Optimization of microwave hyperthermia system for focused breast cancer treatment: A study using realistic digital breast phantoms

BACKGROUND

Microwave breast hyperthermia is a noninvasive treatment method for breast cancer that utilizes microwave energy (ME) sources to raise tissue temperatures above 42∘ C $^{\circ }{\rm C}$ , inducing tumor cell necrosis. The efficiency of ME deposition depends on the electric field magnitude and tissue conductivity, with antenna phase and amplitude adjustments used to maximize the electric field magnitude within tumors. Achieving precise ME focusing in the complex and heterogeneous breast tissue is challenging and can lead to unwanted hot spots in normal tissue. This study presents a novel method for optimizing ME focusing on the center of target tumors, using a simplified calculation of antenna phases, heuristic optimization for antenna amplitudes, and realistic breast phantoms for performance evaluation.

PURPOSE

In this work, we propose an approach to optimize the microwave hyperthermia system, employing phase and amplitude modulation techniques to concentrate the electric field at the center of a malignant tumor within a breast medium. The approach uses line sources arranged in a circular pattern around realistic breast models. The method begins by determining the phase, followed by adjusting the amplitudes of each source in order to maximize the total electric field at the tumor's center. The goal is to maximize the electric field at the tumor center while minimizing the optimization cost and complexity.

METHODS

Simulations are performed at 4 GHz frequency using two different types of digital breast phantoms (fatty and dense breasts) as test beds. The algorithm is tested by using three quantities; that is, the electric field distribution, the power density distribution, and the temperature distribution inside the whole breast region. The electric field and power density are calculated using an in-house method of moments (MoM) algorithm, while the temperature distributions are obtained with computer simulation technology (CST) software. To further evaluate the method with quantitative measures of success, thermal indices are calculated for each phantom and method.

RESULTS

The specific absorbtion rate (SAR) results and corresponding temperature distributions for each breast type and optimization demonstrate that effective focusing is achieved in both cases. However, the combined phase-amplitude optimization provides more precise focusing by eliminating hot spots. Among thermal indices, the TC75 and T90 values obtained from the phase-amplitude combined optimization for both breast types outperform the results found in the literature. The T50 values obtained using the combined optimization are above 42C ∘ ${\rm C}^\circ$ .

CONCLUSIONS

This study presents an optimization method for focusing ME within breast tissue, performed in two steps: first phase optimization, followed by amplitude optimization. The electric field calculations are performed using both the MoM and Finite Difference Time Domain methods. The technique is numerically tested on two realistic breast models, with thermal indices calculated for each phantom and optimization process. Results show T90 values exceeding 40∘ C $^\circ{\rm C}$ and T50 values above 42∘ C $^\circ{\rm C}$ . While the study employs a 2D applicator, it provides a strong foundation for future development in 3D applications.

Numerical study of the induction of intratumoral apoptosis under microwave ablation by changing slot length of microwave coaxial antenna

Recent advances in technology have led to an increase in the detection of previously undetected deep-located tumor tissue. As a result, the medical field is using a variety of methods to treat deep-located tumors, and minimally invasive treatment techniques are being explored. In this study, therapeutic effect of microwave ablation (MWA) on tumor generated inside liver tissue was analyzed through numerical analysis. The distribution of electromagnetic fields in biological tissues emitted by microwave coaxial antenna (MCA) was calculated through the wave equation, and the thermal behavior of the tissue was analyzed through the Pennes bioheat equation. Among various treatment conditions constituting MWA, tumor radius and the slot length inside the MCA were changed, and the resulting treatment effect was quantitatively confirmed through three apoptotic variables. As a result, each tumor radius has optimal power condition for MWA, 2.6W, 2.4W, and 3.0W respectively. This study confirmed optimal therapeutic conditions for MWA. Three apoptotic variables were used to quantitatively identify apoptotic temperature maintenance inside tumor tissue and thermal damage to surrounding normal tissue. The findings of this study are expected to serve as a standard for treatment based on actual MWA treatment.

