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Biomedical subjects

F M Waterman

Publications and source records attributed to F M Waterman.

At least 19 recordsLinked to original sources
PubMed1991

RTOG quality assurance guidelines for clinical trials using hyperthermia administered by ultrasound.

Clinical quality assurance guidelines are established for RTOG hyperthermia protocols in which unfocused planar ultrasound may be used to administer hyperthermia. Measurement of temperature at a few fixed points is no longer considered to be adequate. Thermal mapping is required to obtain profiles of the temperature across the tumor dimensions, including margins of normal tissue. The thermometry strategies established for microwaves are to be adhered to with oblique insertion of the probes recommended. Two types of errors arise which are generally not present with microwaves. A measurement error, commonly referred to as a temperature artifact, arises because of absorption and/or viscous heating of the probe. Another error arises when thermocouples are used due to the conduction of heat along the wire leads, especially the copper wire. Several thermometry systems are evaluated with regard to the expected artifact and conduction errors. Acceptable systems include: a) indexing a polyurethane sheathed single sensor thermocouple in a polyurethane catheter, b) indexing a fiberoptic probe in a steel needle, c) indexing a single sensor thermocouple in a steel needle, and d) use of manganin-constantan multisensor thermocouples. Unacceptable systems include: a) fixed or static probes that do not provide profiles of the temperature across the tumor dimensions, b) copper-constantan multisensor thermocouples, and c) teflon sheathed thermocouples inserted into a teflon catheter.

Clinical Protocols↗
PubMed1991

Blood flow in human tumors during local hyperthermia.

The response of tumor blood flow during local hyperthermia was studied at 40 different points in 15 superficial human tumors. Hyperthermia was administered for 60 minutes by use of 915 MHz microwaves. Blood flow was determined from the rate of thermal clearance by use of the bioheat equation. The rate of thermal clearance was sampled at 10-15 minutes intervals by turning the applied power off for 30 seconds. A correction was made for thermal conduction from orthogonal profiles of the tumor temperature. No measurements were made during the first 10-15 minutes of heating. The response of tumor blood flow was found to be independent of temperature in the range of 40-44 degrees C. The mean blood flow rate increased 10-15% between 15 and 30 minutes, but remained nearly constant thereafter. The coefficient of variation in this pattern is 15-20%. No evidence of a sharp reduction in flow was observed. Furthermore, the mean temperature elevation, net forward power, and rate of thermal conduction all remained nearly constant with time, providing further evidence of stability in the blood flow rate. Data obtained in one tumor suggest that a reduction in flow may occur at temperatures above 44 degrees C. The mean blood flow rates obtained in this study range from 0-34 ml/100g/min with an average value of 15 ml/100g/min.

Adenocarcinoma↗
PubMed1989

Mechanisms of heat removal during local hyperthermia.

Mechanisms of heat removal were studied in five recurrent squamous cell head or neck carcinomas, 50-150 cm3, heated by use of external 915 MHz microwave applicators. Thermal clearance measurements were made at a single point in each tumor. Three profiles of the tissue temperature were also measured in orthogonal directions about this point. The conduction term of the bioheat equation was evaluated from the orthogonal temperature profiles by the method of finite differences. The perfusion term of the bioheat equation was determined from the rate of temperature decay corrected for conduction. The results show that thermal conduction plays a major role in the dissipation of thermal energy during local hyperthermia. The rate of removal thermal energy by conduction ranged between 20 and 150 percent of that by perfusion. The temperature profiles show that conduction is higher than is generally expected due to heterogeneities in the blood flow which produce rapid changes in the temperature gradient. The results of this study demonstrate that the heat transport by thermal conduction in perfused tissue cannot be assumed to be small, or negligible, in comparison to that by perfusion.

Blood Circulation↗
PubMed1987

Response of human tumor blood flow to local hyperthermia.

The effect of heat on blood flow in human tumors was studied as a function of time during 1 hour of local hyperthermia induced by 915 MHz microwaves. Blood flow was determined from the rate of thermal clearance by use of the bio-heat transfer equation. The rate of thermal clearance was measured at intervals of approximately 10 minutes throughout the treatment session by turning off the microwave power for 50 seconds. Tumor blood flow increased by amounts varying from 15 to 250% during the first 20-50 minutes of heating at 41-45 degrees C, after which it remained relatively constant during the remainder of the treatment session. The sharp reduction in blood flow or vascular stasis reported in most transplantable rodent tumors after comparable heating was not observed in human tumors. The maximum blood flow observed in heated human tumors ranged from 10-40 ml/min/100 gm. The systematic error due to thermal conduction was estimated to be equivalent to a blood flow of less than 3 ml/min/100 gm.

