Feasibility of A-mode ultrasound attenuation as a monitoring method of local hyperthermia treatment
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Abstract
Recently, there is an increasing interest in the use of local hyperthermia treatment for a variety of clinical applications. The desired therapeutic outcome in local hyperthermia treatment is achieved by raising the local temperature to surpass the tissue coagulation threshold, resulting in tissue necrosis. In oncology, local hyperthermia is used as an effective way to destroy cancerous tissues and is said to have the potential to replace conventional treatment regime like surgery, chemotherapy or radiotherapy. However, the inability to closely monitor temperature elevations from hyperthermia treatment in real time with high accuracy continues to limit its clinical applicability. Local hyperthermia treatment requires real-time monitoring system to observe the progression of the destroyed tissue during and after the treatment. Ultrasound is one of the modalities that have great potential for local hyperthermia monitoring, as it is non-ionizing, convenient and has relatively simple signal processing requirement compared to magnetic resonance imaging and computed tomography. In a two-dimensional ultrasound imaging system, changes in tissue microstructure during local hyperthermia treatment are observed in terms of pixel value analysis extracted from the ultrasound image itself. Although 2D ultrasound has shown to be the most widely used system for monitoring hyperthermia in ultrasound imaging family, 1D ultrasound on the other hand could offer a real-time monitoring and the method enables quantitative measurement to be conducted faster and with simpler measurement instrument. Therefore, this paper proposes a new local hyperthermia monitoring method that is based on one-dimensional ultrasound. Specifically, the study investigates the effect of ultrasound attenuation in normal and pathological breast tissue when the temperature in tissue is varied between 37 and 65 °C during local hyperthermia treatment. Besides that, the total protein content measurement was also conducted to investigate the relationship between attenuation and tissue denaturation level at different temperature ranges. The tissues were grouped according to their histology results, namely normal tissue with large predominance of cells (NPC), cancer tissue with large predominance of cells (CPC) and cancer with high collagen fiber content (CHF). The result shows that the attenuation coefficient of ultrasound measured following the local hyperthermia treatment increases with the increment of collagen fiber content in tissue as the CHF attenuated ultrasound at the highest rate, followed by NPC and CPC. Additionally, the attenuation increment is more pronounced at the temperature over 55 °C. This describes that the ultrasound wave experienced more energy loss when it propagates through a heated tissue as the tissue structure changes due to protein coagulation effect. Additionally, a significant increase in the sensitivity of attenuation to protein denaturation is also observed with the highest sensitivity obtained in monitoring NPC. Overall, it is concluded that one-dimensional ultrasound can be used as a monitoring method of local hyperthermia since its attenuation is very sensitive to the changes in tissue microstructure during hyperthermia.
Keywords
Local hyperthermia Monitoring One-dimensional ultrasound Total proteinAbbreviations
- MRI
Magnetic resonance imaging
- CT
Computed tomography
- NPC
Normal tissue with large predominance of cells
- CPC
Cancer tissue with large predominance of cells
- CHF
Cancer tissue with high collagen fiber content
- HIFU
High-intensity focused ultrasound
- 1D
One-dimensional
- 2D
Two-dimensional
- 3D
Three-dimensional
- SOS
Sound of speed
- BSC
Backscatter of coefficient
- ARFI
Acoustic radiation force impulse
- ROI
Region of interest
- SSI
Supersonic shear imaging
- ESD
Effective scatterer diameter
- EAC
Effective acoustic concentration
- PRF
Pulse repetition frequency
- UKMAEC
Universiti Kebangsaan Malaysia Animal Ethics Committee
- DMBA
7,12-Dimethylbenz(α)anthracene
- CSV
Comma-separated values
- MATLAB
Matrix laboratory
- FFT
Fast Fourier transform
- dB
Decibel
- SEM
Standard of error mean
- SPSS
Statistical Package for the Social Sciences
- ANOVA
One-way analysis of variance
- ECM
Excessive extracellular matrix
- PSD
Power spectrum density
- DNA
Deoxyribonucleic acid
- HER2
Uman epidermal growth factor receptor 2
Notes
Acknowledgments
The authors would like to express gratitude to the Ministry of Higher Education of Malaysia for granting the Fundamental Research Grant Scheme Vot 4F274 entitled “Investigation of One Dimensional Ultrasound Sensitivity as a Monitoring Method of Minimally Invasive Thermal Therapy” and Universiti Teknologi Malaysia for the Institutional Research Grants Vot 07J20.
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