Feasibility of A-mode ultrasound attenuation as a monitoring method of local hyperthermia treatment

  • Noraida Abd Manaf
  • Maizatul Nadwa Che Aziz
  • Dzulfadhli Saffuan Ridzuan
  • Maheza Irna Mohamad Salim
  • Asnida Abd Wahab
  • Khin Wee Lai
  • Yan Chai Hum
Original Article


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.


Local hyperthermia Monitoring One-dimensional ultrasound Total protein 



Magnetic resonance imaging


Computed tomography


Normal tissue with large predominance of cells


Cancer tissue with large predominance of cells


Cancer tissue with high collagen fiber content


High-intensity focused ultrasound








Sound of speed


Backscatter of coefficient


Acoustic radiation force impulse


Region of interest


Supersonic shear imaging


Effective scatterer diameter


Effective acoustic concentration


Pulse repetition frequency


Universiti Kebangsaan Malaysia Animal Ethics Committee




Comma-separated values


Matrix laboratory


Fast Fourier transform




Standard of error mean


Statistical Package for the Social Sciences


One-way analysis of variance


Excessive extracellular matrix


Power spectrum density


Deoxyribonucleic acid


Uman epidermal growth factor receptor 2



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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Copyright information

© International Federation for Medical and Biological Engineering 2016

Authors and Affiliations

  • Noraida Abd Manaf
    • 1
  • Maizatul Nadwa Che Aziz
    • 1
  • Dzulfadhli Saffuan Ridzuan
    • 1
  • Maheza Irna Mohamad Salim
    • 1
  • Asnida Abd Wahab
    • 1
  • Khin Wee Lai
    • 2
  • Yan Chai Hum
    • 3
  1. 1.Faculty of Biosciences and Medical EngineeringUniversiti Teknologi MalaysiaJohor BaharuMalaysia
  2. 2.Biomedical Engineering Department, Faculty of EngineeringUniversity of MalayaKuala LumpurMalaysia
  3. 3.MIMOS BerhadTaman Teknologi MalaysiaKuala LumpurMalaysia

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