Microwave Array Applicator for Radiometry Controlled

Superficial Hyperthermia
Paul R StaufferBa, Svein Jacobsenb, and Daniel Neuman*a
a
Dept. of Radiation Oncology, Univ. California, SF; b Institute of Physics, Univ. Tromso, Norway

ABSTRACT

Hyperthermia therapy has been shown clinically effective for a variety of skin diseases but current heating equipment is
inadequate for most patients. This effort describes the design and performance of a flexible microstrip array applicator
intended for heating large regions of tissue over contoured anatomy while at the same time monitoring temperature of the
underlying tissue by non-invasive radiometric sensing of blackbody radiation from the heated volume. For this dual purpose
applicator, an array of broadband Archimedean spiral receive antennas is integrated into an array of Dual Concentric
Conductor heating apertures. Applicator heating uniformity is assessed with electric field scans in homogenous muscle
phantoms and with measured temperature distributions in clinical treatments of chestwall recurrence of breast carcinoma.
The data demonstrate precisely controlled heating out to the perimeter of large (40 x 13 cm2) multiaperture conformal array
applicators. Capabilities of the radiometry system are assessed by correlation of brightness temperatures measured in
phantom loads of known temperature distribution as seen through an intervening 5 mm thick water bolus at constant 40°C.
The radiometer demonstrates excellent sensitivity and an accuracy of +0.1-0.45°C for temperature measurements up to 5 cm
deep in phantom when using a one dimensional weighting function analysis and up to 6 independent 500 MHz bandwidths
within the 1-4 GHz range. The data clearly indicate that both heating and radiometric thermometry are possible using the
same thin and flexible printed circuit board microstrip array applicator. Once development is complete, this dual mode
conformal array applicator with multiplexed radiometric display system should provide significantly improved uniformity
and ease of heating large area superficial tissue disease.

Keywords – Radiometry, Microwave Applicator, Conformal Array, Superficial Hyperthermia, Noninvasive Temperature
Measurement

1. INTRODUCTION
There are many diseases and conditions of the skin and underlying superficial tissues which may benefit from the addition of
local heat1-3. Moderate temperatures of just 42-45°C for 1 hour (or thermal doses of about CEM43T90 = 15-240 min) have
been shown effective in the fight against cancer when delivered in conjunction with radiation or chemotherapy. Clinical
trials of adjuvant hyperthermia have demonstrated statistically significant improvement in complete response rates for small
tumors but have failed to make a major impact on the disease due to limitations in the size and location of tumors that can be
heated effectively with current equipment. Similar difficulties with uniform heating of large contoured areas of the body
have restricted use of moderate temperature hyperthermia therapy for other clinical conditions such psoriasis, which also has
been shown responsive to heat4-6.

This report provides an update on the development of a lightweight and flexible printed circuit board (PCB) microstrip array
applicator that has been designed to heat large area superficial disease located over contoured anatomy while simultaneously
performing microwave radiometry measurements of the underlying tissue temperature for feedback control of all array
elements.. The heating capabilities of small subsections of such an array applicator have been reported previously in the form
of FDTD simulations and experimental measurements of power deposition (SAR) patterns in homogenous muscle7-10 as well
as more realistic heterogeneous tissue loads11. The SAR patterns have been translated into expected temperature distributions
for a range of appropriate blood perfusion conditions using finite difference solutions of the bioheat equation in Rossetto et.
al.7. Although this Dual Concentric Conductor (DCC) based microstrip applicator was originally designed for use at 915

f stauffer@radonc17.ucsf.edu; http://itsa.ucsf.edu/~radonc/paulst.html; phone 415-476-4877; fax 415-502-5175; Radiation Oncology

Dept, San Francisco CA, 94143;
 svein,jacobsen@phys.uit.no; phone +47 776 45164; fax +47 776 45580; Institute of Physics, Faculty of Science N-9037 Tromso, Norway

Thermal Treatment of Tissue: Energy Delivery and Assessment, Thomas P. Ryan, Editor,
Proceedings of SPIE Vol. 4247 (2001) © 2001 SPIE · 1605-7422/01/$15.00 19

