121 results on '"Maccarini, Paolo"'
Search Results
2. Plasmonic gold nanostars for synergistic photoimmunotherapy to treat cancer
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Liu Yang, Chorniak Ericka, Odion Ren, Etienne Wiguins, Nair Smita K., Maccarini Paolo, Palmer Gregory M., Inman Brant A., and Vo-Dinh Tuan
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cancer ,gold nanostars ,photoimmunotherapy ,Physics ,QC1-999 - Abstract
Cancer is the second leading cause of death and there is an urgent need to improve cancer management. We have developed an innovative cancer therapy named Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) by combining gold nanostars (GNS)-mediated photothermal ablation with checkpoint inhibitor immunotherapy. Our previous studies have demonstrated that SYMPHONY photoimmunotherapy not only treats the primary tumor but also dramatically amplifies anticancer immune responses in synergy with checkpoint blockade immunotherapy to treat remote and unresectable cancer metastasis. The SYMPHONY treatment also induces a ‘cancer vaccine’ effect leading to immunologic memory and prevents cancer recurrence in murine animal models. This manuscript provides an overview of our research activities on the SYMPHONY therapy with plasmonic GNS for cancer treatment.
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- 2021
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3. Intravital optical imaging for immune cell tracking after photoimmunotherapy with plasmonic gold nanostars.
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Chorniak, Ericka, Liu, Yang, Odion, Ren, Etienne, Wiguins, Canning, Aidan, Nair, Smita K, Maccarini, Paolo, Palmer, Gregory M, Inman, Brant A, and Vo-Dinh, Tuan
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OPTICAL images ,CELL imaging ,KILLER cells ,PLASMONICS ,IMMUNE response ,URODYNAMICS - Abstract
Bladder cancer has been ranked as one of the most commonly occurring cancers in men and women with approximately half of the diagnoses being the late stage and/or metastatic diseases. We have developed a novel cancer treatment by combining gold nanostar-mediated photothermal therapy with checkpoint inhibitor immunotherapy to treat bladder cancer. Experiment results with a murine animal model demonstrated that our developed photoimmunotherapy therapy is more efficacious than any individual studied treatment. In addition, we used intravital optical imaging with a dorsal skinfold window chamber animal model to study immune responses and immune cell accumulation in a distant tumor following our photoimmunotherapy. The mice used have the CX3CR1-GFP receptor on monocytes, natural killer cells, and dendritic cells allowing us to dynamically track their presence by fluorescence imaging. Our proof-of-principle study results showed that the photoimmunotherapy triggered anti-cancer immune responses to generate anti-cancer immune cells which accumulate in metastatic tumors. Our study results illustrate that intravital optical imaging is an efficient and versatile tool to investigate immune responses and mechanisms of photoimmunotherapy in future studies. [ABSTRACT FROM AUTHOR]
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- 2022
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4. A thermal monitoring sheet with low influence from adjacent waterbolus for tissue surface thermometry during clinical hyperthermia
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Arunachalam, Kavitha, Maccarini, Paolo F., and Stauffer, Paul R.
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Temperature measurements -- Methods ,Fever -- Diagnosis ,Hyperthermia -- Diagnosis ,Biological sciences ,Business ,Computers ,Health care industry - Abstract
This paper presents a complete thermal analysis of a novel conformal surface thermometer design with directional sensitivity for real-time temperature monitoring during hyperthermia treatments of large superficial cancer. The thermal monitoring sheet (TMS) discussed in this paper consists of a 2-D array of fiberoptic sensors embedded between two layers of flexible, low-loss, and thermally conductive printed circuit board (PCB) film. Heat transfer across all interfaces from the tissue surface through multiple layers of insulating dielectrics surrounding the small buried temperature sensor and into an adjacent temperature-regulated water coupling bolus was studied using 3-D thermal simulation software. Theoretical analyses were carried out to identify the most effective differential TMS probe configuration possible with commercially available flexible PCB materials and to compare their thermal responses with omnidirectional probes commonly used in clinical hyperthermia. A TMS sensor design that employs 0.0508-mm Kapton MTB and 0.2032-mm Kapton HN flexible polyimide films is proposed for tissue surface thermometry with low influence from the adjacent waterbolus. Comparison of the thermal simulations with clinical probes indicates the new differential TMS probe design to outperform in terms of both transient response and steady-state accuracy in selectively reading the tissue surface temperature, while decreasing the overall thermal barrier of the probe between the coupling waterbolus and tissue surface. Index Terms--Heat transfer, hyperthermia, noninvasive thermometry, surface thermal modeling, temperature distribution measurement, thermal monitoring sheet.
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- 2008
5. Automatic temperature controller for multielement array hyperthermia systems
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Johnson, Jessi E., Maccarini, Paolo F., Neuman, Daniel, and Stauffer, Paul R.
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Antenna arrays -- Usage ,Control systems -- Research ,Control systems -- Usage ,Fever -- Care and treatment ,Hyperthermia -- Care and treatment ,Biological sciences ,Business ,Computers ,Health care industry - Abstract
This paper concerns the optimization and performance analysis of an automatic control algorithm for managing power output of large multielement array hyperthermia applicators. Simulation and corresponding measurement of controller performance in a solid tissue equivalent phantom model is utilized for analysis of controller response to dynamically varying thermal load conditions that simulate clinical treatments. The analysis leads to an optimum controller which demonstrates the ability to achieve a uniform and stable temperature profile over a large surface area regardless of surrounding thermal load. This paper presents several advancements to the performance of a previously published control routine, including: 1) simplified simulation techniques for thorough characterization of controller performance; 2) an optimization procedure leading to an improved hybrid control algorithm for maintaining optimal performance during periods of both 'rising' and 'steady-state' temperature; 3) performance analysis of a control algorithm tailored for large area hyperthermia treatments with a multielement array applicator. The optimized hybrid controller is applied to the conformal microwave array (CMA) hyperthermia system previously developed for heating large area surface disease such as diffuse chestwall recurrence of breast carcinoma, and shown to produce stable, uniform temperatures under the multielement array applicator for all thermal load conditions. Index Terms--Control systems, hyperthermia, microwave antenna arrays, temperature control.
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- 2006
6. Continuum Modeling of the Dynamics of Externally Injection-locked Coupled Oscillator Arrays
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Pogorzelski, Ronald J, Maccarini, Paolo F, and York, Robert A
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Electronics And Electrical Engineering - Abstract
Mutually injection-locked arrays of electronic oscillators provide a novel means of controlling the aperture phase of a phased-array antenna, thus achieving the advantages of spatial power combining while retaining the ability to steer the radiated beam. In a number of design concepts, one or more of the oscillators are injection locked to a signal from an external master-oscillator. The behavior of such a system has been analyzed by numerical solution of a system of nonlinear differential equations which, due to its complexity, yields limited insight into the relationship between the injection signals and the aperture phase. In this paper, we develop a continuum model, which results in a single partial differential equation for the aperture phase as a function of time. Solution of the equation is effected by means of the Laplace transformation and yields detailed information concerning the dynamics of the array under the influence of the external injection signals.
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- 1999
7. Safety and efficacy of intravesical chemotherapy and hyperthermia in the bladder: results of a porcine study.
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Wei Phin Tan, Chang, Andrew, Brousell, Steven C., Grimberg, Dominic C., Fantony, Joseph J., Longo, Thomas A., Etienne, Wiguins, Spasojevic, Ivan, Maccarini, Paolo, and Inman, Brant A.
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INTRAVESICAL administration ,FEVER ,BLADDER ,THERMOTHERAPY ,MITOMYCIN C ,DRUG absorption - Abstract
Background: Hyperthermia (heating to 43 °C) activates the innate immune system and improves bladder cancer chemosensitivity. Objective: To evaluate the tissue penetration and safety of convective hyperthermia combined with intravesical mitomycin C (MMC) pharmacokinetics in live porcine bladder models using the Combat bladder recirculation system (BRS). Methods: Forty 60 kg-female swine were anesthetized and catheterized with a 3-way, 16 F catheter. The Combat device was used to heat the bladders to a target temperature of 43 °C with recirculating intravesical MMC at doses of 40, 80, and 120mg. Dwell-heat time varied from 30-180 min. Rapid necropsy with immediate flash freezing of tissues, blood and urine occurred. MMC concentrations were measured by liquid chromatography tandem-mass spectrometry. Results: The Combat BRS system was able to achieve target range temperature (42-44 °C) in 12 mins, and this temperature was maintained as long as the device was running. Two factors increased tissue penetration of MMC in the bladder: drug concentration, and the presence of heat. In the hyperthermia arm, MMC penetration saturated at 80 mg, suggesting that with heating, drug absorption may saturate and not require higher doses to achieve the maximal biological effect. Convective hyperthermia did not increase the MMC concentration in the liver, heart, kidney, spleen, lung, and lymph node tissue even at the 120mg dose. Conclusions: Convective bladder hyperthermia using the Combat BRS device is safe and the temperature can be maintained at 43 °C. Hyperthermia therapy may increase MMC penetration into the bladder wall but does not result in an increase of MMC levels in other organs. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Plasmonic gold nanostar-mediated photothermal immunotherapy for brain tumor ablation and immunologic memory.