Adenocarcinoma↗
PubMed1979

Energy dependence of the neutron sensitivity of C--CO2, Mg--Ar and TE--TE ionisation chambers.

The neutron sensitivity relative to 60Co of commercially available C--CO2, Mg--Ar and TE--TE ionisation chambers was measured as a function of energy from 1 to 44 MeV. The sensitivity function was obtained by the method of Kuchnir, Vyborny and Skaggs from differences in measurements made at two angles in mixed fields having an isotropic gamma-ray component. Such fields were produced by bombardment of a thick beryllium target with 16 and 28 MeV deuterons, 44 MeV 3He-ions and 35 and 46 MeV protons. The results show that the relative neutron sensitivity of the C--CO2 and Mg--Ar chambers increases continuously with energy, whereas that of the TE--TE chamber is relatively constant.

Argon↗
PubMed1978

Dosimetric properties of neutron beams from the D--D reaction in the energy range from 6.8 to 11.1 MeV.

The tissue kerma in air, the tissue dose at maximum build-up, the relative depth dose on the central axis and the dose build-up characteristics were measured for neutrons produced by 6.8, 8.9 and 11.1 MeV deuterons on deuterium. The neutron beams were produced by a variable-energy cyclotron with a fully stopping deuterium gas target 20 cm long. Measurements were made in a 11.1cm x 11.1 cm field 126 cm from the target entrance window. The dose rate was found to increase rapidly with energy from 0.07 rad min-1 microamperemeter-1 at 6.8MeV to 0.35 rad min-1 muA-1 at 11.1 MeV. The entrance dose is about 50% of the dose maximum for each bombarding energy. The depth of the 95% dose level in the build-up region increased from 50 mg cm-2 at 6.8 MeV to 90 mg cm-2 at 11.1 MeV. The penetration was independent of the bombarding energy in the region investigated. Attenuation of the total dose to 50% of the maximum occurred at 10.2 +/- 0.1 g cm-2 for all three bombarding energies. The dose at the maximum is typically 14% higher than the tissue kerma in air.

Atmosphere↗
PubMed1978

The use of 10B to enhance the tumour dose in fast-neutron therapy.

Incorporation of 10B in tumours treated by fast-neutron therapy would increase the tumour dose via the reaction 10B(n, alpha)7Li which occurs with partially thermalised neutrons. The extent of the dose enhancement was measured for neutron beams with median energies of 2.4, 3.3, 7.0 and 9.0 MeV by two techniques: with a BF3 proportional counter in three beams and activation of 23Na in the fourth. The results obtained with the two techniques are in good agreement. The magnitude of the dose enhancement depends upon the depth, field size and neutron beam energy. The dose enhancement at a depth of 8 cm varied from 0.32% with the lowest-energy beam to 0.07% with the highest-energy beam for each microgram of 10B uptake per gram of tissue. The products of the reaction in 10B would, however, have an RBE about twice that of the fast-neutron dose in the absence of boron. The method may be useful if drugs providing adequate uptake of 10B can be synthesised.

Beryllium↗
PubMed1977

Comparison of two independent methods for determining the neutron/gamma sensitivity of a dosemeter.

Results obtained with two independent methods for measuring the n/gamma sensitivity of non-hydrogenous dosemeters are compared for the neutron beam produced by 8.3 MeV deuterons on beryllium. In one method, a pure neutron field is simulated by taking the difference between measurements made at diffrent angles in a mixed field with an isotropic gamma-ray component. In the second method, the mixed (n+gamma) beam is purified by lead filtration. An assumption in the lead filtration method is that the background radiation is invariant under three different beam conditions. This assumption was found not be be valid in our experimental arrangement; and caused the values obtained for the n/gamma sensitivity to be systematically high. A modification was made in the lead filtration method so that the dosemeter response to background could be determined for each beam condition. Good agreement was obtained between the results of the spectral difference and modified lead filtration methods.

Air↗
PubMedDate not supplied

Neutron spectra.

Explore the source record for details and available documents.

Neutrons↗
PubMedDate not supplied

Neutron spectra from 35 and 46 MeV protons, 16 and 28 MeV deuterons, and 44 MeV 3He ions on thick beryllium.

The energy spectra of neutrons produced by 35 and 46 MeV protons, 16 and 28 MeV deuterons, and 44 MeV 3He ions on thick beryllium were measured at angles of 0 degrees, 15 degrees, and 45 degrees with respect to the incident beams. The spectra were measured by the time-of-flight method for neutrons from the maximum energy down to 1 MeV. Neutron dose rates obtained from the zero-degree spectra by use of available tissue kerma factors agree with TE-TE ionization chamber measurements.

Beryllium↗
PubMedDate not supplied

The response of thermometer probes inserted into catheters.

