A new thermal dose model based on Vogel-Tammann-Fulcher behaviour in thermal damage processes.

Thermal dose models are metrics that quantify the thermal effect on tissues based on the temperature and the time of exposure. These models are used to predict and control the outcome of hyperthermia (up to 45°C) treatments, and of thermal coagulation treatments at higher temperatures (>45°C). The validity and accuracy of the commonly used models (CEM43) are questionable when heating above the hyperthermia temperature range occurs, leading to an over-estimation of the accumulation of thermal damage. A new CEM43 dose model based on an Arrhenius-type, Vogel-Tammann-Fulcher, equation using published data, is introduced in this work. The new dose values for the same damage threshold that was produced at different in-vivo skin experiments were in the same order of magnitude, while the current dose values varied by two orders of magnitude. In addition, the dose values obtained using the new model for the same damage threshold in 6 lesions in ex-vivo liver experiments were more consistent than the current model dose values. The contribution of this work is to provide new modeling approaches to inform more robust thermal dosimetry for improved thermal therapy modeling, monitoring, and control.

Efficient Frequency-Domain Synthetic Aperture Focusing Techniques for Imaging With a High-Frequency Single-Element Focused Transducer.

Synthetic aperture focusing techniques (SAFT) make the spatial resolution of the conventional ultrasound imaging from a single-element focused transducer more uniform in the lateral direction. In this work, two new frequency-domain (FD-SAFT) algorithms are proposed, which are based on the synthetic aperture radar's wavenumber algorithm, and 2-D matched filtering technique for the image reconstruction. The first algorithm is the FD-SAFT virtual source (FD-SAFT-VS) that treats the focus of a focused transducer as a virtual source having a finite size and the diffraction effect in the far-field is taken into consideration in the image reconstruction. The second algorithm is the FD-SAFT deconvolution (FD-SAFT-DE) that uses the simulated point spread function of the imaging system as a matched filter kernel in the image reconstruction. The performance of the proposed algorithms was studied using a series of simulations and experiments, and it was compared with the conventional B-mode and time-domain SAFT (TD-SAFT) imaging techniques. The image quality was analyzed in terms of spatial resolution, sidelobe level, signal-to-noise ratio (SNR), contrast resolution, contrast-to-speckle ratio, and ex vivo image quality. The results showed that the FD-SAFT-VS had the smallest spatial resolution and FD-SAFT-DE had the second smallest spatial resolution. In addition, FD-SAFT-DE had generally the largest SNR. The computation run time of FD-SAFT-VS and FD-SAFT-DE, depending on the image size, was lower by 4 to 174 times and 4 to 189 times, respectively, compared to the TD-SAFT-virtual point source.

Edge-element based finite element analysis of microwave hyperthermia treatments for superficial tumours on the chest wall.

Several three-dimensional hyperthermia treatment planning systems for deep regional hyperthermia have been successfully utilized for improving the performance of applicators such as the BSD Sigma 60. Treatment planning systems for superficial heating in contrast have been less utilized. This paper presents a study of the applicability of the finite element method that has been developed for modelling hyperthermia treatments of recurrent chest wall cancer using a patient geometry. The patient model was created by reconstructing the tissue geometry of a patient using a series of axial CT scans. Tetrahedral grids were generated from this geometry for use in finite element simulations of the SAR profile using edge-elements and in finite element simulations of the steady-state temperature profile using scalar elements. The predicted temperature profile was well correlated with thermometry readings taken after 30 min of heating during a hyperthermia treatment. The model predicted the presence of hot-spots in regions that were not monitored. Simulations also showed that the hot-spots can be manipulated by rotating the applicator by 90 degrees. This study demonstrates the ability of the model to provide detailed and accurate heating profiles in a patient specific model for superficial microwave hyperthermia of the chest wall.

An edge-element based finite element model of microwave heating in hyperthermia: application to a bolus design.

