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At least 235 records · Page 13Linked to original sources

[A multi-modal image registration method for use in thermotherapy of tumor].

In the interactive image-guided thermotherapy, we need the real time image and location of the target tumor. But the current mono-modal imaging technique can not do it. We present a method to register a preoperative 3D MRI volume to a set of intra-operative ultrasound images for the target localization of the liver tumor in the thermotherapy. The registration method is a genetic algorithm based on the features such as liver surface vessels and liver surface.

Humans↗

Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome.

OBJECTIVE: To investigate the efficacy of low intensity ultrasound thermotherapy, a conservative option of treatment of mild to moderate carpal tunnel syndrome (CTS). DESIGN: Prospective experimental, placebo- controlled, before-after treatment trial. SETTING: King Chulalongkorn Memorial Hospital, Outpatient Clinic and Electrodiagnostic Laboratory, Department of Rehabilitation Medicine. PATIENTS: Eighteen women, 30 hands who had clinical and electrophysiologic evidence of mild to moderate CTS. INTERVENTIONS: Patients of CTS were divided into two groups; A and B of 15 hands by random sampling. Group A was given placebo and continuous ultrasound therapy with the intensity of 0.5 W/cm2 applied to the palmar carpal tunnel for 10 minutes. Group B was given Diclofenac 75 mg/day in divided doses and sham ultrasound. The ultrasound was applied 5 days a week for 4 weeks. OUTCOME MEASURES: Each patient was clinically and electrophysiologically evaluated before and after treatment. RESULTS: There were statistically significant improvements (p < 0.05), in the clinical parameters of both groups after treatment. In the electrophysiologic study, the median SNAP amplitude was increased significantly after the treatment in ultrasound group (group A). When both groups were compared, group A had significant difference in increasing of median SNAP amplitude after treatment. CONCLUSION: The therapeutic efficacy of low intensity ultrasound thermotherapy was satisfied for mild to moderate CTS. However, the electrophysiological changes after ultrasound treatment need further investigation.

Adult↗

[The simulation of SAR and temperature distribution and parameters analysis for tumor RF thermotherapy].

In this paper are reported the model establishment and numerical simulation of specific absorption rate(SAR) and the unsteady temperature distribution for the non-invasive tumor RF thermotherapy. The model can correctly reflect the attenuation of electromagnetic wave in the biotissue, the variation of perfusion with temperature and lower perfusion of the tumor tissue are fully considered in the simulation. These measures made simulation results more close to the clinical results. Also presented in the paper are detailed analyses and discussions on the characteristics of SAR of electromagnetic energy and the temperature profiles, the effects of the frequency and the perfusion on the depth for effective treatment. The simulation results are of great significance for directing the clinical application of tumor RF thermotherapy.

Electromagnetic Fields↗

[A case of gastric cancer with multiple liver metastases effectively treated by hepatic arterial infusion of MMC, TS-1/CDDP therapy, and thermotherapy].

A 62-year-old man was revealed to have type 2 gastric cancer with synchronous liver metastasis. We considered liver metastasis to be a prognostic factor, and performed two courses of combination thermochemotherapy consisting of hepatic arterial infusion of MMC and TS-1 and thermotherapy. Partial response was observed in the liver metastases,but the primary lesion showed no changes; therefore, we performed four courses of combination thermochemotherapy consisting of TS-1/CDDP therapy and thermotherapy. By the end of three courses of this therapy,the primary lesion had cicatrized,and endoscopic biopsy revealed no cancer cells. These results suggest that gastric cancer,in which liver metastasis is considered to be a prognostic factor,can be effectively treated by combination therapy with hepatic arterial infusion therapy, followed by thermochemotherapy for the primary lesion.

Adenocarcinoma↗

[Effectiveness of improved intracavity microwave thermotherapy for nasopharyngeal carcinoma].

