2010 3rd International Conference on Biomedical Engineering and Informatics (BMEI 2010)
Review of Tumor Hyperthermia Technique
in Biomedical Engineering Frontier
Guojun Ma1,2, Guotai Jiang1
1 School of Life Sciences and Technology
Tongji University
Shanghai, China
AbstractDevelopment of biomedical engineering technology has
great relation to human health, and tumor as a harmful disease is
taking huge threaten to human health. Methods of tumor
treatment have three kinds such as surgical operation,
radiotherapy and chemotherapy, but all these methods take great
pain for patient during cure process. Microwave ablation,
radiofrequency ablation and high intensive focused ultrasound
(HIFU) are new technologies of treating tumor hyperthermia.
In this paper, mechanism of tumor hyperthermia was introduced;
advantages and disadvantages of three kinds of hyperthermia
methods, and measurement and control of inner temperature
field during hyperthermia process were discussed. It shows that
new hope will be taken to tumor patients if technologies and
methods of hyperthermia are fully used.
Key words-tumor hyperthermia, microwave ablation, radio
frequency ablation, high intensive focused ultrasound (HIFU),
infrared thermography
I. INTRODUCTION
Recently, malignant tumor is an acute disease for human
health and the incidence of disease rises greatly [1] .Now, level
of diagnosis technique in malignant tumor is improving, but
methods of treatment are surgical operation, radiotherapy and
chemotherapy and all these methodologies have limitation in
clinical practice. With the fast development of science and
technology, a completely new green treatment, hyperthermia,
is arousing peoples wide concern and bringing good prospect
for the future of tumor treatment.
Heating method is used during hyperthermia in treatment of
tumor, which compared with other new methods such as gene
therapy, immunization therapy and biotherapy has the support
of basic research and plentiful clinical practice [2, 3]. At the
same time, it is efficient in treatment effects. Clinical research
shows that full ablation rate will double for some tumor
treatment if hyperthermia is correctly used. It has no toxic and
side-effect and good late results. Reports of successful clinical
research showed that this method of hyperthermia maybe have
much more potential development in tumor treatment.
Tumor hyperthermia is an effective and micro port method
for tumor treatment and it has the advantage of simple
operation, low cost and high safety, so it is an important
treatment. Tumor hyperthermia applies physical methods to
create temperature field in tumor area and coagulation necrosis
in high temperature to reach the aim of treatment. During
recent research, tumor hyperthermia and traditional treatment
such as radiotherapy and chemotherapy in combined treatment
978-1-4244-6498-2/10/$26.00 2010 IEEE
2 School of Electronics and Information
Jiangsu University of Science and Technology
Zhenjiang, Jiangsu, China
will increase treatment effect. It will kill tumor cell and do little
damage for normal one to realize tumor treatment.
II. MECHANISM OF TUMOR HYPERTHERMIA AND
BIOLOGICAL TISSUE HEAT TRANSFER
First, Compared with normal tissue, tumor tissue has rich
blood vessel and abnormally grown, which has confusional
structure and pressed blood capillary, so it produces blood
sinusoid and the defective nerve sensory of neonatal tumor
blood has little sensibility of temperature [4]. When heated,
normal tissue besides tumor has good blood circulation,
dilation of blood vessel speeds up blood flow and fastens heat
dissipation, which leads to low temperature rise. But tumor
tissue blood flows slowly with fluid drag and has difficulty in
heat dissipation to form a heat reservoir. There is 5~10 in
tumor inner tissue than its around. At the same time, there is
1~1.5 higher in tumor center.
The maximum and safety temperature value of normal tissue
cell is 45, some area of tissue may endure 42-43 for a long
time. But when high thermal energy participates in duplicate,
transcription, repair of cancer cell will affect metabolize
directly for tumor tissue and limit diffusion to induce tumor
cell death. Otherwise, high temperature will damage normal
tissue around tumor tissue. So there are too many problems will
be studied in tumor hyperthermia.
Biology tissue heat transfer Pennes equation [5] is used to
compute inner temperature field distribution of biology tissue
in certain conditions. If environment temperature is const and
biology tissue in stable state, biology tissue heat transfer
Pennes equation may describe certain temperature increase of
inner tissue when it absorbs heat. Pennes equation is as follows,
T
c t = K 2T b cb (T Tb ) + Qm + Qv 1
Where, ct K is density, specific heat caption and
thermal conductivity of biology tissue respectively, is heat
time, b is blood flow rate in heated area, cb is specific heat
caption of blood, Tb is blood temperature, Qm is metabolic heat
production rate of biology tissue, Qv is heat generation rate of
extra heat supply.
