Kavitha Arunachalam

Characterization of a digital microwave radiometry system for noninvasive thermometry using a temperature-controlled homogeneous test load

Microwave radiometry has been proposed as a viable noninvasive thermometry approach for monitoring subsurface tissue temperatures and potentially controlling power levels of multielement heat applicators during clinical hyperthermia treatments. With the evolution of technology, several analog microwave radiometry devices have been developed for biomedical applications. In this paper, we describe a digital microwave radiometer with built-in electronics for signal processing and automatic self-calibration. The performance of the radiometer with an Archimedean spiral receive antenna is evaluated over a bandwidth of 3.7-4.2 GHz in homogeneous and layered water test loads. Controlled laboratory experiments over the range of 30-50 degrees C characterize measurement accuracy, stability, repeatability and penetration depth sensitivity. The ability to sense load temperature through an intervening water coupling bolus of 6 mm thickness is also investigated. To assess the clinical utility and sensitivity to electromagnetic interference (EMI), experiments are conducted inside standard clinical hyperthermia treatment rooms with no EM shielding. The digital radiometer provided repeatable measurements with 0.075 degrees C resolution and standard deviation of 0.217 degrees C for homogeneous and layered tissue loads at temperatures between 32-45 degrees C. Within the 3.7-4.2 GHz band, EM noise rejection was good other than some interference from overhead fluorescent lights in the same room as the radiometer. The system response obtained for ideal water loads suggests that this digital radiometer should be useful for estimating subcutaneous tissue temperatures under a 6 mm waterbolus used during clinical hyperthermia treatments. The accuracy and stability data obtained in water test loads of several configurations support our expectation that single band radiometry should be sufficient for sub-surface temperature monitoring and power control of large multielement array superficial hyperthermia applicators.

Conformal microwave array (CMA) applicators for hyperthermia of diffuse chest wall recurrence

Purpose: This article summarises the evolution of microwave array applicators for heating large area chest wall disease as an adjuvant to external beam radiation, systemic chemotherapy, and potentially simultaneous brachytherapy. Methods: Current devices used for thermotherapy of chest wall recurrence are reviewed. The largest conformal array applicator to date is evaluated in four studies: (1) ability to conform to the torso is demonstrated with a CT scan of a torso phantom and MR scan of the conformal water bolus component on a mastectomy patient; (2) specific absorption rate (SAR) and temperature distributions are calculated with electromagnetic and thermal simulation software for a mastectomy patient; (3) SAR patterns are measured with a scanning SAR probe in liquid muscle phantom for a buried coplanar waveguide CMA; and (4) heating patterns and patient tolerance of CMA applicators are characterised in a clinical pilot study with 13 patients. Results: CT and MR scans demonstrate excellent conformity of CMA applicators to contoured anatomy. Simulations demonstrate effective control of heating over contoured anatomy. Measurements confirm effective coverage of large treatment areas with no gaps. In 42 hyperthermia treatments, CMA applicators provided well-tolerated effective heating of up to 500 cm2 regions, achieving target temperatures of Tmin = 41.4 ± 0.7°C, T90 = 42.1 ± 0.6°C, Tave = 42.8 ± 0.6°C, and Tmax = 44.3 ± 0.8°C as measured in an average of 90 points per treatment. Conclusion: The CMA applicator is an effective thermal therapy device for heating large-area superficial disease such as diffuse chest wall recurrence. It is able to cover over three times the treatment area of conventional hyperthermia devices while conforming to typical body contours.

