Precooling prevents overheating of subcutaneous fat in the use of RF capacitive heating

The usefulness of precooling subcutaneous tissue in the hyperthermic treatment of deep-seated human tumors with capacitive application of radio-frequency (RF) was investigated. A capacitive hyperthermia unit operated at 8 MHz of radiofrequency was used to heat deep-seated human tumors. The electrode surfaces were covered with flexible vinyl sheets and the space between the electrode and the vinyl sheets perfused with 0.4% saline. The temperature of the saline was controlled by circulating the saline through built-in heat exchangers. The depth of heating was controlled by pairing electrodes of different diameters. When subcutaneous fat was less than 1 cm thick, various deep-seated tumors could be heated to a therapeutic temperature without significant discomfort in the subcutaneous tissue as long as the skin was properly cooled with the cold saline bolus. However, the same cooling method could not prevent the occurrence of pain in subcutaneous tissue in obese patients. The pain usually developed when the temperature of subcutaneous fat 1-2 cm below the skin surface exceeded 42 degrees C. We observed that cooling the human skin surface with 10 degrees C bolus for 20 min could substantially lower the temperature of fat as deep as 2.0-2.5 cm. Therefore, when the subcutaneous tissue was precooled with 10 degrees C saline for 20 min or longer before heating, it was possible to prevent successfully the overheating of subcutaneous fat as thick as 2.0-2.5 cm and to raise the temperature of deep-seated tumors to therapeutic levels.     

Heating patterns induced by a 13.56 MHz radiofrequency generator in large phantoms and pig abdomen and thorax

Heating patterns generated by a commercially available 13.5 MHz radiofrequency generator and induction coil hyperthermia system in human size phantoms and a 230 pound pig were studied using a multichannel computermonitored thermometry system that is noninteractive in electromagnetic fields. The phantom studies were composed of synthetic muscle equivalent material and fresh tissue. The pig was heated in the regions of the upper abdomen and the midthorax, both under anesthesia and dead. The temperature was measured along fine penetrating catheters at 1 cm intervals in all experiments. In a homogeneous cylindrical phantom, under our measurement conditions, the temperature profile across the diameter is parabolic with marked superficial heating and essentially no central heating. In nonhomogeneous phantoms and in the pig, the symmetry of this profile was distorted but the basic pattern of marked superficial heating and nearly absent deep central heating remained. Blood flow in the living animal produced some thermal smoothing. It is considered probable that substantial radial temperature gradients will exist within eccentrically located human tumors heated with this device and that certain deep central tumors will be difficult or impossible to heat. Determination of its ultimate value for investigational clinical hyperthermia studies will require accurate temperature mapping of tumors and normal tissues in various anatomic sites in comparison with other approaches to deep heating.     

Local RF capacitive hyperthermia: thermal profiles and tumour response

At the Cancer Institute we are using RF capacitive hyperthermia as an adjuvant to radiotherapy and/or chemotherapy in the local control of soft tissue sarcomas. We have studied the influence of bolus conductivity, electrode and phantom sizes on the rate of heating of agar phantoms. We have varied the bolus conductivity by varying the saline concentration in the bolus bags from zero to 2.0 per cent, during heating. We found that the rate of heating of phantoms increases and that of the bolus decreases with the increase in the saline concentration of bolus up to 1 per cent, irrespective of phantom and electrode sizes. However, for a given size of electrodes the rate of heating decreased with the increase in the phantom size. When the diameter and height of the phantom were equal to the diameters of electrodes the rate of heating of the phantom was nearly uniform. However, when the diameter of the phantom was larger than that of electrodes the rate of heating in the radial axis decreased with the increase in the radial distance. On the basis of this data we suggest the use of electrodes larger in size by 1.0-3.0 cm than the size of the tumour, where the size of the anatomical site to be heated is larger than the electrode size to be used. Phantom and clinical data have indicated that the presence of bone in the field of heating can lead to hot spots. Preliminary clinical results have shown that the response of sarcomas to thermo-chemo-radiotherapy was superior to that of either thermo-radiotherapy or radiotherapy alone.     

