Intra-luminal thermometry: Is tissue type assignment a necessity for thermal analysis?

Fatehi, Daryoush. and Van Der Zee, J. and Wielheesen, D.H.M. and Van Wieringen, W.N. and Van Rhoon, Gerard.C. (2006) Intra-luminal thermometry: Is tissue type assignment a necessity for thermal analysis? INTERNATIONAL JOURNAL OF HYPERTHERMIA, 22 (6). pp. 463-473.

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Introduction: Tissue type assignment, i.e. differentiation tumour from normal tissue, is a normal procedure for interstitial thermometry. In our department, thermometry in patients with a turnout in the lower pelvis is usually restricted to the intra-luminal tracks. It is unknown whether discrimination between normal and tumour tissue is relevant for deep regional hyperthermia thermal dosimetry using only intra-luminal tumour contact and tumour adjacent thermometry. This study has analysed the acquired temperature data in order to answer this question. Patients and methods: Seventy-five patients with locally advanced cervical carcinoma were selected randomly. Patients were treated with a two or three modality combination, i.e. radiotherapy + hyperthermia or radiotherapy + hyperthermia + chemotherapy from October 1997 to September 2003. The first 100 hyperthermia treatments fulfilling the only selection criterion: no displacement of the thermometry catheter along the insertion length during the treatment, were included in the study, resulting in 43 patients with one-to-five treatments/patient (median 2). Using RHyThM (Rotterdam Hyperthermia Thermal Modulator), for each single treatment tissue type, was defined on the basis of information given by a CT scan in radiotherapy position. A step change in the slope of the profile of the first temperature map was identified to verify the insertion length of the catheter. Results: The average T-50 (median temperature) in bladder tumour indicative, vagina tumour contact and rectum turnout indicative was 40.9 +/- 0.9 degrees C, 39.7 +/- 0.9 degrees C and 40.6 +/- 0.8 degrees C, respectively. The average normal tissue T50 in bladder, vagina and rectum was 40.8 +/- 0.9 degrees C, 40.11 +/- 0.9 degrees C and 40.7 +/- 0.8 degrees C, respectively. The differences between bladder tumour indicative T-50 and bladder normal tissue T-50 and also between vagina tumour contact T-50 and vagina normal tissue T-50 were significant (p = 0.0001). No statistical difference was found between rectum tumour indicative T-50 and rectum normal tissue T-50. Conclusion: At present the cause of the temperature difference is not known. However, as the difference between tumour (indicative/contact) and normal tissue is very small and considering also the inaccuracy in the tissue type assignment it can be stated that this study does not provide sufficient evidence to conclude that the statistical difference has clinical relevance. Therefore, it was concluded that at this time there is no need to differentiate between normal and tumour tissue in intra-luminal thermometry.

Item Type: Article
Uncontrolled Keywords: loco-regional hyperthermia; temperature monitoring; cervical cancer; tissue type assignment
Subjects: WN Radiology . Diagnostic Imaging
WP Gynecology
QZ pathology-Neoplasms
Divisions: Faculty of Medicine > Basic Sciences Academic Groups > Department of Medical Physics
Faculty of Medicine > Department of Clinical Sciences > department of hematology and ancology
Depositing User: Users 1 not found.
Date Deposited: 20 Aug 2017 03:15
Last Modified: 08 May 2018 06:26

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