The data show that for evaluable treatments, excellent correlation (deltaT < 1 degrees C) of MRTI-ROI and invasive measurements can be achieved, but that motion and other artifacts are still serious challenges that must be overcome in future work.

Magnetic resonance (MR) imaging is promising for monitoring and guiding hyperthermia treatments. The goal of this work is to investigate the stability of an algorithm for online MR thermal image guided steering and focusing of heat into the target volume. The control platform comprised a fourantenna mini-annular phased array (MAPA) applicator operating at 140 MHz (used for extremity sarcoma heating) and a GE Signa Excite 1.5 T MR system, both of which were driven by a control workstation. MR proton resonance frequency shift images acquired during heating were used to iteratively update a model of the heated object, starting with an initial finite element computed model estimate. At each iterative step, the current model was used to compute a focusing vector, which was then used to drive the next iteration, until convergence. Perturbation of the driving vector was used to prevent the process from stalling away from the desired focus. Experimental validation of the performance of the automatic treatment platform was conducted with two cylindrical phantom studies, one homogeneous and one muscle equivalent with tumor tissue (conductivity 50% higher) inserted, with initial focal spots being intentionally rotated 90° and 50° away from the desired focus, mimicking initial setup errors in applicator rotation. The integrated MR-HT treatment platform steered the focus of heating into the desired target volume in two quite different phantom tissue loads which model expected patient treatment configurations. For the homogeneous phantom test where the target was intentionally offset by 90° rotation of the applicator, convergence to the proper phase focus in the target occurred after 16 iterations of the algorithm. For the more realistic test with a muscle equivalent phantom with tumor inserted with 50° applicator displacement, only two iterations were necessary to steer the focus into the tumor target. Convergence improved the heating efficacy (the ratio of integral temperature in the tumor to integral temperature in normal tissue) by up to sixfold, compared to the first iteration. The integrated MR-HT treatment algorithm successfully steered the focus of heating into the desired target volume for both the simple homogeneous and the more challenging muscle equivalent phantom with tumor insert models of human extremity sarcomas after 16 and 2 iterations, correspondingly. The adaptive method for MR thermal image guided focal steering shows promise when tested in phantom experiments on a four-antenna phased array applicator.

An RF phased array applicator has been constructed for hyperthermia treatments in the intact breast. This RF phased array consists of four antennas mounted on a Lexan water tank, and geometric focusing is employed so that each antenna points in the direction of the intended target. The operating frequency for this phased array is 140 MHz. The RF array has been characterized both by electric field measurements in a water tank and by electric field simulations using the finite-element method. The finite-element simulations are performed with HFSS software, where the mesh defined for finite-element calculations includes the geometry of the tank enclosure and four end-loaded dipole antennas. The material properties of the water tank enclosure and the antennas are also included in each simulation. The results of the finite-element simulations are compared to the measured values for this configuration, and the results, which include the effects of amplitude shading and phase shifting, show that the electric field predicted by finite-element simulations is similar to the measured field. Simulations also show that the contributions from standing waves are significant, which is consistent with measurement results. Simulated electric field and bio-heat transfer results are also computed within a simple 3D breast model. Temperature simulations show that, although peak temperatures are generated outside the simulated tumour target, this RF phased array applicator is an effective device for regional hyperthermia in the intact breast.

Purpose-This article explores the feasibility of using coupled electromagnetic and thermodynamic simulations to improve planning and control of hyperthermia treatments for cancer. The study investigates the usefulness of preplanning to improve heat localization in tumor targets in treatments monitored with PRFS-based Magnetic Resonance Thermal Imaging (MRTI). .Methods-Heating capabilities of a cylindrical radiofrequency (RF) mini-annular phased array (MAPA) applicator were investigated with electromagnetic and thermal simulations of SAR in homogeneous phantom models and two human leg sarcomas. HFSS (Ansoft Corp) was used for electromagnetic simulations and SAR patterns were coupled into EPhysics (Ansoft Corp) for thermal modeling with temperature dependent variable perfusion. Simulations were accelerated by integrating tumor specific anatomy into a pre-gridded whole body tissue model. To validate this treatment planning approach, simulations were compared with MR thermal images in both homogenous phantoms and heterogeneous tumors.Results-SAR simulations demonstrated excellent agreement with temperature rise distributions obtained with MR thermal imaging in homogeneous phantoms, and clinical treatments of large soft-tissue sarcomas. The results demonstrate feasibility of preplanning appropriate relative phases of antennas for localizing heat in tumor.Conclusions-Advances in the accuracy of computer simulation and non-invasive thermometry via MR thermal imaging have provided powerful new tools for optimization of clinical hyperthermia treatments. Simulations agree well with MR thermal images in both homogeneous tissue models and patients with lower leg tumors. This work demonstrates that better quality hyperthermia treatments should be possible when simplified hybrid model simulations are performed routinely as part of the clinical pretreatment plan.

A critical need has emerged for volumetric thermometry to visualize 3D temperature distributions in real time during deep hyperthermia treatments used as an adjuvant to radiation or chemotherapy for cancer. For the current effort, magnetic resonance thermal imaging (MRTI) is used to measure 2D temperature rise distributions in four cross sections of large extremity soft tissue sarcomas during hyperthermia treatments. Novel hardware and software techniques are described which improve the signal to noise ratio of MR images, minimize motion artifact from circulating coupling fluids, and provide accurate high resolution volumetric thermal dosimetry. For the first 10 extremity sarcoma patients, the mean difference between MRTI region of interest and adjacent interstitial point measurements during the period of steady state temperature was 0.85°C. With 1min temporal resolution of measurements in four image planes, this non-invasive MRTI approach has demonstrated its utility for accurate monitoring and realtime steering of heat into tumors at depth in the body.