Effect of functional magnetic particles on radiofrequency capacitive heating.

Magnetic particles (magnetite) were used to make radiofrequency (RF) capacitive hyperthermia effective to a specific site. In an agar phantom experiment, a magnetite-containing agar piece was buried in a large agar phantom and heated by an 8 MHz-RF capacitive heating device. The magnetite-containing agar piece was heated more than the magnetite-free agar phantom, and the specific adsorption rate in the phantom was increased 1.5 times by the magnetite particles. The temperature distribution in the large agar phantom showed that the highest temperature was obtained at the center of the magnetite-containing piece. The rate of temperature increase was approximately proportional to the magnetite concentration to the power 0.8. This method was applied to an in vivo experiment using a pig. Magnetite was prepared as a colloidal material dispersed in a carboxymethylcellulose solution (CMC-Mag) and intramuscularly injected in the pig femur. As a result of 8 MHz-RF heating, the temperature at the CMC-Mag-injected point increased to over 43 degrees C after 7 min, while the temperature at a point without magnetite was under 40 degrees C at the same time. The specific adsorption rate in the magnetite-containing tissue was twice that of the magnetite-free tissue. In addition, the time required to reach a temperature of over 43 degrees C was only 7 min, while it was over 15 min in the case without the CMC-Mag.     

Effect of Functional Magnetic Particles on Radiofrequency Capacitive Heating

Magnetic particles (magnetite) were used to make radio frequency (RF) capacitive hyperthermia effective to a specific site. In an agar phantom experiment, a magnetite-containing agar piece was buried in a large agar phantom and heated by an 8 MHz-RF capacitive heating device. The magnetite-containing agar piece was heated more than the magnetite-free agar phantom, and the specific adsorption rate in the phantom was increased 1.5 times by the magnetite particles. The temperature distribution in the large agar phantom showed that the highest temperature was obtained at the center of the magnetite-containing piece. The rate of temperature increase was approximately proportional to the magnetite concentration to the power 0.8. This method was applied to an in vivo experiment using a pig. Magnetite was prepared as a colloidal material dispersed in a carboxymethylcellulose solution (CMC-Mag) and intramuscularly injected in the pig femur. As a result of 8 MHz-RF heating, the temperature at the CMC-Mag-injected point increased to over 43°C after 7 min, while the temperature at a point without magnetite was under 40°C at the same time. The specific adsorption rate in the magnetite-containing tissue was twice that of the magnetite- free tissue. In addition, the time required to reach a temperature of over 43°C was only 7 min, while it was over 15 min in the case without the CMC-Mag.     

A comparison of the heating characteristics of capacitive and radiative superficial hyperthermia

Background: Superficial hyperthermia is applied in combination with radiotherapy for e.g. melanoma and recurrent breast cancer, using both capacitive and radiative systems. In this paper, numerical simulations are applied to address the question which technique yields the most favourable heating characteristics.

Methods: A 434?MHz contact flexible microstrip applicator (CFMA type 4H, size 19.6?×?19.6?cm²) and a capacitive system consisting of two circular electrodes with diameter 15 and 25?cm were modelled. The water bolus of the CFMA was filled with deionised water and for capacitive heating both saline and deionised water were modelled. Specific absorption rate (SAR) and temperature simulations were performed for a perfused muscle-equivalent phantom and phantoms with a 1?cm thick superficial fat layer, assuming cylindrical target regions. Subsequently, a real patient model with a chest wall recurrence was studied with the target assumed to have muscle-like properties, fat properties or heterogeneous properties as derived from the CT Hounsfield Units.

Results: Phantom simulations showed that high SAR peaks occur around the bolus edges with capacitive heating. Power absorption below the fat layer is substantially higher for radiative heating and unless the target region is limited to the fat layer, radiative heating yields better target coverage in terms of SAR and temperature. Patient simulations showed that the T₉₀ for radiative heating was 0.4–1.1?°C higher compared with capacitive heating.

