Thermoregulatory responses to RF energy absorption

Effects of transcutaneous radiofrequency diathermy versus ultrasound on latent myofascial trigger points in the upper trapezius: A randomized crossover trial

BACKGROUND

Currently, the use of radiofrequency diathermy for the treatment of neck pain is booming.

OBJECTIVE

This study aimed to evaluate the clinical efficacy of Digital Capacitive Diathermy (DCD®) on stiffness, pain, cervical range of motion, and cervical disability and to compare it with ultrasound (US) in patients with latent myofascial trigger point (MTrP) in the upper trapezius.

METHODS

Nineteen participants with latent MTrPs in the upper trapezius were included in the assessor-masked, randomized, clinical crossover trial. Subjects were exposed to both interventions: US and DCD® and treatment effectiveness was measured by myotonometric variables, pressure pain threshold (PPT), visual analog scale (VAS), cervical side-bending flexion ranges, and the neck disability index scale (NDI).

RESULTS

There were no significant differences between US and DCD® interventions regarding changes in outcome measures. The US group achieved a statistically significant difference of 2.16 to 1.13 points (p= 0.005; r= 0.646) for the VAS. The DCD® intervention showed a statistically significant improvement of 1.11 points for the NDI at 1-week following intervention (95% CI 0.14-2.07; p= 0.27; d= 0.217).

CONCLUSION

Our findings suggest that DCD® and US can both be considered effective modalities for the treatment of latent MTrPs, having a longer duration of action with DCD® therapy.

A Comparison of the Effect of a 4.4-MHz Radiofrequency Deep Heating Therapy and Ultrasound on Low Back Pain: A Randomized, Double-Blind, Multicenter Trial

Despite the increasing interest in RF (Radiofrequency) therapy, little is known about its effectiveness for low back pain (LBP). The aim of this study was to investigate the effectiveness of 4.4-MHz RF diathermy compared to ultrasound (US) in patients with LBP. One-hundred-and-eighteen patients with LBP were randomized with RF (n = 62) or US (n = 56). Investigator and subjects were blinded to the treatment group. Either RF (4.4 MHz, 45 W/cm2) or US (1 MHz, 2 W/cm2) was applied for 10 to 15 min, 3 times per week for 4 weeks. The primary outcome was the Oswestry Disability Index (ODI, %). Secondary outcomes were numeric rating scale (NRS), Biering−Sorensen test, up-and-go test, successful pain relief, and successful functional improvement. Clinical outcomes were evaluated prior to intervention (baseline), and at 4 and 12 weeks after treatment. There were no significant differences between the groups regarding baseline demographic and clinical characteristics. Both groups observed a significant improvement of ODI (%), NRS, Biering−Sorensen test, and up-and-go test at 4 and 12 weeks after treatment (p < 0.05); however, no significant differences were found between groups. The RF group showed a higher proportion of successful pain relief at 12 weeks after treatment than the US group (p = 0.048). The RF diathermy showed favorable results in pain reduction, improvement of function, mobility, and back muscle endurance. Compared with US, RF diathermy obtained slightly better perception of patients in pain relief at 12 weeks after treatment. The results from this study indicated that 4.4-MHz RF diathermy can effectively be used as a conservative treatment option for patients with LBP.

Protection of Workers Exposed to Radiofrequency Electromagnetic Fields: A Perspective on Open Questions in the Context of the New ICNIRP 2020 Guidelines

Workers in occupational settings are usually exposed to numerous sources of electromagnetic fields (EMF) and to different physical agents. Risk assessment for industrial workplaces concerning EMF is not only relevant to operators of devices or machinery emitting EMF, but also to support-workers, bystanders, service and maintenance personnel, and even visitors. Radiofrequency EMF guidelines published in 2020 by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) may also be indirectly applied to assess risks emerging from EMF sources at workplaces by technical standards or legislation. To review the applicability and adequacy to assess exposure to EMF in occupational settings in the European Union, the most current ICNIRP guidelines on radiofrequency EMF are reviewed. Relevant ICNIRP fundamentals and principles are introduced, followed by practical aspects of exposure assessment. To conclude, open questions are formulated pointing out gaps between the guidelines' principles and occupational practice, such as the impact of hot and humid environments and physical activity or controversies around ICNIRPS's reduction factors in view of assessment uncertainty in general. Thus, the article aims to provide scientific policy advisors, labor inspectors, or experts developing standards with a profound understanding about ICNIRP guidelines' applicability to assess hazards related to radiofrequency EMF in occupational settings.

Systemically delivered antibody-labeled magnetic iron oxide nanoparticles are less toxic than plain nanoparticles when activated by alternating magnetic fields

OBJECTIVE

Toxicity from off-target heating with magnetic hyperthermia (MHT) is generally assumed to be understood. MHT research focuses on development of more potent heating magnetic iron oxide nanoparticles (MIONs), yet our understanding of factors that define biodistribution following systemic delivery remains limited. Preclinical development relies on mouse models, thus understanding off-target heating with MHT in mice provides critical knowledge for clinical development.

METHODS

Eight-week old female nude mice received a single tail vein injection of bionized nanoferrite (BNF) MIONs or a counterpart labeled with a polyclonal human antibody (BNF-IgG) at 1 mg, 3 mg or 5 mg Fe/mouse on day 1. On day 3, mice were exposed to an alternating magnetic field (AMF) having amplitude of 32, 48 or 64 kA/m at ∼145 kHz for 20 min. Twenty-four hours later, blood, livers and spleens were harvested and analyzed.

RESULTS

Damage to livers was apparent by histology and serum liver enzymes following MHT with BNF or BNF-IgG at doses ≥3 mg Fe and AMF amplitudes ≥48 kA/m. Differences between effects with BNF vs. BNF-IgG at a dose of 3 mg Fe were noted in all measures, with less damage and increased survival occurring in mice injected with BNF-IgG. Necropsies revealed severe damage to duodenum and upper small intestines, likely the immediate cause of death at the highest MHT doses.