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 MHz, the feasibility of using the same conformal array antenna in foreign countries at an operating frequency of 433 MHz
has also been investigated12. Although these publications allude to the possibility of heating large areas with 32 individually
controlled microwave power sources, clinical use has been hampered by the requirement for tedious thermal mapping of
discreet fiberoptic temperature probes across the array surface to monitor temperatures and control power of the numerous
array elements. Thus, the concept of a dual mode applicator with both heating and non-invasive thermometry capabilities
was introduced13-16. This presentation summarizes the current status of the design, construction and performance evaluation of
the separate heating and radiometric capabilities of large conformal microwave array applicators, as measured in phantom
models and preliminary clinical investigations.

2. MATERIALS AND METHODS

2.1 Large Area Conformal Array Applicator
The current effort considers two closely related multilayer PCB microstrip applicators that represent the current state
of the art for Conformal Microwave Array (CMA) applicators. The first design shown in Fig. 1 consists of a 0.2 mm thick
flexible two layer PCB with an array of 2.5 mm wide slot apertures etched from an otherwise solid copper ground plane on
the front radiating side of the applicator, and an impedance optimized network of microstrip feedline structures etched from
the rear copper surface. The 9 x 3 array of 3 cm square apertures spaced 1.5 cm apart seen in Fig. 1a produces an effective
radiating surface area of 13 x 40 cm2. Fig. 1b shows the associated microstrip feedline network which incorporates several
impedance matching techniques necessary to optimize transmission of microwave power from the RF connectors mounted on
one edge of the PCB to the 27 independently powered antennas. Each microstrip feedline splits twice to feed the center of
each side of the square slot apertures. The apertures are excited by capacitive coupling of energy from the driven patches in
the back layer to isolated patches of matching size and position on the front surface. This excitation scheme creates an
intense radially oriented electric field across each aperture gap which has been determined in previous theoretical and
experimental studies to produce the most uniform power deposition patterns in tissue under square DCC aperture antennas8-11.

3 cm Driven
Patch
1.5cm
2.5mm

Ground RF Connectors
Plane To Coax Cable

λ/4 Matching
43 cm Sections
Radiating
Aperture

39 cm
Meander
Lines

21 cm 12 cm
(a) (b)
Fig. 1 – Diagram of two layer Conformal Microwave Array applicator: a) Front radiating surface of 0.2 mm thick flexible PCB showing
27 element array of 3 cm square DCC apertures etched from copper ground plane; b) Corresponding back layer of PCB showing controlled
impedance microstrip feedline network to distribute microwave power equally to all apertures of the array.

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 In order to drive each aperture with equal power, efficiently and with minimal self-heating of the PCB and coaxial cable
feedlines, the feedline network of Fig. 1b was designed with three primary impedance matching features in addition to using
appropriate line width for 50Ω characteristic impedance microstrip transmission lines. Before the optimized feedline
network of Fig. 1b could be designed, a similar but non-optimized 3 cm array test applicator with constant width 50 Ω
microstrip feedlines was built and placed over a muscle tissue load with 6 mm thick water coupling bolus. Using the time
domain mode of an HP8753C Microwave Network Analyzer to gate out the effects of the long microstrip feedline and
intermediate discontinuities, the driving point edge impedance of one side of a 3 cm square DCC aperture was determined to
be Zin = (45.8 – 2.8j) Ω at 915 MHz. This was determined by cutting away the branching path at each feedline split and
leaving just one continuous trace from an RF connector to one side of a patch. The three design features used to balance the
power distribution feedline network were: i) -3db equal power splitting Tee junctions; ii) quarter-wavelength matching
transformers; and iii) meander lines. These structures are standard engineering practice in microstrip design and so their
implementation in this applicator will be described functionally but not in theory.

