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Biomedical subjects

S T Clegg

Publications and source records attributed to S T Clegg.

25 records · Page 2Linked to original sources

Application of new technology in clinical hyperthermia.

Two areas of technical progress related to hyperthermic oncology are presented: (1) numerical modelling of absorbed power and temperature distributions; and (2) non-invasive thermometry using magnetic resonance imaging. The results represent achievements made during the past 5 years at Duke University Medical Center's Departments of Radiation Oncology and Radiology. They represent examples of progress in the technology of hyperthermia that have potential for greatly improving the delivery, monitoring and assessment of clinical hyperthermia.

Body Temperature↗

Verification of a hyperthermia model method using MR thermometry.

Simulation of hyperthermia induced power and temperature distributions is becoming generally accepted and finding its way into clinical hyperthermia treatments. Such simulations provide a means for understanding the complete three-dimensional temperature distribution. However, the results of the simulation studies should be regarded with caution since modelling errors will result in differences between the actual and simulated temperature distribution. This study uses a diffusion weighted magnetic resonance (MR) based technique to measure hyperthermia induced temperature distributions in a three-dimensional space in a non-perfused phantom. The measured data are used to verify the accuracy of numerical simulations of the same three-dimensional temperature distributions. The simulation algorithm is a finite element based method that first computes the electromagnetic induced power deposition then the temperature distribution. Two non-perfused phantom studies were performed and qualitatively the MR and simulated distributions agreed for steady-state. However, due to the long MR sampling time (approximately 4 min), poor agreement between the simulations and MR measurements were obtained for thermal transients. Good agreement between the simulations and fibreoptic thermometry measurements were obtained. The fiberoptic measurements differed from the simulations by 0.11 +/- 0.59 degrees C and -0.17 +/- 0.29 degrees C (mean +/- standard deviation for the two studies).

Algorithms↗

Simulation of electromagnetically induced hyperthermia: a finite element gridding method.

A finite element gridding method for simulating electromagnetically (EM) induced hyperthermia is presented. The method uses patient CT data as its primary input, with critical structures manually outlined (on a graphics workstation) for explicit demarcation. The paper outlines the various stages involved in mesh creation, including procedures for conforming the finite element representation of critical structures to their smooth boundaries, modelling of heating equipment, and modelling of the outer boundaries. The procedure for generating the finite element model is illustrated for an example treatment. Additionally, the results of computing the SAR in six patients are compared to measured values. The comparison reveals agreement between the model prediction and actual treatment within the limits of measurement error.

Combined Modality Therapy↗

Estimation of cell survival in tumours heated to nonuniform temperature distributions.

UNLABELLED: A stochastic model describing the probability of cell survival as a function of thermal exposure was developed and fit to data arising from studies of CHO cell survival under hyperthermic conditions. This model characterizes the separate risks of temperature-induced cell death and induction of thermotolerance during heating. Tumour cells are assumed to be affected independently of each other by hyperthermia. Tumour geometry, perfusion and power deposition affect hyperthermia-induced temperature distributions in tumours, producing nonuniform temperatures. Two tumours may respond to hyperthermia slightly differently because of differences in tumour geometry, perfusion, power deposition, or by chance alone and the approach presented here incorporates chance and these other factors explicitly. THE RESULTS: (1) the time-temperature history is important for estimating tumour cell survival; (2) tumour temperature heterogeneity leaves more surviving cells at a given T90 temperature than would be expected if the entire tumour were uniformly heated to that same temperature; and (3) changes in the shape of the temperature distribution because of tumour geometry and perfusion distribution greatly influence cell survival between tumours, even when the standard temperature descriptors, such as T90, are fixed. The simulations also showed a modest effect on cell kill attributable to varying the lengths of the warm-up and the cool-down periods. These simulations indicate that these types of sensitivity studies can be used to investigate relationships between various modifiers of temperature distributions achieved when treating tumours with hyperthermia and to assess their potential therapeutic impact in clinical trials.

Animals↗

Hyperthermia treatment planning and temperature distribution reconstruction: a case study.

While a great deal of effort has been applied toward solving the technical problems associated with modelling clinical hyperthermia treatments, much of that effort has focused on only estimating the power deposition. Little effort has been applied toward using the modelled power depositions (either electromagnetic (EM) or ultrasonic) as inputs to estimate the hyperthermia induced three-dimensional temperature distributions. This paper presents a case report of a patient treated with hyperthermia at the Duke University Medical Center where numerical modelling of the EM power deposition was used to prospectively plan the treatment. Additionally, the modelled power was used as input to retrospectively reconstruct the transient three-dimensional temperature distribution. The modelled power deposition indicated the existence of an undesirable region of high power in the normal tissue. Based upon this result, amplitudes and phases for driving the hyperthermia applicator were determined that eliminated the region of high power and subsequent measurements confirmed this. The steady-state and transient three-dimensional temperature distributions were reconstructed for four out of the seven treatments. The reconstructed steady-state temperatures agreed with the measured temperatures; root-mean-square error ranged from 0.45 to 1.21 degrees C. The transient three-dimensional tumour temperature was estimated assuming that the perfusion was constant throughout the treatment. Using the computed three-dimensional transient temperature distribution, the hyperthermia thermal dose was computed. The equivalent minutes at 43 degrees C achieved by 50% (T50Eq43) of the tumour volume was computed from the measured data and the three-dimensional reconstructed distribution yielding T50Eq43 = 40.6 and 19.8 min respectively.

Arm↗