This study sought to evaluate the safety and effectiveness of intracavity microwave thermotherapy for nasopharyngeal carcinoma (NPC). The temperature images of the heating range were attained immediately after heating by LCP. The aim temperature (equal or over 40 degrees C) was achieved and then uniform thermal distribution in these areas was seen. Either phantoms or animal tests suggest that the temperature of all detected points are ranged from top to low: para-radiator, ipsilateral, parietal and contralateral wall of the simulated nasopharygeal cavity. Intracavity microwave thermotherapy is effective and safe for NPC by either phantoms or animal tests.

Animals↗

[Real-time and non-invasive temperature monitoring of thermotherapy using MRI].

High-intensity focused ultrasound (HIFU) thermotherapy is a promising technique for local tumor destruction of solid organs. Temperature is the important parameter which impacts the curative effects of thermotherapy. For safety and efficiency reasons, it is necessary to monitor the temperature changes inside body in real-time, non-invasively and precisely. Recently MRI methods employed for temperature monitoring during HIFU therapy have been paid more and more attentions to. This paper introduces the general principles of non-invasive temperature monitoring using MRI. The authors also review the development of this technique and point out some problems that need to be solved.

Animals↗

[Role of prostatic stents and transurethral microwave thermotherapy in the treatment of voiding disorders related to benign prostatic hyperplasia (CTMH-AFU forum 2005)].

Prostatic stents and microwave thermotherapy are minimally invasive techniques for the treatment of voiding disorders related to benign prostatic hyperplasia. A review of the literature evaluates the place of these treatments in 2006. Permanent prostatic stenting is rarely used, but remains a treatment option for patients with obstructive disorders and a formal anaesthetic contraindication. Temporary stenting can be used to predict the effect of resection in selected patients. Finally, microwave thermotherapy, not widely used in France, has a promising clinical efficacy and occupies a place between medical treatment and surgery.

Humans↗

Ultrasound thermotherapy effect on the recovery of nerve conduction in experimental compression neuropathy.

Bilateral tibial nerves of 18 albino rats were mechanically compressed between knee and ankle. Beginning on the fifth day after compression, ultrasound thermotherapy of 0.5 or 1.0watt/cm2 was applied over the area of nerve compression in one limb for one minute three times per week. The other side (control) was not treated. Motor distal latency (DL), motor nerve conduction velocity (NCV) of the segment with nerve compression, and amplitude of the evoked compound muscle action potential (ACMAP) were measured before and immediately after nerve compression and two or three times per week after compression. The recovery rates of NCV and ACMAP of the tibial nerve treated with ultrasound of 0.5watt/cm2 were significantly faster than those of the control nerve. There was no significant change in the recovery rate of DL. However, if ultrasound of 1.0watt/cm2 was applied, the recovery rate of ACMAP of the treated nerve was slower than that of the control nerve. There were no significant changes in the recovery rates of DL and NCV. Low doses of ultrasound thermotherapy may facilitate recovery of compression neuropathy, but higher doses may induce an adverse effect.

Action Potentials↗

[Microwave transurethral thermotherapy in the treatment of prostatic adenoma].

We report 195 patients with prostatic adenoma treated with microwave transurethral thermotherapy. All patients were initially subjected to a clinical assessment including Madsen-Iversen symptom score, digital rectal examination, measurement of urine flow rate and residual urine volume, transrectal prostatic ultrasound examination and blood prostate specific antigen determination. A prostatron machine was used, installing an urethral probe under local anesthesia. Endourethral and rectal temperatures were simultaneously measured and the procedure was controlled by a special software. The treatment was performed in an outpatient basis with a single procedures that lasted 60 min. Of 31 patients with chronic urinary retention, 28 were left voiding spontaneously, without urethral catheters and 84% of 164 symptomatic patients were relieved. No complications occurred, although 31.1% of patients has a transitory urinary retention after the procedure. It is concluded that microwave thermotherapy is a good therapeutic alternative for prostatic adenoma.

Aged↗

The prediction of clinical outcome from transurethral microwave thermotherapy by pressure-flow analysis: a European multicenter study.