The function of the feedline network is to carry microwave power from RF coaxial connectors mounted on one edge of the
PCB through microstrip feedlines to the independent DCC radiators, with minimum loss and signal reflections. Previous
prototype CMA applicators14, 17 used fixed width microstrip lines with line width calculated for the 50Ω characteristic
impedance of the PCB substrate at 915 MHz. The 50Ω line widths were maintained throughout the splits from one to two and
two to four lines to feed the center of each side gap of the square DCC aperture. The feedlines also varied in length
depending on aperture position within the array, leading to higher signal losses for apertures at the far end of large arrays.
While this configuration provided adequate excitation of the DCC apertures and could be balanced with independent power
level adjustments, it was not impedance matched and led to widely variable signal reflections and return loss |S11| = (–12.3 +
4.7) dB depending on position within the array. For the impedance optimized applicator of Fig. 1, a controlled impedance
feedline network was formed by using variable width microstrip lines. Since the driving point impedance of the patch was
determined to be almost entirely resistive (Zin = 45.8 − 2.8j Ω), microstrip lines with 46 Ω characteristic impedance line
width were used from the four sides of the driven patch to the first pair of Tee junctions where the line width doubled to form
two 23Ω lines. The line widths doubled again at the second pair of Tee junctions to form a short stub of 11.5Ω impedance.
At that point, a quarter wave matching transformer section was inserted into the line to convert the 11.5Ω input impedance of
the primary splitter to appropriate 50Ω characteristic impedance width for the remainder of the feedline running to the RF
connector. Finally, in order to achieve equal radiation from each of the apertures for equal input power levels, meander line
sections were inserted into the shorter feedlines to produce equivalent length (and attenuation) connections for each aperture
of the array. These improvements are barely visible in the Fig. 1b drawing since for this very thin PCB, the microstrip lines
varied from 0.09 mm to 0.27 mm in width for corresponding characteristic impedances of 50Ω and 11.5Ω.

2.2 Dual Mode Applicator

In order to accommodate simultaneous microwave radiometry, the applicator design of Fig. 1 was modified to form a Dual
Mode applicator with both transmit and receive capabilities. Because the electric field radiating from a DCC aperture is
generated across the narrow slot aperture, there is no need for continuous copper in the interior of the inner square patch.
Thus for a Dual Mode applicator, the central copper region of each DCC aperture may be replaced by a second antenna
structure, an Archimedian spiral, located concentrically inside the thin square DCC inner conductor rim. A 2-layer Dual
Mode antenna design was presented previously14 which suffered from the requirement to solder bulky SMA connectors and
attach awkward coaxial cables to the back surface of the array, significantly altering the lightweight characteristics of the
array. Subsequently, a 3-layer flexible PCB array was constructed with sixteen 4 cm square DCC apertures formed by
etching away 2.5 mm wide slots from the otherwise intact front surface ground plane. In this configuration, the radiating
slots are fed with 915 MHz power by microstrip feedlines in the middle copper layer which extend from RF coaxial
connectors mounted on one edge of the PCB across the middle layer towards the driven patch where they each split twice
before connecting to the center of each of the four sides. For this design, the inner conductor of each front surface DCC
aperture is formed not with a square copper patch but rather by a 2.5 mm wide rim of copper with an outer perimeter that
exactly matches the middle layer powered patch. The back copper layer consists of 16 additional microstrip feedlines
extending from separate coax connectors at one end of the PCB through vias in the three layers to connect electrically to the
centers of the front surface spirals. Construction details of one dual antenna element of this 3-layer applicator are shown
diagramatically in Fig. 2. For this configuration, the middle layer patch performs two separate functions during the time-
sequenced heating and radiometry cycles. During the heating period, the patch serves to capacitively couple microwave
power from the microstrip feedline to the front surface DCC antenna inner conductor rim. During the radiometry mode,

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 electrical connection to the middle layer patch is switched to signal ground and it serves as a ground plane for the front
surface microstrip spiral which is connected to the radiometer receiver via the rear surface feedline. The completed
applicator is a 4x4 repetitive array of the individual elements diagrammed in Fig. 2.