CONCLUSION

Results demonstrate that the MION coating affects biodistribution, which in turn determines off-target effects. Developments to improve heating capabilities of MIONs may be clinically irrelevant without better control of biodistribution.

Thermophysiological responses to capacitive resistive monopolar radiofrequency electromagnetic radiation in patients with osteoarthritis of the knee joint: A randomised controlled experimental study

This study investigated the effect of 448 kHz capacitive resistive monopolar radiofrequency (CRMRF) on the superficial and deep physiological responses of patients with osteoarthritis (OA) of the knee(s). Forty-five patients diagnosed with OA in their knee(s) were enrolled into a three-group randomised controlled study, from the waiting list of a local hospital. They received localized treatment with either CRMRF, CRMRF placebo or a control (no treatment) to the knee for 15 minutes. Pre, post, and 20 min follow-up measurements of skin temperature (SKT) and skin blood flow (SBF) were obtained from the knee using the FlexComp Infiniti (SA7550) physiological measurement system. Pre and post-treatment deep blood flow were recorded using Doppler ultrasound. Core temperature, blood pressure (BP) and pulse rate (PR) were concurrently monitored. Group data were compared using the ANOVA model. Statistical significance was set at p ≤ 0.05, 0.8 power, and 95% CI. Significant increases and sustenance of SKT and SBF, and significant increases in volume and intensity of deep blood flow were demonstrated with CRMRF over the placebo and control interventions in all comparisons (p< .001). No meaningful changes in blood flow velocity, core temperature, BP, or PR were noted for any condition. The findings were markedly more pronounced than those previously reported in asymptomatic adults. However, the patients had received a higher average dose of CRMRF (mean (SD): 46.87 (4.08) W) compared to the asymptomatic sample (mean (SD): 42.37 (4.64) W); therefore, further research is needed to better understand the differences in physiological responses between patients and asymptomatic people.

The dietary protein content slightly affects the body temperature of growing pigs exposed to heat stress

Heat stress (HS) increases body temperature (BT) and reduces feed intake in pigs. Increasing the dietary protein content may correct the reduced amino acid intake provoked by HS, but it may further increase BT. The effect of dietary protein level on BT of HS pigs was analyzed with nine ileal cannulated pigs (61.7 ± 2.5 kg body weight). A thermometer set to register BT at 5-min intervals was implanted into the ileum. There were two treatments: low-protein (10.8%) wheat-free-amino acid diet (LP); high-protein (21.6%), wheat-soybean-meal diet (HP). The study was conducted in two 10-d periods; in each period, d1 to d6 was for diet adaptation, d7 to d9 was for data analysis, and d10 for ileal sample collection. Pigs were fed at 0600 h (morning), 1400 h (midday), and 2200 h (evening), same amount each time. Following, the separate contribution of ambient temperature and thermal effect of feeding on the postprandial BT increment was analyzed in fed and fasted pigs. Ambient temperature ranged from 30.1 to 35.4 °C and relative humidity from 50% to 84%. Both ambient temperature and BT followed similar patterns. The BT of HP pigs after the morning and midday meals was higher (P < 0.05) but size of the BT increments did not differ between HP and LP pigs. Midday and evening postprandial BT were higher than postprandial morning BT (P < 0.05). The BT increment was larger and longer after the midday than after the morning and evening meals (P < 0.05). The capacity of pigs to dissipate postprandial body heat depends on the accumulated thermal load received before their meals, because the thermal load before the morning meal was smaller than that before the evening meal. The estimated contribution of thermal effect of feeding (0.42 to 0.87 °C) on the total postprandial BT increment (0.69 to 1.53 °C) was larger (P < 0.05) than that of ambient temperature (0.27 to 0.66 °C). In conclusion, these data indicate that the dietary protein level has a small effect on the BT of HS pigs regardless of feeding time. Also both the thermal effect of feeding and ambient temperature impact the BT of HS pigs, although the former had a stronger effect. This information may be useful to design better feeding strategies for pigs exposed to HS conditions.

Effect of Exposure to a Radiofrequency Electromagnetic Field on Body Temperature in Anesthetized and Non-Anesthetized Rats

Exposure to a radiofrequency (RF) signal at a specific absorption rate (SAR) of 4 W/kg can increase the body temperature by more than 1 °C. In this study, we investigated the effect of anesthesia on the body temperature of rats after exposure to an RF electromagnetic field at 4 W/kg SAR. We also evaluated the influence of body mass on rats' body temperature. Rats weighing 225 and 339 g were divided into sham- and RF-exposure groups. Each of the resulting four groups was subdivided into anesthetized and non-anesthetized groups. The free-moving rats in the four RF-exposure groups were subjected to a 915 MHz RF identification signal at 4 W/kg whole-body SAR for 8 h. The rectal temperature was measured at 1-h intervals during RF exposure using a small-animal temperature probe. The body temperatures of non-anesthetized, mobile 225 and 339 g rats were not significantly affected by exposure to an RF signal. However, the body temperatures of anesthetized 225 and 339 g rats increased by 1.9 °C and 3.3 °C from baseline at 5 and 6 h of RF exposure, respectively. Three of the five 339 g anesthetized and exposed rats died after 6 h of RF exposure. Thus, anesthesia and body mass influenced RF exposure-induced changes in the body temperature of rats. Bioelectromagnetics. 2020;41:104-112. © 2019 Bioelectromagnetics Society.

