Normal brain response after interstitial microwave hyperthermia.

Abstract

The effects of interstitial hyperthermia were assessed in the normal brain after a single 30 min treatment using 2450 MHz microwaves. A single helical coil microwave antenna was inserted into the frontal white matter and reference temperatures of 40, 41, 42, 43 and 44 degrees C maintained for 30 min along a temperature sensing probe 5 mm away and parallel to the antenna. The extent of hyperthermia damage was quantified weekly for 6 weeks using computed tomography (CT), and changes in regional cerebral blood flow (rCBF), tissue vascularity and mean transit time were determined using ultrafast CT. Qualitative histopathological analysis was carried out on tissues at various times after heating. Heat lesions were radiographically characterized by rapid development and resolution and consisted of an area of focal low density surrounded by a ring of contrast enhancement. Histologically, the focus of low density corresponded to regions of tissue necrosis, whereas the ring enhancement showed local reactive changes, including endothelial cell proliferation and infiltration with macrophages. Tissue necrosis occurred at temperatures greater than 43.9 +/- 1.5 degrees C (mean +/- standard deviation), and volumes of necrosis and ring enhancement were at a maximum 1 week following treatment. Relative to the contralateral, unheated hemisphere, rCBF in the heated brain appeared to be reduced for the first 3 weeks after treatment but approached normal by week 4. The mean transit time of blood was increased for weeks 1-3 compared to the untreated hemisphere, and tissue vascularity reached a maximum, 3 weeks after treatment. The rapid CT changes together with ultrafast CT and histopathological findings suggest that focal heat lesions in the brain stimulate a significant and rapid vascular response.