Modeling the detectability of vesicoureteral reflux using microwave radiometry

We present the modeling efforts on antenna design, frequency selection and receiver sensitivity estimation to detect vesicoureteral reflux (VUR) using microwave (MW) radiometry as warm urine from the bladder maintained at fever range temperature using a MW hyperthermia device reflows into the kidneys. The radiometer center frequency (f(c)), frequency band (Deltaf) and aperture radius (r(a)) of the physical antenna for kidney temperature monitoring are determined using a simplified universal antenna model with a circular aperture. Anatomical information extracted from the computed tomography (CT) images of children aged 4-6 years is used to construct a layered 3D tissue model. Radiometric antenna efficiency is evaluated in terms of the ratio of the power collected from the target at depth to the total power received by the antenna (eta). The power ratio of the theoretical antenna is used to design a microstrip log spiral antenna with directional radiation pattern over f(c) +/- Deltaf/2. Power received by the log spiral from the deep target is enhanced using a thin low-loss dielectric matching layer. A cylindrical metal cup is proposed to shield the antenna from electromagnetic interference (EMI). Transient thermal simulations are carried out to determine the minimum detectable change in the antenna brightness temperature (deltaT(B)) for 15-25 mL urine refluxes at 40-42 degrees C located 35 mm from the skin surface. Theoretical antenna simulations indicate maximum eta over 1.1-1.6 GHz for r(a) = 30-40 mm. Simulations of the 35 mm radius tapered log spiral yielded a higher power ratio over f(c) +/- Deltaf/2 for the 35-40 mm deep targets in the presence of an optimal matching layer. Radiometric temperature calculations indicate deltaT(B) 0.1 K for the 15 mL urine at 40 degrees C and 35 mm depth. Higher eta and deltaT(B) were observed for the antenna and matching layer inside the metal cup. Reflection measurements of the log spiral in a saline phantom are in agreement with the simulation data. The numerical study suggests that a radiometer with f(c) = 1.35 GHz, Deltaf = 500 MHz and detector sensitivity better than 0.1 K would be the appropriate tool to noninvasively detect VUR using the log spiral antenna.

Detection of Vesicoureteral Reflux Using Microwave Radiometry—System Characterization With Tissue Phantoms

Microwave (MW) radiometry is proposed for passive monitoring of kidney temperature to detect vesicoureteral reflux (VUR) of urine that is externally heated by a MW hyperthermia device and thereafter reflows from the bladder to kidneys during reflux. Here, we characterize in tissue-mimicking phantoms the performance of a 1.375 GHz radiometry system connected to an electromagnetically (EM) shielded microstrip log spiral antenna optimized for VUR detection. Phantom EM properties are characterized using a coaxial dielectric probe and network analyzer (NA). Power reflection and receive patterns of the antenna are measured in layered tissue phantom. Receiver spectral measurements are used to assess EM shielding provided by a metal cup surrounding the antenna. Radiometer and fiberoptic temperature data are recorded for varying volumes (10-30 mL) and temperatures (40-46°C) of the urine phantom at 35 mm depth surrounded by 36.5°C muscle phantom. Directional receive pattern with about 5% power spectral density at 35 mm target depth and better than -10 dB return loss from tissue load are measured for the antenna. Antenna measurements demonstrate no deterioration in power reception and effective EM shielding in the presence of the metal cup. Radiometry power measurements are in excellent agreement with the temperature of the kidney phantom. Laboratory testing of the radiometry system in temperature-controlled phantoms supports the feasibility of passive kidney thermometry for VUR detection.

Performance evaluation of a conformal thermal monitoring sheet sensor array for measurement of surface temperature distributions during superficial hyperthermia treatments