The time constants of three commercially available thermometer probes were measured when inserted into catheters commonly used in hyperthermia. The catheter typically increases the time constant by a factor of 3. Following the transition from a constant to continuously changing temperature, the rate of change of temperature indicated by such a probe is initially incorrect, but it attains the true rate of change of temperature after an elapsed time that depends on the rate of change of temperature and the time constant of the probe. This elapsed time varies from 3.5 to 8 time constants, as the rate of change of temperature increases from 0.05 to 10 degrees C/min. The specific absorption rate determined from a least-squares fit to temperatures recorded during the first 30 s following such a transition, are typically in error by 1%, 3%, and 6% when thermometer probes having time constants of 1, 2, and 3 s are used. These errors can be reduced to less than 0.1% by excluding the data recorded during an initial period of the first 3 time constants following the transition. Errors of similar magnitude result when blood flow is determined from the first 30 s of thermal clearance. These errors are similarly reduced to typically less than 1% by excluding the data recorded during the first 3 time constants from the determination.

Animals↗
PubMedDate not supplied

The effect of coupling materials on specific absorption rate distributions at 915 MHz.

Deionized water is commonly used to couple microwave applicators to the patient surface in the administration of local hyperthermia. Profiles of the specific absorption rate (SAR) at 1-cm depth show that deionized water coupling significantly distorts the SAR distributions of the Clini-Therm 915-MHz 10 X 10 and 15 X 15 cm2 applicators. Maxima and minima that are discernible in the SAR profiles obtained by direct applicator load contact are amplified producing unexpected hot and cold regions in the heating pattern. An exception is coupling achieved by use of the Clini-Therm cooling pad, oriented such that the direction of deionized water flow is perpendicular to the electric field. The distortion in the SAR distribution can also be eliminated by replacing deionized water with mineral oil, a material having a much lower dielectric constant (epsilon = 2). The SAR profiles for mineral oil coupling are comparable to those obtained for direct contact; however, the efficiency of power transfer is slightly less (70%) and the level of microwave leakage is approximately four times greater.

Absorption↗
PubMedDate not supplied

Determination of the temperature artifact during ultrasound hyperthermia.

Temperature artifacts produced by very small uncoated thermocouples during ultrasonic heating are evaluated by backward extrapolation of the linear portion of the temperature rise curve or by backward extrapolation of the exponential portion of the temperature decay curve. The accuracy of these techniques for larger clinically used thermocouples is investigated by use of a two-dimensional model of the bioheat equation which simulates the transfer of heat radially from a probe 1 mm in diameter. The accuracy of these techniques is found to depend upon the perfusion rate. In the absence of perfusion, both extrapolation techniques underestimate the artifact by nearly 40%. Extrapolation of the temperature rise curve is very sensitive to the perfusion rate and this technique results in errors exceeding 100% when the perfusion rate is high. Extrapolation of the temperature decay curve produces more consistent results. Over a blood flow range of 0-100 ml/100 g per min, the artifact is underestimated by an amount that varies from approximately 40% to 30% respectively. Thus, the artifact can be determined to within 5% by this technique by increasing the extrapolated value by 35%.

Blood Flow Velocity↗
PubMedDate not supplied

Catheter induced temperature artifacts in ultrasound hyperthermia.

Temperature artifacts were evaluated at 72 different sensor locations in 10 different tumour sites heated by use of planar ultrasound transducers operated at 1 and 3 MHz. Thermometry was carried out by single- and multisensor thermocouple probes inserted into 19- and 16-gauge polyurethane catheters, respectively. Nearly all catheters were oriented approximately perpendicular to the ultrasound beam. The artifacts were determined by backward extrapolation of the thermal decay 30-60s after the power was turned off. The effective blood flow and specific absorption rate (SAR) at the sensor locations were determined from the rate of decay and the steady-state temperature. The sample mean steady-state temperature, effective blood flow, and SAR were 41.4 degrees C, 17.5 ml/100 g/min, and 46.3 W/kg, respectively. The most frequent artifact was in the range 0-0.2 degrees C and the mean artifact was 0.6 degrees C. Less than 15% of the artifacts were above 1 degree C. The magnitude of the artifact correlates with the SAR of ultrasonic power, the effective blood flow rate, and the steady-state temperature. These results indicate that the artifact produced at 1 MHz by a multisensor, Teflon-sheathed thermocouple inserted into a 16-gauge polyurethane catheter is 1.7 +/- 0.4 degrees at an SAR of 100 W/kg.

Body Temperature↗
PubMedDate not supplied

Temperature artifacts produced by thermocouples used in conjunction with 1 and 3 MHz ultrasound.