Heart rate variability affected by radiofrequency electromagnetic field in adolescent students

This study examines the possible effect of radiofrequency (RF) electromagnetic fields (EMF) on the autonomic nervous system (ANS). The effect of RF EMF on ANS activity was studied by measuring heart rate variability (HRV) during ortho-clinostatic test (i.e., transition from lying to standing and back) in 46 healthy grammar school students. A 1788 MHz pulsed wave with intensity of 54 ± 1.6 V/m was applied intermittently for 18 min in each trial. Maximum specific absorption rate (SAR₁₀ ) value was determined to 0.405 W/kg. We also measured the respiration rate and estimated a subjective perception of EMF exposure. RF exposure decreased heart rate of subjects in a lying position, while no such change was seen in standing students. After exposure while lying, a rise in high frequency band of HRV and root Mean Square of the Successive Differences was observed, which indicated an increase in parasympathetic nerve activity. Tympanic temperature and skin temperature were measured showing no heating under RF exposure. No RF effect on respiration rate was observed. None of the tested subjects were able to distinguish real exposure from sham exposure when queried at the end of the trial. In conclusion, short-term RF EMF exposure of students in a lying position during the ortho-clinostatic test affected ANS with significant increase in parasympathetic nerve activity compared to sham exposed group. Bioelectromagnetics. 39:277-288, 2018. © 2018 Wiley Periodicals, Inc.

Skeptical approaches concerning the effect of exposure to electromagnetic fields on brain hormones and enzyme activities

This review discusses the effects of various frequencies of electromagnetic fields (EMF) on brain hormones and enzyme activity. In this context, the mechanism underlying the effects of EMF exposure on tissues generally and cellular pathway specifically has been discussed. The cell membrane plays important roles in mediating enzymatic activities as to response and reacts with extracellular environment. Alterations in the calcium signaling pathways in the cell membrane are activated in response to the effects of EMF exposure. Experimental and epidemiological studies have demonstrated that no changes occur in serum prolactin levels in humans following short-term exposure to 900 Mega Hertz (MHz) EMF emitted by mobile phones. The effects of EMF on melatonin and its metabolite, 6-sulfatoxymelatonin, in humans have also been investigated in the clinical studies to show a disturbance in metabolic activity of melatonin. In addition, although 900 MHz EMF effects on NF-κB inflammation, its effects on NF-κB are not clear. Abbreviations: ELF-EMF, extremely low frequency electromagnetic fields; EMF, electromagnetic fields; RF, Radiofrequency; ROS, reactive oxygen species; VGCCs, voltage-gated calcium channels; MAPK, mitogen-activated phosphokinase; NF-κB, nuclear factor kappa B; ERK-1/2, extracellular signal-regulated kinase; GSH-Px, glutathione peroxidase; JNK, Jun N-terminal kinases; SOD, superoxide dismutase; MnSOD, manganese-dependent superoxide dismutase; GLUT1, glucose transporter 1; GSSG-Rd, glutathione reductase MDA malondialdehyde; NO, nitric oxide; LH, luteinizing hormone; FSH, follicle-stimulating hormone.

Thermal Response of Human Skin to Microwave Energy: A Critical Review

This is a review/modeling study of heating of tissue by microwave energy in the frequency range from 3 GHz through the millimeter frequency range (30-300 GHz). The literature was reviewed to identify studies that reported RF-induced increases in skin temperature. A simple thermal model, based on a simplified form of Pennes' bioheat equation (BHTE), was developed, using parameter values taken from the literature with no further adjustment. The predictions of the model were in excellent agreement with available data. A parametric analysis of the model shows that there are two heating regimes with different dominant mechanisms of heat transfer. For small irradiated areas (less than about 0.5-1 cm in radius) the temperature increase at the skin surface is chiefly limited by conduction of heat into deeper tissue layers, while for larger irradiated areas, the steady-state temperature increase is limited by convective cooling by blood perfusion. The results support the use of this simple thermal model to aid in the development and evaluation of RF safety limits at frequencies above 3 GHz and for millimeter waves, particularly when the irradiated area of skin is small. However, very limited thermal response data are available, particularly for exposures lasting more than a few minutes to areas of skin larger than 1-2 cm in diameter. The paper concludes with comments about possible uses and limitations of thermal modeling for setting exposure limits in the considered frequency range.

Computational evaluation of amplitude modulation for enhanced magnetic nanoparticle hyperthermia

Magnetic nanoparticles (MNPs) can interact with alternating magnetic fields (AMFs) to deposit localized energy for hyperthermia treatment of cancer. Hyperthermia is useful in the context of multimodality treatments with radiation or chemotherapy to enhance disease control without increased toxicity. The unique attributes of heat deposition and transfer with MNPs have generated considerable attention and have been the focus of extensive investigations to elucidate mechanisms and optimize performance. Three-dimensional (3D) simulations are often conducted with the finite element method (FEM) using the Pennes' bioheat equation. In the current study, the Pennes' equation was modified to include a thermal damage-dependent perfusion profile to improve model predictions with respect to known physiological responses to tissue heating. A normal distribution of MNPs in a model liver tumor was combined with empirical nanoparticle heating data to calculate tumor temperature distributions and resulting survival fraction of cancer cells. In addition, calculated spatiotemporal temperature changes were compared among magnetic field amplitude modulations of a base 150-kHz sinusoidal waveform, specifically, no modulation, sinusoidal, rectangular, and triangular modulation. Complex relationships were observed between nanoparticle heating and cancer tissue damage when amplitude modulation and damage-related perfusion profiles were varied. These results are tantalizing and motivate further exploration of amplitude modulation as a means to enhance efficiency of and overcome technical challenges associated with magnetic nanoparticle hyperthermia (MNH).