(a) (b)
Fig. 2. (a) Diagram of the three layer Dual Mode antenna design. The middle layer square patch is the same size as the front surface inner
conducting rim of the DCC aperture and capacitively couples microwave power to the front surface DCC aperture gap. In this
configuration, the patch alternately acts as ground plane for the front surface spiral receive antenna. Microstrip feedlines in the back layer
connect through vias to the front surface spirals. (b) Perspective view from behind the 3 layer PCB antenna.

Fig. 3 shows a physical realization of a 3 layer flexible PCB conformal microwave array applicator as proposed in the Fig. 2
schematic. The total thickness of the array is less than 0.2 mm and is highly conformal, even with the associated 6 mm thick
water coupling bolus. The performance of this 3 layer Dual Mode antenna array is characterized in terms of SAR patterns in
muscle phantom from the square DCC apertures, and in terms of the sensitivity and accuracy of radiometric temperature
measurements possible in simple phantom loads from the concentrically mounted Archimedean spiral antennas.

Fig. 3 – Three layer PCB Dual Mode applicator showing spiral antennas etched concentrically inside the square DCC apertures on the front
patient side of the flexible array, the middle copper layer microstrip feedline network, and the rear layer with single feedlines connecting to
the front surface spirals through vias in the center of each driven patch.

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 For either two or three layer applicator configurations, the individual DCC elements are spaced 1.5 cm apart when using a
water bolus layer of 6 mm thickness and 915 MHz operating frequency, as determined from previous theoretical design
optimization studies7. For clinical use, the PCB array is placed on top of a 6-9 mm thick coupling bolus which is contained in
a custom fitting plastic bag with tubing connections for circulating temperature regulated 42.5°C water, and elastic straps for
maintaining its position over the intended anatomy. After placing catheters for temperature mapping across the skin surface,
the bolus and PCB array are covered with a stretchable fabric (e.g. Spandex sport shirt, ace bandage) to hold everything in
place over the desired treatment site. This enables effective heat treatment of the patient while in a sitting, standing (pacing),
or prone position.

2.3 Applicator Performance Evaluation

During the course of this investigation, two similar techniques were used to characterize radiated fields from the antennas.
For individual antennas under consideration as radiometry receivers, radiation patterns were measured in 6 g/l saline solution
using various excitation frequencies between 915 MHz and 4 GHz. The larger DCC aperture arrays were characterized under
conditions which mimic the clinical requirements by powering the apertures with independent 915 MHz sources at
approximately 10 Watts per aperture, with the array placed adjacent to a 6 mm thick water bolus layer inside a 30x38x60 cm3
tank of liquid muscle tissue-equivalent phantom18. In either case, the antenna radiation patterns were measured with a
miniature (~4 mm dia.) electric field probe which gives an output signal proportional to E2. Because all three E field
components were measured, the output was proportional to power deposition (SAR ∝ Ex2 + Ey2 + Ez2). The field probe was
raster scanned through the liquid phantom in 1-2.5 mm increments in a plane 1 cm from the surface of the water bolus, with
measurements extending 10-20 mm beyond the outer perimeter of the aperture(s). Accuracy and validity of this SAR
mapping procedure have been described previously19.

For characterizing the radiometric capabilities of the Dual Mode applicator, a Dicke null-balancing radiometer was
constructed with an operating frequency range of 1-4 GHz. The integration bandwidth was fixed at 500 MHz and during the
course of these experiments radiometric measurements were made in up to six bands, with center frequencies ranging from
1.25-3.75 GHz. Integration time for the measurements in this study ranged from 2-5 seconds, with a sampling (recording)
time of up to 40 sec per frequency band. Considering the internal noise specifications of the prototype system, the
temperature resolution of the radiometer was estimated to be 0.056°C, which was similar to that measured experimentally.
Details regarding the theory and construction of this radiometer circuit are presented elsewhere15. For initial tests of the
radiometer capabilities, two different experimental configurations were used. The first configuration consisted of the Dual
Mode antenna element of Figs. 2,3 placed flush against a 0.2 mm thick polyurethane bag containing a 6 mm thick layer of
temperature controlled deionized water at 40°C, on top of a 5 cm thick bag of deionized water which served as a variable
temperature object under investigation. Radiometer measurements were recorded as a function of water load temperature for
both the DCC and spiral antennas, for comparison of efficiency and sensitivity of the two antenna structures. Because the
test laboratory is located <500 m from a high-power radio transmission tower, the measurement setup was
electromagnetically shielded from outside environmental interference by surrounding the antennas and load with a simple
shield made from four layers of shieldcloth fabric (EMF Inc., Ghent, NY) which was loosely stitched together at the sides
with thin copper thread. With a thickness of only 0.15 mm, the shield fabric is lightweight and conformal, similar to regular
shirt fabric. This simple phantom was used for initial determinations of sensitivity and accuracy of the radiometer and
receive antennas in a well-defined homogenous temperature load.

