title: Implications of clinical RF hyperthermia on protection limits in the RF range.
abstract: The systemic temperature is meticulously regulated to 37-37.5 degrees C. Organ systems (skin, digestive system, muscles) have a considerable potential to regulate the perfusion for thermal regulation, physical activity, or digestion. While the regulation of the systemic temperature (37.5 degrees C) is quite strict, the tolerance and regulation potential with respect to local heat is more variable. Laboratory studies provided the relationship between thermal doses and cytotoxic effects. Tissue damage for short-term expositions (in the range of minutes) is only possible for temperatures above 50 degrees C. Radiofrequency radiation is utilized in cancer therapy, inducing local tissue temperatures in the range of 40-45 degrees C for 30-60 min. During local hyperthermia (with heated volumes <1 L) specific absorption rates (SARs) of 100-200 W kg, reactive perfusions of 20-40 mL/100 g/min, and tumor temperatures of 42-43 degrees C are achieved. Normally no side effects or damage in the normal tissue, such as muscle or skin, have been seen. During regional hyperthermia, SARs of 30-40 W kg are found in heated volumes of 10 L with temperatures of 41-42 degrees C in tumor-related measurement points. Then the reactive average perfusion is 6-9 mL/100 g/min (mean value 8 mL/100 g/min). Local temperatures even for higher SAR are regulated to values of not more than 40-42 degrees C. For these temperatures no damages in normal tissues have been found after regional hyperthermia in hundreds of patients. We conclude that the thermoregulatory potential for the whole body or large body regions is limited by the cardiac output, which can at least double the output from 5 to 10 L min. Even higher is the potential to compensate in smaller volumes. Here the perfusion in muscle can be increased from the basal value of 2-4 mL/100 g/min more than 5-10-fold.
authors.affiliation: Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Germany. peter.wust@charite.de
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Jacek
authors.initials: J
authors.lastname: Nadobny
authors.forename: Michael
authors.initials: M
authors.lastname: Szimtenings
authors.forename: Eckart
authors.initials: E
authors.lastname: Stetter
authors.forename: Johanna
authors.initials: J
authors.lastname: Gellermann
mesh_terms: D001822:Body Burden; D004781:Environmental Exposure / Q000032:analysis* / Q000592:standards; D006801:Humans; D006979:Hyperthermia, Induced; D008279:Magnetic Resonance Imaging; D020714:Maximum Tolerated Dose; D008954:Models, Biological; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods / Q000592:standards*; D011835:Radiation Protection / Q000379:methods* / Q000592:standards; D011846:Radio Waves; D012062:Relative Biological Effectiveness; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014915:Whole-Body Counting / Q000379:methods* / Q000592:standards