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T C Cetas

Publications and source records attributed to T C Cetas.

At least 19 recordsLinked to original sources
PubMed1998

A ferrite core/metallic sheath thermoseed for interstitial thermal therapies.

An alternative form of ferromagnetic seed for thermal therapy has been developed following Matsuki, Murakami, and their colleagues [1]-[4]. A nearly lossless ceramic ferrite core (FC) is surrounded by an electrically conductive sheath. The FC has a high relative intrinsic permeability, typically 3000 at low magnetic field strengths, and a sharp transition from the ferrimagnetic state to the nonmagnetic state. The sheath is either a metallic tube or coating on the core. When this composite seed is excited with a radiofrequency magnetic field, large eddy currents are induced in the metallic sheath (MS) due to the concentrated magnetic flux in the core leading to Joule heating. Advantages of this configuration are that this ferrite core/metallic sheath (FC/MS) thermoseed has high power absorption efficiency and a sharp transition compared to ferromagnetic alloy systems; means of optimizing efficiency are apparent from simple expressions; the outer sheath can be of any biocompatible metal; the production method for the ferrites leads to large quantities of seeds with reproducible properties. The FC/MS configuration solves many of the technical problems that have hindered the clinical implementation of thermally regulating ferromagnetic implants for thermal therapies.

Biocompatible Materials↗
PubMed1996

Power absorption and temperature control of multi-filament palladium-nickel thermoseeds for interstitial hyperthermia.

In interstitial hyperthermia using ferromagnetic seeds, multi-filament seeds have gained interest because of a more effective power absorption than solid seeds. Palladium-nickel (PdNi) seeds composed of filaments with diameters in the range from 0.1 to 1.0 mm (maximally 90 filaments) have been investigated to find the conditions for optimal power absorption and temperature control. Magnetic and calorimetric experiments have shown that a decreasing filament radius results in a more effective power absorption. The power absorption approaches a common asymptote for high field intensities at all filament diameters. This asymptotic behaviour can be understood as a consequence of the approach of saturation magnetization of PdNi. The sharpness of the transition at the Curie temperature, which is a measure for the quality of temperature control, improves as the magnetic field strength increases, but it is limited by the asymptote of the power absorption. When the asymptote has been reached the quality of temperature regulation of a seed can only be improved by increasing the amount of PdNi, e.g. by increasing the number of filaments. Calculations of the power absorption, using the generally applied theory based on a linear relation between the magnetization of PdNi and the magnetic field strength, do not correspond quantitatively with experimental results for seeds having an induction number smaller than the 'optimal value' of 2.5. For these seeds the measured heat production is larger than the calculated one.

Calorimetry↗
PubMed1994

Clinical hyperthermia with a new device: the current sheet applicator.

PURPOSE: The current sheet applicator (CSA) is a newly developed microwave hyperthermia device. Advantages over commercial microwave applicators include its small size and high ratio of heating area to physical aperture area. These physical characteristics make the CSA excellent for heating constricted areas and allow the use of arrays of CSAs over large surfaces. This study examines the clinical efficacy of the CSA for heating superficial malignant tumors. METHODS AND MATERIALS: From December 1989 through October 1991, 19 patients with recurrent or metastatic superficial malignant tumors were treated once or twice weekly to 30 hyperthermia fields using one to four CSAs. Each field received from one to four hyperthermia treatments for a total of 74 treatments. The treatment objective was to elevate the tumor temperature to a minimum of 42.5 degrees C for 30 min (2 patients) or 60 min (17 patients). Intratumor temperatures were measured with percutaneous fiberoptic thermometry probes. All patients received concurrent fractionated radiation therapy with total dose ranging from 20 to 65 Gy (median 46 Gy). Seventeen of the 30 fields had been previously irradiated to a median dose of 50 Gy. RESULTS: Mean values for the maximum temperature, average temperature, and minimum temperature were 43.6 degrees C +/- 1.0, 42.2 degrees C +/- 1.4, and 41.0 degrees C +/- 1.5, respectively. Mean values for T50 and T90 were 42.2 degrees C +/- 1.1 and 41.0 degrees C +/- 1.3, respectively. The overall response rate for all assessable fields was 96%. Only Only three responding tumors have progressed with a median follow-up period of 6 months. Treatment related morbidity was generally mild and self-limited. CONCLUSION: The CSA is a promising new microwave hyperthermia device capable of heating superficial tumors to therapeutic temperatures. When used in combination with radiotherapy, response rates are excellent without excessive toxicity.

Aged↗
PubMed1994

Fast and efficient computer modeling of ferromagnetic seed arrays of arbitrary orientation for hyperthermia treatment planning.

