeling. In particular, recent design efforts have focused on improving antenna efficiency and reducing losses and reflections in the feedline network. A second challenge involves measurement of antenna properties in conditions more similar to the treatment environment, since temperature and loading condition affect antenna radiation and thus design requirements. We present the challenges of both antenna design and characterization, along with preliminary results of recent design improvements.

Combination applicator for simultaneous heat and radiation

We present the development of operator and patient friendly conformal applicators that can deliver moderate temperature hyperthermia simultaneously with radiation in superficial tissue overlying contoured anatomy. This applicator combines the uniform heating capabilities of large area conformal microwave array (CMA) flexible printed circuit board applicators with a patient interface (coupling bolus) that facilitates positioning of brachytherapy sources at a fixed distance (e.g. 1.5 cm) from the skin. A customized inverse treatment planning program (IPSA) was used to optimize spacing of a parallel array of source catheters and separation distance from skin, and to characterize the effects of bolus thickness and conformal array curvature on radiation dose uniformity. Performance of a 15 cm/spl times/15 cm combination applicator was evaluated in flat and contoured homogenous muscle tissue models. Results demonstrate effective heating and radiation distributions to 1-1.5 cm depth and out to the periphery of the array. This applicator should prove useful for treatment of diffuse chestwall disease located over contoured anatomy that is difficult to treat with external beam radiation. By applying heat and radiation simultaneously for maximum synergism of modalities, this device should expand the number of patients that can benefit from effective thermoradiotherapy for superficial disease.