Conclusions: Radiative heating yields more favourable SAR and temperature distributions for superficial tumours, compared with capacitive heating, especially within heterogeneous tissues. Higher tumour temperatures are achieved without occurrence of treatment limiting hot spots.     

Radiofrequency capacitive hyperthermia for deep-seated tumors. I. Studies on thermometry

The thermometry results of radiofrequency (RF) capacitive hyperthermia for 60 deep-seated tumors in 59 patients are reported. Hyperthermia was administered regionally using two RF capacitive heating equipments which the authors have developed in cooperation with Yamamoto Vinyter Company Ltd., (Osaka, Japan). Intratumor temperatures were measured by thermocouples inserted through angiocatheters which were placed 5 cm to 12 cm deep into the tissues. Tumor center temperatures were measured for 307 treatments in all tumors; thermal distributions within tumors and surrounding normal tissues were obtained for 266 treatments of 53 tumors by microthermocouples. Thermometry results obtained were summarized as follows. A maximum tumor center temperature greater than 43 degrees C and 42 degrees C to 43 degrees C was obtained in 23 (38%) and 14 (23%) of the 60 tumors respectively. The time required to reach 43 degrees C in the tumor center was within 20 minutes after the start of hyperthermia in 87% of tumors heated to more than 43 degrees C. Temperature variations within a tumor exceeded 2 degrees C in 81% of tumors heated to more than 43 degrees C. The lowest tumor temperature greater than 42 degrees C was achieved in six of the 53 tumors (11%). Of 42 tumors in which temperatures of the subcutaneous fat, surrounding normal tissues, and the tumor center were compared, 24 (57%) showed the highest temperature in the tumor center and ten (24%) in the subcutaneous fat. When the heating efficacy was assessed in terms of a maximum tumor center, it great deal depended on the treatment site, tumor size, thickness of subcutaneous fat, and tumor type. Tumors in the head and neck, thorax, lower abdomen, and pelvis could be heated better than tumors in the upper abdomen. Greater heating efficacy was shown in patients with large, hypovascular tumors, and with the subcutaneous fat measuring less than 15 mm thick. The predominant limiting factor for power elevation was pain associated with heating. Systemic signs including increases in pulse rate and body temperature were not serious and seldom became limiting factors for power elevation. Our thermometry results indicate that the advantages of deep RF capacitive heating are its applicability to various anatomic sites and negligible systemic effects. The disadvantages are that its primary usefulness is limited to patients with thin subcutaneous fat and with large or hypovascular tumors.     

Pathophysiological changes after local heating of rat liver

Changes in blood flow in rat liver by local heating of the left lateral lobe were studied. A small portion of the left lateral lobe was heated by capacitive application of 8 MHz RF with a 2 cm diameter electrode on the ventral surface and a 7 cm diameter electrode on the dorsal surface of upper body of rats. A circular area with diameter of about 1 cm in the left lateral lobe could be heated to relatively homogeneous temperatures. The temperature in the remaining part of the left lateral lobe as well as in the rest of liver tissue also increased to varying degrees during the local heating of the left lateral lobe. When heated at 39 degrees or 41 degrees C for 45 min, the arterial blood flow, as measured with the radioactive microsphere method, in the heated area, and that in the rest of the left lateral lobe as well as in the whole liver initially increased during the first 30 min and then started to decline. During a 45 min heating at 43 degrees C, the arterial blood flow in the heated area slightly increased for 15 min and then significantly decreased thereafter. The arterial blood flow in the rest of the liver tissue also increased during the first 15 min of a 43 degrees C heating and began to decline. Histological examination of liver heated at 43 degrees C for 30 min showed wedge-shaped infarctions early on, which appeared to be organized into scar tissue by 7 days after heating. The concentrations of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), and lactate dehydrogenase (LDH) in the serum significantly increased 2 hr after heating the small portion of the left lateral lobe at 43 degrees C for 30 min and began to decrease thereafter although the serum level of GOT and GPT was still greater than the control value 24 hr after heating.     

