増永 慎一郎, 平岡 真寛, 李 宇萍, 西村 恭昌, 光森 通英, 小石 元紹, 岡嶋 馨, 永田 靖, 阿部 光幸, 伊藤 公一, 古屋 克巳, 葛西 晴雄, 寺川 隆成, 近藤 正博
日本ハイパーサーミア学会誌 9(2) 115-124 1993年
We have developed a microwave coaxial ring-slot applicator for interstitial hyperthermia and have tested it on muscle-equivalent agar phantoms. Based on these results, the clinical use of this applicator was evaluated in animal experiments and in combination with operation of a clinically used microwave hyperthermia system.<BR>The applicator delivers 400-430 MHz microwaves produced by a signal generator (Type 8656A Hewlett Packard Co.) and a power amplifier (RF Power Labs Inc.), and is made of a 0.86 mm coaxial semirigid cable. Several ring slots, which radiate microwave power into the surrounding tissue, are placed at equidistant intervals along this semirigid cable on the outer conductors, and the tip of the coaxial cable is short-circuited to expand the terminal heating region. This antenna can be inserted into a 21 G plastic catheter and the specific absorption rate (SAR) distribution along it can be changed by adjusting the parameters of the slots. The applicator inside a catheter was inserted into normal rabbit muscles and into VX-2 tumors implanted in the thighs of rabbits. Temperature distributions were measured by fluoroptic thermometers (Luxtron model 3000) or thermocouples. The locations of the antennas and thermal probes were identified by CT scanning after heating, and the thermal distribution was obtained by a combination of computer simulation and the raw thermometry data.<BR>When a single antenna (6 cm active length) was inserted into the muscle and supplied with a power of 20 watts for 6 minutes, it heated the tissue in a radius of 13 mm along the applicator to >42°C. Two antennas (4 cm active length) were inserted 2 cm apart into a 5.5x 4x 3 cm tumor, and four were inserted into a 7x 6x 2cm tumor at 0.5-cm intervals. Almost all regions of each tumor were heated to > 41°C. Histological examination of the tumors 3 days after heating showed necrosis, nuclear pyknosis and endthelial destruction with hemorrhage in the areas heated to > 43°C on the computerized temperature simulation made using thermometry data. Moreover, 5 applicators (4cm active length, 4 on the corners of a square with 4 cm sides and 1 at the center) were horizontally inserted into a tumor with a diameter of 5 cm, and operated at a power of 60 watts for 5 minutes, followed by 55 watts for 5 minutes and 50 watts for 8 minutes. Almost all parts of the tumor were heated to >41°C. Finally, 4 applicators (4cm active length) were longitudinally inserted into a tumor with a diameter of 8 cm at 3-cm intervals, and supplied with a power of 30 watts for 8 minutes and then 20 watts for 2 minutes. Almost all parts of the tumor were heated to >43°C.<BR>These animal experiments demonstrated several advantages of this newly-developed microwave applicator, including a relatively large heating area when multiple applicators were used, relatively uniform heating along the applicator, and the small diameter of the applicator. Moreover, this applicator could operate using microwaves generated by a 430 MHz microwave hyperthermia system with an electric field converging (lens) applicator, which is already clinically used for heating localized subsurface tumors in some institutions.<BR>The feasibility of this applicator for clinical use appears worth investigating further. It is seems possible that interstitial hyperthermia using the ring-slot array applicator may eventually be performed in combination with intraoperative radiotherapy by implanting angiocatheters into tumors at operation, or else it could be applied after an angiocatheter was inserted under CT guidance.