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Liu, Yang, Chongsathidkiet, Pakawat, Crawford, Bridget M, Odion, Ren, Dechant, Cosette A, Kemeny, Hanna R, Cui, Xiuyu, Maccarini, Paolo F, Lascola, Christopher D, Fecci, Peter E, and Vo-Dinh, Tuan
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- 2019
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9. Real-Time Verification of Cylinder-Based GYN HDR Treatments Using a Fiber-Optic Detector
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Shen, Xinyi, Rokni, Michelle, Maccarini, Paolo, Langloss, Brian, Therien, Michael, Yoshizumi, Terry, Chino, Junzo, and Craciunescu, Oana
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- 2019
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10. Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) To Treat Metastatic Cancers and Induce Anti-Cancer Vaccine Effect.
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Tuan Vo-Dinh, Inman, Brant, Maccarini, Paolo, Palmer, Gregory, and Yang Liu
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- 2017
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11. Optimization of chest wall hyperthermia treatment using a virtual human chest model.
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Rodrigues, Dario B., Hurwitz, Mark D., Maccarini, Paolo F., and Stauffer, Paul R.
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- 2015
12. A novel compact microwave radiometric sensor to noninvasively track deep tissue thermal profiles.
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Maccarini, Paolo F., Shah, Ankur, Palani, Sharmila Y., Pearce, Donald V., Vardhan, Madhurima, Stauffer, Paul R., Rodrigues, Dario B., Salahi, Sara, Oliveira, Tiago R., Reudink, Doug, and Snow, Brent W.
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- 2015
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13. Thermal dosimetry for bladder hyperthermia treatment. An overview.
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Schooneveldt, Gerben, Bakker, Akke, Balidemaj, Edmond, Chopra, Rajiv, Crezee, Johannes, Geijsen, Elisabeth D., Hartmann, Josefin, Hulshof, Maarten C.C.M., Kok, H. Petra, Paulides, Margarethus M., Sousa-Escandon, Alejandro, Stauffer, Paul R., and Maccarini, Paolo F.
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THERMAL dosimetry ,FEVER ,URINARY organs ,BIOMATERIALS ,SCIENTIFIC method - Abstract
The urinary bladder is a fluid-filled organ. This makes, on the one hand, the internal surface of the bladder wall relatively easy to heat and ensures in most cases a relatively homogeneous temperature distribution; on the other hand the variable volume, organ motion, and moving fluid cause artefacts for most non-invasive thermometry methods, and require additional efforts in planning accurate thermal treatment of bladder cancer. We give an overview of the thermometry methods currently used and investigated for hyperthermia treatments of bladder cancer, and discuss their advantages and disadvantages within the context of the specific disease (muscle-invasive or non-muscle-invasive bladder cancer) and the heating technique used. The role of treatment simulation to determine the thermal dose delivered is also discussed. Generally speaking, invasive measurement methods are more accurate than non-invasive methods, but provide more limited spatial information; therefore, a combination of both is desirable, preferably supplemented by simulations. Current efforts at research and clinical centres continue to improve non-invasive thermometry methods and the reliability of treatment planning and control software. Due to the challenges in measuring temperature across the non-stationary bladder wall and surrounding tissues, more research is needed to increase our knowledge about the penetration depth and typical heating pattern of the various hyperthermia devices, in order to further improve treatments. The ability to better determine the delivered thermal dose will enable clinicians to investigate the optimal treatment parameters, and consequentially, to give better controlled, thus even more reliable and effective, thermal treatments. [ABSTRACT FROM AUTHOR]
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- 2016
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14. An imaging study to assess displacement between brachytherapy applicator and chestwall during simultaneous thermobrachytherapy of cancer.
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Chukkala, Divya Priya, Arunachalam, Kavitha, Craciunescu, Oana I., Maccarini, Paolo, Stauffer, Paul R., and Schlorff, Jaime L
- Abstract
A conformal surface applicator was developed for simultaneous radiation and hyperthermia treatment of superficial cancer. A preclinical volunteer study was carried out to assess the displacement between the high dose rate (HDR) brachytherapy applicator and the chestwall (CW) of mastectomy volunteers using magnetic resonance imaging (MRI) technique. Image processing algorithms were developed to pre-process 3D MRI data of each volunteer and identify brachytherapy tube positions and CW treatment area. Processed MRI image series of individual volunteer acquired every 15 minutes for 90 minutes were aligned using image registration technique. 3D catheter coordinate positions extracted for the treatment area from the processed 30 and 60 minute MRI data were compared with baseline measurements. Displacement of the brachytherapy tubes from the CW surface measured for 2 cm spaced array of 15 brachytherapy tubes was used to assess applicator positioning errors during simultaneous thermobrachytherapy of superficial cancer. Preclinical results on the displacement between the TBSA and CW were measured for a mastectomy volunteer with 72×280 mm treatment area. Image processing algorithms developed for MRI data analysis were incorporated into a user-friendly graphical user interface (GUI) to analyze remaining volunteer MR data quantitatively for 3D displacement of the TBSA brachytherapy catheters between the 30 and 60 min scans. [ABSTRACT FROM PUBLISHER]
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- 2013
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15. Microwave radiometry for non-invasive detection of vesicoureteral reflux (VUR) following bladder warming.
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Stauffer, Paul R., Maccarini, Paolo F., Arunachalam, Kavitha, De Luca, Valeria, Salahi, Sara, Boico, Alina, Klemetsen, Oystein, Birkelund, Yngve, Jacobsen, Svein K., Bardati, Fernando, Tognolotti, Piero, and Snow, Brent
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- 2011
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16. Progress on thermobrachytherapy surface applicator for superficial tissue disease.
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Arunachalam, Kavitha, Craciunescu, Oana I., Maccarini, Paolo F., Schlorff, Jaime L., Markowitz, Edward, and Stauffer, Paul R.
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- 2009
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17. Size reduction and radiation pattern shaping of multi-fed DCC slot antennas used in conformal microwave array hyperthermia applicators.
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Maccarini, Paolo F., Arunachalam, Kavitha, Martins, Carlos D., and Stauffer, Paul R.
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- 2009
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18. Electromagnetic optimization of dual-mode antennas for radiometry-controlled heating of superficial tissue.
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Maccarini, Paolo F., Rolfsnes, Hans O., Neuman Jr., Daniel G., Johnson, Jessi E., Juang, Titania, Jacobsen, Svein, and Stauffer, Paul R.
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- 2005
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19. Progress on system for applying simultaneous heat and brachytherapy to large-area surface disease (Invited Paper).
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Stauffer, Paul R., Schlorff, Jaime L., Juang, Titania, Neuman Jr., Daniel G., Johnson, Jessi E., Maccarini, Paolo F., and Pouliot, Jean
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- 2005
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20. Synchronization of Oscillating Systems for Microwave Antennas and RF Electronics.
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York, Robert A., Maccarini, Paolo F., and Buckwalter, James
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MICROWAVE antennas , *OSCILLATIONS , *SYNCHRONIZATION , *ANTENNAS (Electronics) - Abstract
During the past decade we have demonstrated that coupled nonlinear systems (oscillator arrays) can offer simple methods for phase control in microwave antenna arrays, and hence provides alternatives to conventional electronic beam scanning capability. Numerous experiments have been carried out at microwave frequencies to verify the analysis, and the experimental work proved valuable in guiding parallel theoretical efforts and demonstrating the advantages and limitations of such techniques for practical systems. During the course of this work, models have been developed and refined and used to explore new dynamical phenomena, such as “mode-locked” quasi-periodic states for pulse generation, phase noise reduction in oscillator array systems (verified experimentally at X-band), and other practical design issues. More recently, efforts have focused on the potential for coupled phase-locked-loop systems that promise more robust locking bandwidths and phase-control. We present an overview of our experimental efforts in exploiting the synchronization of oscillating systems for microwave antennas and RF electronics. © 2003 American Institute of Physics [ABSTRACT FROM AUTHOR]
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- 2003
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21. Two phase I dose-escalation/pharmacokinetics studies of low temperature liposomal doxorubicin (LTLD) and mild local hyperthermia in heavily pretreated patients with local regionally recurrent breast cancer.
