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J B Van de Kamer

Publications and source records attributed to J B Van de Kamer.

11 recordsLinked to original sources

High-resolution temperature-based optimization for hyperthermia treatment planning.

In regional hyperthermia, optimization techniques are valuable in order to obtain amplitude/phase settings for the applicators to achieve maximal tumour heating without toxicity to normal tissue. We implemented a temperature-based optimization technique and maximized tumour temperature with constraints on normal tissue temperature to prevent hot spots. E-field distributions are the primary input for the optimization method. Due to computer limitations we are restricted to a resolution of 1 x 1 x 1 cm3 for E-field calculations, too low for reliable treatment planning. A major problem is the fact that hot spots at low-resolution (LR) do not always correspond to hot spots at high-resolution (HR), and vice versa. Thus, HR temperature-based optimization is necessary for adequate treatment planning and satisfactory results cannot be obtained with LR strategies. To obtain HR power density (PD) distributions from LR E-field calculations, a quasi-static zooming technique has been developed earlier at the UMC Utrecht. However, quasi-static zooming does not preserve phase information and therefore it does not provide the HR E-field information required for direct HR optimization. We combined quasi-static zooming with the optimization method to obtain a millimetre resolution temperature-based optimization strategy. First we performed a LR (1 cm) optimization and used the obtained settings to calculate the HR (2 mm) PD and corresponding HR temperature distribution. Next, we performed a HR optimization using an estimation of the new HR temperature distribution based on previous calculations. This estimation is based on the assumption that the HR and LR temperature distributions, though strongly different, respond in a similar way to amplitude/phase steering. To verify the newly obtained settings, we calculate the corresponding HR temperature distribution. This method was applied to several clinical situations and found to work very well. Deviations of this estimation method for the AMC-4 system were typically smaller than 0.2 degrees C in the volume of interest, which is accurate enough for treatment planning purposes.

Body Burden↗

Computation of high-resolution SAR distributions in a head due to a radiating dipole antenna representing a hand-held mobile phone.

SAR distributions in a healthy female adult head as a result of a radiating vertical dipole antenna (frequency 915 MHz) representing a hand-held mobile phone have been computed for three different resolutions: 2 mm, 1 mm and 0.4 mm. The extremely high resolution of 0.4 mm was obtained with our quasistatic zooming technique, which is briefly described in this paper. For an effectively transmitted power of 0.25 W, the maximum averaged SAR values in both cubic- and arbitrary-shaped volumes are, respectively, about 1.72 and 2.55 W kg(-1) for 1 g and 0.98 and 1.73 W kg(-1) for 10 g of tissue. These numbers do not vary much (<8%) for the different resolutions, indicating that SAR computations at a resolution of 2 mm are sufficiently accurate to describe the large-scale distribution. However, considering the detailed SAR pattern in the head, large differences may occur if high-resolution computations are performed rather than low-resolution ones. These deviations are caused by both increased modelling accuracy and improved anatomical description in higher resolution simulations. For example, the SAR profile across a boundary between tissues with high dielectric contrast is much more accurately described at higher resolutions. Furthermore, low-resolution dielectric geometries may suffer from loss of anatomical detail, which greatly affects small-scale SAR distributions. Thus. for strongly inhomogeneous regions high-resolution SAR modelling is an absolute necessity.

Adult↗

High-resolution SAR modelling for regional hyperthermia: testing quasistatic zooming at 10 MHz.

Present-day regional hyperthermia treatment planning systems are limited to centimetre resolution. To obtain CT-resolution SAR distributions, a method called quasistatic zooming has been developed: using the centimetre-resolution E-field distribution and the CT-resolution tomogram, the CT-resolution SAR distribution is obtained. For a low frequency of 10 MHz this method has been validated sucessfully using CT-resolution SAR computations. It appears that these CT-resolution SAR distributions are completely different from centimetre-resolution SAR distributions, indicating the necessity for high-resolution SAR modelling. Using the presented zooming technique, reliable CT-resolution SAR modelling is now possible with relatively short computation times. So far, the zooming method has only been validated for low frequencies, but clinically relevant frequencies appear to be possible.

Algorithms↗

Quasistatic zooming for regional hyperthermia treatment planning.