The relative temperature artifacts produced by a selection of commercially available thermocouples and catheters were evaluated in radiation bolus and beef phantoms heated by 1 and 3 MHz continuous ultrasound. The thermocouples included a 23 gauge needle microprobe inserted directly into the phantoms, polyurethane-sheathed, Teflon-sheathed, and exposed-tip thermocouples, each inserted into a 19 gauge polyurethane closed-end catheter, a multisensor Teflon-sheathed probe inserted into a 16 gauge polyurethane catheter and a Teflon-sheathed single-sensor probe without a catheter. The needle microprobe and the polyurethane-sheathed thermocouple produce equivalent artifacts. The artifacts produced by the Teflon and exposed-tip thermocouples are 1.4 +/- 0.3 times greater, that produced by the multisensor Teflon-sheathed probe is 2.1 +/- 0.3 times greater, and that produced by the Teflon-sheathed thermocouple without a catheter is 2.3 +/- 0.4 times greater. The results in the beef phantom indicate that the needle microprobe and polyurethane-sheathed thermocouple both produce artifacts of 0.7 +/- 0.1 degree in tissue at an SAR of 100 W/kg.

Body Temperature↗
PubMedDate not supplied

Modified thermal clearance technique for determination of blood flow during local hyperthermia.

The thermal clearance method utilizes the rate of temperature decay after the applied power is turned off to estimate the local blood flow. A limitation of this method has been its inability to account for the contribution of thermal conduction to the rate of temperature decay. As a result, the blood flow is generally overestimated. A modification of the thermal clearance method is described in this paper which enables the conduction component to be determined. Profiles of the tissue temperature are obtained in three mutually orthogonal directions about the point where thermal clearance is measured. The Laplacian of the temperature is evaluated from these profiles by the method of finite differences. The tissue thermal conductivity is estimated from literature values. The greatest source of error is the uncertainty in the location of the washout point in each catheter. Strict thermometry requirements must be adopted to reduce the localization error to +/- 0.25 cm. The thermometry catheters should be orthogonal to within +/- 10 degrees and all three catheters should be in contact at the washout point. The methodology was tested in a phantom, studied by use of a computer model, and implemented in the clinic. The experimental error in the conduction component is typically 50%. The resulting error in the blood flow depends on the relative rates of energy removal by blood flow and thermal conduction. When perfusion is the dominant mode of energy removal, the resulting uncertainty in the blood flow is typically in the range 20-30%.

Blood Flow Velocity↗
PubMedDate not supplied

Optimization of hyperthermia with CT scanning.

In a prospective study CT scanning was used to evaluate the precision of thermometry catheter placement in tumours in the head and neck or on the chest wall in 30 consecutive patients prior to hyperthermia treatment. Patients had variable-sized tumours from several primary sites. Thermometry catheter placement was guided by palpation with or without a prior CT scan. Catheter placement was confirmed by CT. All lesions were less than 8 x 8 x 6 cm (L x W x D) in size. A mean of 4.2 +/- 0.2 (+/- 1 SEM, range 2-7) closed-end polyurethane catheters were inserted orthogonally by the same experienced radiation oncologist. Horizontal thermometry catheters were intended to traverse the centre and base of the tumour mass, and a vertical catheter was often inserted to intersect a horizontal catheter. After catheter placement, wire cables with 1 cm spacings were inserted into the catheters and positions determined using orthogonal films and CT scans. The success of catheter placement was judged on the following criteria: (1) catheter distribution factor (CDF = proportion of tumour CT slices transected by at least one catheter); (2) catheter hit ratio (CHR = average number of catheters in tumour per CT slice); (3) catheter miss factor (CMF = average number of catheters out of tumour per CT slice); (4) catheter placement index, CPI = [(CHR)(CDF)]-CMF; and (5) distance of nearest catheter from the visually estimated centre of tumour in the most central tumour CT scan. In the first seven lesions with 3-6 cm depth catheter insertion was guided by palpation only. In the next 23 lesions catheter insertion was guided by a prior CT scan. In the latter group, 15 lesions had depth 3-6 cm while eight lesions had depth < or = 3 cm. Catheter placement by palpation only, without the benefit of CT scan, was much less accurate in terms of the nearest catheter to the centre of the tumour (p = .001), the proportion of CT slices with catheter in tumour (CDF, p = 0.04) and the probability of a catheter being outside the tumour (CMF, p = 0.01). The catheter placement index (CPI) was a good measure of the accuracy and adequacy of catheter placement in large tumours (p = 0.04). Displacement of normal tissue structures by tumour precluded accurate catheter placement and led to a low CPI. It was difficult to accurately instrument lesions < or = 3 cm depth even with the benefit of a prior CT scan.(ABSTRACT TRUNCATED AT 400 WORDS)

Catheterization↗