Improvement of Phased Antenna Array Applied in Focused Microwave Breast Hyperthermia

Focused microwave breast hyperthermia (FMBH) employs a phased antenna array to perform beamforming that can focus microwave energy at targeted breast tumors. Selective heating of the tumor endows the hyperthermia treatment with high accuracy and low side effects. The effect of FMBH is highly dependent on the applied phased antenna array. This work investigates the effect of polarizations of antenna elements on the microwave-focusing results by simulations. We explore two kinds of antenna arrays with the same number of elements using different digital realistic human breast phantoms. The first array has all the elements' polarization in the vertical plane of the breast, while the second array has half of the elements' polarization in the vertical plane and the other half in the transverse plane, i.e., cross polarization. In total, 96 sets of different simulations are performed, and the results show that the second array leads to a better focusing effect in dense breasts than the first array. This work is very meaningful for the potential improvement of the antenna array for FMBH, which is of great significance for the future clinical applications of FMBH. The antenna array with cross polarization can also be applied in microwave imaging and sensing for biomedical applications.

Comparison of Microwave Hyperthermia Applicator Designs with Fora Dipole and Connected Array

In microwave hyperthermia tumor therapy, electromagnetic waves focus energy on the tumor to elevate the temperature above its normal levels with minimal injury to the surrounding healthy tissue. Microwave hyperthermia applicator design is important for the effectiveness of the therapy and the feasibility of real-time application. In this study, the potential of using fractal octagonal ring antenna elements as a dipole antenna array and as a connected array at 2.45 GHz for breast tumor hyperthermia application was investigated. Microwave hyperthermia treatment models consisting of different fractal octagonal ring antenna array designs and a breast phantom are simulated in COMSOL Multiphysics to obtain the field distributions. The antenna excitation phases and magnitudes are optimized using the global particle swarm algorithm to selectively increase the specific absorption rate at the target region while minimizing hot spots in other regions within the breast. Specific absorption rate distributions, obtained inside the phantom, are analyzed for each proposed microwave hyperthermia applicator design. The dipole fractal octagonal ring antenna arrays are comparatively assessed for three different designs: circular, linear, and Cross-array. The 16-antenna dipole array performance was superior for all three 1-layer applicator designs, and no distinct difference was found between 16-antenna circular, linear, or cross arrays. Two-layer dipole arrays have better performance in the deep-tissue targets than one-layer arrays. The performance of the connected array with a higher number of layers exceeds the performance of the dipole arrays in the superficial regions, while they are comparable for deep regions of the breast. The 1-layer 12-antenna circular FORA dipole array feasibility as a microwave hyperthermia applicator was experimentally shown.

Differential Evolution Optimization of Microwave Focused Hyperthermia Phased Array Excitation for Targeted Breast Cancer Heating

Microwave hyperthermia using the phased array applicator is a non-invasive treatment modality for breast cancer. Hyperthermia treatment planning (HTP) is critical to accurately treating breast cancer and avoiding damage to the patient's healthy tissue. A global optimization algorithm, differential evolution (DE) algorithm, has been applied to optimize HTP for breast cancer and its ability to improve the treatment effect was proved by electromagnetic (EM) and thermal simulation results. DE algorithm is compared to time reversal (TR) technology, particle swarm optimization (PSO) algorithm, and genetic algorithm (GA) in HTP for breast cancer in terms of convergence rate and treatment results, such as treatment indicators and temperature parameters. The current approaches in breast cancer microwave hyperthermia still have the problem of hotspots in healthy tissue. DE enhances focused microwave energy absorption into the tumor and reduces the relative energy of healthy tissue during hyperthermia treatment. By comparing the treatment results of each objective function used in DE, the DE algorithm with hotspot to target quotient (HTQ) as the objective function has outstanding performance in HTP for breast cancer, which can increase the focused microwave energy of the tumor and decrease the damage to healthy tissue.

Design of Ultra-Wideband Phased Array Applicator for Breast Cancer Hyperthermia Therapy

Focused microwave-hyperthermia therapy has recently emerged as a key technology in the treatment of breast cancer due to non-invasive treatment. An applicator of a three-ring phased array consisting of ultra-wideband (UWB) microstrip antennas was designed for breast cancer therapy and operates at 0.915 GHz and 2.45 GHz. The proposed antenna has an ultra-wideband from 0.7 GHz to 5.5 GHz with resonant frequencies of 0.915 GHz and 2.45 GHz and dimensions of 15 × 43.5 × 1.575 mm³. The number of each ring was chosen to be 12 based on the SAR distribution and the performance indicators of tumor off-center focusing results for four different numbers of single-ring arrays. The homogeneous breast model is applied to a three-ring phased array consisting of 36 elements for focused simulation, and 1 cm³ and 2 cm³ tumors are placed in three different locations in the breast. The simulation results show that the proposed phased array has good performance and the capability to raise the temperature of different volumes of breast cancer above 42.5 °C after choosing a suitable operating frequency. The proposed applicator allows for precise treatment of tumors by selecting the appropriate operating frequency based on the size of the malignant tumor.

