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Purpose: Hyperthermia is an established (neo)adjuvant treatment modality for a number of pelvic malignancies. Optimal treatment of these tumors requires robust treatment planning, but up until now, the urinary bladder was not modeled accurately, making current simulations less reliable. The authors improved the dielectric and thermophysical model of the urinary bladder in their treatment planning system, and showed the improvements using phantom experiments. Methods: The authors suspended a porcine bladder in muscle tissue equivalent gel and filled it with 120 ml 0.9% saline. The authors heated the phantom during 15 min with their deep hyperthermia device, using clinical settings, and measured the temperature both inside and outside the bladder. The authors simulated the experiment, both using the clinically used treatment planning system, and using the improved model featuring correct dielectric properties for the bladder content and an enhanced thermophysical model, enabling the simulation of convection. Results: Although the dielectric changes have an impact throughout the phantom, the dominant effect is a higher net heat absorption in the bladder. The effects of changing the thermophysical model are limited to the bladder and its surroundings, but result in a very different temperature profile. The temperatures predicted by the simulations using the new bladder model were in much better agreement with the measurements than those predicted by currently used treatment planning system. Conclusions: Modeling convection in the urinary bladder is very important for accurate hyperthermia treatment planning in the pelvic area. [ABSTRACT FROM AUTHOR]

Specific absorption rate (SAR) assessment is essential for safety purposes during MR acquisition. Online SAR assessment is not trivial and requires, in addition, knowledge of the electric tissue properties and the electric fields in the human anatomy. In this study, the potential of the recently developed CSI-EPT method to reconstruct SAR distributions is investigated. This method is based on integral representations for the electromagnetic field and attempts to reconstruct the tissue parameters and the electric field strength based on [Formula: see text] field data only. Full three-dimensional FDTD simulations using a female pelvis model are used to validate two-dimensional CSI reconstruction results in the central transverse plane of a 3T body coil. Numerical experiments demonstrate that the reconstructed SAR distributions are in good agreement with the SAR distributions as determined via 3D FDTD simulations and show that these distributions can be computed very efficiently in the central transverse plane of a body coil with the two-dimensional approach of CSI-EPT.

Introduction The reliability of hyperthermia treatment planning (HTP) is strongly dependent on the accuracy of the electric properties of each tissue. The values currently used are mostly based on ex vivo measurements. In this study, in vivo conductivity of human muscle, bladder content and cervical tumours, acquired with magnetic resonance-based electric properties tomography (MR-EPT), are exploited to investigate the effect on HTP for cervical cancer patients. Methods Temperature-based optimisation of five different patients was performed using literature-based conductivity values yielding certain antenna settings, which are then used to compute the temperature distribution of the patient models with EPT-based conductivity values. Furthermore, the effects of altered bladder and muscle conductivity were studied separately. Finally, the temperature-based optimisation was performed with patient models based on EPT conductivity values. Results The tumour temperatures for all EPT-based dielectric patient models were lower compared to the optimal tumour temperatures based on literature values. The largest deviation was observed for patient 1 with ΔT90 = -1.37 °C. A negative impact was also observed when the treatment was optimised based on the EPT values. For four patients ΔT90 was less than 0.6 °C; for one patient it was 1.5 °C. Conclusions Electric conductivity values acquired by EPT are higher than commonly used from literature. This difference has a substantial impact on cervical tumour temperatures achieved during hyperthermia. A higher conductivity in the bladder and in the muscle tissue surrounding the tumour leads to higher power dissipation in the bladder and muscle, and therefore to lower tumour temperatures.

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.

The in vivo electric conductivity (σ) values of tissue are essential for accurate electromagnetic simulations and specific absorption rate (SAR) assessment for applications such as thermal dose computations in hyperthermia. Currently used σ-values are mostly based on ex vivo measurements. In this study the conductivity of human muscle, bladder content and cervical tumors is acquired non-invasively in vivo using MRI. The conductivity of 20 cervical cancer patients was measured with the MR-based electric properties tomography method on a standard 3T MRI system. The average in vivo σ-value of muscle is 14% higher than currently used in human simulation models. The σ-value of bladder content is an order of magnitude higher than the value for bladder wall tissue that is used for the complete bladder in many models. Our findings are confirmed by various in vivo animal studies from the literature. In cervical tumors, the observed average conductivity was 13% higher than the literature value reported for cervical tissue. Considerable deviations were found for the electrical conductivity observed in this study and the commonly used values for SAR assessment, emphasizing the importance of acquiring in vivo conductivity for more accurate SAR assessment in various applications.

Electric properties tomography (EPT) is an imaging modality to reconstruct the electric conductivity and permittivity inside the human body based on B1(+) maps acquired by a magnetic resonance imaging (MRI) system. Current implementations of EPT are based on the local Maxwell equations and assume piecewise constant media. The accuracy of the reconstructed maps may therefore be sensitive to noise and reconstruction errors occur near tissue boundaries. In this paper, we introduce a multiplicative regularized CSI-EPT method (contrast source inversion-electric properties tomography) where the electric tissue properties are retrieved in an iterative fashion based on a contrast source inversion approach. The method takes the integral representations for the electromagnetic field as a starting point and the tissue parameters are obtained by iteratively minimizing an objective function which measures the discrepancy between measured and modeled data and the discrepancy in satisfying a consistency equation known as the object equation. Furthermore, the objective function consists of a multiplicative Total Variation factor for noise suppression during the reconstruction process. Finally, the presented implementation is able to simultaneously include more than one B1(+) data set acquired by complementary RF excitation settings. We have performed in vivo simulations using a female pelvis model to compute the B1(+) fields. Three different RF excitation settings were used to acquire complementary B1(+) fields for an improved overall reconstruction. Numerical results illustrate the improved reconstruction near tissue boundaries and the ability of CSI-EPT to reconstruct small tissue structures.

Purpose: Investigation of the validity of the "transceive phase assumption" for Electric Property Tomography of pelvic tumors at 3T. The acquired electric conductivities of pelvic tumors are beneficial for improved specific absorption rate determination in hyperthermia treatment planning., Methods: Electromagnetic simulations and magnetic resonance imaging measurements of a pelvic-sized phantom and the human pelvis of a volunteer and a cervix cancer patient., Results: The reconstructed conductivity values of the phantom tumor model are in good quantitative agreement (mean deviation: 1-10%) with the probe measurements. Furthermore, the average reconstructed conductivity of a pelvic tumor model was in close agreement with the input conductivity (0.86 S/m vs. 0.90 S/m). The reconstructed tumor conductivity of the presented patient (cervical carcinoma, Stage: IVA) was 1.16 ± 0.40 S/m., Conclusion: This study demonstrates the feasibility of electric property tomography to measure quantitatively the conductivity of centrally located tumors in a pelvic-sized phantom and human pelvis with a standard magnetic resonance (MR) system and MR sequences. A good quantitative agreement was found between the reconstructed σ-values and probe measurements for a wide range of σ-values and for off-axis located spherical compartment. As most pelvic tumors are located in the central region of the pelvis, these results can be exploited in hyperthermia treatment planning systems., (© 2014 Wiley Periodicals, Inc.)