A second phantom configuration was constructed in order to establish a load with more complex thermal distribution under
the antenna. Fig. 4 shows the depth cross section of a 20 x 20 x 9 cm3 test phantom with 50°C heating plate covering the
bottom of an insulated box of TX-150 muscle-equivalent phantom, and a 10 x 16 cm2 water bolus held at 40°C centered on
the top surface. In steady state, a temperature gradient was established vertically between the two sources with little variation
in temperature horizontally. This created a nearly linear temperature gradient with depth down the center of the insulated
box, falling off slightly more rapidly near the upper surface where the temperature controlled bolus did not completely cover
the surface. The phantom was implanted with a vertical row of thermistors just off center for measuring temperature as a
function of depth below the water bolus. The radiometer was connected to the inner Archimedean spiral of a Dual Mode
antenna element (Figs. 2, 3) which was positioned on top of the 6 mm thick upper bolus in a symmetric location on the non-
instrumented side of phantom, to avoid interference from the implanted thermistor probes.

In order to characterize tissue temperature distributions during clinical use of large CMA arrays, sufficient invasive
thermometry was clearly not possible. Instead, fiber optic temperature sensors were pulled in 1 cm increments along 4-8 #20
ga catheters which were placed in intimate contact with the tissue surface and water bolus, crossing under and between rows

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 of DCC apertures. Temperatures were recorded manually to produce linear temperature profiles under the arrays, once
essentially steady state conditions were reached. Previous investigations have correlated such skin surface measurements
with subsurface tissue temperatures and shown good correlation for depths less than 5-10 mm when using a coupling bolus
temperature close to the desired tissue temperature20-22. Following implementation of time-multiplexed radiometry into the
conformal array applicators, this thermal mapping technique will be used to correlate the surface temperature distribution
with radiometer measurements of sub-surface temperatures, rather than to control the power levels of each aperture.

RADIOMETER

'&&5,0
63,5$/

40°C WATER

50°C

Fig. 4 – Test phantom to establish known temperature gradient for radiometric measurements of brightness temperature.

3. RESULTS AND DISCUSSION

3.1 Single Antenna Radiation Patterns

Fig. 5 shows the power deposition patterns measured in 6 g/l saline phantom for one of the Figs. 2,3 Dual Mode antenna’s 4
cm square DCC apertures at the intended operating frequency of 915 MHz. Note the broad central plateau between 50 and
75% of maximum SAR and the peripherally enhanced 4 corner peak SAR pattern characteristic of DCC apertures when
excited by feedlines at the center of each side of a square patch radiator. Since the pattern falls off rapidly just outside the
aperture boundary (dashed line) and thermal conduction and convection effects in tissue tend to fill in temperature centrally
from a peripherally peaked SAR distribution, the DCC aperture appears well-suited for use as a building block element of
multiaperture arrays. Comparison of SAR from a direct contact aperture (Fig. 5a) with that of a water bolus coupled aperture
(Fig. 5b) reveals little effect on the power deposition pattern from the 5 mm thick bolus layer necessary for controlling skin
surface temperatures in the clinic. Fig. 6 shows corresponding SAR patterns 1 cm deep in 6 g/l saline phantom for the
concentrically mounted 2.8 cm diameter Archimedian spirals tested with the same 5 mm water bolus at: (a) 1310 MHz and
(b) 2540 MHz. While the spiral radiation pattern is nicely directional along the central beam axis at the lower frequency, the
central peak is attenuated at higher frequencies producing a broader mutipeak pattern more similar to the DCC aperture.
Thus if a spiral receive antenna placed on the back side of a 5 mm water bolus layer is used for radiometry, it will collect its
temperature dependent signal primarily from tissues under the aperture center at lower more penetrating frequencies, and
from an increasingly broader area of the DCC heated region more superficially at higher sense frequencies. In normal use of
the dual mode applicator, these are the locations of optimum temperature monitoring – superficially under the aperture gap to
sample maximum tissue temperatures and more deeply under the aperture center to monitor minimum target temperatures.