Measurement of Charge and Refractive Indices in Optically Trapped and Ionized Living Cells

The post-ionization dynamics of chemo-treated and untreated 4T1 breast cancer cells ionized by laser trapping techniques are studied. We have determined each cell's charge and refractive index by developing a theoretical model for the forces determining the post-ionization dynamics. The shift in a cell's refractive index due to an intense oscillating electric field was studied, and the results are reported here. We observed that a trapped cell, as it becomes charged, will eventually exit the trap perpendicular to the beam's direction; this means that the electric force of the cell overcomes the trapping force. As a result, the cell's conductivity changes due to the oscillating field, causing a decrease in the cell's refractive index.

Rotationally Adjustable Hyperthermia Applicators: A Computational Comparative Study of Circular and Linear Array Applicators

Microwave breast hyperthermia (MH) aims to increase the temperature at the tumor location with minimal change in the healthy tissue. To this end, the specific absorption rate (SAR) inside the breast is optimized. The choice of the MH applicator design is important for a superior energy focus on the target. Although hyperthermia treatment planning (HTP) changes for every patient, the MH applicator is required to be effective for different breast models and tumor types. The linear applicator (LA) is one of the previously proposed applicator designs with linearly arranged antennas; however, it suffers from low focusing ability in certain breast regions due to its unsymmetrical geometrical features. In this paper, we propose to radially adjust the LA to obtain alternative excitation schemes without actually changing the applicator. Antipodal Vivaldi antennas were utilized, and the antenna excitations were optimized with particle swarm optimization (PSO). The comparison of the rotated and the fixed linear applicator, between 12-antenna circular and linear applicators, and finally, between a 24-antenna circular applicator are provided. Within the 12 rotation angles and two target locations that were analyzed, the 135° axially rotated linear applicator gave a 35% to 84% higher target-to-breast SAR ratio (TBRS) and a 21% to 28% higher target-to-breast temperature ratio (TBRT) than the fixed linear applicator. For the deep-seated target, the 135° rotated linear applicator had an 80% higher TBRS and a 59% higher TBRT than the 12-antenna circular applicator, while the results were comparable to the 24-antenna circular applicator.

Antenna Excitation Optimization with Deep Learning for Microwave Breast Cancer Hyperthermia

Microwave hyperthermia (MH) requires the effective calibration of antenna excitations for the selective focusing of the microwave energy on the target region, with a nominal effect on the surrounding tissue. To this end, many different antenna calibration methods, such as optimization techniques and look-up tables, have been proposed in the literature. These optimization procedures, however, do not consider the whole nature of the electric field, which is a complex vector field; instead, it is simplified to a real and scalar field component. Furthermore, most of the approaches in the literature are system-specific, limiting the applicability of the proposed methods to specific configurations. In this paper, we propose an antenna excitation optimization scheme applicable to a variety of configurations and present the results of a convolutional neural network (CNN)-based approach for two different configurations. The data set for CNN training is collected by superposing the information obtained from individual antenna elements. The results of the CNN models outperform the look-up table results. The proposed approach is promising, as the phase-only optimization and phase-power-combined optimization show a 27% and 4% lower hotspot-to-target energy ratio, respectively, than the look-up table results for the linear MH applicator. The proposed deep-learning-based optimization technique can be utilized as a protocol to be applied on any MH applicator for the optimization of the antenna excitations, as well as for a comparison of MH applicators.

Rapid SAR optimization for hyperthermic oncology: combining multi-goal optimization and time-multiplexed steering for hotspot suppression

PURPOSE

Healthy tissue hotspots are a main limiting factor in administering deep hyperthermia cancer therapy. We propose an optimization scheme that uses time-multiplexed steering (TMPS) among minimally correlated (nearly) Pareto-optimal solutions to suppress hotspots without reducing tumor heating. Furthermore, tumor heating homogeneity is maximized, thus reducing toxicity and avoiding underexposed tumor regions, which in turn may reduce recurrence.

