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Abstract The usage of heating power as a healing system has been well-known for long time. A
completely new motivation, however, came up when heat treating was recognized as a new and
promising form of cancer therapy. It was found that cancer growth was stopped at temperature higher
than about 42 C. It created new subject of research in the area of application of electromagnetic fields in
medicine. In the paper the two main methods of heating have been described and two kinds of devices
have been presented. Some advantages and drawbacks of the methods are discussed.
Introduction
Hyperthermia, a procedure in which body tissue is exposed to high temperatures (up to 42C and above),
is under investigation to assess its effectiveness in the treatment of cancer. Hyperthermia has by now become
the chosen treatment for some important physiotherapeutic pathologies of the muscle-tendon apparatus, and
plays a fundamental role integrating with other methodologies in the more general rehabilitating program.
Scientists believe that heat may help shrink tumors by damaging cells or depriving them of substances
they need to live. They are studying local, regional, and whole-body hyperthermia, using external and internal
heating devices. Hyperthermia is almost always used with other forms of therapy (radiation therapy,
chemotherapy, and biological therapy) in attempt to increase their effectiveness.
Main problems
The wave propagates from the surface of the tissues towards the inside, and while it proceeds it is adsorbed,
loosing electromagnetic energy that is transformed into heat. The mechanisms of heat deposition in tissues by
electromagnetic fields is followed. When the tissue's electric dipoles (both permanent and induced) oscillate in
response to the E-field of an applied wave, heat is generated by a process analogous to friction. Similarly, when
free charges (electrons and ions) in the tissue are set in motion by the E-field, collisions with immobile atoms
and molecules in the tissue generate heat. The propensity of the tissue to produce heat for a given sinusoidal Efield magnitude is determined by the values of the imaginary part of its relative permittivity " and its
conductivity . It is important that the internal E-field (i.e. the electric field inside the body) is responsible for
the heat generation. In addition, the internal H-field is not directly responsible for heating because tissue has a
permeability close to that of free space with no magnetic losses. But the time-varying H-field produces a
resulting internal E-field (eddy currents) and in this way it causes heating of tissue.
The human body has an intricate structure (roughly stratified structure of the muscle-skeletal apparatus:
skin, fat, muscle, bone), and that patients have a variety of physiological and psychological responses to
hyperthermia treatment. The underlying principle is that a patient's responses must be monitored and considered
in later designs, so as to reduce the patient's complaints and ultimately improve the efficiency by which the
treatment is delivered.
From the very beginning of the application in question, there have been two essential problems to
overcome:
Generation of heat within the region of interest leaving all the vicinity of it unaffected.
Monitoring and controlling the temperature, both in the region of interest and its vicinity.
The above problems are attempted to be solved by using different methods of heating, like capacitive,
inductive, by microwave radiation, or by ultrasounds. It seems, however, that the therapy is still at the stage of
medical research.
Sawomir Wiak, Andrzej Krawczyk, Mladen Trlep (eds.), Computer Engineering in Applied Electromagnetism, 337342.
2005 Springer. Printed in Great Britain.
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Plewako et al.
regional,
local hyperthermia.
Whole-body heating is used to treat metastatic cancer1 that has spread throughout the body. It can be
accomplished using warm-water blankets, hot wax, inductive coils (like those in electric blankets), or thermal
chambers (similar to large incubators). In regional hyperthermia, an organ or a limb is heated. Magnets and
devices that produce high energy are placed over the region to be heated. In another approach, called perfusion2,
some of the patient's blood is removed, heated, and then pumped (perfused) into the region that is to be heated
internally. Local hyperthermia refers to the heat that is applied to a very small area, such as a tumor. The area
may be heated externally with high-frequency waves aimed at a tumor from a device outside the body. To
achieve internal heating, one of several types of sterile probes may be used, including thin, heated wires or
hollow tubes filled with warm water; implanted microwave antennae; and radio-frequency electrodes.
The two major categories of applicators are developed for electromagnetic hyperthermia:
noninvasive applicators, which use devices external to the body to produce the internal E-field:
capacitive,
inductive,
radiative,
invasive applicators, which penetrate the body either through the skin or in natural body orifices. The
invasive applicators are listed in order of the types of external fields that are principally responsible
for the internal E-field:
electrodes,
radiative antennas.
Capacitive Applicators
A capacitive applicator is composed of two conducting electrodes which are placed on or near the
surface of the body (Fig. 1). The electrodes can have various shapes and sizes. A voltage source is connected
across the electrodes, producing an E-field stretching throughout the volume between them. The E-field lines
terminate on charges contained in the electrodes. Since these applicators are often intended to heat deeper
tissues, the frequency of the voltage source is relatively low (in the high kHz to low MHz range).
The advantages of the capacitive-type applicator are based upon its simplicity. The placement and shape
of the electrodes can be tailored to the location of the region that is to be heated. It is relatively easy to visualize
the paths that the field lines take. Also, the electrodes can be curved to match the skin contour.