A total of 100 patients treated with a single session of microwave thermotherapy at 4 European centers was stratified according to 2 different types of obstruction (constrictive and compressive) and compared to clinical outcome at 6 months. Patients had a Madsen-Iversen score of 8 or more, maximum flow rate of 15 ml. per second or less and residual urine volume of 300 ml. or less at entry. The change in Madsen-Iversen score was the same in the 2 groups. Maximum flow rate increased from 8.71 +/- 2.62 to 14.73 +/- 4.04 ml. per second in the constrictive group, and from 8.54 +/- 2.26 to 10.41 +/- 4.52 in the compressive group (p < or = 0.0001). Residual urine decreased from 96.00 +/- 72.85 to 40.34 +/- 56.33 ml. in the constrictive group and from 109.86 +/- 67.09 to 84.65 +/- 81.45 ml. in the compressive group (p < or = 0.0001). Success, as defined by an increase of 50% or more in maximum flow rate and Madsen-Iversen score, was noted in 68% of the constrictive but only 15% of the compressive groups (p < or = 0.0001 chi-square test for trend). Selection by pressure-flow criteria for patients being considered for thermotherapy should improve the overall clinical results.

Diathermy↗

The importance of the prostate weight in transurethral microwave thermotherapy.

OBJECTIVE: Transurethral resection of the prostate (TURP) is still the gold standard in the treatment of benign prostatic hyperplasia (BPH). Prostate weight could be of importance on the result of transurethral microwave thermotherapy (TUMT). The present study attempted to elucidate this point. MATERIAL AND METHODS: Transurethral microwave thermotherapy (TUMT) was administered to 106 men with BPH. The patients were classified into two groups according to the weight of the prostate. Group 1 comprised 69 patients, aged 52 to 84 years (mean 65 years), whose prostate weighed up to 50 gm. Group 2 comprised 37 men, aged 55 to 87 years (mean 68 years) whose prostate weighed more than 50 gm. Prostate weight was determined by transrectal ultrasound. The protocol included history and physical examination (particularly digital rectal examination), laboratory evaluation (particularly measurement of PSA), transrectal ultrasound and uroflowmetry. The post-void residual urine was measured by urethral catheterization and ultrasound examination. RESULTS: There were 5/106 (4.7%) failure; therefore, a total of 101 patients were followed from 3 to 27 months, mean 7.7 months. Postoperatively, both groups showed improvement of all the parameters analyzed, except PSA (p < 0.01). However, comparison of the two groups for irritative and obstructive symptoms score and uroflow showed no significant difference. The decrease of the post-void residual urine was statistically greater in group 1 (p < 0.01). Group 2 showed a larger reduction in weight in comparison to group 1 (p < 0.01). Complications were observed in 12/101 (11.9%) cases, with no statistical difference between groups. Of a total of 7 patients with ejaculatory disorders, 5 patients with smaller prostate were observed. Recovery was not seen at more than 6 months follow up. CONCLUSION: The results showed no correlation between the prostatic weight and the efficiency of TUMT in the treatment of BPH.

Aged↗

[Laser-induced thermotherapy of liver metastases with MRI control. Prospective results of an optimized therapy procedure].

In a prospective study MR-guided laser-induced thermotherapy (LITT) of liver metastases was optimized and the clinical parameters evaluated. Seventeen patients (4 women, 13 men) with a total of 29 lesions underwent LITT in 25 sessions through 1 March 1994. Twelve of them suffered from colorectal carcinomas, 5 from other primary tumors. Under local anesthesia a maximum of 5 lesions per patient were treated. For MR-guided LITT a neodymium yttrium aluminum garnet laser (Nd-YAG 1064 nm) with energy varying from 3 to 7.5 W was used. Energy and application time were defined through a computer program; they varied, dependent on the lesion size, location and consistency. To monitor the progress of LITT two special thermosensitive MR sequences (Thermo-Turbo-FLASH and FLASH-2D sequences) were individually optimized, whereby the increase in temperature correlates with an increase in signal loss. All procedures were well tolerated without significant early or late side effects. In only one patient was minimal air documentated in the pleural cavity with spontaneous resorption. Patients were dismissed without complaints after 24-h hospitalization. The control parameters of the contrast-enhanced dynamic MRI documented at optimal response a hypointense signal around the tip of the laser applicator, in accordance with laser-induced necrosis. In lesions 20 mm or smaller, nearly 100% tumor necrosis was achieved and in lesions larger than 20 mm, only 50%. Follow-up evaluation 6 months after treatment shows a significantly better response in lesions with a diameter of 20 mm or smaller, with a local tumor control rate of 66%. In lesions larger than 20 mm only a local tumor control rate of 35% could be achieved. Laser-induced thermotherapy (LITT) represents a new, minimally invasive technique for tumor destruction and a high response rate in small liver metastases.