EEG Changes Due to Experimentally Induced 3G Mobile Phone Radiation

The aim of this study was to investigate whether a 15-minute placement of a 3G dialing mobile phone causes direct changes in EEG activity compared to the placement of a sham phone. Furthermore, it was investigated whether placement of the mobile phone on the ear or the heart would result in different outcomes. Thirty-one healthy females participated. All subjects were measured twice: on one of the two days the mobile phone was attached to the ear, the other day to the chest. In this single-blind, cross-over design, assessments in the sham phone condition were conducted directly preceding and following the mobile phone exposure. During each assessment, EEG activity and radiofrequency radiation were recorded jointly. Delta, theta, alpha, slowbeta, fastbeta, and gamma activity was computed. The association between radiation exposure and the EEG was tested using multilevel random regression analyses with radiation as predictor of main interest. Significant radiation effects were found for the alpha, slowbeta, fastbeta, and gamma bands. When analyzed separately, ear location of the phone was associated with significant results, while chest placement was not. The results support the notion that EEG alterations are associated with mobile phone usage and that the effect is dependent on site of placement. Further studies are required to demonstrate the physiological relevance of these findings.

Does the Brain Detect 3G Mobile Phone Radiation Peaks? An Explorative In-Depth Analysis of an Experimental Study

This study aimed to investigate whether third generation mobile phone radiation peaks result in event related potentials. Thirty-one healthy females participated. In this single-blind, cross-over design, a 15 minute mobile phone exposure was compared to two 15 minute sham phone conditions, one preceding and one following the exposure condition. Each participant was measured on two separate days, where mobile phone placement was varied between the ear and heart. EEG activity and radiofrequency radiation were recorded jointly. Epochs of 1200 ms, starting 200 ms before and lasting until 1000 ms after the onset of a radiation peak, were extracted from the exposure condition. Control epochs were randomly selected from the two sham phone conditions. The main a-priori hypothesis to be tested concerned an increase of the area in the 240-500 ms post-stimulus interval, in the exposure session with ear-placement. Using multilevel regression analyses the placement*exposure interaction effect was significant for the frontal and central cortical regions, indicating that only in the mobile phone exposure with ear-placement an enlarged cortical reactivity was found. Post-hoc analyses based on visual inspection of the ERPs showed a second significantly increased area between 500-1000 ms post-stimulus for almost every EEG location measured. It was concluded that, when a dialing mobile phone is placed on the ear, its radiation, although unconsciously, is electrically detected by the brain. The question of whether or not this cortical reactivity results in a negative health outcome has to be answered in future longitudinal experiments.

A novel brain stimulation technology provides compatibility with MRI

Clinical electrical stimulation systems--such as pacemakers and deep brain stimulators (DBS)--are an increasingly common therapeutic option to treat a large range of medical conditions. Despite their remarkable success, one of the significant limitations of these medical devices is the limited compatibility with magnetic resonance imaging (MRI), a standard diagnostic tool in medicine. During an MRI exam, the leads used with these devices, implanted in the body of the patient, act as an electric antenna potentially causing a large amount of energy to be absorbed in the tissue, which can lead to serious heat-related injury. This study presents a novel lead design that reduces the antenna effect and allows for decreased tissue heating during MRI. The optimal parameters of the wire design were determined by a combination of computational modeling and experimental measurements. The results of these simulations were used to build a prototype, which was tested in a gel phantom during an MRI scan. Measurement results showed a three-fold decrease in heating when compared to a commercially available DBS lead. Accordingly, the proposed design may allow a significantly increased number of patients with medical implants to have safe access to the diagnostic benefits of MRI.

Effects of microwave radiation on brain energy metabolism and related mechanisms

With the rapid development of electronic technologies, anxiety regarding the potential health hazards induced by microwave radiation (MW) has been growing in recent years. The brain is one of the most sensitive target organs for microwave radiation, where mitochondrial injury occurs earlier and more severely than in other organs. Energy metabolism disorders do play an important role during the process of microwave radiation-induced brain damage. In this paper, we will review the biological effects of microwave radiation, the features of brain energy supply and consumption and the effects of microwave radiation on mitochondrial energy metabolism and potential related mechanisms.

Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90

Non-ionizing radiation at 2.45 GHz may modify the morphology and expression of genes that codify heat shock proteins (HSP) in the thyroid gland. Diathermy is the therapeutic application of non-ionizing radiation to humans for its beneficial effects in rheumatological and musculo-skeletal pain processes. We used a diathermy model on laboratory rats subjected to maximum exposure in the left front leg, in order to study the effects of radiation on the nearby thyroid tissue. Fifty-six rats were individually exposed once or repeatedly (10 times in two weeks) for 30 min to 2.45 GHz radiation in a commercial chamber at different non-thermal specific absorption rates (SARs), which were calculated using the finite difference time domain technique. We used immunohistochemistry methods to study the expression of HSP-90 and morphological changes in thyroid gland tissues. Ninety minutes after radiation with the highest SAR, the central and peripheral follicles presented increased size and the thickness of the peripheral septa had decreased. Twenty-four hours after radiation, only peripheral follicles radiated at 12 W were found to be smaller. Peripheral follicles increased in size with repeated exposure at 3 W power. Morphological changes in the thyroid tissue may indicate a glandular response to acute or repeated stress from radiation in the hypothalamic-pituitary-thyroid axis. Further research is needed to determine if the effect of this physical agent over time may cause disease in the human thyroid gland.

Magnetic resonance imaging contrast of iron oxide nanoparticles developed for hyperthermia is dominated by iron content

PURPOSE

Magnetic iron oxide nanoparticles (MNPs) are used as contrast agents for magnetic resonance imaging (MRI) and hyperthermia for cancer treatment. The relationship between MRI signal intensity and cellular iron concentration for many new formulations, particularly MNPs having magnetic properties designed for heating in hyperthermia, is lacking. In this study, we examine the correlation between MRI T2 relaxation time and iron content in cancer cells loaded with various MNP formulations.

MATERIALS AND METHODS

Human prostate carcinoma DU-145 cells were loaded with starch-coated bionised nanoferrite (BNF), iron oxide (Nanomag® D-SPIO), Feridex™, and dextran-coated Johns Hopkins University (JHU) particles at a target concentration of 50 pg Fe/cell using poly-D-lysine transfection reagent. T2-weighted MRI of serial dilutions of these labelled cells was performed at 9.4 T and iron content quantification was performed using inductively coupled plasma mass spectrometry (ICP-MS). Clonogenic assay was used to characterise cytotoxicity.