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Zagar, Timothy M., Vujaskovic, Zeljko, Formenti, Silvia, Rugo, Hope, Muggia, Franco, O'Connor, Brigid, Myerson, Robert, Stauffer, Paul, Hsu, I-Chow, Diederich, Chris, Straube, William, Boss, Mary-Keara, Boico, Alina, Craciunescu, Oana, Maccarini, Paolo, Needham, David, Borys, Nicholas, Blackwell, Kimberly L., and Dewhirst, Mark W.
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DOXORUBICIN ,TREATMENT of fever ,BREAST cancer research ,CANCER relapse ,DRUG delivery systems - Abstract
Purpose: Unresectable chest wall recurrences of breast cancer (CWR) in heavily pretreated patients are especially difficult to treat. We hypothesised that thermally enhanced drug delivery using low temperature liposomal doxorubicin (LTLD), given with mild local hyperthermia (MLHT), will be safe and effective in this population. Patients and methods: This paper combines the results of two similarly designed phase I trials. Eligible CWR patients had progressed on the chest wall after prior hormone therapy, chemotherapy, and radiotherapy. Patients were to get six cycles of LTLD every 21-35 days, followed immediately by chest wall MLHT for 1 hour at 40-42 °C. In the first trial 18 subjects received LTLD at 20, 30, or 40 mg/m
2 ; in the second trial, 11 subjects received LTLD at 40 or 50 mg/m2 . Results: The median age of all 29 patients enrolled was 57 years. Thirteen patients (45%) had distant metastases on enrolment. Patients had received a median dose of 256 mg/m2 of prior anthracyclines and a median dose of 61 Gy of prior radiation. The median number of study treatments that subjects completed was four. The maximum tolerated dose was 50 mg/m2 , with seven subjects (24%) developing reversible grade 3-4 neutropenia and four (14%) reversible grade 3-4 leucopenia. The rate of overall local response was 48% (14/29, 95% CI: 30-66%), with. five patients (17%) achieving complete local responses and nine patients (31%) having partial local responses. Conclusion: LTLD at 50 mg/m2 and MLHT is safe. This combined therapy produces objective responses in heavily pretreated CWR patients. Future work should test thermally enhanced LTLD delivery in a less advanced patient population. [ABSTRACT FROM AUTHOR]- Published
- 2014
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22. Design and Optimization of an Ultra Wideband and Compact Microwave Antenna for Radiometric Monitoring of Brain Temperature.
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Rodrigues, Dario B., Maccarini, Paolo F., Salahi, Sara, Oliveira, Tiago R., Pereira, Pedro J. S., Limao-Vieira, Paulo, Snow, Brent W., Reudink, Doug, and Stauffer, Paul R.
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PATIENT monitoring research , *BRAIN research , *BODY temperature , *VITAL signs , *MEDICAL thermography , *MICROWAVE radiometry , *RADIOMETRIC methods - Abstract
We present the modeling efforts on antenna design and frequency selection to monitor brain temperature during prolonged surgery using noninvasive microwave radiometry. A tapered log-spiral antenna design is chosen for its wideband characteristics that allow higher power collection from deep brain. Parametric analysis with the software HFSS is used to optimize antenna performance for deep brain temperature sensing. Radiometric antenna efficiency (η) is evaluated in terms of the ratio of power collected from brain to total power received by the antenna. Anatomical information extracted from several adult computed tomography scans is used to establish design parameters for constructing an accurate layered 3-D tissue phantom. This head phantom includes separate brain and scalp regions, with tissue equivalent liquids circulating at independent temperatures on either side of an intact skull. The optimized frequency band is 1.1–1.6 GHz producing an average antenna efficiency of 50.3% from a two turn log-spiral antenna. The entire sensor package is contained in a lightweight and low-profile 2.8 cm diameter by 1.5 cm high assembly that can be held in place over the skin with an electromagnetic interference shielding adhesive patch. The calculated radiometric equivalent brain temperature tracks within 0.4 °C of the measured brain phantom temperature when the brain phantom is lowered 10 °C and then returned to the original temperature (37 °C) over a 4.6-h experiment. The numerical and experimental results demonstrate that the optimized 2.5-cm log-spiral antenna is well suited for the noninvasive radiometric sensing of deep brain temperature. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
- Full Text
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23. Thermal dosimetry characteristics of deep regional heating of non-muscle invasive bladder cancer.
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Juang, Titania, Stauffer, Paul R., Craciunescu, Oana A., Maccarini, Paolo F., Yuan, Yu, Das, Shiva K., Dewhirst, Mark W., Inman, Brant A., and Vujaskovic, Zeljko
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THERMAL dosimetry ,BLADDER cancer treatment ,CANCER chemotherapy ,CANCER thermotherapy ,MEDICAL thermometry - Abstract
Purpose: The aim of this paper is to report thermal dosimetry characteristics of external deep regional pelvic hyperthermia combined with intravesical mitomycin C (MMC) for treating bladder cancer following transurethral resection of bladder tumour, and to use thermal data to evaluate reliability of delivering the prescribed hyperthermia dose to bladder tissue. Materials and methods: A total of 14 patients were treated with MMC and deep regional hyperthermia (BSD-2000, Sigma Ellipse or Sigma 60). The hyperthermia objective was 42° ± 2 °C to bladder tissue for ≥40 min per treatment. Temperatures were monitored with thermistor probes and recorded values were used to calculate thermal dose and evaluate treatment. Anatomical characteristics were examined for possible correlations with heating. Results: Combined with BSD-2000 standard treatment planning and patient feedback, real-time temperature monitoring allowed thermal steering of heat sufficient to attain the prescribed thermal dose to bladder tissue within patient tolerance in 91.6% of treatments. Mean treatment time for bladder tissue >40 °C was 61.9 ± 11.4 min and mean thermal dose was 21.3 ± 16.5 CEM43. Average thermal doses obtained in normal tissues were 1.6 ± 1.2 CEM43 for the rectum and 0.8 ± 1.3 CEM43 in superficial normal tissues. No significant correlation was seen between patient anatomical characteristics and thermal dose achieved in bladder tissue. Conclusions: This study demonstrates that a hyperthermia prescription of 42° ± 2 °C for 40-60 min can be delivered safely to bladder tissue with external radiofrequency phased array applicators for a typical range of patient sizes. Using the available thermometry and treatment planning, the BSD-2000 hyperthermia system was shown to be an effective method of focusing heat regionally around the bladder with good patient tolerance. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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24. A pilot clinical trial of intravesical mitomycin-C and external deep pelvic hyperthermia for non-muscle-invasive bladder cancer.
- Author
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Inman, Brant A., Stauffer, Paul R., Craciunescu, Oana A., Maccarini, Paolo F., Dewhirst, Mark W., and Vujaskovic, Zeljko
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BLADDER cancer treatment ,MITOMYCIN C ,CLINICAL trials ,CANCER chemotherapy ,CANCER relapse ,THERAPEUTICS - Abstract
Purpose: This paper aims to evaluate the safety and heating efficiency of external deep pelvic hyperthermia combined with intravesical mitomycin C (MMC) as a novel therapy for non-muscle-invasive bladder cancer (NMIBC). Materials and methods: We enrolled subjects with bacillus Calmette-Guérin (BCG) refractory NMIBC to an early phase clinical trial of external deep pelvic hyperthermia (using a BSD-2000 device) combined with MMC. Bladders were heated to 42 °C for 1 h during intravesical MMC treatment. Treatments were given weekly for 6 weeks, then monthly for 4 months. Heating parameters, treatment toxicity, and clinical outcomes were systematically measured. Results: Fifteen patients were enrolled on the clinical trial. Median age was 66 years and 87% were male. Median European Organisation for Research and Treatment of Cancer (EORTC) recurrence and progression scores were 6 and 8, respectively. The full treatment course was attained in 73% of subjects. Effective bladder heating was possible in all but one patient who could not tolerate the supine position due to lung disease. Adverse events were all minor (grade 2 or less) and no systemic toxicity was observed. The most common adverse effects were Foley catheter pain (40%), abdominal discomfort (33%), chemical cystitis symptoms (27%), and abdominal skin swelling (27%). With a median follow-up of 3.18 years, 67% experienced another bladder cancer recurrence (none were muscle invasive) and 13% experienced an upper tract recurrence. Conclusions: External deep pelvic hyperthermia using the BSD-2000 device is a safe and reproducible method of heating the bladder in patients undergoing intravesical MMC. The efficacy of this treatment modality should be explored further in clinical trials. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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25. Non-Invasive Measurement of Brain Temperature with Microwave Radiometry: Demonstration in a Head Phantom and Clinical Case.