Due to current computer limitations, specific absorption rate (SAR) distributions in regional hyperthermia treatment planning (HTP) are limited to centimetre resolution. However, since patient anatomy is highly structured on a millimetre scale, millimetre-resolution SAR modelling is required. A method called quasistatic zooming has been developed to obtain a high-resolution SAR distribution within a volume of interest (VOI): using the low-resolution E-field distribution and the high-resolution patient anatomy, the high-resolution SAR distribution is computed within a small zoom volume Q (small compared with the wavelength in water (lambda(w))). Repeating this procedure yields the zoomed-resolution SAR distribution in an arbitrary VOI. To validate this method for a VOI that is not small compared with lambda(w), high-resolution finite-difference time-domain (FDTD) modelling is needed. Since this is impractical for a clinical applicator, a computer model of a small applicator has been created. A partial patient anatomy is inserted into the applicator and both high- and low-resolution SAR distributions are computed for this geometry. For the same geometry, zoomed-resolution SAR distributions are computed with different sizes of Q. To compare the low- and zoomed-resolution SAR distributions with the high-resolution one, the correlation and averaged absolute difference are computed. These numbers are improved considerably using zooming (correlation 58% to 92%; averaged absolute difference 43% to 20%). These results appear to be independent of the size of Q, up to 0.3 lambda(w). Quasistatic zooming is a valuable tool in high-resolution regional HTP.

Computer Simulation↗

Quasistatic zooming of FDTD E-field computations: the impact of down-scaling techniques.

Due to current computer limitations, regional hyperthermia treatment planning (HTP) is practically limited to a resolution of 1 cm, whereas a millimetre resolution is desired. Using the centimetre resolution E-field distribution, computed with, for example, the finite-difference time-domain (FDTD) method and the millimetre resolution patient anatomy it is possible to obtain a millimetre resolution SAR distribution in a volume of interest (VOI) by means of quasistatic zooming. To compute the required low-resolution E-field distribution, a low-resolution dielectric geometry is needed which is constructed by down-scaling the millimetre resolution dielectric geometry. In this study we have investigated which down-scaling technique results in a dielectric geometry that yields the best low-resolution E-field distribution as input for quasistatic zooming. A segmented 2 mm resolution CT data set of a patient has been down-scaled to 1 cm resolution using three different techniques: 'winner-takes-all', 'volumetric averaging' and 'anisotropic volumetric averaging'. The E-field distributions computed for those low-resolution dielectric geometries have been used as input for quasistatic zooming. The resulting zoomed-resolution SAR distributions were compared with a reference: the 2 mm resolution SAR distribution computed with the FDTD method. The E-field distribution for both a simple phantom and the complex partial patient geometry down-scaled using 'anisotropic volumetric averaging' resulted in zoomed-resolution SAR distributions that best approximate the corresponding high-resolution SAR distribution (correlation 97, 96% and absolute averaged difference 6, 14% respectively).

Anisotropy↗

Monitoring of deep brain temperature in infants using multi-frequency microwave radiometry and thermal modelling.

In this study we present a design for a multi-frequency microwave radiometer aimed at prolonged monitoring of deep brain temperature in newborn infants and suitable for use during hypothermic neural rescue therapy. We identify appropriate hardware to measure brightness temperature and evaluate the accuracy of the measurements. We describe a method to estimate the tissue temperature distribution from measured brightness temperatures which uses the results of numerical simulations of the tissue temperature as well as the propagation of the microwaves in a realistic detailed three-dimensional infant head model. The temperature retrieval method is then used to evaluate how the statistical fluctuations in the measured brightness temperatures limit the confidence interval for the estimated temperature: for an 18 degrees C temperature differential between cooled surface and deep brain we found a standard error in the estimated central brain temperature of 0.75 degrees C. Evaluation of the systematic errors arising from inaccuracies in model parameters showed that realistic deviations in tissue parameters have little impact compared to uncertainty in the thickness of the bolus between the receiving antenna and the infant's head or in the skull thickness. This highlights the need to pay particular attention to these latter parameters in future practical implementation of the technique.

Body Temperature↗

Regional hyperthermia applicator design using FDTD modelling.

Recently published results confirm the positive effect of regional hyperthermia combined with external radiotherapy on pelvic tumours. Several studies have been published on the improvement of RF annular array applicator systems with dipoles and a closed water bolus. This study investigates the performance of a next-generation applicator system for regional hyperthermia with a multi-ring annular array of antennas and an open water bolus. A cavity slot antenna is introduced to enhance the directivity and reduce mutual coupling between the antennas. Several design parameters, i.e. dimensions, number of antennas and operating frequency, have been evaluated using several patient models. Performance indices have been defined to evaluate the effect of parameter variation on the specific absorption rate (SAR) distribution. The performance of the new applicator type is compared with the Coaxial TEM. Operating frequency appears to be the main parameter with a positive influence on the performance. A SAR increase in tumour of 1.7 relative to the Coaxial TEM system can be obtained with a three-ring, six-antenna per ring cavity slot applicator operating at 150 MHz.

Female↗

Development of a regional hyperthermia treatment planning system.