Locoregional hyperthermia of deep-seated tumours applied with capacitive and radiative systems: a simulation study

Background: Locoregional hyperthermia is applied to deep-seated tumours in the pelvic region. Two very different heating techniques are often applied: capacitive and radiative heating. In this paper, numerical simulations are applied to compare the performance of both techniques in heating of deep-seated tumours.

Methods: Phantom simulations were performed for small (30?×?20?×?50?cm³) and large (45?×?30?×?50?cm³), homogeneous fatless and inhomogeneous fat-muscle, tissue-equivalent phantoms with a central or eccentric target region. Radiative heating was simulated with the 70?MHz AMC-4 system and capacitive heating was simulated at 13.56?MHz. Simulations were performed for small fatless, small (i.e. fat layer typically <2?cm) and large (i.e. fat layer typically >3?cm) patients with cervix, prostate, bladder and rectum cancer. Temperature distributions were simulated using constant hyperthermic-level perfusion values with tissue constraints of 44?°C and compared for both heating techniques.

Results: For the small homogeneous phantom, similar target heating was predicted with radiative and capacitive heating. For the large homogeneous phantom, most effective target heating was predicted with capacitive heating. For inhomogeneous phantoms, hot spots in the fat layer limit adequate capacitive heating, and simulated target temperatures with radiative heating were 2–4?°C higher. Patient simulations predicted therapeutic target temperatures with capacitive heating for fatless patients, but radiative heating was more robust for all tumour sites and patient sizes, yielding target temperatures 1–3?°C higher than those predicted for capacitive heating.

Conclusion: Generally, radiative locoregional heating yields more favourable simulated temperature distributions for deep-seated pelvic tumours, compared with capacitive heating. Therapeutic temperatures are predicted for capacitive heating in patients with (almost) no fat.     

Deep-heating characteristics of an RF capacitive heating device

An RF capacitive heating device was constructed and its deep-heating characteristics were studied using three mini-pigs. The deep-heating ability of RF capacitive heating was found to be improved by enlarging the electrodes, driving at 8 MHz, cooling the skin under the electrodes, inserting a bolus between the body and the electrodes and considering the anatomical structure of the body. The heating characteristics obtained were as follows. When applicators were placed on both sides of the abdomen of a mini-pig, 7 mm in fat layer thickness and 23 cm in lateral chest thickness, the increase in temperature of the deep part was greater than that of the fat layer. When applicators were placed on the posterior and anterior abdomen, overheating was noted in the fat and muscle near the back. The temperature was highest in a mock tumour, made by blocking blood flow to the spleen. The bio-heat equation revealed that RF capacitive heating accompanied by surface cooling at 10 degrees C could heat the deep portion of the body to 42 degrees C without excessive heating of a 1.6 cm thick fat layer.     

Regional hyperthermia combined with blockade of the hepatic arterial blood flow by degradable starch microspheres in pigs

The benefit of hepatic arterial microembolization by degradable starch microspheres (DSM) was investigated in regional hyperthermia of the liver. Hyperthermia with and without blood flow blockade of the hepatic artery using degradable starch microspheres was performed on six pigs. Heat was given for 30 min in each treatment by 8 MHz radiofrequency capacitive heating equipment. To maintain blood flow blockade during hyperthermia, 10 mg/kg of degradable starch microspheres was administered into the hepatic artery as an initial dose and 5 mg/kg of the drug was added periodically under the measurement of hepatic arterial blood flow by an electromagnetic flowmeter. To evaluate the effect of degradable starch microspheres, the temperature increase in the liver and rectum was compared between the treatment with and without DSM. All pigs showed a larger increase in intrahepatic temperature when heated in combination with degradable starch microspheres than without. On the other hand, temperature increase in the rectum as a result of hyperthermia to the liver was suppressed by DSM as compared with hyperthermia alone. These results indicate that hepatic arterial embolization by degradable starch microspheres potentiates radiofrequency capacitive heating of the liver. Although this study was not made with liver tumors, regional hyperthermia may be effective in the control of liver tumors when heat is given after the blockade of the hepatic artery by DSM.     