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STAUFFER, PAUL R., SNOW, BRENT W., RODRIGUES, DARIO B., SALAHI, SARA, OLIVEIRA, TIAGO R., REUDINK, DOUG, and MACCARINI, PAOLO F.
- Abstract
This study characterizes the sensitivity and accuracy of a non-invasive microwave radiometric thermometer intended for monitoring body core temperature directly in brain to assist rapid recovery from hypothermia such as occurs during surgical procedures. To study this approach, a human head model was constructed with separate brain and scalp regions consisting of tissue equivalent liquids circulating at independent temperatures on either side of intact skull. This test setup provided differential surface/deep tissue temperatures for quantifying sensitivity to change in brain temperature independent of scalp and surrounding environment. A single band radiometer was calibrated and tested in a multilayer model of the human head with differential scalp and brain temperature. Following calibration of a 500MHz bandwidth microwave radiometer in the head model, feasibility of clinical monitoring was assessed in a pediatric patient during a 2-hour surgery. The results of phantom testing showed that calculated radiometric equivalent brain temperature agreed within 0.4°C of measured temperature when the brain phantom was lowered 10°C and returned to original temperature (37°C), while scalp was maintained constant over a 4.6-hour experiment. The intended clinical use of this system was demonstrated by monitoring brain temperature during surgery of a pediatric patient. Over the 2-hour surgery, the radiometrically measured brain temperature tracked within 1-2°C of rectal and nasopharynx temperatures, except during rapid cooldown and heatup periods when brain temperature deviated 2-4°C from slower responding core temperature surrogates. In summary, the radiometer demonstrated long term stability, accuracy and sensitivity sufficient for clinical monitoring of deep brain temperature during surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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26. Magnetic fluid hyperthermia for bladder cancer: A preclinical dosimetry study.
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Oliveira, Tiago R., Stauffer, Paul R., Lee, Chen-Ting, Landon, Chelsea D., Etienne, Wiguins, Ashcraft, Kathleen A., McNerny, Katie L., Mashal, Alireza, Nouls, John, Maccarini, Paolo F., Beyer, Wayne F., Inman, Brant, and Dewhirst, Mark W.
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THERMOTHERAPY ,BLADDER cancer ,MAGNETITE ,CATHETERIZATION complications ,FEVER - Abstract
Purpose: This paper describes a preclinical investigation of the feasibility of thermotherapy treatment of bladder cancer with magnetic fluid hyperthermia (MFH), performed by analysing the thermal dosimetry of nanoparticle heating in a rat bladder model. Materials and methods: The bladders of 25 female rats were instilled with magnetite-based nanoparticles, and hyperthermia was induced using a novel small animal magnetic field applicator (Actium Biosystems, Boulder, CO). We aimed to increase the bladder lumen temperature to 42 °C in <10 min and maintain that temperature for 60 min. Temperatures were measured within the bladder lumen and throughout the rat with seven fibre-optic probes (OpSens Technologies, Quebec, Canada). An MRI analysis was used to confirm the effectiveness of the catheterisation method to deliver and maintain various nanoparticle volumes within the bladder. Thermal dosimetry measurements recorded the temperature rise of rat tissues for a variety of nanoparticle exposure conditions. Results: Thermal dosimetry data demonstrated our ability to raise and control the temperature of rat bladder lumen ≥1 °C/min to a steady state of 42 °C with minimal heating of surrounding normal tissues. MRI scans confirmed the homogenous nanoparticle distribution throughout the bladder. Conclusion: These data demonstrate that our MFH system with magnetite-based nanoparticles provides well-localised heating of rat bladder lumen with effective control of temperature in the bladder and minimal heating of surrounding tissues. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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27. Simulation techniques in hyperthermia treatment planning.
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Paulides, Margarethus M., Stauffer, Paul R., Neufeld, Esra, Maccarini, Paolo F., Kyriakou, Adamos, Canters, Richard A.M., Diederich, Chris J., Bakker, Jurriaan F., and Van Rhoon, Gerard C.
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TREATMENT of fever ,RADIOTHERAPY ,CANCER chemotherapy ,COMPUTED tomography ,MAGNETIC resonance imaging ,POWER density - Abstract
Clinical trials have shown that hyperthermia (HT), i.e. an increase of tissue temperature to 39-44 °C, significantly enhance radiotherapy and chemotherapy effectiveness [1]. Driven by the developments in computational techniques and computing power, personalised hyperthermia treatment planning (HTP) has matured and has become a powerful tool for optimising treatment quality. Electromagnetic, ultrasound, and thermal simulations using realistic clinical set-ups are now being performed to achieve patient-specific treatment optimisation. In addition, extensive studies aimed to properly implement novel HT tools and techniques, and to assess the quality of HT, are becoming more common. In this paper, we review the simulation tools and techniques developed for clinical hyperthermia, and evaluate their current status on the path from 'model' to 'clinic'. In addition, we illustrate the major techniques employed for validation and optimisation. HTP has become an essential tool for improvement, control, and assessment of HT treatment quality. As such, it plays a pivotal role in the quest to establish HT as an efficacious addition to multi-modality treatment of cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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28. The impact of temperature and urinary constituents on urine viscosity and its relevance to bladder hyperthermia treatment.
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Inman, Brant A., Etienne, Wiguins, Rubin, Rainier, Owusu, Richmond A., Oliveira, Tiago R., Rodriques, Dario B., Maccarini, Paolo F., Stauffer, Paul R., Mashal, Alireza, and Dewhirst, Mark W.
- Subjects
EFFECT of temperature on viscosity ,URINE ,TREATMENT of fever ,BLADDER cancer treatment ,FLUID mechanics ,HEAT transfer ,URINALYSIS ,MEASUREMENT of viscosity - Abstract
Purpose: The aim of this study was to determine the kinematic viscosity of human urine and factors associated with its variability. This value is necessary for accurate modelling of fluid mechanics and heat transfer during hyperthermia treatments of bladder cancer. Materials and methods: Urine samples from 64 patients undergoing routine clinical testing were subject to dipstick urinalysis and measurement of viscosity with a Cannon-Fenske viscometer. Viscosity measurements were taken at relevant temperatures for hyperthermia studies: 20 °C (room temperature), 37 °C (body temperature), and 42 °C (clinical hyperthermia temperature). Factors that might affect viscosity were assessed, including glucosuria, haematuria, urinary tract infection status, ketonuria and proteinuria status. The correlation of urine specific gravity and viscosity was measured with Spearman's rho. Results: Urine kinematic viscosity at 20 °C was 1.0700 cSt (standard deviation (SD) = 0.1076), at 37 °C 0.8293 cSt (SD = 0.0851), and at 42 °C 0.6928 cSt (SD = 0.0247). Proteinuria appeared to increase urine viscosity, whereas age, gender, urinary tract infection, glucosuria, ketonuria, and haematuria did not affect it. Urine specific gravity was only modestly correlated with urine viscosity at 20 °C (rho = 0.259), 37 °C (rho = 0.266), and 42 °C (rho = 0.255). Conclusions: The kinematic viscosity of human urine is temperature dependent and higher than water. Urine specific gravity was not a good predictor of viscosity. Of factors that might affect urine viscosity, only proteinuria appeared to be clinically relevant. Estimates of urine viscosity provided in this manuscript may be useful for temperature modelling of bladder hyperthermia treatments with regard to correct prediction of the thermal conduction effects. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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29. Miniature microwave applicator for murine bladder hyperthermia studies.
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Salahi, Sara, Maccarini, Paolo F., Rodrigues, Dario B., Etienne, Wiguins, Landon, Chelsea D., Inman, Brant A., Dewhirst, Mark W., and Stauffer, Paul R.