Boundary conditions and initial conditions are needed to
resolve Pennes equation. But it is too complexity for tumor and
usually simple model is used.
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 III. METHODS OF TUMOR HYPERTHERMIA
Until now, tumor hyperthermia methods are microwave,
radio, ultrasonic, electromagnetic field heating, etc. The
mechanism for tumor treatment of them applies
electromagnetic wave interactive with tissue of human body to
produce heat. For example, microwave directly radiates
electromagnetic wave, and cancer tissues temperature will
increase quickly than normal tissue nearby for its poor blood
circulation. Cancer tissue cell will die because of high
temperature if it keeps this state for a long time. High
microwave frequency will bring high temperature under the
same conditions, but it needs to decrease microwave frequency
when microwave pass through certain depth. A perfect
microwave frequency may be 2450MHz, 915 MHz or
434MHz.
The frequency of radio frequency hyperthermia is lower than
microwave; it is 13.56MHz or 27.12MHz. According to
difference of radio frequency amplifier output device,
radio-frequency heating is divided into two kinds, that is,
electric field heating -capacitive heating and magnetic field
induction-magnetic heating.
Ultrasound in medicine refers to electromagnetic wave
which frequent is than 20 KHz. Its energy is easy to
concentrate and may transfer to one direction. Tissue cell will
vibrate when ultrasound wave propagate in tissue while it
converting mechanical energy to heat energy of tissue.
Several ultrasound wave radiators may be used to focus
energy into deep parts or wide area of disease to heat. So, it is
an effective heating method for cancer tissue in deep part of
human body.
A. microwave ablation
Microwave ablation [6] technique usually used in tumor
hyperthermia and it has many advantages [7]. The mechanism of
microwave coagulate tissue is that molecule friction produce
heat by micro electronic field, and induce part tissue coagulate
with high temperature. It is mainly used in superficial tumor.
When needle type unipole antenna is manufactured, it focuses
microwave energy at the needle end while there is no
microwave leakage at needle body. Microwave heat ablation is
used in puncture beneath the skin by image supervisory control
of CT or type B ultrasound etc, and it does little damage for
normal tissue to treat deep tumor.
B. Radio frequency ablation
Radio frequency ablation [8, 9] may be used to heat deep
tumor but it needs water to cool part body and fat beneath skin
tend to pain for high temperature. Radio frequency ablation
puts needle into tumor tissue through skin and radio frequency
wave excited ion vibration to produce high temperature to
coagulate tissue and make them die.
Old single electrode such as simple root radio frequency
needle with maximum power of 50W, coagulate diameter is
smaller than 1.6cm, because radio frequency output total
energy decreases fast when distance increases while the
accumulated heat will increase around electrode. But the
accumulated heat beyonds area of electrode is too small to get
the temperature of killing cancer cell, which has not enough
total energy. Improved inner cool electrode with several poles
will make coagulate diameter than 5cm and can be used in
superficial and deep tumor.
C. High intensive focused ultrasound
High Intensive Focused Ultrasound (HIFU) applies the
converged and penetrates physical ability of ultrasonic beam to
focus low energy out of body into target region [10]. It produces
transient high temperature to coagulate tumor and have no
damage for normal tissue to make tumor tissue die and cure the
cancer.
HIFU is a technique of noninvasive for tumor treatment, and
method of tumor treatment is not heat diffusion but appropriate
out of body, real time control and energy and temperature
distribution is regular in target area. It can reflect effects of
treatment in time and can cure tumor of all kinds of shape and
size.
HIFU is suitable for treatment superficial and inner deep
tumor. There are several advantages to kill tumor with HIFU,
(1) high intensity with short radiation time. Tumor cell will be
killed in short time when its temperature gets 60, (2) high
accurate. General speaking, HIFU can focus on small area and
concentrate high temperate, where tissue temperature out of
focused area is safe, (3) there is no heat diffusion effects by
great vessels when heating tumor tissue. So HIFU may be
successfully used to treat or die tumor with all kinds of size and
shape.