RESULTS

No cytotoxicity was observed at twice the target intracellular iron concentration (∼100 pg Fe/cell). ICP-MS revealed highest iron uptake efficiency with BNF and JHU particles, followed by Feridex and Nanomag-D-SPIO, respectively. Imaging data showed a linear correlation between increased intracellular iron concentration and decreased T2 times, with no apparent correlation among MNP magnetic properties.

CONCLUSIONS

This study demonstrates that for the range of nanoparticle concentrations internalised by cancer cells the signal intensity of T2-weighted MRI correlates closely with absolute iron concentration associated with the cells. This correlation may benefit applications for cell-based cancer imaging and therapy including nanoparticle-mediated drug delivery and hyperthermia.

Localized hyperthermia with iron oxide-doped yttrium microparticles: steps toward image-guided thermoradiotherapy in liver cancer

PURPOSE

To test whether iron oxide (IO)-containing yttrium aluminosilicate (YAS) microparticles (MPs) can generate localized therapeutic hyperthermia (≥ 43°C) when injected intratumorally in an animal model of liver cancer and whether MP distributions could be visualized with magnetic resonance (MR) imaging.

MATERIALS AND METHODS

Twenty-one Sprague-Dawley rats implanted with N1-S1 liver tumors were assigned to alternating magnetic field (AMF) exposure following intratumoral injection with IO-YAS MPs (n = 7), sham surgery (n = 7), or baseline iron quantification (n = 7). Three fiberoptic probes allowed spatial and temporal monitoring of temperatures during 24 minutes of AMF exposure. T2-weighted turbo spin-echo MR imaging was performed within 1 hour after the procedure to detect signal voids caused by IO-YAS deposition. Hematoxylin and eosin-stained pathologic slides were also obtained, and the presence of IO-YAS was evaluated with inductively coupled plasma optical emission spectroscopy.

RESULTS

Following AMF exposure, intratumoral temperatures after IO-YAS MP injection achieved therapeutic hyperthermia whereas those after sham surgery did not (46.6°C ± 1.3 vs 36.8°C ± 0.4; P < .0001). Within the treated group, the normal hepatic parenchyma (NHP) and rectal temperatures were 37.4°C ± 0.9 and 36.5°C ± 1.0 (P = .0809) at the conclusion of AMF exposure, respectively. A T2-weighted signal void at the tumor site was observed in all seven treated animals, and intratumoral IO-YAS was visualized on subsequent histopathologic examination in each case. The mean ratio of tumor:NHP Fe concentrations attributable to IO-YAS MPs was 108:1.

CONCLUSIONS

AMF exposure of intratumoral IO-YAS MPs generates localized therapeutic hyperthermia in an animal model of liver cancer. MR detectability and potential for combination brachytherapy warrants further investigation for thermoradiotherapy in liver cancer.

Method to reduce non-specific tissue heating of small animals in solenoid coils

PURPOSE

Solenoid coils that generate time-varying or alternating magnetic fields (AMFs) are used in biomedical devices for research, imaging and therapy. Interactions of AMF and tissue produce eddy currents that deposit power within tissue, thus limiting effectiveness and safety. We aim to develop methods that minimise excess heating of mice exposed to AMFs for cancer therapy experiments.

MATERIALS AND METHODS

Numerical and experimental data were obtained to characterise thermal management properties of water using a continuous, custom water jacket in a four-turn simple solenoid. Theoretical data were obtained with method-of-moments (MoM) numerical field calculations and finite element method (FEM) thermal simulations. Experimental data were obtained from gel phantoms and mice exposed to AMFs having amplitude >50 kA/m and frequency of 160 kHz.

RESULTS

Water has a high specific heat and thermal conductivity, is diamagnetic, polar, and nearly transparent to magnetic fields. We report at least a two-fold reduction of temperature increase from gel phantom and animal models when a continuous layer of circulating water was placed between the sample and solenoid, compared with no water. Thermal simulations indicate the superior efficiency in thermal management by the developed continuous single chamber cooling system over a double chamber non-continuous system. Further reductions of heating were obtained by regulating water temperature and flow for active cooling.

CONCLUSIONS

These results demonstrate the potential value of a contiguous layer of circulating water to permit sustained exposure to high intensity alternating magnetic fields at this frequency for research using small animal models exposed to AMFs.

Computational estimation of decline in sweating in the elderly from measured body temperatures and sweating for passive heat exposure

Several studies reported the difference in heat tolerance between younger and older adults, which may be attributable to the decline in the sweating rate. One of the studies suggested a hypothesis that the dominant factor causing the decline in sweating was the decline in thermal sensitivity due to a weaker signal from the periphery to the regulatory centres. However, no quantitative investigation of the skin temperature threshold for activating the sweating has been conducted in previous studies. In this study, we developed a computational code to simulate the time evolution of the temperature variation and sweating in realistic human models under heat exposure, in part by comparing the computational results with measured data from younger and older adults. Based on our computational results, the difference in the threshold temperatures for activating the thermophysiological response, especially for sweating, is examined between older and younger adults. The threshold for activating sweating in older individuals was found to be about 1.5 °C higher than that in younger individuals. However, our computation did not suggest that it was possible to evaluate the central alteration with ageing by comparing the computation with the measurements for passive heat exposure, since the sweating rate is marginally affected by core temperature elevation at least for the scenarios considered here. The computational technique developed herein is useful for understanding the thermophysiological response of older individuals from measured data.

