title: Multisectored interstitial ultrasound applicators for dynamic angular control of thermal therapy.
abstract: Dynamic angular control of thermal ablation and hyperthermia therapy with current interstitial heating technology is limited in capability, and often relies upon nonadjustable angular power deposition patterns and/or mechanical manipulation of the heating device. The objective of this study was to investigate the potential of multisectored tubular interstitial ultrasound devices to provide control of the angular heating distribution without device manipulation. Multisectored tubular transducers with independent sector power control were incorporated into modified versions of internally cooled (1.9 mm OD) and catheter-cooled (2.4 mm OD) interstitial ultrasound applicators in this work. The heating capabilities of these multisectored devices were evaluated by measurements of acoustic output properties, measurements of thermal lesions produced in ex vivo tissue samples, biothermal simulations of thermal ablation and hyperthermia treatments, and MR temperature imaging of ex vivo and in vivo experiments. Acoustic beam measurements of each applicator type displayed a 35 degrees -40 degrees acoustic dead zone between each independent sector, with negligible mechanical or electrical coupling. Thermal lesions produced in ex vivo liver tissue with one, two, or three sectors activated ranged from 13-18 mm in radius with contiguous zones of coagulation between active sectors. The simulations demonstrated the degree of angular control possible by using variable power levels applied to each sector, variable duration of applied constant power to individual sectors, respectively, or a multipoint temperature controller to vary the power applied to each sector. Despite the acoustic dead zone between sectors, the simulations also showed that the variance from the maximum lesion radius with three elements activated is within 4%-13% for tissue perfusions from 1-10 kg m(-3) s(-1). Simulations of hyperthermia with maximum tissue temperatures of 45 degrees C and 48 degrees C displayed radial penetration up to 2 cm of the 40 degrees C steady-state contour. Thermal characterizations of trisectored applicators in ex vivo and in vivo muscle, using real-time MR thermal imaging, reinforced angular controllability and negligible radial variance of the heating pattern from the applicators, demonstrated effective heating penetration, and displayed MR compatibility. The multisectored interstitial ultrasound applicators developed in this study demonstrated a significant degree of dynamic angular control of a heating pattern without device manipulation, while maintaining heat penetration consistent with previously reported results from other interstitial ultrasound applicators.
authors.affiliation: Thermal Therapy Research Group, Department of Radiation Oncology, University of California, San Francisco, California 94115-1708, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Kinsey
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Diederich
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Tyreus
authors.forename: William H
authors.initials: WH
authors.lastname: Nau
authors.forename: Viola
authors.initials: V
authors.lastname: Rieke
authors.forename: Kim Butts
authors.initials: KB
authors.lastname: Pauly
mesh_terms: D000818:Animals; D001831:Body Temperature / Q000502:physiology*; D004285:Dogs; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006979:Hyperthermia, Induced / Q000295:instrumentation* / Q000379:methods; D066298:In Vitro Techniques; D018482:Muscle, Skeletal / Q000502:physiology*; D014159:Transducers; D014464:Ultrasonic Therapy / Q000295:instrumentation* / Q000379:methods