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Numerical models for commercially available MA251 antennas (915 MHz, BSD Medical) were developed in COMSOL Multiphysics, a finite element analysis software package. To expedite treatment planning, electric fields, power deposition and temperature rises were computed for a single straight antenna in 2D axisymmetric geometry. A precomputed library of electric field and temperature solutions was created for a range of insertion depths (5-12 cm) and blood perfusion rates (0.5-5 kg/m3/s). 3D models of multiple antennas and benchtop phantoms experiments using temperature-sensitive liquid crystal paper to monitor heating by curved antennas were performed for comparative evaluation of the treatment planning platform.
A patient-customizable hyperthermia treatment planning software package was developed in MATLAB with capabilities to interface with a commercial radiation therapy planning platform (Oncentra, Nucleotron), import patient and multicatheter implant geometries, calculate insertion depths, and perform hyperthermia planning with antennas operating in asynchronous or synchronous mode. During asynchronous operation, the net power deposition and temperature rises were approximated as a superposition sum of the respective quantities for one single antenna. During synchronous excitation, a superposition of complex electrical fields was performed with appropriate phasing to compute power deposition. Electric fields and temperatures from the pre-computed single-antenna library were utilized following appropriate non-rigid coordinate transformations. Comparison to 3D models indicated that superposition of electric fields around parallel antennas is valid when they are at least 15 mm apart. Phantom experiments with curved antennas produced temperature profiles quite similar to those created using the planning system.
The hyperthermia planning software allowed users to select power and phasing, assess the corresponding 3D contours of energy and temperature, and optimize treatment parameters through gradient search techniques. The system produces fairly accurate temperature distributions in cases when the antennas are at least 15 mm apart.
The proof-of-concept ultrasound applicators were designed for sub-xyphoid access to the pericardial space through a steerable 14-Fr sheath. The catheter consists of two rectangular planar transducers, for therapy (6.4 MHz) and imaging (5 MHz), mounted at the tip of a 3.5-mm flexible nylon catheter coupled and encapsulated within a custom-shaped balloon for cooling.
Thermal lesions were created in the LV in a swine (n = 10) model in vivo. The ultrasound applicator was positioned fluoroscopically. Its orientation and contact with the LV were verified using A-mode imaging and a radio-opaque marker. Ablations employed 60-s exposures at 15 – 30 W (electrical power). Histology indicated thermal coagulation and ablative lesions penetrating 8 – 12 mm into the left ventricle on lateral and anterior walls and along the left anterior descending artery.
The transducer design enabled successful sparing from the epicardial surface to 2 – 4 mm of intervening ventricle tissue and epicardial fat. The feasibility of targeted epicardial ablation with catheter-based ultrasound was demonstrated.
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