MATERIALS AND METHODS

The novel optimization scheme combines random generation of steering parameters with local optimization to efficiently identify the set of (Pareto-) optimal solutions of conflicting optimization goals. To achieve simultaneous suppression of hotspots, multiple steering parameter configurations with minimally correlated hotspots are selected near the Pareto front and combined in TMPS. The performance of the novel scheme was compared with that of a multi-goal Genetic Algorithm for a range of simulated treatment configurations involving a modular applicator heating a generic tumor situated in the bladder, cervix, or pelvic bone. SAR cumulative histograms in tumor and healthy tissue, as well as hotspot volumes are used as metrics.

RESULTS

Compared to the non-TMPS optimization, the proposed scheme was able to reduce the peak temperature in healthy tissue by 0.2 °C-1.0 °C (a thermal dose reduction by at least 26%) and, importantly, the hotspot volume above 42 °C in healthy tissue by 41%-86%. At the same time, tumor heating homogeneity was maintained or improved.

CONCLUSIONS

The extremely rapid optimization (5 s for TMPS part, on a standard PC) permits closed-loop treatment reoptimization during treatment administration, and empowers physicians with a selection of optimal treatment scenarios reflecting different weighting of conflicting treatment goals.

Thermal Boost to Breast Tumor Bed—New Technique Description, Treatment Application and Example Clinical Results

(1) Current breast-conserving therapy for breast cancer consists of a combination of many consecutive treatment modalities. The most crucial goal of postoperative treatment is to eradicate potentially relapse-forming residual cancerous cells within the tumor bed. To achieve this, the HDR brachytherapy boost standardly added to external beam radiotherapy was enhanced with an initial thermal boost. This study presents an original thermal boost technique developed in the clinic. (2) A detailed point-by-point description of thermal boost application is presented. Data on proper patient selection, microwave thermal boost planning, and interstitial hyperthermia treatment delivery are supported by relevant figures and schemes. (3) Out of 1134 breast cancer patients who were administered HDR brachytherapy boost in the tumor bed, 262 were also pre-heated interstitially without unexpected complications. The results are supported by two example cases of hyperthermia planning and delivery. (4) Additional breast cancer interstitial thermal boost preceding HDR brachytherapy boost as a part of combined treatment in a unique postoperative setting was feasible, well-tolerated, completed in a reasonable amount of time, and reproducible. A commercially available interstitial hyperthermia system fit and worked well with standard interstitial brachytherapy equipment.

Elastic property of sickle cell anemia and sickle cell trait red blood cells

SIGNIFICANCE

We introduce a model for better calibration of the trapping force using an equal but oppositely directed drag force acting on a trapped red blood cell (RBC). We demonstrate this approach by studying RBCs' elastic properties from deidentified sickle cell anemia (SCA) and sickle cell trait (SCT) blood samples.

AIM

A laser trapping (LT) force was formulated and analytically calculated in a cylindrical model. Using this trapping force relative percent difference, the maximum (longitudinal) and minimum (transverse) radius rate and stiffness were used to study the elasticity.

APPROACH

The elastic property of SCA and SCT RBCs was analyzed using LT technique with computer controlled piezo-driven stage, in order to trap and stretch the RBCs.

RESULTS

For all parameters, the results show that the SCT RBC samples have higher elastic property than the SCA RBCs. The higher rigidity in the SCA cell may be due to the lipid composition of the membrane, which was affected by the cholesterol concentration.

CONCLUSIONS

By developing a theoretical model for different trapping forces, we have also studied the elasticity of RBCs in SCT (with hemoglobin type HbAS) and in SCA (with hemoglobin type HbSS). The results for the quantities describing the elasticity of the cells consistently showed that the RBCs in the SCT display lower rigidity and higher deformability than the RBCs with SCA.

A Preclinical System Prototype for Focused Microwave Breast Hyperthermia Guided by Compressive Thermoacoustic Tomography

OBJECTIVE

As a newly developed technique, focused microwave breast hyperthermia (FMBH) can provide accurate and cost-effective treatment of breast tumors with low side effect. A clinically feasible FMBH system requires a guidance technique to monitor the microwave power distribution in the breast. Compressive thermoacoustic tomography (CTT) is a suitable guidance approach for FMBH, which is more cost-effective than MRI. However, no experimental validation based on a realized FMBH-CTT system has been reported, which greatly hinders the further advancement of this novel approach.

METHODS

We developed a preclinical system prototype for the FMBH-CTT technique, containing a microwave phased antenna array, a microwave source, an ultrasound transducer array and associated data acquisition module.

