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J Wiersma

Publications and source records attributed to J Wiersma.

22 records · Page 2Linked to original sources

A flexible optimization tool for hyperthermia treatments with RF phased array systems.

In hyperthermia treatments performed with a radio-frequency phased array, the main issue to apply the excitation amplitudes and phases of the applicators for which tumour heating is optimal, i.e. the maximal therapeutic gain without unwanted side effects. Due to the complex interaction of the radiated EM-field and the patient's tissues, it is very difficult to find these optimal excitation (amplitude and phase) parameters by intuition. Calculation of the EM-field distribution within the patient can aid in finding the optimal excitation setting. However, this remains a difficult task because of the degrees of freedom available (2n - 1, with n the number of applicators in the array) and because a large temperature elevation may occur at healthy tissue sites resulting in unwanted side effects, e.g. pain or healthy tissue damage. Therefore, determining the excitation amplitudes and phases yielding optimal tumour heating can be done effectively only by application of a computerized optimization procedure. Optimization of the temperature distribution in the patient requires detailed knowledge of the thermal tissue parameters. Techniques for determining these properties are not commonly available and the use of averaged values for parameters like the tissue perfusion is expected to introduce large errors for individual patient treatment planning. As a consequence, the SAR distribution, being proportional to the temperature increase at treatment start, is more often selected for optimization. The 'optimized' excitation amplitudes and phases are found by maximization of a certain SAR ratio. Several propositions for this SAR ratio have been reported in the literature, e.g. the ratio of the SAR at the tumour site and the SAR at sites where unwanted side effects may occur. However, the definition of these ratios does not constrain the SAR value at these tissue locations to a safe value. In this paper, a tool for the optimization of the SAR distribution including the specification of constraints is presented. The tool focuses on the definition of the average SAR as a function of the excitation amplitudes and phases in a volume of arbitrary size (e.g. the tumour volume or the whole patient volume). These functions can be applied in either customized or commercially available optimization routines and they enable the definition of constraints for the average SAR in a certain volume. The described tool is illustrated for a patient case, showing the flexibility and easy application of the tool.

Hyperthermia, Induced↗

RF hyperthermia array modelling; validation by means of measured EM-field distributions.

The accuracy of a hyperthermia treatment simulation determines its role in prospective treatment planning and dosimetry for the individual patient. Of importance are (1) the accuracy of the numerical simulation method, and (2) the numerical description of the hyperthermia treatment system. The accuracy of the numerical method is generally determined by analysis of a problem that is analytically solvable. The validity of the description of the hyperthermia system is to be investigated by comparison of the simulated and measured EM-field amplitude and phase of the clinical operational hyperthermia system. In this paper, the numerical description of the AMC-4 waveguide phased array for which treatment planning is performed by the Weak Form of the Conjugate Gradient FFT method is investigated. The accuracy of the description is analysed for four set-ups, varying the bolus size and the number of waveguides attached to a phantom. The comparison of experimental and numerical data has demonstrated the ability of the Weak Formulation of the Conjugate Gradient FFT method to predict the EM-field of the AMC-4 waveguide array hyperthermia system, including effects due to bolus size variations. However, based on the comparison of the measured EM-field distributions and those obtained from simulations, the accuracy of the planning system is found to be insufficient for quantitative SAR dosimetry for individual patients. Qualitative SAR dosimetry can be applied in cases where the accuracy is of minor importance, e.g. for the retrospective analysis of problematic hyperthermia treatments. Prospective applications of the treatment planning system include the (qualitative) determination/simulation of a set of starting points giving a 'close to optimal' amplitude and phase setting, the prediction of possible problem areas and the analysis of the performance of new/improved hyperthermia devices.

Algorithms↗

SAR characteristics of three types of Contact Flexible Microstrip Applicators for superficial hyperthermia.

The Effective Field Sizes (EFS) and the Effective Heating Depths (EDH) of Contact Flexible Microstrip Applicators (CFMA), tuned at a frequency of 434 MHz, were determined on two fat/muscle phantoms. One phantom was box-shaped with a flat top layer of 1 cm thick artificial fat and the other one a tube of which the cross-section was elliptically shaped (25 x 36 cm) having a fat equivalent shell of 1 cm thick. For the muscle material a 6 g/l saline (NaCl) solution was used. On the flat rectangular phantom, the effective field size at 1 cm depth in saline was measured to be 4.7 x 13.5 cm, 17.5 x 17.7 cm and 12.5 x 14.0 cm for the 1H-applicator, the 3H-applicator and the 5H-applicator, respectively. For the 3H-and the 5H-applicator, the Specific absorption rate (SAR) distribution at 1 cm depth showed a single maximum of SAR for a thin bolus, which split into two separate "hot spots' for a thicker bolus. The Effective Heating Depths in the phantom with a flat surface were of the order of that of a plane wave (approximately 1.4 cm), whereas a larger EHD of 2.4 cm was achieved below the 3H-applicator bent to fit the elliptical phantom. Due to the large effective field size and the "flatness' of the SAR distribution, the applicators 3H and 5H are suitable to adequately treat large superficial tumours.

Fats↗

The measurement of fringing fields in a radio-frequency hyperthermia array with emphasis on bolus size.

The limited aperture size through which the em-field of the applicator is emanated and the constraining of this em-field near the bolus' edge is related to the appearance of superficial 'hot spot' phenomena in radiative hyperthermia. Regarding systems based on the concept of the annular phased array two questions arise: (1) what is the relative strength of the radial component present in the incident field of the radiators, and (2) in what way are fringing fields related to the bolus size? To address both of the above questions, the spatial distribution of the em-field emanated through the aperture of an applicator of the Amsterdam four waveguide-array system has been investigated for a long bolus and a short bolus. The em vector field emanated by the applicator has been characterized in two perpendicular planes, i.e. the aperture midplane and the sagittal midplane. It should be noted that this distribution depends on the propagation conditions throughout the coupling bolus, the phantom and other volumes attached, such as other applicators. Therefore two sets of propagation conditions have been measured: (1) the minimum number of parameters determining the propagation of the em-field namely one single waveguide, one bolus and a homogeneous phantom, and (2) the propagation conditions as for the clinical setting. It is stressed that the study concerns one specific radiative hyperthermia system, namely the AMC four-waveguide array, but that, based on the similarities discussed above, results may be extrapolated towards other radiative hyperthermia systems. According to the current study, bolus prolongation might lead to a clear clinical improvement, which is due to a decrease of the fringing field amplitude compared to the field amplitude in the centre of the aperture midplane. Bolus prolongation will lead to an extended heating area, the field lines being more aligned to the patient's main axis.

Electromagnetic Fields↗