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

Dielectric-loaded coaxial-slot antenna for interstitial microwave hyperthermia: longitudinal control of heating patterns

In this paper, the microwave interstitial antenna with the dielectric load in part near the tip is introduced to realize the tip-heating and to improve the dependence of the heating patterns on the insertion depth. Numerical simulations using the Finite Difference Time Domain (FDTD) method have been conducted at the frequency of 915 MHz for four different configurations of the coaxial-slot antenna inserted into a catheter: the media between the antenna and the catheter are (a) no, (b) a thin air layer, (c) a thin dielectric layer, and (d) a thin air layer and a dielectric load in part near the tip. The diameter of the antenna including the catheter is sufficiently small for minimally invasive therapy. Comparison of the SARs for the four configurations makes it clear that the dielectric-loaded antenna can realize the best tip-heating and suppress the hot spot near the surface of the human body. Dependence of the SAR distributions on the insertion depth of the antenna has also been examined. It is found from the investigation that the dielectric-loaded antenna has little dependence on the insertion depth.

Multivariate analysis of prognostic parameters using interstitial thermoradiotherapy (IHT-IRT): tumor and treatment variables predict outcome

PURPOSE

From January 1986 to October 1991, 90 patients with localized tumors were treated in a Phase I/II trial using low-dose 192Ir brachytherapy (IRT) plus interstitial 915 MHz microwave (MW) hyperthermia (IHT) and external beam radiotherapy (ERT). Tumors were classified as locally advanced primary (class 1: 27), recurrent (class 2: 40), metastatic (class 3: 10) and persistent (class 4: 13) lesions. The treatment sites included tumors of the head and neck (62), pelvis (26), and others (2). The mean cuboidal tumor volume was 63 cm3 (range: 8-288 cm3). Most recurrent and metastatic lesions (48) had received prior treatment including ERT.

METHODS AND MATERIALS

The treatment protocol prescribed two heating sessions (each 60 min) at 41-44 degrees C before and after IRT. One hundred sixty-one IHT sessions were evaluated. Invasive thermal data were recorded at an average of 18 sites throughout the implant volume. Several thermal variables were analyzed (e.g., averaged parameters: Tmaxav, Tmean, Tminav; index parameters: T10, T50, T90). The study was evaluated with a minimum follow up (FU) of one year. Median follow-up was 19 months.

RESULTS

At 3 months FU, a complete response (CR) was observed in 59 of 90 (66%) patients. At 12 months FU, local control (LC) was achieved in 54 of 84 (64%) evaluable patients. Ten patients developed a local and 14 a regional recurrence (REC) after achieving a CR and/or LC. At last FU, a total of 31 (34%) patients were still alive and 28 (31%) patients had relapse-free survival. For all 90 patients, the median overall survival was 20 months and the median relapse-free survival was 17 months. Overall and relapse-free survival was significantly longer for primary and persistent lesions as compared to recurrent and metastatic lesions (p = 0.002; p < 0.001). Totally 22 (24%) patients experienced acute or subacute side-effects (Grade 1: 12 patients; Grade 2: eight patients; Grade 3: two patients).

CONCLUSION

Univariate logistic regression analysis revealed significant dependencies of CR, LC and REC upon tumor parameters as well as radiation and thermal parameters. The overall and relapse free survival was associated with tumor and radiation parameters. The multivariate analysis revealed two independent predictors of CR: tumor volume and minimum tumor temperature variables. We conclude, that IHT-IRT is a safe and effective treatment. The results provide important implications for planning HT-RT studies and for defining quality assurance (QA) criteria and thermal performance standards in HT studies.

A theoretical model for input impedance of interstitial microwave antennas with choke

PURPOSE

Two important characteristics for interstitial microwave antennas used in clinical hyperthermia are: (1) a good impedance match to minimize reflected power; and (2) a good power deposition pattern which is independent of insertion depth. A major problem of the miniature coaxial dipole antennas used for interstitial hyperthermia is the fact that the impedance and power deposition patterns of these antennas change with insertion depth. One possible solution is the addition of a coaxial choke. A theoretical model for calculating the input impedance of interstitial microwave antennas having a coaxial choke is presented, which may serve as the first step in the design of such antennas.