Purpose: This paper presents a novel conformal thermal monitoring sheet (TMS) sensor array with differential thermal sensitivity for measuring temperature distributions over large surface areas. Performance of the sensor array is evaluated in terms of thermal accuracy, mechanical stability and conformity to contoured surfaces, probe self-heating under irradiation from microwave and ultrasound hyperthermia sources, and electromagnetic field perturbation. Materials and methods: A prototype with 4 × 4 array of fiber-optic sensors embedded between two flexible and thermally conducting polyimide films was developed as an alternative to the standard 1–2 mm diameter plastic catheter-based probes used in clinical hyperthermia. Computed tomography images and bending tests were performed to evaluate the conformability and mechanical stability respectively. Irradiation and thermal barrier tests were conducted and thermal response of the prototype was compared with round cross-sectional clinical probes. Results: Bending and conformity tests demonstrated higher flexibility, dimensional stability and close conformity to human torso. Minimal perturbation of microwave fields and low probe self-heating was observed when irradiated with 915 MHz microwave and 3.4 MHz ultrasound sources. The transient and steady state thermal responses of the TMS array were superior compared to the clinical probes. Conclusions: A conformal TMS sensor array with improved thermal sensitivity and dimensional stability was investigated for real-time skin temperature monitoring. This fixed-geometry, body-conforming array of thermal sensors allows fast and accurate characterization of two-dimensional temperature distributions over large surface areas. The prototype TMS demonstrates significant advantages over clinical probes for characterizing skin temperature distributions during hyperthermia treatments of superficial tissue disease.

Thermal characteristics of thermobrachytherapy surface applicators for treating chest wall recurrence.

The aim of this study was to investigate temperature and thermal dose distributions of thermobrachytherapy surface applicators (TBSAs) developed for concurrent or sequential high dose rate (HDR) brachytherapy and microwave hyperthermia treatment of chest wall recurrence and other superficial diseases. A steady-state thermodynamics model coupled with the fluid dynamics of a water bolus and electromagnetic radiation of the hyperthermia applicator is used to characterize the temperature distributions achievable with TBSAs in an elliptical phantom model of the human torso. Power deposited by 915 MHz conformal microwave array (CMA) applicators is used to assess the specific absorption rate (SAR) distributions of rectangular (500 cm(2)) and L-shaped (875 cm(2)) TBSAs. The SAR distribution in tissue and fluid flow distribution inside the dual-input dual-output (DIDO) water bolus are coupled to solve the steady-state temperature and thermal dose distributions of the rectangular TBSA (R-TBSA) for superficial tumor targets extending 10-15 mm beneath the skin surface. Thermal simulations are carried out for a range of bolus inlet temperature (T(b) = 38-43 degrees C), water flow rate (Q(b) = 2-4 L min(-1)) and tumor blood perfusion (omega(b) = 2-5 kg m(-3) s(-1)) to characterize their influence on thermal dosimetry. Steady-state SAR patterns of the R- and L-TBSA demonstrate the ability to produce conformal and localized power deposition inside the tumor target sparing surrounding normal tissues and nearby critical organs. Acceptably low variation in tissue surface cooling and surface temperature homogeneity was observed for the new DIDO bolus at a 2 L min(-1) water flow rate. Temperature depth profiles and thermal dose volume histograms indicate bolus inlet temperature (T(b)) to be the most influential factor on thermal dosimetry. A 42 degrees C water bolus was observed to be the optimal choice for superficial tumors extending 10-15 mm from the surface even under significant blood perfusion. Lower bolus temperature may be chosen to reduce the thermal enhancement ratio (TER) in the most sensitive skin where maximum radiation dose is delivered and to extend the thermal enhancement of radiation dose deeper. This computational study indicates that well-localized elevation of tumor target temperature to 40-44 degrees C can be accomplished by large surface-conforming TBSAs using appropriate selection of coupling bolus temperature.

A Computational Investigation of Microwave Breast Imaging Using Deformable Reflector

In recent years, active microwave breast imaging is increasingly being viewed as a promising complementary imaging modality for cancer detection. In this paper, we present a novel deformable reflector microwave tomography technique for noninvasive characterization of the breast tissue. In contrast to conventional multitransceiver designs, the proposed technique utilizes a continuously deformable reflector with metallic coating to acquire field measurements for imaging. Computational feasibility of the proposed technique to image heterogeneous dielectric tissue property is evaluated using simplified 2-D breast models. The robustness of the deformable reflector-based tomography technique in imaging the spatial distribution of the tissue dielectric property in the presence of measurement noise is investigated using first-order Tikhonov regularization. Preliminary results obtained for the 2-D breast models appear promising and indicate further investigation of the new microwave tomography technique for breast imaging.