Adult↗

Transurethral microwave thermotherapy in the treatment of chronic abacterial prostatitis: a 2 years follow-up.

OBJECTIVE: Transurethral microwave thermotherapy (TUMT) is a minimally invasive, outpatient treatment, applied as a single session of 1-hour duration. SUBJECTS AND METHODS: A group of 11 patients with chronic abacterial prostatitis, who failed to respond to a variety of conventional treatments, underwent this therapy in our centre. RESULTS: The results after two years of follow-up are encouraging: 88% remain free of symptoms. CONCLUSION: Thermotherapy seems to add a new alternative for this hard to manage disease.

Chronic Disease↗

[Transurethral thermotherapy with microwaves in symptomatic prostatic benign hypertrophy: comparison between the high-energy (2.5) protocol and the standard protocol (2.0)].

OBJECTIVES: The efficacy of three therapeutic protocols of transurethral microwave thermotherapy (TUMT), was compared in a study comprised of 355 patients that had been treated for benign prostatic hypertrophy (BPH) between March, 1992 and March, 1995. METHODS: TUMT were performed with the Prostatron device with intravenous analgosedation and on an outpatient basis. In the first group (Protocol A), 122 patients received a standard treatment (Prostasoft 2.0/hour); the second group of 81 patients were included into Protocol B (Prostasoft 2.0/2 hours); 152 patients were treated with higher-energy in Protocol C (Prostasoft 2.5/1 hour). The number of sessions (635) performed were based on prostatic length: L < 45 mm - one session (Prostanec catheter); L < 55 mm - two sessions (additional black catheter session); L < 65 mm - three session (additional white catheter session). RESULTS: All groups improved significantly for subjective symptoms (symptom score) and objective parameters (peak flow, residual urine). Comparison of the results between the three groups at 6 and 12 months showed a significantly better clinical outcome in protocol C >> B > A: Morbidity was higher in group C than in group B than in group A. CONCLUSION: Our results indicate that transurethral microwave thermotherapy is a safe and effective procedure which improves objective and subjective parameters. Better outcomes were obtained with long session times (2H) and overall higher energy (2.5) input, which may be explained by the creation by cavities within the prostate, but at the cost of increased morbidity. However, TUMT can still be delivered as an anesthesia-free and outpatient non-surgical alternative treatment for BPH.

Aged↗

[The treatment of prostatic adenoma by means of local hyperthermia and thermotherapy].

The study was aimed at clinical evaluation of different heat treatment modalities: transrectal microwave hyperthermia (TRMH), transurethral microwave hyperthermia (TUMH) and transurethral microwave thermotherapy (TUMT). The treatment of 311 patients with TRMH, 79 patients with TUMH and 59 patients with TUMT was performed using integrated software and hardware system "Yakhta-4M" (432 MHz, 200 W). The temperature within the prostate achieved 43-44 degrees C (hyperthermia) and 54-55 degrees C (thermotherapy). The results were evaluated by both subjective (I-PSS symptom scoring system) and objective (prostatic size, residual urine, mean peak flow) criteria. The study showed reliability, simplicity, low morbidity and high efficiency of the above modalities. According to both subjective and objective criteria thermal treatment produced marked improvement of the condition.