METHODS AND MATERIALS

A theoretical model for calculating the input impedance of coaxial microwave antennas with and without a choke is presented using insulated antenna theory. The theoretical model was used to calculate the input impedance of several prototype antennas having various choke and feedline dimensions, and comparison was made with experimentally measured impedance measurements in tissue-equivalent phantom.

RESULTS

The choke section of the antenna is not ideal if conventional plastic insulation is used as the choke dielectric, because the desired radiating length of the antenna is significantly shorter than the quarter-wavelength in the choke dielectric. Impedance calculations based on the theoretical model correlate reasonably well with experimentally measured impedance. Based on these calculations, the effect of parameters such as choke layer thickness and choke dielectric constant are discussed for a 915 MHz antenna with choke.

CONCLUSION

The theoretical model can serve as a design aid for optimizing choked microwave antenna designs, as well as predicting the impedance match of a given antenna design at a given insertion depth. The model allows the effect of some variables not accessible experimentally such as termination impedance to be studied, which may also be useful in the understanding of these antennas. Calculations are easily performed on a desktop computer.

Evaluation of microwave and radio frequency catheter ablation in a myocardium-equivalent phantom model

A highly localized burst of energy applied to the myocardium via a transvenous catheter-mounted power source can be used to destroy endocardial tissue regions which mediate life-threatening arrhythmias. In the past, high-voltage direct current pulses, radio-frequency (RF) current, and laser light have been used as energy sources. In this paper, the use of 2450 MHz microwave energy applied via a miniature coaxial cable-mounted helical coil antenna designed specifically for this application was investigated as a means to increase the treated volume of cardiac tissue in a controllable and efficient manner during ablation. Using an array of fiber optic temperature probes implanted in a saline-perfused, tissue-equivalent gel phantom model designed to simulate the myocardium during ablation, the heating pattern from the microwave antenna was characterized and compared to that induced by a commercial RF electrode catheter at 550 kHz. Effects of variable contact angle between the heat source and heart wall were assessed in terms of the radial penetration and overall volume of heated tissue. Heating patterns from the RF electrodes dropped off much more abruptly both radially and axially than the microwave antenna such that the volume of effectively heated tissue was more than ten times larger for the microwave antenna when the heat sources were well-coupled to the tissue, and more than four times larger for the microwave antenna when the sources were angled 30 degrees away from the tissue surface.

An eccentrically coated asymmetric antenna applicator for intracavitary hyperthermia treatment of cancer

In this paper a model based on transmission line theory is used to predict the behavior of an eccentrically coated asymmetric antenna applicator for use in intracavitary hyperthermia. Theoretical results for the heating rate (HR) of the applicators are compared to experimental results. The experimental results were obtained at City of Hope National Medical Center using four different 915-MHz applicators, each with a different antenna size and eccentricity of the coating. A parameter delta is defined where delta << 1.0 is a thin wire approximation; delta is primarily a function of the eccentricity of the coating, the antenna diameter, and the coating diameter. It is found that when delta approximately less than 0.5, the theoretical model works well. In particular, it predicts the directivity due to the eccentricity of the coating. However, as this eccentricity is increased or as the antenna diameter is increased (delta approximately greater than 0.6), the model no longer accurately predicts directivity. Thus, the model that can be used to predict the HR profiles for an eccentrically coated asymmetric antenna only when delta approximately less than 0.5.

Interstitial microwave hyperthermia and brachytherapy for malignancies of the vulva and vagina. I: Design and testing of a modified intracavitary obturator

