title: Improvement of absorbing structures used in regional hyperthermia.
abstract: Local pain is a major limiting factor in regional hyperthermia treatment with radiative applicators. Absorbing structures, consisting of agar bound saline water, have been used successfully to reduce peripheral hot spots. However, both clinical experience and simulation results indicate a SAR elevation in the tissue under the edges of the absorber block. This paper investigates the effect of modification of shape, position and spatial composition of the absorber blocks on the central attenuating effect and the SAR elevating effect at the edges. A selection from a set of five options is made based on simulations with a phantom and a single ring dipole applicator. The simulations have been performed with the FDTD core of the regional hyperthermia treatment planning system. It is shown that tapering of the absorber edge and introduction of a water layer between the absorber and the skin can reduce the edge effect in the superficial fat layer by approximately 50% with respect to a rectangular absorber. A further reduction of 15% can be obtained by an absorber with an appropriate gradient of its conductivity in the direction of the dominant E-field. The modified absorbers produce a central attenuating effect comparable to the rectangular type. The use of a water layer type and a sigma gradient type absorber is also analysed in a patient anatomy, both in the dipole ring applicator, operating at 70 MHz, as well as in a three ring Cavity Slot (CS) applicator, operating at 150 MHz. The mutual influence of phase-amplitude steering and the application of absorbers is investigated in the CS applicator. It appears that absorbers have a significant influence on the interference pattern in the patient model, possibly causing substantial reduction of the SAR value in the tumour and limiting the possibility of ad hoc application of absorbers. Re-optimization can only partly cancel this effect. Local SAR reduction by phase-amplitude control alone can match or improve the effect obtained with modified absorbers.
authors.affiliation: Department of Radiotherapy, University Medical Centre Utrecht, (MS Q00.118), PO Box 85500, 3508 GA Utrecht, The Netherlands. h.kroeze@radth.med.uu.nl
authors.forename: H
authors.initials: H
authors.lastname: Kroeze
authors.forename: M
authors.initials: M
authors.lastname: Van Vulpen
authors.forename: A A C
authors.initials: AA
authors.lastname: De Leeuw
authors.forename: J B
authors.initials: JB
authors.lastname: Van de Kamer
authors.forename: Jan J W
authors.initials: JJ
authors.lastname: Lagendijk
mesh_terms: D000042:Absorption; D000273:Adipose Tissue; D001842:Bone and Bones; D003198:Computer Simulation; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008954:Models, Biological; D014867:Water
chemical_list: D014867:Water