Cancer that has spread from the place in which it started to other parts of the body
Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of
anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread
2
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Inductive Applicators
In this type of applicator, an external coil or some other means of generating high currents near the body
is used to produce an H-field inside the body (Fig. 2). The magnetic field itself, according to the mechanism of
heating described above, does not produce any heat, but if the H-field is time-varying it will induce an internal
E-field for heating. These applicators are generally provided to deep heating, which suggests again lower
frequency. However, since the generation of the internal E-field is proportional to the time rate of change of the
H-field, the frequency should be high enough to produce a sufficient internal E-field. Operating frequencies are
generally in the low MHz range.
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One disadvantage is that centrally located tumors would not be heated effectively. Heating is greatest at the
periphery, so surface heating is a major concern with inductive applicators, as it is with capacitive applicators.
Because the E-field lines are produced by the time-varying H-field they encircle the H-field lines. There is a
center of rotation for the E-field and here the field is zero. Also, eddy currents are zero in tissue. The field and
current grow linearly toward the periphery of the cylinder. Because power deposition P is proportional to the
square of the E-field, the heating pattern has a parabolic shape.
If the tissue properties are not uniform as in this simple example, eddy currents will not follow a
radially linear profile and will be more irregular. This sometimes can be used to advantage. For example, a highconductivity tumor surrounded by lower conductivity tissue will have a local eddy-current pattern flowing
around the approximate center of the tumor. The local eddy-current patterns can lead to increased heating of a
deep tumor, but the amount of improvement depends on the conductivities of the tissues involved, which may
vary considerably from case to case.
Radiative Applicators
This class of applicators relies upon the coupling of E and H to carry electromagnetic energy into the
tissue. They operate either at higher frequencies when localized surface heating is needed or at lower frequencies
when deeper penetration is desired. The applicator and feed configurations are chosen to maximize the coupling
of the launched wave into the tissues. One version of a radiative applicator is shown in Fig. 3. It basically
consists of an open-ended waveguide that is coupled to the skin with a quarter-wavelength matching slab. The
waveguide is loaded on both sides with dielectric strips. This produces a mode structure, thus giving a more
uniform pattern in the transverse direction than an unloaded waveguide. The size of the waveguide dictates its
relatively high operating frequency, namely 2450 MHz, so it is appropriate for heating superficial tumors.
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Fig. 4. The penetration of planewaves of various frequencies into a dielectric halfspace with the
properties of muscle [1]
A radiator is not very effective unless at least one dimension of the radiating structure is one-half of a
wavelength or larger. If the frequency is lower, the applicator will be even larger. This means it will be rather
bulky and heavy, and more important, the energy coming from the applicator will spread out due to diffraction.
Localized heating is difficult at the low frequencies that will penetrate deeply. They are drawbacks of this type of
applicators.
Ultrasound waves obey these same laws but with different constants and with a much different outcome.
Ultrasound's advantage of being able to penetrate deeply with small-wavelength beams is one reason ultrasound
energy is being seriously considered for hyperthermia therapy. A disadvantage, however, is that ultrasound will
not effectively penetrate bone or air, so treatment is limited to regions of the body where access is through soft
tissue.
Invasive Applicators
To circumvent the difficulty of obtaining deep, localized heating patterns from external electromagnetic
applicators, some investigators use invasive probes. These probes are placed in natural cavities of the body (if
the tumor is nearby) or directly through the skin. The cavity applicators are often designed as thin radiating
antennas. Higher frequencies are used to get good radiation efficiency from the small antennas, and penetration
depth is not as critical as with external applicators. The probes that pierce the skin may also be small radiating
antennas or may be an array of lower-frequency electrodes. In the latter case, conduction current in the tissues
produces the heating.
The advantage of invasive probes is that the heat can be localized with more precision and in a smaller
volume at depth than with external applicators. One disadvantage is much more uncomfortable for the patient.
Also, even using multiple probes does not assure uniform heating; there still may be considerable no uniformity
to the power deposition pattern depending on the placement and individual patterns from the probes.
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Plewako et al.
Summary
It should be clear from the previous discussion that one area that remains problematic with electromagnetic
hyperthermia is the ability to heat deeply in a well-controlled and localized manner. Too often there is surface
overheating that accompanies deep heating, regardless of the type of applicator used. Based upon the concepts of
electromagnetics, it seems unlikely that this problem will be easily solved. When localized superficial heating is
desired, on the other hand, several of the approaches, in particular the small radiating applicators, are successful.
Other engineering issues remain. These include the need for multiple-point temperature measurements for
accurate and thorough monitoring. Treatment planning will require accurate characterization of the applicator
deposition pattern and the tissue parameters, as well as a numerical technique to predict the resultant heating
pattern. Tissue perfusion significantly modifies the temperature distribution for any given power deposition
pattern, often in a time-variable and unpredictable way. Still, the promise of even a partially successful therapy
for cancer spurs the continued study of hyperthermia.
References
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2000
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[6] T. Sugahara, I.Yamamoto, V.Ostapenko, How to develop hyperthermia equipment for deep-seated tumors,
http://www.taishitsu.or.jp/hyperthermia/hp1-e.html
[7] http://www.nebraskahealthsystem.com/cancer/cancer.cfm
[8] http://www.esho.info/professionals/hyperthermia/
[9] http://www.veramed.de/index2.html
[10] http://www.hot-oncotherm.de/english/prof/index.htm