A vaginal obturator was fabricated to be used in combination with implanted catheters to provide microwave hyperthermia and brachytherapy to the vulva and vaginal wall. This site is difficult to heat or irradiate solely with interstitial techniques. The obturator was modified to provide grooves for the mounting of interstitial catheters into the outer wall and was matched with a template for circumferential implants. Power deposition tests were done using arrays of three microwave antenna designs: dipole (hA = hB = 3.9 cm), helical (3.9 cm coil, shorted), and modified dipole (1.0 cm helix on dipole tip) to test the performance of the obturator. The obturator and four non-obturator catheters were positioned in muscle-equivalent phantom. Two obturator catheters along with two free-standing catheters formed the obturator array. Four freestanding catheters formed the non-obturator array. Power deposition or specific absorption rate (SAR) measurements were made along the central axis, bisect, and diagonal transect of each array. SAR results showed that antennas in the obturator wall radiated as dipole theory predicts, although with less power density when compared to antennas in the same catheters spaced 1.8 cm from the obturator. This could be compensated for by increasing the power to the antennas in the obturator by 42%. Adjacent pairs of antennas were placed 90 degrees out of phase for 0.25 sec and rotated around the array. Phase rotation demonstrated that the central array SAR peaks could be lowered from 100% to 50% SAR, with dipole antennas thus resulting in lowered peak temperatures and the ability to heat larger volumes by improving the distribution of power. With helical antennas, there was 50% SAR at the array center when operated coherently without phase rotation. Three patients were treated with the obturator and a custom-made template using dipole antennas, and temperatures were measured in five obturator catheters. Therapeutic heating was measured in the catheters on the obturator between antennas in contact with the vaginal mucosa.

Three-dimensional theoretical temperature distributions produced by 915 MHz dipole antenna arrays with varying insertion depths in muscle tissue

Interstitial microwave antenna array hyperthermia (IMAAH) systems are currently being used in the treatment of cancer. The insertion depth of an interstitial microwave antenna, defined as the length of the antenna from the tip to the point of insertion in tissue, affects its ability to produce uniform power deposition patterns in tumor volumes. The effect of varying insertion depths on the ability of an IMAAH system to heat two theoretical tumor models was examined. Four dipole microwave antennas were implanted in a 2 x 2 cm array and driven at 915 MHz in muscle tissue. The explicit power deposition patterns were calculated for each insertion depth using known theory. The bioheat transfer equation was solved for the 3-dimensional steady-state temperature distributions in cylindrical and ellipsoidal tumor models using a finite element method. Homogeneous and nonhomogeneous blood flow models were considered. As a basis of comparison of the various temperature distributions, the volume of tumor heated to greater than or equal to 43 degrees C was calculated. Under the conditions of this study, the insertion depth was shown to have a significant effect on the ability of an IMAAH system to heat the tumor volumes. A sharp decrease in the percentage of tumor volume heated to greater than or equal to 43 degrees C was seen for insertion depths between 7.8 and 14.6 cm. At an insertion depth of 11.7 cm (3/4 lambda) there was virtually no heating of the tumor. Regions of elevated power occurred outside of the desired treatment volume, stressing the importance of adequate thermometry techniques and demonstrating the need for hyperthermia treatment planning prior to implantation of an antenna array. Plots of the power deposition patterns and the corresponding temperatures produced in the diagonal plane of the antenna arrays are present.

Prediction of heating patterns of a microwave interstitial antenna array at various insertion depths

Measurements made on the interstitial microwave antennas used for hyperthermia cancer therapy indicate that the heating patterns vary with the insertion depths (defined as the distance from the antenna tip to air-tissue interface). The antennas are made of thin coaxial cables with a radiation gap or gaps on the outer conductor. The antennas are inserted into small polypropylene catheters implanted in the tumour volume. This type of antenna may be simulated as an asymmetric dipole with one arm being the tip section consisting of the expanded extension of the inner conductor, and the other arm being the section of the outer conductor from the gap to the insertion point (air-tissue interface). We use four of the antennas to form a 2 cm x 2 cm array. The antennas are positioned on the corners of a 2 cm square. Measurements on both single antennas and multi-antenna arrays show that the maximum heating is not stationary with position along the antenna when the depth of insertion is changed. This paper investigates the theoretical prediction of the changes in heating patterns of interstitial microwave antennas at different insertion depths. Each of the antennas in the array is simulated as an asymmetric dipole. The SAR (specific absorption rate) is computed by using the insulated dipole theory. The temperature distribution in absence of perfusion is obtained through a thermal simulation routine to convert the SAR pattern into the temperature pattern. Excellent qualitative agreement is found between the theoretical heating pattern and the measured pattern in a non-perfused phantom on a 2 cm x 2 antenna array. Since the insertion depths of the interstitial antennas are different from patient to patient, it is recommended that simulation of the heating be done before treatments, to confirm the delivery of power to the target region.