Radiometry Controlled Conformal Array Heat Applicator

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Adjuvant hyperthermia has been shown effective when sufficiently high thermal doses are delivered in close association with radiation or drug therapies. In previous work, we developed lightweight Conformal microwave Array (CMA) applicators from flexible printed circuit board (PCB) material and 6 mm thick water plus layers for heating large area superficial disease. These applicators were designed for treating chestwall recurrence of breast carcinoma and superficial melanomas <1.5 cm deep, but may eventually find use for treatment of other common skin diseases such as plaque psoriasis. While controllable heating of large contoured areas with CMA applicators has recently become an established IRB-approved procedure at UCSF with excellent heating effectiveness and patient acceptance, more widespread use awaits an improved patient interface that simplifies treatment setup and thermal monitoring/control of the large number of independent heat apertures. Thus, collaborative efforts have completed preliminary development of a microwave radiometer for non-invasive monitoring of subsurface tissue temperature. In this proposal, we plan to optimize the patient interface of current CMA applicators to allow integration of non-invasive temperature monitoring under each independent heat source. Such "Dual Mode" applicators will be characterized in terms of uniformity of power deposition and accuracy of temperature monitoring in chestwall tissue phantoms and comprehensive in vivo temperature distribution measurements in a small number of animals. Finally, applicator functionality in the clinic will be evaluated for improved operator convenience as well as for uniformity of heating, patient tolerance, and toxicity of higher minimum thermal dose treatments. The underlying goal of this development is to rekindle and significantly expand the use of hyperthermia therapy for superficial disease, a treatment that has been proven effective in randomized clinical trials but has stalled awaiting introduction of an easy to use applicator capable of effective heating of small areas with high resolution control, or large areas overlying contoured anatomy. Because of important new capabilities of integrated non-invasive volume-averaged tissue temperature monitoring and automatic self-balancing of applicator output, this applicator should facilitate new clinical protocols with exciting potential for improved therapy of diffuse superficial disease, such as longer duration low level heat in combination with systemic chemotherapy, heat enhanced drug delivery, and heat applied simultaneously with external beam radiation.
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