RESULTS

Experimental results employing homogeneous and inhomogeneous breast-mimicking phantoms demonstrate that the CTT technique can offer reliable guidance for the entire process of the FMBH. In addition, small phase noises do not deteriorate the overall performance of the system prototype.

CONCLUSION

The realized preclinical FMBH-CTT system prototype is capable for noninvasive, accurate and low-side-effect breast tumor treatment with effective guidance.

SIGNIFICANCE

The experimentally validated FMBH-CTT system prototype provides a feasible paradigm for CTT guided FMBH, establishes a practical platform for future improvement of this technique, and paves the way for potential clinical translation.

Efficient focusing of microwave hyperthermia for small deep-seated breast tumors treatment using particle swarm optimization

Focused microwave hyperthermia is a technique with advantage of high accuracy and low side effects for breast tumor treatments. In this study, an efficient focusing technique for noninvasive microwave hyperthermia treatment for breast tumors is presented. Particle Swarm Optimization (PSO) is used to find the optimum excitations (phases and amplitudes) of a three dimension (3D) Micro-Strip Patch (MSP) antenna array operating at 2.45 GHz. The antenna excitations are optimized to maximize the power loss density and the Specific Absorption Rate (SAR) at the tumor location, to reach the required hyperthermia temperature (above 42 °C) at the tumor location without causing hot spots in healthy tissues. The technique is tested on a challenging scenario of a 3D realistic breast model having a tumor less than 1 cm³ volume and embedded in different locations deep in the glandular tissue of a very dense breast. The results confirmed the capability of the focusing technique.

A Novel Approach on Microwave Hyperthermia

Microwave hyperthermia (MH) requires the selective focusing of microwave energy on the targeted region while minimally affecting the healthy tissue. Emerging from the simple nature of the linear antenna arrays, this work demonstrates focusing maps as an application guide for MH focusing by adjusting the antenna phase values. The focusing of the heating potential (HP) on different density breast models is performed via the proposed method using Vivaldi antennas. The effect of the tumor conductivity on the focusing is discussed. As a straightforward approach and utilizing the Vivaldi antennas, the system can be further combined with MH monitoring application.

Chemo-treated 4T1 breast cancer cells radiation response measured by single and multiple cell ionization using infrared laser trap

We present a study that uses a laser trapping technique for measurement of radiation sensitivity of untreated and chemo-treated cancer cells. We used a human mammary tumor cell line (4T1) treated by an antitumor compound, 2-Dodecyl-6-methoxycyclohexa-2, 5-diene-1,4-dione (DMDD), which was extracted from the root of Averrhoa carambola L. The untreated control group, and both 2-hour and 24-hour treated groups of 4T1 cells were used in this study. The absorbed threshold ionization energy (TIE) and the threshold radiation dose (TRD) were determined using a high-power infrared laser (at 1064 nm) trap by single and multiple cells trapping and ionization. The results were analyzed using descriptive and t-statistics. The relation of the TIE and TRD to the mass of the individual cells were also analyzed for different hours of treatment in comparison with the control group. Both TIE and TRD decrease with increasing treatment periods. However, the TRD decreases with mass regardless of the treatment. Analyses of the TRD for single vs multiple cells ionizations within each group have also consistently showed this same behavior regardless of the treatment. The underlying factors for these observed relations are explained in terms of radiation, hyperthermia, and chemo effects.

Thermosensitive Nanosystems Associated with Hyperthermia for Cancer Treatment

Conventional chemotherapy regimens have limitations due to serious adverse effects. Targeted drug delivery systems to reduce systemic toxicity are a powerful drug development platform. Encapsulation of antitumor drug(s) in thermosensitive nanocarriers is an emerging approach with a promise to improve uptake and increase therapeutic efficacy, as they can be activated by hyperthermia selectively at the tumor site. In this review, we focus on thermosensitive nanosystems associated with hyperthermia for the treatment of cancer, in preclinical and clinical use.

Potential of Ablation Therapy during Hepatocellular Carcinoma

BACKGROUND

This study explored the potential of ablation therapy on membrane fluidity changes in diethylnitrosamine (DEN) induced hepatic cancer.

METHODS

Male Wistar rats were segregated into four groups viz., normal control, DEN treated, ablation therapy treated, and DEN ablation therapy treated. We assessed the viscosities as well as fluidity parameters in isolated brush border membranes using the membrane extrinsic fluorophore pyrene.