A flexible and fast regional hyperthermia treatment planning system for the Coaxial TEM System has been devised and is presented. Using Hounsfield Unit based thresholding and manually outlining of the tumour, a 40 cm CT data set (slice thickness 5 mm) is segmented and down scaled to a resolution of 1 cm, requiring only 30 min. The SAR model is based on the finite-difference time-domain (FDTD) method. The number of time steps to achieve numerical stability has been determined and was found to be 7000. Various optimizations of the SAR model have been applied, resulting in a relatively short computation time of 3.7 h (memory requirements 121 MB) on a Pentium III, 450 MHz standard personal computer, running GNU/Linux. The model has been validated using absolute value(Ez) measurements in a standard phantom inserted in the Coaxial TEM Applicator under different conditions and a good agreement was found. Hyperthermia treatment planning in combination with the homemade visualization tools have provided much insight in the regional hyperthermia treatment with the Coaxial TEM Applicator.

Electromagnetic Fields↗

The use of absorbing structures during regional hyperthermia treatment.

Local pain is the main factor that limits regional hyperthermia treatment. Using the SAR model of the regional hyperthermia treatment planning system, the capability of absorbing blocks to reduce peripheral hot spots was investigated. The effect of rectangular absorbers of various size and salinity on an elliptical phantom in the Coaxial TEM was evaluated. The computed results were compared with SAR values measured in the phantom. Absorbers of 9 x 9 x 4 cm3 and a salinity of 18 gram l(-1) provide a SAR reduction in the muscle equivalent material, centrally under the absorber of at least 50% at a depth of up to 3 cm. The effect on the central (i.e. tumour) region is less than 20%. Larger absorbers have a more global effect and cause more attenuation in the central region. The attenuating effect depends strongly on the thickness of the fat layer between muscle and absorber. More than 2 cm fat limits the effective use of absorbers. Absorbers can induce a significant increase of SAR in muscle and fat near their edges. This effect also depends on absorber size and salinity and the thickness of the fat layer. The effect of an absorber was also evaluated with a patient anatomy, yielding results in agreement with the phantom experiments.

Humans↗

The significance of accurate dielectric tissue data for hyperthermia treatment planning.

For hyperthermia treatment planning, dielectric properties of several tissue types are required. Since it is difficult to perform patient specific dielectric imaging, default values based on literature data are used. However, these show a large spread (approximately 50%). Consequently, it is important to know what limit this spread imposes on the accuracy of the SAR and subsequently on the temperature distributions. Hyperthermia treatment plans performed with different values for the dielectric properties were compared. This showed that a spread of 50% resulted in the average absolute difference of approximately 20% in both SAR and temperature distributions (heat sink approach) for regional hyperthermia. For interstitial hyperthermia, a spread of 25% resulted in the averaged absolute difference of approximately 10% in the SAR distributions and 5% in the temperature distributions (heat sink approach). Considering other problems that hamper hyperthermia treatment planning, it can be concluded that default values for the dielectric properties suffice.

Brain Neoplasms↗

Improvement of absorbing structures used in regional hyperthermia.

Local pain is a major limiting factor in regional hyperthermia treatment with radiative applicators. Absorbing structures, consisting of agar bound saline water, have been used successfully to reduce peripheral hot spots. However, both clinical experience and simulation results indicate a SAR elevation in the tissue under the edges of the absorber block. This paper investigates the effect of modification of shape, position and spatial composition of the absorber blocks on the central attenuating effect and the SAR elevating effect at the edges. A selection from a set of five options is made based on simulations with a phantom and a single ring dipole applicator. The simulations have been performed with the FDTD core of the regional hyperthermia treatment planning system. It is shown that tapering of the absorber edge and introduction of a water layer between the absorber and the skin can reduce the edge effect in the superficial fat layer by approximately 50% with respect to a rectangular absorber. A further reduction of 15% can be obtained by an absorber with an appropriate gradient of its conductivity in the direction of the dominant E-field. The modified absorbers produce a central attenuating effect comparable to the rectangular type. The use of a water layer type and a sigma gradient type absorber is also analysed in a patient anatomy, both in the dipole ring applicator, operating at 70 MHz, as well as in a three ring Cavity Slot (CS) applicator, operating at 150 MHz. The mutual influence of phase-amplitude steering and the application of absorbers is investigated in the CS applicator. It appears that absorbers have a significant influence on the interference pattern in the patient model, possibly causing substantial reduction of the SAR value in the tumour and limiting the possibility of ad hoc application of absorbers. Re-optimization can only partly cancel this effect. Local SAR reduction by phase-amplitude control alone can match or improve the effect obtained with modified absorbers.

Absorption↗