Computational modeling of temperature elevation and thermoregulatory response in the brains of anesthetized rats locally exposed at 1.5 GHz

The dominant effect of human exposures to microwaves is caused by temperature elevation ('thermal effect'). In the safety guidelines/standards, the specific absorption rate averaged over a specific volume is used as a metric for human protection from localized exposure. Further investigation on the use of this metric is required, especially in terms of thermophysiology. The World Health Organization (2006 RF research agenda) has given high priority to research into the extent and consequences of microwave-induced temperature elevation in children. In this study, an electromagnetic-thermal computational code was developed to model electromagnetic power absorption and resulting temperature elevation leading to changes in active blood flow in response to localized 1.457 GHz exposure in rat heads. Both juvenile (4 week old) and young adult (8 week old) rats were considered. The computational code was validated against measurements for 4 and 8 week old rats. Our computational results suggest that the blood flow rate depends on both brain and core temperature elevations. No significant difference was observed between thermophysiological responses in 4 and 8 week old rats under these exposure conditions. The computational model developed herein is thus applicable to set exposure conditions for rats in laboratory investigations, as well as in planning treatment protocols in the thermal therapy.

Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation

The use of computed tomography (CT) and magnetic resonance (MR) imaging has increased tremendously in the past 2 decades. Hence, pregnant and breast-feeding women, although generally healthier than the population at large, are also more likely to require contrast material-enhanced imaging. When a contrast-enhanced CT or MR imaging study is being considered for a pregnant or lactating patient, the potential risks to the fetus related to exposure to radiation, high magnetic fields, or contrast agents must be considered and weighed carefully against the risks of potential misdiagnosis due to withholding contrast agents and imaging studies. Fetal radiation doses up to 1 mGy are considered acceptable; with larger doses, the risk of carcinogenesis approximately doubles, although it remains low in absolute terms. No damage to a developing human fetus caused by MR imaging exposure has been documented. However, caution is advised, and risks and benefits must always be considered before evaluating a pregnant patient with MR imaging. The use of iodinated contrast agents is generally safe during pregnancy; nevertheless, these agents should be used with caution due to the risk of fetal hypothyroidism and should be administered only when the clinical situation clearly requires doing so. The use of gadolinium-based contrast agents during pregnancy remains controversial due to lack of human clinical data and potential toxicity. Use of all contrast agents is considered safe during lactation. It is hoped that this knowledge will help radiologists develop a consensus with their clinical colleagues regarding case management of pregnant and lactating patients.

Dominant factors affecting temperature rise in simulations of human thermoregulation during RF exposure

Numerical models of the human thermoregulatory system can be used together with realistic voxel models of the human anatomy to simulate the body temperature increases caused by the power absorption from radio-frequency electromagnetic fields. In this paper, the Pennes bioheat equation with a thermoregulatory model is used for calculating local peak temperatures as well as the body-core-temperature elevation in a realistic human body model for grounded plane-wave exposures at frequencies 39, 800 and 2400 MHz. The electromagnetic power loss is solved by the finite-difference time-domain (FDTD) method, and the discretized bioheat equation is solved by the geometric multigrid method. Human thermoregulatory models contain numerous thermophysiological and computational parameters--some of which may be subject to considerable uncertainty--that affect the simulated core and local temperature elevations. The goal of this paper is to find how greatly the computed temperature is influenced by changes in various modelling parameters, such as the skin blood flow rate, models for vasodilation and sweating, and clothing and air movement. The results show that the peak temperature rises are most strongly affected by the modelling of tissue blood flow and its temperature dependence, and mostly unaffected by the central control mechanism for vasodilation and sweating. Almost the opposite is true for the body-core-temperature rise, which is however typically greatly lower than the peak temperature rise. It also seems that ignoring the thermoregulation and the blood temperature increase is a good approximation when the local 10 g averaged specific absorption rate is smaller than 10 W kg(-1).

Thermal aspects of exposure to radiofrequency energy: report of a workshop

This special issue contains papers presented at an international workshop entitled 'Thermal Aspects of Radio Frequency Exposure' convened in Gaithersburg, Maryland, USA on 11-12 January 2010, and co-sponsored by the Mobile Manufacturers Forum, the GSM Association, and the US Food and Drug Administration. The goals of the workshop were to (1) identify appropriate health endpoints associated with thermal hazards and their time-dependence thresholds, and (2) outline future directions for research that might lead to an improved understanding of health and safety implications of human exposure to radiofrequency energy and design of improved exposure limits for this energy. This present contribution summarises some of the major conclusions of the speakers, and offers comments by one of the present authors on proposed research priorities and the implications of the material presented at the workshop for setting improved thermally based limits for human exposure to RF energy.

Radiofrequency radiation at 40 kHz induces hepatic injury in Long-Evans Cinnamon (LEC) rats, an animal model for human Wilson disease

In the present study, we examined effects of radiofrequency (RF) radiation at 40 kHz on hepatic injury in Long-Evans Cinnamon (LEC) rats, an animal model for human Wilson disease, which is a heritable disease of copper metabolism in the liver. The activities of ALT and AST in serum of LEC rats exposed to RF radiation for 2 weeks were approximately 3.8-fold and 2-fold higher than those in serum of sham-exposed rats, respectively. Although there were no significant differences in hepatic copper contents between LEC rats exposed to RF radiation for 2 weeks and sham-exposed rats, copper contents in the kidney and serum of exposed LEC rats were approximately 4.2-fold and 12.9-fold higher than those in sham-exposed rats, respectively. Relative O₂⁻-scavenging activities in the S-100 fraction of the liver of LEC rats exposed to RF radiation for 2 weeks were 1.6-fold higher than those in sham-exposed rats. No significant differences were observed in activities of AST and ALT in serum and relative O₂⁻-scavenging activity in the S-100 fraction of the liver of normal control WKAH rats that were sham-exposed and exposed to RF radiation. No significant differences were observed in copper contents in the liver, kidney and serum of WKAH rats that were sham-exposed and exposed to RF radiation for 2 weeks. The results show that RF radiation at 40 kHz induced hepatic injury in LEC rats.