RESULTS

DEN treatment successfully induced hepatic cancer in the livers of rats and ablation therapy worked well in terms of therapy. DEN treatment resulted in a significant rise in lipid peroxidation (LPO) and significant decrease in the, reduced glutathione levels (GSH). A significant decrease was also noticed in the activities of glutathione reductase (GR), glutathione transferase (GST), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) following DEN treatment. On the other hand, ablation therapy treatment to DEN-treated rats resulted in a significant decrease in the LPO levels but caused a significant rise in the levels of GSH. Moreover, the activities of GR, GST, SOD, CAT, and GPx showed significant improvement after ablation therapy treatment. The results further demonstrated a marked decrease in membrane microviscosity following DEN treatment. On the other hand, a significant increase was noticed in both excimer/monomer ratio and fluidity parameter in DEN-treated rats. However, membrane microviscosity and the fluidity alterations were significantly restored back to near normal with ablation therapy treatment.

CONCLUSIONS

The study, therefore, concluded that ablation therapy holds good therapeutic potential against DEN-induced hepatic cancer.

Ultrawideband, Stable Normal and Cancer Skin Tissue Phantoms for Millimeter-Wave Skin Cancer Imaging

This work introduces new, stable, and broadband skin-equivalent semisolid phantoms for mimicking interactions of millimeter waves with the human skin and skin tumors. Realistic skin phantoms serve as an invaluable tool for exploring the feasibility of new technologies and improving design concepts related to millimeter-wave skin cancer detection methods. Normal and malignant skin tissues are separately mimicked by using appropriate mixtures of deionized water, oil, gelatin powder, formaldehyde, TX-150 (a gelling agent, widely referred to as "super stuff"), and detergent. The dielectric properties of the phantoms are characterized over the frequency band of 0.5-50 GHz using a slim-form open-ended coaxial probe in conjunction with a millimeter-wave vector network analyzer. The measured permittivity results show excellent match with ex vivo, fresh skin (both normal and malignant) permittivities determined in our prior work over the entire frequency range. This work results in the closest match among all phantoms reported in the literature to surrogate human skin tissues. The stability of dielectric properties over time is also investigated. The phantoms demonstrate long-term stability (up to 7 months was investigated). In addition, the penetration depth of millimeter waves into normal and malignant skin phantoms is calculated. It is determined that millimeter waves penetrate the human skin deep enough (0.6 mm on average at 50 GHz) to affect the majority of the epidermis and dermis skin structures.

Beamforming for hyperthermia treatment by training a weighted network of an ultrasonic array

We propose a beamforming algorithm based on waveform diversity for hyperthermia treatment of breast cancer using an ultrasonic array. The introduced array has a structure with a network connecting the feeding nodes and the array elements, and the objective of the algorithm is to train the weight matrix of the network to minimize the difference between the generated beam pattern and the ideal one. The training procedure of the algorithm, which is inspired by the idea of machine learning, comprises three parts: forward calculation, comparison, and backward calculation. The forward calculation maps the weight matrix to the beam pattern, and in the comparison step, the generated beam pattern is modified based on the error, and finally, the backward calculation maps the modified beam pattern to a refined weight matrix which performs better than the original one. An optimal weight matrix is obtained by iterative training. The effectiveness of the algorithm is demonstrated by using numerical simulations.

Enhanced Energy Localization in Hyperthermia Treatment Based on Hybrid Electromagnetic and Ultrasonic System: Proof of Concept with Numerical Simulations

This paper proposes a hybrid hyperthermia treatment system, utilizing two noninvasive modalities for treating brain tumors. The proposed system depends on focusing electromagnetic (EM) and ultrasound (US) energies. The EM hyperthermia subsystem enhances energy localization by incorporating a multichannel wideband setting and coherent-phased-array technique. A genetic algorithm based optimization tool is developed to enhance the specific absorption rate (SAR) distribution by reducing hotspots and maximizing energy deposition at tumor regions. The treatment performance is also enhanced by augmenting an ultrasonic subsystem to allow focused energy deposition into deep tumors. The therapeutic faculty of ultrasonic energy is assessed by examining the control of mechanical alignment of transducer array elements. A time reversal (TR) approach is then investigated to address challenges in energy focus in both subsystems. Simulation results of the synergetic effect of both modalities assuming a simplified model of human head phantom demonstrate the feasibility of the proposed hybrid technique as a noninvasive tool for thermal treatment of brain tumors.