Evaluation Studies as Topic↗

[Benign prostatic hypertrophy: mini-invasive treatments (interstitial laser-transurethral needle ablation-thermotherapy)].

Endoscopic resection is the "gold standard" to treat benign prostatic hyperplasia refractory to medical treatments, because it is effective and only relatively aggressive. In young patients or debilitated elderly patients, there is a place for so-called minimally invasive surgical treatments, consisting of three possibilities: interstitial laser, TUNA (transurethral needle ablation), and thermotherapy. The results of these last two techniques are very similar o those obtained by endoscopic resection, with virtually no complications. These treatments are performed on an outpatient basis and have no consequences for sexuality. Thermotherapy has also been approved by the FDA in the USA. In France, these treatments can only be used in the context of a clinical trial.

Ambulatory Surgical Procedures↗

Transscleral thermotherapy: short- and long-term effects of transscleral conductive heating in rabbit eyes.

OBJECTIVE: To determine the highest safe treatment temperature, at 30- and 60-second exposure durations, for transscleral thermotherapy (TSTT) of choroidal melanoma. METHODS AND DESIGN: Transscleral conductive heating was performed in 15 rabbits at 50 degrees C to 70 degrees C for 30 or 60 seconds. The thermal lesions in the ocular fundus were monitored for 4 months with ophthalmoscopic, photographic, and fluorescein angiographic examination. Histologic examination included polarized light microscopy. RESULTS: The effect of TSTT was similar for both exposure durations. Vascular occlusion in the retina and choroid developed at temperatures of 55 degrees C and higher. After heating at 60 degrees C, scleral collagen fibers developed a minimal undulation; at 65 degrees C, they became clearly undulated. The undulation resolved in the 3 to 4 months after heating. Heating at 70 degrees C caused persistent severe damage to the sclera. Retinal tears developed after heating at 65 degrees C and 70 degrees C. CONCLUSIONS: A temperature of 65 degrees C was found to be the highest temperature that did not cause permanent damage to the sclera at both exposure durations. A temperature of 60 degrees C may be the optimal temperature for TSTT of choroidal melanoma because retinal tears may develop at 65 degrees C. CLINICAL RELEVANCE: In TSTT, the temperature levels reached are cytotoxic for choroidal melanoma as well as intrascleral tumor cells. Occlusion of choroidal vessels induced by TSTT may contribute to tumor necrosis because these vessels serve as feeder vessels for the tumor.

Animals↗

Histological effect and protein expression in subthreshold transpupillary thermotherapy in rabbit eyes.

OBJECTIVE: To investigate the histological effect of subthreshold transpupillary thermotherapy (TTT) on the retina. METHODS: We performed TTT in normal pigmented rabbit eyes using an 810-nm diode laser with spot size of 1.2 mm, power of 50 mW, and varying durations of 15, 30, or 60 seconds. Four weeks later, fluorescein angiography was performed, and the enucleated eyes were examined by means of electron microscopy and immunohistochemical staining. RESULTS: Funduscopy immediately and at 4 weeks showed no discernable changes at TTT sites, and fluorescein angiography at 4 weeks showed no abnormalities. However, electron microscopy showed photoreceptor and retinal pigment epithelium cell disruption, changes more prominent with longer durations of treatment. Immunohistochemical staining was positive for heat shock protein 60, heat shock protein 70, tumor necrosis factor alpha, and vascular cell adhesion molecule 1 in the photoreceptors and retinal pigment epithelium at TTT sites. Untreated control eyes showed no staining. CONCLUSIONS: Despite the absence of changes evident by funduscopy and fluorescein angiography, TTT resulted in dose-dependent histological changes in photoreceptors and retinal pigment epithelium. The induction of heat shock proteins, cytokines, and cell adhesion molecules may play a role in the tissue response to subthreshold TTT. Clinical Relevance Unrecognized damage to the retina and retinal pigment epithelium may contribute to visual loss in eyes that undergo subthreshold TTT.

Animals↗