Quantum cascade laser thermal therapy guided by FDOCT

We demonstrate Fourier domain optical coherenc tomography （FDOCT） monitoring and guiding of quantum cascade laser （QCL） therapy. The laser therapy is performed with a 6.1-tim mid-IR QCL and it involves both tissue coagulation or ablation. FDOCT allows real-time monitoring that minimize unnecessary damage to the surrounding tissues. We perform lipid phantom tissue ablation, chicken egg yolk coagulation, and tissue and blood vessel coagulation on chicken embryo to validate the FDOCT guiding quantum cascade laser therapy.

Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation

AIM： To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome （IBS） accompanying predominant constipation. METHODS： A total of 3872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnare to collect personal data on social and occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic add breath test and as oro-cecal transit time for lactulose breath test. RESULTS： A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients, The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 （87.5%） of 56 dyspepUc patients. Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91 ± 12 （T1/2） and 53± 11 （T-lag）, Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study. CONCLUSION： Mineral water supplementation treatment for functional dyspepsia or conspipation accompanying IBS can improve gastric add output and intestinal transit time.

Advanced Treatment Planning in Cancer Thermal Therapies

CEM43 thermal dose is a very common concept in thermal oncology.Thermal dose is the maximum amount of energy that can be transmitted during hyperthermia therapy conducted on temperature-sensitive tissue.Thermal dose is also the maximum value of local energy accumulation in human bodies,which can lead to tissue injury and pain.Thermal dose can also decrease the finishing temperature and reduce the energy to the tolerable range.There are two functions of the individualized hyperthermia treatment plan:it determines the setting and location that can realize the best tumor hyperthermia therapy;at the same time,it can decrease the effect of hyperthermia therapy on healthy tissues.There are four steps in the treatment plan of hyperthermia therapy for tumors:the first step is to establish a three dimensional human body model and its corresponding an atomical structure that can be used in numerical algorithm via medical imaging resources;the second step is to determine the volume of the electromagnetic energy accumulation.Based on the peculiarity of frequency and materials,even full-wave electromagnetic wave or quasi-static technique can be used to determine the tissue distribution.Evaluation of the therapy can be conducted based on thermal dose and the corresponding tissue damage model;the third step is to use Arrhenius model to provide direct evaluation of tissues in the thermal ablation zone,solidification zone,as well as the necrotic area;the last step is the optimization of the treatment plan.

Mn-doped Ti-based MOFs for magnetic resonance imaging-guided synergistic microwave thermal and microwave dynamic therapy of liver cancer

Currently,precise ablation of tumors without damaging the surrounding normal tissue is still an urgent problem for clinical microwave therapy of liver cancer.Herein,we synthesized Mn-doped Ti MOFs(Mn-Ti MOFs)nanosheets by in-situ doping method and applied them for microwave therapy.Infrared thermal imaging results indicate Mn-Ti MOFs can rapidly increase the temperature of normal saline,attributing to the porous structure improving microwave-induced ion collision frequency.Moreover,Mn-Ti MOFs show higher 1O2 output than Ti MOFs under 2 W of low-power microwave irradiation due to the narrower band-gap after Mn doping.At the same time,Mn endows the MOFs with a desirable T1 contrast of magnetic resonance imaging(r2/r1=2.315).Further,results on HepG2 tumor-bearing mice prove that microwave-triggered Mn-Ti MOFs nearly eradicate the tumors after 14 days of treatment.Our study offers a promising sensitizer for synergistic microwave thermal and microwave dynamic therapy of liver cancer.