Hyperthermia combined with radiation therapy for primarily unresectable and recurrent colorectal cancer.

The value of adjuvant hyperthermia to radiotherapy in the treatment of locally advanced colorectal cancers was investigated. Between 1981 and 1989, 71 primarily unresectable or recurrent colorectal tumors were treated with radiotherapy at the Department of Radiology, Kyoto University Hospital. Of the 71 tumors, 35 were treated with radiotherapy plus hyperthermia (group I), while 36 tumors (group II) were unsuitable for hyperthermia mainly because of difficulties with the insertion of temperature probes or the thickness of the patient's subcutaneous fat (greater than 2 cm). The mean total radiation dose was 58 Gy and 57 Gy for groups I and II, respectively. Thirty deep-seated pelvic tumors were treated with an 8 MHz radiofrequency capacitive heating device, and five subsurface tumors were treated with a 430 MHz microwave hyperthermia system. Hyperthermia was given following radiotherapy for 30-60 min for a total of 2-14 sessions (mean 5.7). In 32 of the 35 tumors heated, direct measurement of tumor temperature was performed. For the five tumors treated with the microwave heating device, the means of the mean maximum, average, and minimum measured intratumoral temperatures were 45.4 degrees C, 43.3 degrees C, and 40.6 degrees C, respectively. The corresponding values were 42.2 degrees C, 41.3 degrees C, and 40.3 degrees C for the 27 tumors treated with the capacitive heating device. Effective heating of deep-seated pelvic tumors was more difficult than heating of abdominal wall or perineal tumors. The local control rate at 6 months after the treatment, which was defined as absence of local progression of the tumors, was 59% (17/29) and 37% (11/30) for groups I and II, respectively. The objective tumor response rate (complete regression plus partial response) evaluated by computed tomography was 54% (19/35) in group I, whereas it was 36% (10/28) in group II. A better response rate of 67% was obtained in the 15 tumors with a mean average tumor temperature of greater than 42 degrees C. Although limitation of our current heating devices exist, the combination of hyperthermia with radiotherapy is a promising treatment modality in the treatment of locally advanced colorectal cancer.     

Increased heating efficiency of hyperthermia using an ultrasound contrast agent: A phantom study

It is known that there are large temperature elevations in proximity to air bubbles during US (ultrasound) heating. The existence of tiny air bubbles in the target tissue may enhance the temperature elevation in US hyperthermia. To examine this hypothesis, phantom tissue experiments using an US contrast agent consisting of tiny air bubbles surrounded by a 5% (w/v) human albumin shell (Alb) were performed. As a phantom tissue, a 2 cm cube of beef was used. The phantom tissue was heated with or without the US contrast agent by an US hyperthermia device for 3 min. The heating device was operated at 1.5 MHz with the US intensity of 0.9 W/cm². Physiological saline solution, iodized oil, and ethanol were used for control experiments. The effect of multiple needle punctures to the beef phantom was also examined. The temperature elevation rate (TER) was defined as the ratio of temperature elevation by heating with Alb or control materials to the temperature elevation by US heating alone. The TER of Alb was 1.7, whereas the TERs of the control materials and of the multiple needle punctures were approximately 1. The administration of Alb significantly increased the temperature in US hyperthermia. In addition, the heating efficiency of Alb was compared to the effect of an increase in the US intensity. Phantom tissue was heated at various US intensities. When the US intensity was increased from 0.9 to 1.8 W/ cm², the temperature elevated by approximately 1.7-fold. Thus, the effect of the administration of Alb was almost equivalent to the effect of increase in US power intensities from 0.9 to 1.8W/cm² in the present experimental settings. The results suggest that the US contrast agent can be a potential enhancer in US hyperthermia.     