IV. PROBLEMS IN HYPERTHERMIA AND ITS SOLUTION
A. problems in microwave ablation and HIFU
Human inner organs and tissues are affected by
electromagnetic influence during microwave ablation including
electromagnetic wave reflection and absorption[11]. When
electromagnetic wave gets inner deep part, it becomes weak
and cannot heat tumor effectively. At the same, all parts of
human body is inhomogeneous medium and its physical
characteristics such as heat conductivity, electric conductivity
and dielectric constant are not the same. It is difficult for them
to get uniform temperature at region with certain depth and
size. Further more, it is easy to become tissue cool pot at the
edge of tumor tissue for its fast blood circulation and heat
transmission.
There are some drawbacks in HIFU for hyperthermia. Big
size of tumor needs scanning treatment for its small focused
area, and it needs high acute position and tracking techniques.
Human body structure, tumor position and complexity of shape
bring difficulty for accurate treatment. Research results show
that HIFU will damage normal tissue if it is not correctly used.
These problems indicate that imaging and positional technical
will act as important part. Much more study will be done before
treatment for tissue structure. Electronic highly accurate
focused position system, 3D image reconstruction and
treatment planning will guarantee safety in hyperthermia.
B. problems of temperature measurement and control in
hyperthermia
To realize high effective application of tumor hyperthermia,
the problems of temperature measurement [12] and control are as
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follows, (1) heat diffusion must be in the target area, that is
tumor area, produce temperature high enough, and the health
part is in the safe temperature; (2) there are smallest invasion of
tissue by needle; (3) temperature measurement and control is
easy to be done in target tissue area.
In clinic hyperthermia, thermocouple is punctured into tissue
to measure temperature of tumor inner part of human body. It is
invasive and will bring pain to patient and transfer cancer cell.
This kind of measurement is not accurate enough. Noninvasive
measurement of temperature in hyperthermia is being paid
more and more attention.
There are several kinds of noninvasive temperature
measurement, such as ultrasound temperature measurement in
hyperthermia. The main noninvasive methods to measure tissue
parameters as temperature changes, nuclear magnetic
resonance (NMR) and electrical impedance tomography (EIT),
etc. Noninvasive ultrasound temperature measurement is paid
more attention for it does little damage for human and has the
advantage of electromagnetic immunity.
C. infrared radiation and temperature measurement
Any object will radiate electromagnetic wave for
surrounding if its temperature is upper 0K. Black body radiate
energy under different wave length may be described by
planks constant law (2) ,
c1 1 [3]
E = c2 / T
2 humans. Bioelectromagnetics. 2004.25(3).p146-159
5
e 1
Where, E is spectrum radiometric force of black body
(w/m3) is wave length (m)T is absolute temperature (K)
C1, C2 is first and second radiation constant respectively,
c1=3.741410-16wm2, c2=1.438810-2mk.
Total radiation power of all wave length in black body
changes as temperature changes, it may be illustrated by
Stefan-Boltzmann law (3) ,
E = E d = T 4 3 [8]
0 cancer using dual deformable mirrors -computational study. AIP
Where, E is total radiation of black body (w/m2), is
Stefan-Boltzmann constant, =5.669710-8w/(m2k4).
Stefan-Boltzmann law shows that radiation of black body is
direct proportion 4 times of thermodynamic temperature. At the
same time, Wiens law reflects maximum wave length max of
spectrum distribution is inversely proportional to absolute
temperature T (4),
A Colloquium on `The Application of Microwaves in Medicine 1995.
max = (4)
T [12]
Where, A=2.897610-3mk.
Because of infrared thermography[13] technique is applied in
medical clinic step by step, and it develops quickly. Infrared
thermography technique can get temperature distribution of
biology tissue, and inner thermal estimation is used to
determine abnormal heat source to diagnosis disease area. The
infrared temperature measurement can get the information of
biology inner body and it is a new fast and convenient
detection method. A lot of work has been done by many
researchers in engineering and medicine.
V. CONCLUSION
Frontiers problems of tumor hyperthermia theory, methods,
technology were discussed in biomedical engineering.
Problems during tumor hyperthermia, methods to be done, its
solution research hot spot and direction were widely discussed.
With the development of science and technology, the problems
in tumor hyperthermia will be released and resolved. New
methods, techniques and means will be applied to tumor
hyperthermia to improve human health.
ACKNOWLEDGMENT
This paper is supported by National Natural Science
Foundation of China (50977064).
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