A low-cost invasive microwave ablation antenna with a directional heating pattern

Microwave ablation(MWA) is a cancer treatment method. The tumor tissue absorbs electromagnetic energy, which heats and kills it. A microwave ablation antenna plays a critical role in this process. Its radiation field must completely cover the tumor but not the healthy tissue. At present, the radiation pattern of most invasive ablation antennas is spherical.However, in the clinic, the shape of some tumors may be asymmetrical or the antenna cannot be inserted into the center of the tumor for some other reason. In order to solve these problems, a directional heating antenna for microwave ablation is proposed in this paper. The proposed antenna, operating at 2.45 GHz, consists of a monopole and a reflector. The feed is given by a substrate integrated coaxial line(SICL) and coplanar waveguide(CPW). The omnidirectional radiation field of the monopole is reflected by a reflector that is extended from the outer conductors of the SICL to form a directional radiation field. The impedance matching network is designed on SICL to match the antenna to 50 Ω. The antenna is fabricated using a mature printed circuit board(PCB). The reflection coefficient of the antenna in porcine liver tissue measured by a vector network analyzer shows good agreement with the simulations. Then, an ablation experiment in porcine liver is conducted with power of 10 W for 10 min, and the experimental results confirm the validity of the design.

Temperature imaging with speed of ultrasonic transmission tomography for medical treatment control:A physical model-based method

Hyperthermia is a promising method to enhance chemo and radiation therapy of breast cancer. In the process of hyperthermia, temperature monitoring is of great importance to assure the effectiveness of treatment. The transmission speed of ultrasound in biomedical tissue changes with temperature. However, when mapping the speed of sound directly to temperature in each pixel as desired for using all speeds of ultrasound data, temperature bipolar edge enhancement artifacts occur near the boundary of two tissues with different speeds of ultrasound. After the analysis of the reasons for causing these artifacts, an optimized method is introduced to rebuild the temperature field image by using the continuity constraint as the judgment criterion. The significant smoothness of the rebuilding image in the transitional area shows that our proposed method can build a more precise temperature image for controlling the medical thermal treatment.

Targeting nanoplatform synergistic glutathione depletion-enhanced chemodynamic,microwave dynamic,and selective-microwave thermal to treat lung cancer bone metastasis

Once bone metastasis occurs in lung cancer,the efficiency of treatment can be greatly reduced.Current mainstream treatments are focused on inhibiting cancer cell growth and preventing bone destruction.Microwave ablation(MWA)has been used to treat bone tumors.However,MWA may damage the surrounding normal tissues.Therefore,it could be beneficial to develop a nanocarrier combined with microwave to treat bone metastasis.Herein,a microwave-responsive nanoplatform(MgFe_(2)O_(4)@ZOL)was constructed.MgFe_(2)O_(4)ZOL NPs release the cargos of Fe^(3+),Mg^(2+)and zoledronic acid(ZOL)in the acidic tumor microenvironment(TME).Fe^(3+)can deplete intracellular glutathione(GSH)and catalyze H_(2)O_(2)to generate•OH,resulting in chemodynamic therapy(CDT).In addition,the microwave can significantly enhance the production of reactive oxygen species(ROS),thereby enabling the effective implementation of microwave dynamic therapy(MDT).Moreover,Mg^(2+)and ZOL promote osteoblast differentiation.In addition,MgFe_(2)O_(4)ZOL NPs could target and selectively heat tumor tissue and enhance the effect of microwave thermal therapy(MTT).Both in vitro and in vivo experiments revealed that synergistic targeting,GSH depletion-enhanced CDT,MDT,and selective MTT exhibited significant antitumor efficacy and bone repair.This multimodal combination therapy provides a promising strategy for the treatment of bone metastasis in lung cancer patients.

Ultrasound-guided microwave ablation for abdominal wall metastatic tumors: A preliminary study