Heating of superficial tumours with microwave waveguide applicators has been shown in phase III trials to significantly improve the local control of small lesions when combined with radiation therapy. This success has not yet translated to the treatment of larger tumours, due to difficulty in adequately heating the entire tumour region. Several modifications to the water bolus used with external waveguide applicators have been made in the past in order to increase the heating area. One such modification consisted of a large, microwave-absorbing patch placed inside the bolus, which flattens out the beam profile produced by the applicator. Using this bolus instead of a conventional one resulted in a 30% increase in the effective heating volume produced by the BSD MA120 applicator. This paper describes an optimization procedure for this bolus design which utilises a new finite element model of microwave heating described in an accompanying paper. The optimization procedure resulted in a further 28% increase in the effective heating volume.

An edge-element based finite element model of microwave heating in hyperthermia: method and verification.

Hyperthermia has been shown to improve local tumour control of superficial and deep seated lesions when combined with radiotherapy. There remains difficulty in heating larger tumours with conventional applicators, but this is being addressed by several new applicator designs. This paper presents a new numerical model of microwave heating which is designed to aid in the development of new applicators for superficial heating. The model is based on a finite element method which utilises vector valued basis functions instead of the more conventional scalar valued basis functions. These basis functions were chosen since they are inherently suited for the solution of Maxwell's equations due to their vector nature. The model was successfully verified against an analytic solution to the Mie scattering problem as well as against previously published measurements of heating from a modified water bolus attached to a conventional waveguide applicator. An accompanying paper describes an application of this model to the design optimization of this modified bolus.

Effect of simultaneous pulsed hyperthermia and pulsed radiation treatment on survival of SiHa cells.

Relatively mild temperatures (40-41.5 degrees C) can sensitize human cells to radiation without the development of thermal tolerance to radiosensitization. Therefore there may be a therapeutic benefit to adding mild hyperthermia to brachytherapy regimens for the treatment of cancer. However, the required heating times are long (approximately 48 h) which renders this approach somewhat impractical. A novel alternative is to combine pulsed brachytherapy with pulsed hyperthermia to enable the total radiation dose to be given at an elevated temperature while the total heating time is kept short. A treatment schedule in which 1 Gy radiation pulses were given once per hour during 5-min heating pulses also delivered once per hour, was investigated in vitro in the human cervical carcinoma line, SiHa. The degree of cytotoxicity and thermoradiosensitization of the cells were assessed by cell survival using the colony forming assay. Cells were exposed to pulsed hyperthermia alone (5 min at 45 degrees C, delivered once per hour), acute hyperthermia alone (45 degrees C), pulsed radiation alone (1 Gy per hour), acute radiation alone, and simultaneous pulsed hyperthermia and pulsed radiation. Pulsed heating alone caused little cytotoxicity. However when pulsed heating was added to pulsed radiation, the level of cytotoxicity was greater than for pulsed radiation alone or acute radiation alone. The effect was also greater than would be predicted from a simple additive effect of pulsed radiation and pulsed heating. In conclusion, pulsed heating at 45 degrees C sensitized cells to pulsed radiation without the development of thermal tolerance.

Digital portal image registration by sequential anatomical matchpoint and image correlations for real-time continuous field alignment verification.

Detection of radiotherapy field misalignments with electronic portal imaging devices requires the precise initial registration of the digital portal image with a reference image indicating the prescribed field alignment. Moreover, for real-time continuous detection this registration must be performed rapidly--arguably within 250 ms. The quality of this registration is sensitive to the ability of the user to accurately identify corresponding anatomical landmarks in the image pair. To improve the accuracy of the registration and, ultimately, that of the field misalignment measurement, we have developed a sequential digital portal image registration method using both user-identified anatomical matchpoints and image information. A first pass generates registration parameters from user-provided matchpoint coordinates and explicitly accounts for the uncertainty in matchpoint identification. The second pass uses both the initial registration parameters and image information to further improve the registration quality by maximizing cross correlations between segments of the image pair. As this registration method does not use massive matrix/vector computations common to other algorithms, it is inherently faster and well-suited for real-time field placement error detection. On a platform representative of those controlling many commercial electronic portal imaging devices (486 CPU), this algorithm registers portal images in times of less than 6 ms per matchpoint with errors of less than 2% in magnification, 0.5 degree in in-plane rotation, and less than 1 pixel dimension in in-plane translation. As the algorithm assumes a rigid-body geometry, it is sensitive to out-of-plane rotations. A quantitative analysis of this algorithm is presented, indicates its accuracy, and describes its sensitivity to out-of-plane rotations.