Focal heating of V-2 tumors with a hybrid radiofrequency applicator

A hybrid radiofrequency heating system previously reported to produce highly focused heating patterns at less than or equal to 10 cm depth in phantom models was utilized to selectively heat hypervascular, heat resistant rabbit V-2 tumors implanted in the left hindlimb. Spheroidal heating patterns 3 to 4 cm in diameter with minimal temperatures of 43 degrees C to 46 degrees C in two non-field perturbing probes at opposing edges of the tumor were consistently produced; however, temperature maxima 0.5 +/- 0.4 to 8.6 +/- 5.9 degrees C above minimum target temperatures of 43 degrees C and 46 degrees C, respectively, were observed. This led to both tumor regressions and adjacent normal tissue damage in some animals. These findings suggest this system may have application to selective heating of deep seated tumors, but that problems related to accurate thermal mapping and to intratumor temperature distribution must first be resolved.     

Nanoparticle-mediated radiofrequency capacitive hyperthermia: A phantom study with magnetic resonance thermometry

Abstract

In hyperthermia, focusing heat generation on tumour tissues and precisely monitoring the temperature around the tumour region is important. To focus heat generation in radiofrequency (RF) capacitive heating, magnetic nanoparticles suspended in sodium carboxymethyl cellulose (CMC) solution were used, based on the hypothesis that the nanoparticle suspension would elevate electrical conductivity and RF current density at the nanoparticle-populated region. A tissue-mimicking phantom with compartments with and without nanoparticles was made for RF capacitive heating experiments. An FDTD model of the phantom was developed to simulate temperature increases at the phantom. To monitor temperature inside the phantom, MR thermometry was performed intermittently during RF heating inside a 3Tesla MRI magnet bore. FDTD simulation on the phantom model was performed in two steps: electromagnetic simulation to compute specific absorption rate and thermal simulation to compute temperature changes. Experimental temperature maps were similar to simulated temperature maps, demonstrating that nanoparticle-populated regions drew more heat than background regions. Nanoparticle-mediated RF heating could mitigate concerns about normal tissue death during RF capacitive hyperthermia.     

Changes in heating patterns of interstitial microwave antenna arrays at different insertion depths

The changes in heating patterns of interstitial microwave antennas at different insertion depths were investigated in a static phantom at 915 MHz. Antennas for the Clini-Therm Mark VI system were inserted 5-15 cm into muscle-equivalent material, through nylon catheters. The phantom was heated with arrays of antennas at 2 cm spacings for 60 s at 15 W per antenna. Midplane and transverse heating patterns were determined thermographically with the antennas inserted parallel or perpendicular to the split of the phantom. Hot spots, independent of heating near the junction plane, were observed in the midplane of the 2 x 2 and 2 x 4 arrays at 2.8 cm from the insertion end. The magnitudes of these hot spots were reduced by 40-45 per cent as insertion depth was increased from 7 to 10.5 cm. With insertion depths of more than 11.5 cm the hot spots gradually diminished and heating occurred mostly near the junction plane. The observed heating patterns were caused by changes in impedance of the antenna arrays at different insertion depths. The impedance mismatch had resulted in different wave propagation within the tissue material which produced different radiation patterns. During treatments, because heating varies with insertion depth, great care must be exercised in monitoring temperatures.     

Effect of functional magnetic particles on radiofrequency capacitive heating: an in vivo study.

Specific heating of magnetic particles in radiofrequency (RF) capacitive hyperthermia and its hyperthermic effect were investigated in an in vivo study. Magnetite cationic liposomes (MCLs) were injected into a rat tumor on the femur and 8 MHz-RF capacitive heating was applied to the rat under "mild heating" conditions. Although the input power of RF capacitive heating was low under the same power conditions, the MCLs-injected tumor was heated over 43 degrees C, whereas it was only heated to 41 degrees C in the case of the rats not injected with MCLs. A necrotic area in the tumor was observed in the heated rats. From the results of histological observation of the removed tissue, the necrotic area in the MCLs-injected tumor was wider than that in MCLs-free tumor. Complete tumor suppression was observed in 71% (5 / 7) of MCLs-injected rats, and the hyperthermic effect was greatly improved by the MCLs.     

