title: Multilayer conformal applicator for microwave heating and brachytherapy treatment of superficial tissue disease.
abstract: OBJECTIVE
  The purpose of this study was to construct and perform preliminary functionality evaluations of a multilayer conformal applicator with provisions for thermal monitoring, tight conformity and simultaneous microwave heating and brachytherapy treatment of large-area contoured surfaces.
  
  
  METHODS
  The multilayer conformal applicator consists of thermal monitoring catheters for fibre-optic monitoring of skin temperatures, a waterbolus, a PCB microwave antenna array, a dielectric spacer for brachytherapy considerations, brachytherapy catheters for delivering HDR radiation and an inflatable air bladder for improving conformity to contoured surfaces. The applicator also includes an elastic attachment structure to hold the applicator securely in place on the patient. The conformity of the applicator to irregular surfaces was evaluated through CT imaging of the applicator fitted onto a life-sized human torso phantom. The fluid flow dynamics of the waterbolus, which impact the effectiveness of temperature control, were evaluated with thermometry during a 19 degrees C step change temperature of the circulating water.
  
  
  RESULTS
  CT imaging showed improved conformity to the torso phantom surface following the application of gentle inward pressure from inflating the outer air bladder. Only a small number of 1-5 mm sized air gaps separated the conformal applicator and tissue surface. Thermometry testing of the bolus fluid flow dynamics demonstrated temperature uniformity within +/-0.82 degrees C across a 19 x 34 x 0.6 cm area bolus and +/-0.85 degrees C across a large 42 x 32 x 0.6 cm area bolus.
  
  
  CONCLUSIONS
  CT scans of the applicator confirmed that the applicator conforms well to complex body contours and should maintain good conformity and positional stability even when worn on a mobile patient. Thermometry testing of two different waterbolus geometries demonstrated that uniform circulation and temperature control can be maintained throughout large, complex bolus shapes.
authors.affiliation: Department of Radiation Oncology, University of California at San Francisco, San Francisco, CA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Juang
authors.forename: P R
authors.initials: PR
authors.lastname: Stauffer
authors.forename: D G
authors.initials: DG
authors.lastname: Neuman
authors.forename: J L
authors.initials: JL
authors.lastname: Schlorff
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization / Q000295:instrumentation; D004867:Equipment Design; D006358:Hot Temperature; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation* / Q000379:methods; D008872:Microwaves / Q000627:therapeutic use*; D020266:Radiotherapy, Conformal / Q000379:methods