Effects of W-CDMA 1950 MHz EMF emitted by mobile phones on regional cerebral blood flow in humans

Use of the third generation mobile phone system is increasing worldwide. This is the first study to investigate the effects of the third generation system on regional cerebral blood flow (rCBF) in humans. We compared effects of the electromagnetic field (EMF) emitted from the Wideband Code Division Multiple Access (W-CDMA) cellular system versus sham control exposure on rCBF in humans. Nine healthy male volunteers participated in this study. Positron emission tomography (PET) scans were obtained before, during, and after unilateral 30 min EMF exposure. The subtraction analysis revealed no significant rCBF changes caused by the EMF conditions compared with the sham exposure, suggesting that EMF emitted by a third generation mobile phone does not affect rCBF in humans.

Nearly complete regression of tumors via collective behavior of magnetic nanoparticles in hyperthermia

One potential cancer treatment selectively deposits heat to the tumor through activation of magnetic nanoparticles inside the tumor. This can damage or kill the cancer cells without harming the surrounding healthy tissue. The properties assumed to be most important for this heat generation (saturation magnetization, amplitude and frequency of external magnetic field) originate from theoretical models that assume non-interacting nanoparticles. Although these factors certainly contribute, the fundamental assumption of 'no interaction' is flawed and consequently fails to anticipate their interactions with biological systems and the resulting heat deposition. Experimental evidence demonstrates that for interacting magnetite nanoparticles, determined by their spacing and anisotropy, the resulting collective behavior in the kilohertz frequency regime generates significant heat, leading to nearly complete regression of aggressive mammary tumors in mice.

Physiological recordings: basic concepts and implementation during functional magnetic resonance imaging

Combining human functional neuroimaging with other forms of psychophysiological measurement, including autonomic monitoring, provides an empirical basis for understanding brain-body interactions. This approach can be applied to characterize unwanted physiological noise, examine the neural control and representation of bodily processes relevant to health and morbidity, and index covert expression of affective and cognitive processes to enhance the interpretation of task-evoked regional brain activity. In recent years, human neuroimaging has been dominated by functional magnetic resonance imaging (fMRI) studies. The spatiotemporal information of fMRI regarding central neural activity is valuably complemented by parallel physiological monitoring, yet such studies still remain in the minority. This review article highlights fMRI studies that employed cardiac, vascular, respiratory, electrodermal, gastrointestinal and pupillary psychophysiological indices to address specific questions regarding interaction between brain and bodily state in the context of experience, cognition, emotion and behaviour. Physiological monitoring within the fMRI environment presents specific technical issues, most importantly related to safety. Mechanical and electrical hazards may present dangers to scanned subjects, operator and/or equipment. Furthermore, physiological monitoring may interfere with the quality of neuroimaging data, or itself be compromised by artefacts induced by the operation of the scanner. We review the sources of these potential problems and the current approaches and advice to enable the combination of fMRI and physiological monitoring in a safe and effective manner.

Quantitative evaluations of mechanisms of radiofrequency interactions with biological molecules and processes

The complexity of interactions of electromagnetic fields up to 10(12) Hz with the ions, atoms, and molecules of biological systems has given rise to a large number of established and proposed biophysical mechanisms applicable over a wide range of time and distance scales, field amplitudes, frequencies, and waveforms. This review focuses on the physical principles that guide quantitative assessment of mechanisms applicable for exposures at or below the level of endogenous electric fields associated with development, wound healing, and excitation of muscles and the nervous system (generally, 1 to 10(2) V m(-1)), with emphasis on conditions where temperature increases are insignificant (<<1 K). Experiment and theory demonstrate possible demodulation at membrane barriers for frequencies < or =10 MHz, but not at higher frequencies. Although signal levels somewhat below system noise can be detected, signal-to-noise ratios substantially less than 0.1 cannot be overcome by cooperativity, signal averaging, coherent detection, or by nonlinear dynamical systems. Sensory systems and possible effects on biological magnetite suggest paradigms for extreme sensitivity at lower frequencies, but there are no known radiofrequency (RF) analogues. At the molecular level, vibrational modes are so overdamped by water molecules that excitation of molecular modes below the far infrared cannot occur. Two RF mechanisms plausibly may affect biological matter under common exposure conditions. For frequencies below approximately 150 MHz, shifts in the rate of chemical reactions can be mediated by radical pairs and, at all frequencies, dielectric and resistive heating can raise temperature and increase the entropy of the affected biological system.

Reminiscences of a journeyman scientist: studies of thermoregulation in non-human primates and humans

After graduating from Mount Holyoke College in 1948 where I majored in experimental psychology I worked at the College for 2 years with the Johns Hopkins Thermophysiological Unit. My graduate work later at the University of Wisconsin, centering on sensory psychology, culminated in my 1955 PhD thesis on human dark adaptation. I continued work in sensory psychology later with Neal Miller at Yale and then moved to the John B. Pierce Foundation--a Yale affiliate--where I began the studies of thermoregulation that constitute the center of my scientific career. Those studies were largely--later wholly--conducted using microwave energy as a thermal load and were thus published in Bioelectromagnetics even as I played an active role in the Bioelectromagnetics Society. In the beginning this work was centered on the responses of Squirrel Monkeys to thermal loads. Later, serving as Senior Scientist at the Air Force Research Laboratory at San Antonio, I completed an extensive analysis of thermal regulation in humans. I consider this work of special note inasmuch as the extraordinary human thermoregulatory ability was surely among the attributes that were paramount in initially separating humans from the other anthropoid primates.