- Subjects
- *
THERMOTHERAPY , *DRUG therapy , *MICROWAVE devices , *SIMULATION methods & models ,BLADDER tumors - Abstract
Purpose: Novel combinations of heat with chemotherapeutic agents are often studied in murine tumour models. Currently, no device exists to selectively heat small tumours at depth in mice. In this project we modelled, built and tested a miniature microwave heat applicator, the physical dimensions of which can be scaled to adjust the volume and depth of heating to focus on the tumour volume. Of particular interest is a device that can selectively heat murine bladder. Materials and methods: Using Avizo® segmentation software, we created a numerical mouse model based on micro-MRI scan data. The model was imported into HFSS™ (Ansys) simulation software and parametric studies were performed to optimise the dimensions of a water-loaded circular waveguide for selective power deposition inside a 0.15 mL bladder. A working prototype was constructed operating at 2.45 GHz. Heating performance was characterised by mapping fibre-optic temperature sensors along catheters inserted at depths of 0-1 mm (subcutaneous), 2-3 mm (vaginal), and 4-5 mm (rectal) below the abdominal wall, with the mid depth catheter adjacent to the bladder. Core temperature was monitored orally. Results: Thermal measurements confirm the simulations which demonstrate that this applicator can provide local heating at depth in small animals. Measured temperatures in murine pelvis show well-localised bladder heating to 42-43°C while maintaining normothermic skin and core temperatures. Conclusions: Simulation techniques facilitate the design optimisation of microwave antennas for use in pre-clinical applications such as localised tumour heating in small animals. Laboratory measurements demonstrate the effectiveness of a new miniature water-coupled microwave applicator for localised heating of murine bladder. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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30. Thermal dose fractionation affects tumour physiological response.
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Thrall, Donald E., Maccarini, Paolo, Stauffer, Paul, Macfall, James, Hauck, Marlene, Snyder, Stacey, Case, Beth, Linder, Keith, Lan, Lan, Mccall, Linda, and Dewhirst, Mark W.
- Subjects
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CELL fractionation , *THERMAL dosimetry , *RADIOTHERAPY , *VETERINARY radiography , *CANCER in animals , *DOG diseases - Abstract
Purpose: It is unknown whether a thermal dose should be administered using a few large fractions with higher temperatures or a larger number of fractions with lower temperatures. To evaluate this we assessed the effect of administering the same total thermal dose, approximately 30 CEM43T90, in one versus three to four fractions per week, over 5 weeks. Materials and methods: Canine sarcomas were randomised to receive one of the hyperthermia fractionation schemes along with fractionated radiotherapy. Tumour response was based on changes in tumour volume, oxygenation, water diffusion quantified using MRI, and a panel of histological and immunohistochemical end points. Results: There was a greater reduction in tumour volume and water diffusion at the end of therapy in tumours receiving one hyperthermia fraction per week. There was a weak but significant association between improved tumour oxygenation 24 h after the first hyperthermia treatment and extent of volume reduction at the end of therapy. Finally, the direction of change of HIF-1α and CA-IX immunoreactivity after the first hyperthermia fraction was similar and there was an inverse relationship between temperature and the direction of change of CA-IX. There were no significant changes in interstitial fluid pressure, VEGF, vWF, apoptosis or necrosis as a function of treatment group or temperature. Conclusions: We did not identify an advantage to a three to four per week hyperthermia prescription, and response data pointed to a one per week prescription being superior. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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31. A heterogeneous human tissue mimicking phantom for RF heating and MRI thermal monitoring verification.
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Yuan, Yu, Wyatt, Cory, Maccarini, Paolo, Craciunescu, Oana, MacFall, James, Dewhirst, Mark, and Das, Shiva K.
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IMAGING phantoms ,TISSUES ,RADIO frequency ,MAGNETIC resonance imaging ,THERMAL analysis ,TEMPERATURE measurements ,DIELECTRICS ,DIFFERENTIAL scanning calorimetry - Abstract
This paper describes a heterogeneous phantom that mimics a human thigh with a deep-seated tumor, for the purpose of studying the performance of radiofrequency (RF) heating equipment and non-invasive temperature monitoring with magnetic resonance imaging (MRI). The heterogeneous cylindrical phantom was constructed with an outer fat layer surrounding an inner core of phantom material mimicking muscle, tumor and marrowfilled bone. The component materials were formulated to have dielectric and thermal properties similar to human tissues. The dielectric properties of the tissue mimicking phantom materials were measured with a microwave vector network analyzer and impedance probe over the frequency range of 80-500 MHz and at temperatures of 24, 37 and 45 ?C. The specific heat values of the component materials were measured using a differential scanning calorimeter over the temperature range of 15-55 ?C. The thermal conductivity value was obtained from fitting the curves obtained from one-dimensional heat transfer measurement. The phantom was used to verify the operation of a cylindrical four-antenna annular phased array extremity applicator (140 MHz) by examining the proton resonance frequency shift (PRFS) thermal imaging patterns for various magnitude/phase settings (including settings to focus heating in tumors). For muscle and tumor materials, MRI was also used to measure T1/T2* values (1.5 T) and to obtain the slope of the PRFS phase change versus temperature change curve. The dielectric and thermal properties of the phantom materials were in close agreement to well-accepted published results for human tissues. The phantom was able to successfully demonstrate satisfactory operation of the tested heating equipment. The MRImeasured thermal distributions matched the expected patterns for various magnitude/phase settings of the applicator, allowing the phantom to be used as a quality assurance tool. Importantly, the material formulations for the various tissue types may be used to construct customized phantoms that are tailored for different anatomical sites. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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32. Utility of treatment planning for thermochemotherapy treatment of nonmuscle invasive bladder carcinoma.
- Author
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Yuan, Yu, Cheng, Kung-Shan, Craciunescu, Oana I., Stauffer, Paul R., Maccarini, Paolo F., Arunachalam, Kavitha, Vujaskovic, Zeljko, Dewhirst, Mark W., and Das, Shiva K.
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CANCER chemotherapy ,BLADDER cancer treatment ,CLINICAL trials ,MITOMYCIN C ,RETROSPECTIVE studies - Abstract
Purpose: A recently completed Phase I clinical trial combined concurrent Mitomycin-C chemotherapy with deep regional heating using BSD-2000 Sigma-Ellipse applicator (BSD Corporation, Salt Lake City, UT, U.S.A.) for the treatment of nonmuscle invasive bladder cancer. This work presents a new treatment planning approach, and demonstrates potential impact of this approach on improvement of treatment quality. Methods: This study retrospectively analyzes a subset of five patients on the trial. For each treatment, expert operators selected 'clinical-optimal' settings based on simple model calculation on the BSD-2000 control console. Computed tomography (CT) scans acquired prior to treatment were segmented to create finite element patient models for retrospective simulations with Sigma-HyperPlan (Dr. Sennewald Medizintechnik GmbH, Munchen, Germany). Since Sigma-HyperPlan does not account for the convective nature of heat transfer within a fluid filled bladder, an effective thermal conductivity for bladder was introduced. This effective thermal conductivity value was determined by comparing simulation results with clinical measurements of bladder and rectum temperatures. Regions of predicted high temperature in normal tissues were compared with patient complaints during treatment. Treatment results using 'computed-optimal' settings from the planning system were compared with clinical results using clinical-optimal settings to evaluate potential of treatment improvement by reducing hot spot volume. Results: For all five patients, retrospective treatment planning indicated improved matches between simulated and measured bladder temperatures with increasing effective thermal conductivity. The differences were mostly within 1.3 °C when using an effective thermal conductivity value above 10 W/K/m. Changes in effective bladder thermal conductivity affected surrounding normal tissues within a distance of ∼1.5 cm from the bladder wall. Rectal temperature differences between simulation and measurement were large due to sensitivity to the sampling locations in rectum. The predicted bladder T90 correlated well with single-point bladder temperature measurement. Hot spot locations predicted by the simulation agreed qualitatively with patient complaints during treatment. Furthermore, comparison between the temperature distributions with clinical and computed-optimal settings demonstrated that the computed-optimal settings resulted in substantially reduced hot spot volumes. Conclusions: Determination of an effective thermal conductivity value for fluid filled bladder was essential for matching simulation and treatment temperatures. Prospectively planning patients using the effective thermal conductivity determined in this work can potentially improve treatment efficacy (compared to manual operator adjustments) by potentially lower discomfort from reduced hot spots in normal tissue. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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33. Vesicoureteral Reflux in Children: A Phantom Study of Microwave Heating and Radiometric Thermometry of Pediatric Bladder.