PURPOSE: Effective hyperthermia treatment planning requires an ability to predict temperatures quickly and accurately from an arbitrary distribution of power. Our purpose was to design such a fast executing computer code, MGARRAY, to compute steady-state temperatures from ferromagnetic seed heating, allowing seeds to have arbitrary orientations and to be curved to permit more realistic modeling of clinical situations. We further required flexibility for the tissue domain, allowing inhomogeneity with respect to thermal conductivity and blood perfusion, as well as an arbitrary shaped boundary. METHODS AND MATERIALS: MGARRAY uses multigrid methods and a finite volume discretization to solve the Pennes bioheat transfer equation in three dimensions. We used MGARRAY to compare temperature distributions that result from an array of straight, parallel seeds and from an array of seeds that were curved and tilted randomly by 13 degrees. RESULTS: On a personal workstation the Central Processing Unit (CPU) time of MGARRAY was under 4 min. We found that the median temperature in a predetermined target volume was approximately 0.8 degrees C higher in the straight array than in the curved array. At specific locations within the target volume temperature differed by approximately 0.5-0.9 degrees C, but could differ by up to several degrees, depending on proximity to a seed and the level of blood perfusion. CONCLUSION: These differences can impact on retrospective analyses whereby temperatures at a few locations are used to infer the overall temperature field and blood perfusion levels. The flexibility and computational speed of MGARRAY could potentially lead to a substantial improvement in both retrospective and prospective hyperthermia treatment planning.

Computer Simulation↗
PubMed1993

A phase I study of the toxicity of regional hyperthermia with systemic warming.

This study examines the consequences of allowing moderate systemic hyperthermia during regional heating of the abdomen and pelvis in 29 patients participating in Phase I studies of hyperthermia combined with chemotherapy or radiation therapy. In Group 1 (20 patients, 42 treatments), systemic temperatures were limited by employing surface cooling, while in Group 2 (9 patients, 24 treatments), surface warming and insulation were used so that systemic temperature would rise. Mean time-averaged oral temperatures were 38.4 degrees C and 39.9 degrees C for Groups 1 and 2, respectively. Time-averaged mean regional temperatures were 40.2 +/- 0.7 degrees C and 41.5 +/- 0.2 degrees C for Groups 1 and 2, respectively (p < .001). Regional temperatures > or = 41.0 degrees C were achieved by 64% of Group 1 and all Group 2 patients. The mean time-averaged power required was significantly lower for Group 2 (453 W vs 740 W; p = .032), as was the incidence of pain. Mean maximum pulse rate was significantly higher in Group 2, although this was not associated with symptoms. Allowing systemic temperature to rise decreased power requirements and treatment-related pain, at the cost of an asymptomatic increase in heart rate. The results suggest that regional heating may be more readily achieved in the setting of elevated systemic temperature.

Adolescent↗
PubMed1993

Temperature distribution in tissues from a regular array of hot source implants: an analytical approximation.

An approximate analytical model based upon the bioheat transfer equation is derived and used to calculate temperatures within a perfused region implanted regularly with dielectrically coated hot source implants; for example, hot water tubes, electrically heated rods, or inductively heated ferromagnetic implants. The effect of a regular array of mutually parallel heat sources of cylindrical shape is approximated by idealizing one of the boundary conditions. The solution, as could be expected, is in terms of modified Bessel functions. In calculating the temperature of each thermoregulating source in the array, the steady state power balance is enforced. The important feature of the model is that the finite size of implant diameter and its dielectric coating can be incorporated. The effect of thickness and thermal conductivity of the coating on the source and tissue temperatures along with various other interesting features are deduced from this model. The analytically calculated implant and tissue temperatures are compared with those of a numerical 3-D finite difference model. The analytical model also is used to define a range of parameters such that minimal therapeutic temperatures will be achieved in the implanted volume without exceeding prescribed maximum temperatures. This approach leads to a simple means of selecting implant spacing and regulation temperatures of hot source methods prospectively.

Blood Flow Velocity↗
PubMed1990

Interstitial thermoradiotherapy: thermal dosimetry and clinical results.