AIM: To evaluate the feasibility, safety and efficacy of ultrasound-guided microwave (MW) ablation for abdominal wall metastatic tumors. METHODS: From August 2007 to December 2010, a total of 11 patients with 23 abdominal wall nodules (diameter 2.59 cm ± 1.11 cm, range 1.3 cm to 5.0 cm) were treated with MW ablation. One antenna was inserted into the center of tumors less than 1.7 cm, and multiple antennae were inserted simultaneously into tumors 1.7 cm or larger. A 21 gauge thermocouple was inserted near important organs which required protection (such as bowel or gallbladder) for real-time temperature monitoring during MW ablation. Treatment outcome was observed by contrast-enhanced ultrasound and magnetic resonance imaging (MRI) [or computed tomography (CT)] during follow-up. RESULTS: MW ablation was well tolerated by all patients. Six patients with 11 nodules had 1 thermocouple inserted near important organs for real-time temperature monitoring and the maximum temperature was 56 ℃. Major complications included mild pain (54.5%), post-ablation fever (100%) and abdominal wall edema (25%). All 23 tumors (100%) in this group were completely ablated, and no residual tumor or local recurrence was observed at a median follow-up of 13 mo (range 1 to 32 mo). The ablation zone was well defined on contrast-enhanced imaging (contrast-enhanced CT, MRI and/or contrast-enhanced ultrasound) and gradually shrank with time. CONCLUSION: Ultrasound-guided MW ablation may be a feasible, safe and effective treatment for abdominal wall metastatic tumors in selected patients.

Effect of hyperthermia combined with opioids on cancer pain control and surgical stress in patients with gastrointestinal cancer

BACKGROUND Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors.However,these patients generally expe-rience high levels of cancer pain,which can in turn stimulate the body’s stress and undermine the effect of external surgery.Although opioid drugs have a signifi-cantly positive effect on controlling cancer pain,they can induce adverse drug reactions and potential damage to the body’s immune function.Hyperthermia therapy produces a thermal effect that shrinks tumor tissues.However,its effect on relieving the pain of middle and late stage gastrointestinal tumors but also the stress of surgical palliative surgery remains unclear.AIM To investigate the effect of hyperthermia combined with opioids on controlling cancer pain in patients with middle and late stage gastrointestinal cancer and evaluate its impact on surgical palliative surgical stress.METHODS This was a retrospective study using the data of 70 patients with middle and late stage gastrointestinal tumors who underwent cancer pain treatment and surgical palliative surgery in the Ninth People’s Hospital of Suzhou,China from January 2021 to June 2024.Patients were grouped according to different cancer pain control regimens before surgical palliative surgery,with n=35 cases in each group,as follows:Patients who solely used opioid drugs to control cancer pain were included in Group S,while patients who received hyperthermia treatment combined with opioid drugs were included in Group L.In both groups,we compared the effectiveness of cancer pain control(pain score,burst pain score,24-hour burst pain frequency,immune function,daily dosage of opioid drugs,and adverse reactions),surgical palliative indicators(surgery time,intraoperative bleeding,stress response),and postoperative recovery time,including first oral feeding time,postoperative hospital stay).RESULTS Analgesic treatment resulted in a significant decrease in the average pain score,burst pain score,and 24-hour burst pain frequency in both Groups L and S;however,these scores were statistically significantly lower in Group L than in Group S group(P<0.001).Analgesic treatment also resulted in significant differences,namely serum CD4+(29.18±5.64 vs 26.05±4.76,P=0.014),CD8+(26.28±3.75 vs 29.23±3.89,P=0.002),CD4+/CD8+(0.97±0.12 vs 0.83±0.17,P<0.001),between Group L and Group S,respectively.The daily dosage of opioid drugs incidence of adverse reactions such as nausea,vomiting,constipation,and difficulty urinating were statistically significantly lower in Group L than those in group S(P<0.05).Furthermore,palliative surgery time and intraoperative blood loss in Group L were slightly lower than those in Group S;however,the difference was not statistically significant(P>0.05).On the first day after surgery,serum cortisol and C-reactive protein levels of patients in group L and group S were 161.43±21.07 vs 179.35±27.86 ug/L(P=0.003)and 10.51±2.05 vs 13.49±2.17 mg/L(P<0.001),respectively.Finally,the first oral feeding time and hospitalization time after surgery in group L were statistically significantly shorter than those in group S(P<0.05).CONCLUSION Our findings showed that hyperthermia combined with opioids is effective in controlling cancer pain in patients with middle and late stage gastrointestinal tumors.Furthermore,this method can reduce the dosage of opioids used and minimize potential adverse drug reactions,reduce the patient’s surgical palliative surgical stress response,and shorten the overall postoperative recovery time required.