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Birkelund, Yngve, Klemetsen, Øystein, Jacobsen, Svein K., Arunachalam, Kavitha, Maccarini, Paolo, and Stauffer, Paul R.
- Subjects
VESICO-ureteral reflux in children ,MICROWAVE heating ,RADIATION measurements ,MEDICAL thermometry ,BLADDER ,ELECTROMAGNETISM in medicine ,FEVER ,MICROWAVE antennas - Abstract
We have investigated the use of microwave heating and radiometry to safely heat urine inside a pediatric bladder. The medical application for this research is to create a safe and reliable method to detect vesicoureteral reflux, a pediatric disorder, where urine flow is reversed and flows from the bladder back up into the kidney. Using fat and muscle tissue models, we have performed both experimental and numerical simulations of a pediatric bladder model using planar dual concentric conductor microstrip antennas at 915 MHz for microwave heating. A planar elliptical antenna connected to a 500 MHz bandwidth microwave radiometer centered at 3.5 GHz was used for noninvasive temperature measurement inside tissue. Temperatures were measured in the phantom models at points during the experiment with implanted fiberoptic sensors, and 2-D distributions in cut planes at depth in the phantom with an infrared camera at the end of the experiment. Cycling between 20 s with 20 Watts power for heating, and 10 s without power to allow for undisturbed microwave radiometry measurements, the experimental results show that the target tissue temperature inside the phantom increases fast and that the radiometer provides useful measurements of spatially averaged temperature of the illuminated volume. The presented numerical and experimental results show excellent concordance, which confirms that the proposed system for microwave heating and radiometry is applicable for safe and reliable heating of pediatric bladder. [ABSTRACT FROM PUBLISHER]
- Published
- 2011
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34. Detection of Vesicoureteral Reflux Using Microwave Radiometry—System Characterization With Tissue Phantoms.
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Arunachalam, Kavitha, Maccarini, Paolo, De Luca, Valeria, Tognolatti, Piero, Bardati, Fernando, Snow, Brent, and Stauffer, Paul
- Subjects
- *
VESICO-ureteral reflux , *RADIATION measurements , *MICROWAVES , *IMAGING phantoms , *TEMPERATURE measurements , *ELECTROMAGNETIC shielding , *ANTENNAS (Electronics) , *SPECTRAL energy distribution , *POWER spectra , *DIAGNOSIS - Abstract
Microwave (MW) radiometry is proposed for passive monitoring of kidney temperature to detect vesicoureteral reflux (VUR) of urine that is externally heated by a MW hyperthermia device and thereafter reflows from the bladder to kidneys during reflux. Here, we characterize in tissue-mimicking phantoms the performance of a 1.375 GHz radiometry system connected to an electromagnetically (EM) shielded microstrip log spiral antenna optimized for VUR detection. Phantom EM properties are characterized using a coaxial dielectric probe and network analyzer (NA). Power reflection and receive patterns of the antenna are measured in layered tissue phantom. Receiver spectral measurements are used to assess EM shielding provided by a metal cup surrounding the antenna. Radiometer and fiberoptic temperature data are recorded for varying volumes (10–30 mL) and temperaturesg (40–46 °C) of the urine phantom at 35 mm depth surrounded by 36.5 °C muscle phantom. Directional receive pattern with about 5% power spectral density at 35 mm target depth and better than −10 dB return loss from tissue load are measured for the antenna. Antenna measurements demonstrate no deterioration in power reception and effective EM shielding in the presence of the metal cup. Radiometry power measurements are in excellent agreement with the temperature of the kidney phantom. Laboratory testing of the radiometry system in temperature-controlled phantoms supports the feasibility of passive kidney thermometry for VUR detection. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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35. Improved hyperthermia treatment control using SAR/temperature simulation and PRFS magnetic resonance thermal imaging.
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Li, Zhen, Vogel, Martin, Maccarini, Paolo F., Stakhursky, Vadim, Soher, Brian J., Craciunescu, Oana I., Das, Shiva, Arabe, Omar A., Joines, Williams T., and Stauffer, Paul R.
- Subjects
THERMOTHERAPY ,ADJUVANT treatment of cancer ,MAGNETIC fields ,RADIO frequency ,RESONANCE ,ELECTROMAGNETIC devices ,COMPUTER simulation ,THERAPEUTICS - Abstract
Purpose: This article explores the feasibility of using coupled electromagnetic and thermodynamic simulations to improve planning and control of hyperthermia treatments for cancer. The study investigates the usefulness of preplanning to improve heat localisation in tumour targets in treatments monitored with PRFS-based magnetic resonance thermal imaging (MRTI). Methods: Heating capabilities of a cylindrical radiofrequency (RF) mini-annular phased array (MAPA) applicator were investigated with electromagnetic and thermal simulations of SAR in homogeneous phantom models and two human leg sarcomas. High frequency structure simulator (HFSS) (Ansoft) was used for electromagnetic simulations and SAR patterns were coupled into EPhysics (Ansoft) for thermal modelling with temperature-dependent variable perfusion. Simulations were accelerated by integrating tumour-specific anatomy into a pre-gridded whole body tissue model. To validate this treatment planning approach, simulations were compared with MR thermal images in both homogenous phantoms and heterogeneous tumours. Results: SAR simulations demonstrated excellent agreement with temperature rise distributions obtained with MR thermal imaging in homogeneous phantoms and clinical treatments of large soft-tissue sarcomas. The results demonstrate feasibility of preplanning appropriate relative phases of antennas for localising heat in tumour. Conclusions: Advances in the accuracy of computer simulation and non-invasive thermometry via MR thermal imaging have provided powerful new tools for optimisation of clinical hyperthermia treatments. Simulations agree well with MR thermal images in both homogeneous tissue models and patients with lower leg tumours. This work demonstrates that better quality hyperthermia treatments should be possible when simplified hybrid model simulations are performed routinely as part of the clinical pretreatment plan. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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36. Conformal microwave array (CMA) applicators for hyperthermia of diffuse chest wall recurrence.
- Author
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Stauffer, Paul R., Maccarini, Paolo, Arunachalam, Kavitha, Craciunescu, Oana, Diederich, Chris, Juang, Titania, Rossetto, Francesca, Schlorff, Jaime, Milligan, Andrew, Hsu, Joe, Sneed, Penny, and Vujaskovic, Zeljko
- Subjects
- *
FEVER , *DRUG therapy , *MASTECTOMY , *BREAST cancer surgery , *THERMOTHERAPY , *RADIOEMBOLIZATION - Abstract
Purpose: This article summarises the evolution of microwave array applicators for heating large area chest wall disease as an adjuvant to external beam radiation, systemic chemotherapy, and potentially simultaneous brachytherapy. Methods: Current devices used for thermotherapy of chest wall recurrence are reviewed. The largest conformal array applicator to date is evaluated in four studies: (1) ability to conform to the torso is demonstrated with a CT scan of a torso phantom and MR scan of the conformal water bolus component on a mastectomy patient; (2) specific absorption rate (SAR) and temperature distributions are calculated with electromagnetic and thermal simulation software for a mastectomy patient; (3) SAR patterns are measured with a scanning SAR probe in liquid muscle phantom for a buried coplanar waveguide CMA; and (4) heating patterns and patient tolerance of CMA applicators are characterised in a clinical pilot study with 13 patients. Results: CT and MR scans demonstrate excellent conformity of CMA applicators to contoured anatomy. Simulations demonstrate effective control of heating over contoured anatomy. Measurements confirm effective coverage of large treatment areas with no gaps. In 42 hyperthermia treatments, CMA applicators provided well-tolerated effective heating of up to 500 cm2 regions, achieving target temperatures of Tmin = 41.4 ± 0.7°C, T90 = 42.1 ± 0.6°C, Tave = 42.8 ± 0.6°C, and Tmax = 44.3 ± 0.8°C as measured in an average of 90 points per treatment. Conclusion: The CMA applicator is an effective thermal therapy device for heating large-area superficial disease such as diffuse chest wall recurrence. It is able to cover over three times the treatment area of conventional hyperthermia devices while conforming to typical body contours. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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37. Design of a water coupling bolus with improved flow distribution for multi-element superficial hyperthermia applicators.
- Author
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Arunachalam, Kavitha, Maccarini, Paolo F., Schlorff, Jaime L., Birkelund, Yngve, Jacobsen, Svein, and Stauffer, Paul R.