From August 1977 to August 1986, 72 patients with advanced primary or recurrent cancers were treated using interstitial thermoradiotherapy. Sites treated included the pelvis in 49 patients, the head and neck in 15, and other sites in six. Median tumor volume was 52 cm3, and all but nine patients had received prior irradiation. In 69 patients, hollow stainless steel catheters were implanted and used as electrodes with a 0.5 MHz radiofrequency (RF) generator, whereas in three patients, standard plastic Henschke tubes were used with a commercially available interstitial microwave (MW) system operating at 915 MHz. Most patients were heated intraoperatively for 30 minutes, aiming for a minimum measured intratumoral temperature (Tmin) of 42 degrees C. The implant was occasionally preceded by external irradiation, and after hyperthermia, the catheters were afterloaded with 192Ir for brachytherapy. Tmin exceeded 42 degrees, 42.5 degrees, 43 degrees, and 44 degrees in 25, 16, 12, and 3, respectively, of 70 patients with temperature data available, and the probability of successful heating was independent of tumor volume or site. Twenty-five of 69 (36%) evaluable patients achieved a complete response (CR). Probability of CR demonstrated a significant univariate dependence upon Tmin, radiation dose, site treated, and tumor volume, but multivariate analysis showed only three significant predictor variables: tumor volume, radiation dose, and Tmin. The probability of a CR ranged from 95% for patients with small tumors receiving high doses of radiation and adequate heat, to 5% for patients with large tumors receiving low radiation doses and less than adequate heat. Of 25 patients with CR, 10 relapsed; median response duration was less than 18 months, depended marginally upon disease site, and was independent of Tmin, radiation dose, and tumor volume. Seventeen patients sustained a complication, of which nine were severe enough to require hospitalization or surgery. All severe complications occurred in patients with pelvic tumors. The probability of a complication of any severity had a significant univariate association with maximum intratumoral temperature (Tmax) and tumor size. We conclude that interstitial thermoradiotherapy offers the promise of heating large tumors in locations where externally applied hyperthermia has not been successful.

Brachytherapy↗
PubMed1990

Interstitial thermoradiotherapy of brain tumors: preliminary results of a phase I clinical trial.

A Phase I clinical trial has been initiated to determine the feasibility, tolerance, and toxicity of interstitial thermoradiotherapy in the treatment of high-grade supratentorial brain gliomas. Hyperthermia was delivered by means of thermally-regulating ferromagnetic implants afterloaded into stereotactically placed plastic catheters. Heat treatments were given immediately before interstitial irradiation; in addition, five patients received a second heat treatment at the completion of brachytherapy. The desired target temperature for the 60-minute hyperthermia session was between 42 degrees C and 45 degrees C. Following hyperthermia, the catheters were afterloaded with Ir-192, which delivered a variable radiation dose of 14-50 Gy depending on the clinical situation. Interstitial irradiation was supplemented with external beam radiotherapy (40-41.4 Gy) in patients with previously untreated tumors. A total of 14 patients (4 males, 10 females) have been treated to date on this protocol. Eleven of the patients had a diagnosis of glioblastoma multiforme, whereas three had anaplastic astrocytoma. The mean implant volume was 61.5 cm3 (range: 9-119 cm3); the median number of interstitial treatment catheters implanted was 19 (range: 7-33). Continuous temperature monitoring was performed by means of multisensor thermocouple probes inserted in the center as well as in the periphery of the tumor. Of the 175 monitored intratumoral points, 83 (47%) had time-averaged mean temperatures of greater than 42 degrees C, and only 12 sensors (7%) exceeded a temperature of 45 degrees C. Among the 19 heat treatments attempted, there have been four minor acute toxicities, all of which resolved with conservative medical management and one major complication resulting in the demise of a patient. These preliminary results indicate that ferromagnetic implants offer a promising new approach to treating brain tumors with hyperthermia.

Adult↗
PubMed1990

Treatment planning of template-guided stereotaxic brain implants.

We have initiated a Phase I clinical trial of interstitial hyperthermia induced with inductively heated ferromagnetic implants in combination with Ir-192 implants for glioblastomas and anaplastic astrocytomas of the brain. For speed and accuracy of the implant procedure, and to control the radiation and thermal dose, a stereotaxic frame is used to position a template. We have modified the Brown-Roberts-Wells frame to be used with a variety of templates which we designed. On the morning of the implant procedure, a CT scan is done, and a CT-based treatment plan is then completed before the patient goes to the operating room. We also describe the CT-based treatment planning system developed to accommodate the template-guided implant and illustrate its clinical use.

Brachytherapy↗
PubMed1990

Use of Gaussian beam model in predicting SAR distributions from current sheet applicators.

The Gaussian beam model is shown to be a good predictor of SAR distributions due to current sheet applicators (CSAs). It is fast, efficient and adaptable. SAR distributions from a single applicator and from simple arrays of CSAs in homogeneous and layered lossy media are computed at 434 and 450 MHz at CPU times of less than 60 s. The good agreement between theory and experiment justifies the use of the Gaussian beam model to predict SAR distributions from CSAs.