Non-invasive vesicoureteral reflux detection: Heating risk studies for a new device

OBJECTIVE To investigate a novel non-invasive device developed to warm bladder urine and to measure kidney temperature to detect vesicoureteral reflux. MATERIALS AND METHODS Microwave antennas focused energy within the bladder. Phantom experiments measured the results. The heating protocol was optimized in an in-vivo porcine model, and then tested once, twice and three times consecutively in three pigs followed by pathologic examinations. RESULTS Computer simulations showed a dual concentric conductor square slot antenna to be the best. Phantom studies revealed that this antenna easily heated a bladder phantom without over heating intervening layers. In-vivo a bladder heating protocol of 3 min with 30 W each to two adjacent antennas 45 s on 15 s off followed by 15 min of 15 s on and 45 s off was sufficient. When pigs were heated once, twice and three times with this heating protocol, pathologic examination of all tissues in the heated area showed no thermal changes. More intensive heating in the animal may have resulted in damage to muscle fibers in the anterior abdominal wall. CONCLUSIONS Selective warming of bladder urine was successfully demonstrated in phantom and animals. Localized heating for this novel vesicoureteral reflux device requires low-power levels and should be safe for humans.

Vesicoureteral Reflux in Children: A Phantom Study of Microwave Heating and Radiometric Thermometry of Pediatric Bladder

We have investigated the use of microwave heating and radiometry to safely heat urine inside a pediatric bladder. The medical application for this research is to create a safe and reliable method to detect vesicoureteral reflux, a pediatric disorder, where urine flow is reversed and flows from the bladder back up into the kidney. Using fat and muscle tissue models, we have performed both experimental and numerical simulations of a pediatric bladder model using planar dual concentric conductor microstrip antennas at 915 MHz for microwave heating. A planar elliptical antenna connected to a 500 MHz bandwidth microwave radiometer centered at 3.5 GHz was used for noninvasive temperature measurement inside tissue. Temperatures were measured in the phantom models at points during the experiment with implanted fiberoptic sensors, and 2-D distributions in cut planes at depth in the phantom with an infrared camera at the end of the experiment. Cycling between 20 s with 20 Watts power for heating, and 10 s without power to allow for undisturbed microwave radiometry measurements, the experimental results show that the target tissue temperature inside the phantom increases fast and that the radiometer provides useful measurements of spatially averaged temperature of the illuminated volume. The presented numerical and experimental results show excellent concordance, which confirms that the proposed system for microwave heating and radiometry is applicable for safe and reliable heating of pediatric bladder.

A Thermal Monitoring Sheet With Low Influence From Adjacent Waterbolus for Tissue Surface Thermometry During Clinical Hyperthermia

This paper presents a complete thermal analysis of a novel conformal surface thermometer design with directional sensitivity for real-time temperature monitoring during hyperthermia treatments of large superficial cancer. The thermal monitoring sheet (TMS) discussed in this paper consists of a 2-D array of fiberoptic sensors embedded between two layers of flexible, low-loss, and thermally conductive printed circuit board (PCB) film. Heat transfer across all interfaces from the tissue surface through multiple layers of insulating dielectrics surrounding the small buried temperature sensor and into an adjacent temperature-regulated water coupling bolus was studied using 3-D thermal simulation software. Theoretical analyses were carried out to identify the most effective differential TMS probe configuration possible with commercially available flexible PCB materials and to compare their thermal responses with omnidirectional probes commonly used in clinical hyperthermia. A TMS sensor design that employs 0.0508-mm Kapton MTB and 0.2032-mm Kapton HN flexible polyimide films is proposed for tissue surface thermometry with low influence from the adjacent waterbolus. Comparison of the thermal simulations with clinical probes indicates the new differential TMS probe design to outperform in terms of both transient response and steady-state accuracy in selectively reading the tissue surface temperature, while decreasing the overall thermal barrier of the probe between the coupling waterbolus and tissue surface.