- Subjects
- *
FEVER , *ELECTROMAGNETIC waves , *FLUID dynamics , *TEMPERATURE , *WATER temperature - Abstract
A water bolus used in superficial hyperthermia couples the electromagnetic (EM) or acoustic energy into the target tissue and cools the tissue surface to minimise thermal hotspots and patient discomfort during treatment. Parametric analyses of the fluid pressure inside the bolus computed using 3D fluid dynamics simulations are used in this study to determine a bolus design with improved flow and surface temperature distributions for large area superficial heat applicators. The simulation results are used in the design and fabrication of a 19 × 32 cm prototype bolus with dual input-dual output (DIDO) flow channels. Sequential thermal images of the bolus surface temperature recorded for a step change in the circulating water temperature are used to assess steady state flow and surface temperature distributions across the bolus. Modelling and measurement data indicate substantial improvement in bolus flow and surface temperature distributions when changing from the previous single input-single output (SISO) to DIDO configuration. Temperature variation across the bolus at steady state was measured to be less than 0.8°C for the DIDO bolus compared to 1.5°C for the SISO water bolus. The new DIDO bolus configuration maintains a nearly uniform flow distribution and low variation in surface temperature over a large area typically treated in superficial hyperthermia. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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- View/download PDF
38. Accuracy of real time noninvasive temperature measurements using magnetic resonance thermal imaging in patients treated for high grade extremity soft tissue sarcomas.
- Author
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Craciunescu, Oana I., Stauffer, Paul R., Soher, Brian J., Wyatt, Cory R., Arabe, Omar, Maccarini, Paolo, Das, Shiva K., Cheng, Kung-Shan, Wong, Terence Z., Jones, Ellen L., Dewhirst, Mark W., Vujaskovic, Zeljko, and MacFall, James R.
- Subjects
NONINVASIVE diagnostic tests ,MAGNETIC resonance imaging ,SARCOMA ,TISSUES ,FEVER - Abstract
Purpose: To establish accuracy of real time noninvasive temperature measurements using magnetic resonance thermal imaging in patients treated for high grade extremity soft tissue sarcomas. Methods: Protocol patients with advanced extremity sarcomas were treated with external beam radiation therapy and hyperthermia. Invasive temperature measures were compared to noninvasive magnetic resonance thermal imaging (MRTI) at 1.5 T performed during hyperthermia. Volumetric temperature rise images were obtained using the proton resonance frequency shift (PRFS) technique during heating in a 140 MHz miniannular phased array applicator. MRTI temperature changes were compared to invasive measurements of temperature with a multisensor fiber optic probe inside a #15 g catheter in the tumor. Since the PRFS technique is sensitive to drifts in the primary imaging magnetic field, temperature change distributions were corrected automatically during treatment using temperature-stable reference materials to characterize field changes in 3D. The authors analyzed MRT images and compared, in evaluable treatments, MR-derived temperatures to invasive temperatures measured in extremity sarcomas. Small regions of interest (ROIs) were specified near each invasive sensor identified on MR images. Temperature changes in the interstitial sensors were compared to the corresponding ROI PRFS-based temperature changes over the entire treatment and over the steady-state period. Nonevaluable treatments (motion/imaging artifacts, noncorrectable drifts) were not included in the analysis. Results: The mean difference between MRTI and interstitial probe measurements was 0.91 °C for the entire heating time and 0.85 °C for the time at steady state. These values were obtained from both tumor and normal tissue ROIs. When the analysis is done on just the tumor ROIs, the mean difference for the whole power on time was 0.74 °C and during the period of steady state was 0.62 °C. Conclusions: The data show that for evaluable treatments, excellent correlation (ΔT<1 °C) of MRTI-ROI and invasive measurements can be achieved, but that motion and other artifacts are still serious challenges that must be overcome in future work. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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39. Hyperthermia MRI temperature measurement: Evaluation of measurement stabilisation strategies for extremity and breast tumours.
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Wyatt, Cory, Soher, Brian, Maccarini, Paolo, Charles, H. Cecil, Stauffer, Paul, and Macfall, James
- Subjects
FEVER ,BREAST tumors ,TEMPERATURE measurements ,PROTON magnetic resonance ,MEDICAL imaging systems - Abstract
Purpose: MR thermometry using the proton resonance frequency shift (PRFS) method has been used to measure temperature changes during clinical hyperthermia treatment. However, frequency drift of the MRI system can add large errors to the measured temperature change. These drifts can be measured and corrected using oil references placed around the treatment region. In this study, the number and position of four or more oil references were investigated to obtain a practical approach to correct frequency drift during PRFS thermometry in phantoms and in vivo. Materials and methods: Experiments were performed in a 140 MHz four antenna mini-annular phased array (MAPA) heat applicator (for treatment of extremity tumours) and an applicator for heating of the breast, with symmetric and asymmetric positioning of the oil references, respectively. Temperature change PRFS images were obtained during an hour or more of measurement with no application of heat. Afterwards, errors in calculating temperature change due to system drift were quantified with and without various oil reference correction arrangements. Results: Results showed good temperature correction in phantoms and in a human leg, with average errors of 0.28°C and 0.94°C respectively. There was further improvement in the leg when using eight or more oil references, reducing the average error to 0.44°C, while the phantoms showed no significant improvement. Conclusions: These results indicate that oil reference correction performs well in vivo, and that eight references can improve the correction by up to 0.5°C compared to four references. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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40. Monitoring brown fat metabolic activity using microwave radiometry: Antenna design and frequency selection.
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Rodrigues, Dario B., Stauffer, Paul R., and Maccarini, Paolo F.
- Published
- 2014
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41. Utility of microwave radiometry for diagnostic and therapeutic applications of non-invasive temperature monitoring.
- Author
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Stauffer, Paul R., Rodrigues, Dario B., and Maccarini, Paolo F.
- Published
- 2014
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42. A continuum model of the dynamics of coupled oscillator arrays...
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Pogorzelski, Ronald J. and Maccarini, Paolo F.
- Subjects
- *
MICROWAVE oscillators , *POISSON'S equation - Abstract
Presents a continuum model of the dynamics of coupled oscillator arrays for phase-shifterless beam scanning. Simplified theory of such arrays; Beam steering; Injection locked; Phased array; Poisson's equation.
- Published
- 1999
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43. Nanostar probes: a golden platform for Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) for the treatment of metastatic cancer.
- Author
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Vo-Dinh, Tuan, Ho, Ho-Pui A., Ray, Krishanu, Cupil-Garcia, Vanessa, Liu, Yang, Crawford, Bridget M., Chongsathidkiet, Pakawat, Palmer, Gregory, Maccarini, Paolo, Fecci, Peter E., and Inman, Brant
- Published
- 2019
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44. Dosimetric characterization of the thermobrachytherapy surface applicator
- Author
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Craciunescu, Oana I., Arunachalam, Kavitha, Steffey, Beverly A., Maccarini, Paolo, Schlorff, Jaime L., and Stauffer, Paul R
- Published
- 2009
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45. 576 NONINVASIVE GRADE V VESICOURETERAL REFLUX DETECTION: AN ANIMAL STUDY.
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Snow, Brent, Arunchalam, Kavitha, De Luca, Valeria, Klemetsen, Oystein, Birkelund, Yngve, Stauffer, Paul, and Maccarini, Paolo
- Published
- 2011
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46. Gold Nanostars Obviate Limitations to Laser Interstitial Thermal Therapy (LITT) for the Treatment of Intracranial Tumors.
