Radiometry Controlled Conformal Array Heat Applicator

描述(申请人提供)：当足够高的热剂量与放射或药物治疗密切相关时，辅助热疗已被证明是有效的。在之前的工作中，我们用柔性印刷电路板(PCB)材料和6 mm厚的水加层开发了轻型共形微波阵列(CMA)敷贴器，用于加热大面积表面疾病。这些敷贴器被设计用于治疗乳腺癌和1.5厘米深的浅表黑色素瘤的胸壁复发，但最终可能会被用于治疗其他常见的皮肤病，如斑块状牛皮癣。虽然使用CMA敷贴器对大的轮廓区域进行可控加热最近已成为加州大学旧金山分校IRB批准的程序，具有出色的加热效果和患者接受度，但更广泛的应用还有待改进的患者界面，以简化治疗设置和对大量独立热孔的热监测/控制。因此，合作努力已经完成了用于非侵入性监测地下组织温度的微波辐射计的初步开发。在这项建议中，我们计划优化现有CMA敷贴器的患者界面，以允许在每个独立热源下集成非侵入性温度监测。这种“双模式”敷贴器的特点是能量沉积的一致性和胸壁组织模体温度监测的准确性，以及在少数动物体内全面的温度分布测量。最后，将评估临床中的敷贴器功能，以改善操作员的便利性，以及加热的一致性、患者耐受性和更高最小热剂量治疗的毒性。这一发展的基本目标是重新启动并显著扩大热疗对浅表疾病的使用，这种治疗已在随机临床试验中被证明有效，但已陷入停滞，等待一种易于使用的敷贴器的推出，该敷贴器能够通过高分辨率控制对小区域或覆盖在轮廓解剖上的大区域进行有效加热。由于集成的无创体积平均组织温度监测和敷贴器输出的自动自我平衡的重要新功能，该敷贴器将促进具有改善弥漫性表浅疾病治疗的令人兴奋的潜力的新的临床方案，例如更长时间的低水平热疗结合全身化疗，热增强药物输送，以及同时热疗与外照射。

DESCRIPTION (provided by applicant): 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.