Radiofrequency (RF) capacitive hyperthermia combined with radiotherapy in the treatment of abdominal and pelvic deep-seated tumors

Thermal parameters and tumor response were determined in 33 abdominal and pelvic deep-seated tumors which were treated with hyperthermia in combination with radiation therapy. Hyperthermia was applied regionally for a total of 3-14 sessions (mean; 6.4 sessions), using an 8 MHz radiofrequency (RF) capacitive heating device. An average tumor temperature (Tav) of more than 42 degrees C was achieved in 17 (52%) tumors, and intratumor temperatures above 42 degrees C could be maintained for more than 20 min (effective heat session) in 103 (52%) of the 198 heat sessions. Of the 33 tumors, 4 tumors exhibited complete regression (CR), 7 PRa (80-99% regression), 7 PRb (50-79% regression) and 15 NR (less than 50% regression). Tumor response (CR + PRa) was apparently dependent on the thermal parameters. Tumors with Tav of more than 42 degrees C or those receiving more than three effective heat sessions showed a significantly higher response rate than those heated less effectively. This trend was also noted in minimum tumor temperature. As to radiation dose, most of the responders received a total of 60-70 Gy irradiation. The two characteristic features in tumor response in effectively heated tumors, were slow tumor regression and appearance of an intratumor low density area on post-treatment computed tomography.     

Comparative thermal dosimetry of interstitial microwave and radiofrequency-LCF hyperthermia

Steady-state temperature distributions induced by commercial radiofrequency localized current field (RF-LCF) and microwave (MW) interstitial heating systems were compared in dog thigh muscle in vivo using repeated 15-min heating experiments in the same implant site. Control experiments consisting of up to nine successive, identical heat trials with either modality verified that induced temperature distributions could be duplicated reliably. For all comparative dosimetry experiments a square array of parallel heat sources and thermometry probes was inserted percutaneously through a 5 mm grid Plexiglas template to a depth of 7.0-8.0 cm. Metal trocar electrodes were left at the corners of square arrays for two or three successive RF-LCF heat trials. After the metal trocars were removed, two or three more heat trials were performed using dipole microwave antennas in Teflon catheters at the same four positions. The three-dimensional temperature distributions within the array boundaries were characterized by mapping up to 11 fibre optic temperature probes in 1 cm increments during the steady-state plateau of each trial. The distributions were analysed quantitatively in terms of the percentage of measured points which achieved at least 50 per cent of the maximum array temperature increase above baseline (delta Tmax). Results showed that the RF-LCF technique heated more uniformly with depth along the bare metal electrodes and more consistently within the array boundaries than the microwave dipole antennas. For all array spacings studied (1.0-3.5 cm), the RF electrodes heated approximately 10-20 per cent more of the array volume to greater than 50 per cent of delta Tmax.     

Changes in heating patterns of interstitial microwave antenna arrays at different insertion depths

The changes in heating patterns of interstitial microwave antennas at different insertion depths were investigated in a static phantom at 915 MHz. Antennas for the Clini-Therm Mark VI system were inserted 5–15 cm into muscle-equivalent material, through nylon catheters. The phantom was heated with arrays of antennas at 2 cm spacings for 60 s at 15 W per antenna. Midplane and transverse heating patterns were determined thermographically with the antennas inserted parallel or perpendicular to the split of the phantom. Hot spots, independent of heating near the junction plane, were observed in the midplane of the 2×2 and 2×4 arrays at 2.8 cm from the insertion end. The magnitudes of these hot spots were reduced by 40–45 per cent as insertion depth was increased from 7 to 10–5 cm. With insertion depths of more than 11–5 cm the hot spots gradually diminished and heating occurred mostly near the junction plane. The observed heating patterns were caused by changes in impedance of the antenna arrays at different insertion depths. The impedance mismatch had resulted in different wave propagation within the tissue material which produced different radiation patterns. During treatments, because heating varies with insertion depth, great care must be exercised in monitoring temperatures.