Computer Simulation↗
PubMed1989

The CDRH helix. A phase I clinical trial.

Seventeen patients have been given regional hyperthermia treatments using the Center for Devices and Radiologic Health (CDRH) Helix, a resonant helical coil unit. Most of these patients had large, clinically advanced tumors, whose mean volume exceeded 1000 cc. Mean maximum, minimum, and average temperatures were 40.6, 38.6, and 39.6 degrees C, respectively, for all sites combined. The pelvic heating capabilities of the CDRH Helix and the BSD-1000 annular phased array were compared, and generally were equivalent. Although the Helix could be used in a wider variety of locations, and was more comfortable and easier to use than the BSD-1000 annular phased array, neither device was particularly effective in generating clinically useful temperatures; the Helix is currently under investigation for use in regional-systemic hyperthermia in combination with antineoplastic drugs and biologic response modifiers.

Clinical Protocols↗
PubMed1988

Development of Ni-4 wt.% Si thermoseeds for hyperthermia cancer treatment.

Ferromagnetic alloys, used in the form of "thermoseeds" for surgical implantation, have been developed and used to induce localized hyperthermia in cancerous growths. Alloys of nickel with approx. 4 wt.% Si were chosen for this study because they have Curie temperatures in the desired range of 45-60 degrees C. The thermoseeds were prepared by using either a special casting technique or casting and swaging followed by homogenization. The effects of these different processing schedules on the magnetic behavior of these alloys are discussed. In particular, the importance of minimizing oxidation during melting and heat treating, and the effects of homogenizing the thermoseeds on the relative permeability at temperatures near the Curie temperature are pointed out. The best processing schedule is casting small ingots while avoiding oxidation, followed by swaging, drawing, and homogenization. Actual induction heating experiments and the results from magnetization tests indicate that Ni-4 wt.% Si alloys prepared in this manner can be used as thermoseeds with predictable Curie temperatures. These thermoseeds can be used to obtain nearly uniform and constant temperatures in tumors with variable blood flows.

Alloys↗
PubMed1985

Obtaining local SAR and blood perfusion data from temperature measurements: steady state and transient techniques compared.

A series of analyses and experiments was performed to determine the extent that SAR and blood perfusion information can be extracted from steady state temperature values and from transient temperature measurements following a step change in applied power. Multiple local temperature measurements were made in canine thighs heated by 2450 MHZ microwaves to evaluate two parameters: the local absorbed power in the tissue, and the local "effective blood perfusion." The theoretical bases for these calculations are presented in order to identify their underlying assumptions and to obtain a unified basis for comparison of the various calculation methods used by previous investigators. From energy balance considerations it can be shown that the local absorbed power can be obtained from either the rate of increase of temperature following a step increase in power, or from the rate of decrease in temperature immediately following a step decrease in power. These theoretical observations are verified experimentally by comparing the SAR results at fixed positions in canine thighs as calculated from both increasing and decreasing power steps. For decreasing power steps, the resulting decreasing temperature curves can also be used to calculate an effective blood perfusion rate if thermal conduction is included. Alternatively, this same effective blood perfusion rate can be calculated from steady state data. (These two approaches have been used by previous investigators to determine "blood perfusion" values. We have added the modifier "effective" to specifically denote the presence of thermal conduction effects in such perfusion calculations.) From our experimental results and theoretical calculations it appears that differences between the predictions of the two calculation methods arise from changing thermal conduction values during the cooling period of the thermal clearance method. The steady state calculation approach is easier to apply than the washout method, but it requires the additional knowledge of the local SAR value. It is important to realize that effective blood perfusion values calculated using thermal techniques are subject to large errors under conditions where thermal conduction is important, unless this conduction is explicitLy included in the calculation. Such effective blood perfusion values should not be quantitatively compared to values calculated from non-thermal techniques that are not affected by thermal conduction. Unless such conduction effects are known to be negligible, effective perfusion values are only qualitative indicators of the presence of changes in blood perfusion.

Absorption↗
PubMed1985

Oscillatory temperature response to constant power applied to canine muscle.

A previously unreported oscillatory temperature response has been observed in canine thigh muscle subjected to an abrupt application of a constant specific energy absorption rate (SAR). The power was applied to anesthetized dogs (stage 3 plane of anesthesia) using 2,450-MHz microwaves. Five types of responses have been identified that have occurrences depending on the maximal temperature produced by the applied power. In particular, for SAR values resulting in sufficiently high initial temperatures, self-sustaining temperature oscillations lasting over 4 h have been observed with amplitudes up to 7 degrees C. The temperature oscillations are believed to be caused by oscillations in the local blood perfusion rate.

Animals↗