The influence of the call with a mobile phone on heart rate variability parameters in healthy volunteers

It is possible that electromagnetic field (EMF) generated by mobile phones (MP) may have an influence on the autonomic nervous system (ANS) and modulates the function of circulatory system. The aim of the study was to estimate the influence of the call with a mobile phone on heart rate variability (HRV) in young healthy people. The time and frequency domain HRV analyses were performed to assess the changes in sympathovagal balance in a group of 32 healthy students with normal electrocardiogram (ECG) and echocardiogram at rest. The frequency domain variables were computed: ultra low frequency (ULF) power, very low frequency (VLF) power, low frequency (LF) power, high frequency (HF) power and LF/HF ratio was determined. ECG Holter monitoring was recorded in standardized conditions: from 08:00 to 09:00 in the morning in a sitting position, within 20 min periods: before the telephone call (period I), during the call with use of mobile phone (period II), and after the telephone call (period III). During 20 min call with a mobile phone time domain parameters such as standard deviation of all normal sinus RR intervals (SDNN [ms]--period I: 73.94+/-25.02, period II: 91.63+/-35.99, period III: 75.06+/-27.62; I-II: p<0.05, II-III: p<0.05) and standard deviation of the averaged normal sinus RR intervals for all 5-mm segments (SDANN [ms]--period I: 47.78+/-22.69, period II: 60.72+/-27.55, period III: 47.12+/-23.21; I-II: p<0.05, II-III: p<0.05) were significantly increased. As well as very low frequency (VLF [ms2]--period I: 456.62+/-214.13, period II: 566.84+/-216.99, period III: 477.43+/-203.94; I-II: p<0.05), low frequency (LF [ms(2)]--period I: 607.97+/-201.33, period II: 758.28+/-307.90, period III: 627.09+/-220.33; I-II: p<0.01, II-III: p<0.05) and high frequency (HF [ms(2)]--period I: 538.44+/-290.63, period II: 730.31+/-445.78, period III: 590.94+/-301.64; I-II: p<0.05) components were the highest and the LF/HF ratio (period I: 1.48+/-0.38, period II: 1.16+/-0.35, period III: 1.46+/-0.40; I-II: p<0.05, II-III: p<0.05) was the lowest during a call with a mobile phone. The tone of the parasympathetic system measured indirectly by analysis of heart rate variability was increased while sympathetic tone was lowered during the call with use of a mobile phone. It was shown that the call with a mobile phone may change the autonomic balance in healthy subjects. Changes in heart rate variability during the call with a mobile phone could be affected by electromagnetic field but the influence of speaking cannot be excluded.

The effect of mobile phone electromagnetic fields on the alpha rhythm of human electroencephalogram

Mobile phones (MP) emit low-level electromagnetic fields that have been reported to affect neural function in humans; however, demonstrations of such effects have not been conclusive. The purpose of the present study was to test one of the strongest findings in the literature; that of increased "alpha" power in response to MP-type radiation. Healthy participants (N = 120) were tested using a double-blind counterbalanced crossover design, with each receiving a 30-min Active and a 30-min Sham Exposure 1 week apart, while electroencephalogram (EEG) data were recorded. Resting alpha power (8-12 Hz) was then derived as a function of time, for periods both during and following exposure. Non-parametric analyses were employed as data could not be normalized. Previous reports of an overall alpha power enhancement during the MP exposure were confirmed (relative to Sham), with this effect larger at ipsilateral than contralateral sites over posterior regions. No overall change to alpha power was observed following exposure cessation; however, there was less alpha power contralateral to the exposure source during this period (relative to ipsilateral). Employing a strong methodology, the current findings support previous research that has reported an effect of MP exposure on EEG alpha power.

Accounting for human variability and sensitivity in setting standards for electromagnetic fields

Biological sensitivity and variability are key issues for risk assessment and standard setting. Variability encompasses general inter-individual variations in population responses, while sensitivity relates to unusual or extreme responses based on genetic, congenital, medical, or environmental conditions. For risk assessment and standard setting, these factors affect estimates of thresholds for effects and dose-response relationships and inform efforts to protect the more sensitive members of the population, not just the typical or average person. While issues of variability and sensitivity can be addressed by experimental and clinical studies of electromagnetic fields, investigators have paid little attention to these important issues. This paper provides examples that illustrate how default assumptions regarding variability can be incorporated into estimates of 60-Hz magnetic field exposures with no risk of cardiac stimulation and how population thresholds and variability of peripheral nerve stimulation responses at 60-Hz can be estimated from studies of pulsed gradient magnetic fields in magnetic resonance imaging studies. In the setting of standards for radiofrequency exposures, the International Commission for Non-Ionizing Radiation Protection uses inter-individual differences in thermal sensitivity as one of the considerations in the development of "safety factors." However, neither the range of sensitivity nor the sufficiency or excess of the 10-fold and the additional 5-fold safety factors have been assessed quantitatively. Data on the range of responses between median and sensitive individuals regarding heat stress and cognitive function should be evaluated to inform a reassessment of these safety factors and to identify data gaps.

Role of blood flow on RF exposure induced skin temperature elevations in rabbit ears

In this in vivo study, we measured local temperature changes in rabbit pinnae, which were evoked by radiofrequency (RF) exposure for 20 min at localized SAR levels of 0 (sham exposure), 2.3, 10.0, and 34.3 W/kg over 1.0 g rabbit ear tissue. The effects of RF exposures on skin temperature were measured under normal blood flow and without blood flow in the ear. The results showed: (1) physiological blood flow clearly modified RF induced thermal elevation in the pinna as blood flow significantly suppressed temperature increases even at 34.3 W/kg; (2) under normal blood flow conditions, exposures at 2.3 and 10.0 W/kg, approximating existing safety limits for the general public (2 W/kg) and occupational exposure (10 W/kg), did not induce significant temperature rises in the rabbit ear. However, 2.3 W/kg induced local skin temperature elevation under no blood flow conditions. Our results demonstrate that the physiological effects of blood flow should be considered when extrapolating modeling data to living animals, and particular caution is needed when interpreting the results of modeling studies that do not include blood flow.