- Author
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Srinivasan ES, Liu Y, Odion RA, Chongsathidkiet P, Wachsmuth LP, Haskell-Mendoza AP, Edwards RM, Canning AJ, Willoughby G, Hinton J, Norton SJ, Lascola CD, Maccarini PF, Mariani CL, Vo-Dinh T, and Fecci PE
- Subjects
- Humans, Animals, Mice, Gold, Positron Emission Tomography Computed Tomography, Lasers, Brain Neoplasms surgery, Hyperthermia, Induced methods
- Abstract
Purpose: Laser interstitial thermal therapy (LITT) is an effective minimally invasive treatment option for intracranial tumors. Our group produced plasmonics-active gold nanostars (GNS) designed to preferentially accumulate within intracranial tumors and amplify the ablative capacity of LITT., Experimental Design: The impact of GNS on LITT coverage capacity was tested in ex vivo models using clinical LITT equipment and agarose gel-based phantoms of control and GNS-infused central "tumors." In vivo accumulation of GNS and amplification of ablation were tested in murine intracranial and extracranial tumor models followed by intravenous GNS injection, PET/CT, two-photon photoluminescence, inductively coupled plasma mass spectrometry (ICP-MS), histopathology, and laser ablation., Results: Monte Carlo simulations demonstrated the potential of GNS to accelerate and specify thermal distributions. In ex vivo cuboid tumor phantoms, the GNS-infused phantom heated 5.5× faster than the control. In a split-cylinder tumor phantom, the GNS-infused border heated 2× faster and the surrounding area was exposed to 30% lower temperatures, with margin conformation observed in a model of irregular GNS distribution. In vivo, GNS preferentially accumulated within intracranial tumors on PET/CT, two-photon photoluminescence, and ICP-MS at 24 and 72 hours and significantly expedited and increased the maximal temperature achieved in laser ablation compared with control., Conclusions: Our results provide evidence for use of GNS to improve the efficiency and potentially safety of LITT. The in vivo data support selective accumulation within intracranial tumors and amplification of laser ablation, and the GNS-infused phantom experiments demonstrate increased rates of heating, heat contouring to tumor borders, and decreased heating of surrounding regions representing normal structures., (©2023 The Authors; Published by the American Association for Cancer Research.)
- Published
- 2023
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47. Safety and efficacy of intravesical chemotherapy and hyperthermia in the bladder: results of a porcine study.
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Tan WP, Chang A, Brousell SC, Grimberg DC, Fantony JJ, Longo TA, Etienne W, Spasojevic I, Maccarini P, and Inman BA
- Subjects
- Administration, Intravesical, Animals, Antibiotics, Antineoplastic therapeutic use, Female, Hyperthermia, Mitomycin therapeutic use, Swine, Hyperthermia, Induced, Urinary Bladder Neoplasms drug therapy
- Abstract
Background: Hyperthermia (heating to 43 °C) activates the innate immune system and improves bladder cancer chemosensitivity., Objective: To evaluate the tissue penetration and safety of convective hyperthermia combined with intravesical mitomycin C (MMC) pharmacokinetics in live porcine bladder models using the Combat bladder recirculation system (BRS)., Methods: Forty 60 kg-female swine were anesthetized and catheterized with a 3-way, 16 F catheter. The Combat device was used to heat the bladders to a target temperature of 43 °C with recirculating intravesical MMC at doses of 40, 80, and 120 mg. Dwell-heat time varied from 30-180 min. Rapid necropsy with immediate flash freezing of tissues, blood and urine occurred. MMC concentrations were measured by liquid chromatography tandem-mass spectrometry., Results: The Combat BRS system was able to achieve target range temperature (42-44 °C) in 12 mins, and this temperature was maintained as long as the device was running. Two factors increased tissue penetration of MMC in the bladder: drug concentration, and the presence of heat. In the hyperthermia arm, MMC penetration saturated at 80 mg, suggesting that with heating, drug absorption may saturate and not require higher doses to achieve the maximal biological effect. Convective hyperthermia did not increase the MMC concentration in the liver, heart, kidney, spleen, lung, and lymph node tissue even at the 120 mg dose., Conclusions: Convective bladder hyperthermia using the Combat BRS device is safe and the temperature can be maintained at 43 °C. Hyperthermia therapy may increase MMC penetration into the bladder wall but does not result in an increase of MMC levels in other organs.
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- 2020
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48. Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) for the Treatment of Unresectable and Metastatic Cancers.
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Liu Y, Maccarini P, Palmer GM, Etienne W, Zhao Y, Lee CT, Ma X, Inman BA, and Vo-Dinh T
- Subjects
- Animals, Immunophenotyping, Kaplan-Meier Estimate, Mice, Neoplasm Metastasis, Hyperthermia, Induced, Phototherapy, Theranostic Nanomedicine, Urinary Bladder Neoplasms immunology, Urinary Bladder Neoplasms therapy
- Abstract
Metastatic spread is the mechanism in more than 90 percent of cancer deaths and current therapeutic options, such as systemic chemotherapy, are often ineffective. Here we provide a proof of principle for a novel two-pronged modality referred to as Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) having the potential to safely eradicate both primary tumors and distant metastatic foci. Using a combination of immune-checkpoint inhibition and plasmonic gold nanostar (GNS)-mediated photothermal therapy, we were able to achieve complete eradication of primary treated tumors and distant untreated tumors in some mice implanted with the MB49 bladder cancer cells. Delayed rechallenge with MB49 cancer cells injection in mice that appeared cured by SYMPHONY did not lead to new tumor formation after 60 days observation, indicating that SYMPHONY treatment induced effective long-lasting immunity against MB49 cancer cells.
- Published
- 2017
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49. Numerical 3D modeling of heat transfer in human tissues for microwave radiometry monitoring of brown fat metabolism.
- Author
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Rodrigues DB, Maccarini PF, Salahi S, Colebeck E, Topsakal E, Pereira PJ, Limão-Vieira P, and Stauffer PR
- Abstract
Background: Brown adipose tissue (BAT) plays an important role in whole body metabolism and could potentially mediate weight gain and insulin sensitivity. Although some imaging techniques allow BAT detection, there are currently no viable methods for continuous acquisition of BAT energy expenditure. We present a non-invasive technique for long term monitoring of BAT metabolism using microwave radiometry., Methods: A multilayer 3D computational model was created in HFSS™ with 1.5 mm skin, 3-10 mm subcutaneous fat, 200 mm muscle and a BAT region (2-6 cm
3 ) located between fat and muscle. Based on this model, a log-spiral antenna was designed and optimized to maximize reception of thermal emissions from the target (BAT). The power absorption patterns calculated in HFSS™ were combined with simulated thermal distributions computed in COMSOL® to predict radiometric signal measured from an ultra-low-noise microwave radiometer. The power received by the antenna was characterized as a function of different levels of BAT metabolism under cold and noradrenergic stimulation., Results: The optimized frequency band was 1.5-2.2 GHz, with averaged antenna efficiency of 19%. The simulated power received by the radiometric antenna increased 2-9 mdBm (noradrenergic stimulus) and 4-15 mdBm (cold stimulus) corresponding to increased 15-fold BAT metabolism., Conclusions: Results demonstrated the ability to detect thermal radiation from small volumes (2-6 cm3 ) of BAT located up to 12 mm deep and to monitor small changes (0.5 °C) in BAT metabolism. As such, the developed miniature radiometric antenna sensor appears suitable for non-invasive long term monitoring of BAT metabolism.- Published
- 2013
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50. Preclinical Dosimetry of Magnetic Fluid Hyperthermia for Bladder Cancer.
- Author
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Oliveira TR, Stauffer PR, Lee CT, Landon C, Etienne W, Maccarini PF, Inman B, and Dewhirst MW
- Abstract
Background: Despite positive efficacy, thermotherapy is not widely used in clinical oncology. Difficulties associated with field penetration and controlling power deposition patterns in heterogeneous tissue have limited its use for heating deep in the body. Heat generation using iron-oxide super-paramagnetic nanoparticles excited with magnetic fields has been demonstrated to overcome some of these limitations. The objective of this preclinical study is to investigate the feasibility of treating bladder cancer with magnetic fluid hyperthermia (MFH) by analyzing the thermal dosimetry of nanoparticle heating in a rat bladder model., Methods: The bladders of 25 female rats were injected with 0.4 ml of Actium Biosystems magnetite-based nanoparticles (Actium Biosystems, Boulder CO) via catheters inserted in the urethra. To assess the distribution of nanoparticles in the rat after injection we used the 7 T small animal MRI system (Bruker ClinScan, Bruker BioSpin MRI GmbH, Ettlingen, Germany). Heat treatments were performed with a small animal magnetic field applicator (Actium Biosystems, Boulder CO) with a goal of raising bladder temperature to 42°C in <10min and maintaining for 60min. Temperatures were measured throughout the rat with seven fiberoptic temperature probes (OpSens Technologies, Quebec Canada) to characterize our ability to localize heat within the bladder target., Results: The MRI study confirms the effectiveness of the catheterization procedure to homogenously distribute nanoparticles throughout the bladder. Thermal dosimetry data demonstrate our ability to controllably raise temperature of rat bladder ≥1°C/min to a steady-state of 42°C., Conclusion: Our data demonstrate that a MFH system provides well-localized heating of rat bladder with effective control of temperature in the bladder and minimal heating of surrounding tissues.
- Published
- 2013
- Full Text
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