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 (a) (b)
Fig. 5. SAR distribution 1 cm deep in saline phantom for a 4 cm square DCC aperture at 915 MHz. Contour lines are at 25%, 50%, and
75% SARmax and the dashed line represents the DCC perimeter. (a) DCC in direct contact with phantom load; (b) DCC coupled with 5
mm water bolus.

(a) (b)
Fig. 6 – SAR distributions 1 cm deep in saline phantom from PCB 2.8 cm diameter Archimedian spiral coupled through 5 mm water bolus:
(a) 1310 MHz and (b) 2450 MHz. Contour lines at 25, 50, and 75% SARmax. Dashed line denotes perimeter of surrounding DCC aperture.

3.2 Radiometry Capabilities

Results are given for two experiments which quantify overall sensitivity of the prototype radiometer system. Fig. 7 looks at
the radiometer “brightness temperature” response as a function of variable water load temperature for both the spiral receive
antenna as well as the DCC heating aperture for reference. For this test, the signal was integrated for 5 seconds over a 500
MHz bandwidth with a center frequency of 2.25 MHz. As expected, the broadband spiral demonstrates more linear
correlation of radiometer output with load temperature, and about 75% higher sensitivity than the DCC aperture. The
resolution (accuracy) of determining true water load temperature through the 5 mm thick fixed temperature coupling bolus is
+0.14°C for the spiral and +0.48°C for the DCC antenna. Radiometer measurements over three other frequency bands
produced similar accuracy of brightness temperature measurements, ranging from +0.14-0.19 for the spirals and +0.48-
2.09°C for the DCC apertures. The data demonstrate that at least the spiral antennas provide adequate temperature resolution
from the radiometer in 5 seconds or less for a single band radiometer. This excellent accuracy is possible since the
radiometer is interrogating a homogeneous load at homogeneous temperature.

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 Temperature Rise of Test Medium (°C)
Fig. 7. Measured increase in brightness temperature for DCC (circles) and spiral (bullets) antennas interrogating a homogeneous deionized
water load of variable temperature viewed through a 5 mm thick water bolus at fixed 40°C. Radiometer integration time is 5 sec for a 500
MHz bandwidth at a center frequency of 2.25 GHz.

To assess the radiometric capabilities of Dual Mode applicators for determining temperature at depth in tissue with variable
temperature, the more complex test configuration of Fig. 4 was used. Because the phantom temperature varied within the
sense region of the spiral, the radiometer was used at multiple frequencies to gain information about temperature as a
function of depth. With minimal variation of temperature laterally across the insulated phantom cross section, a one
dimensional weighting function analysis was used to convert spiral antenna receive signals to effective brightness
temperature. Using this 1-D analysis, Fig. 8 shows the accuracy of estimating phantom temperature at various depths using a
radiometer with 6 independent 500 MHz measurement bands centered at 1.25, 1.75, 2.25, 2.75, 3.25, and 3.75 GHz. For this
experiment, 200 samples were taken over a period of 40 sec for each frequency band. This oversampling produced excellent
correlation of average measured brightness temperature with true phantom temperature, as seen by comparing the solid and
dashed lines for two independent temperature distributions shown in Fig. 8. Even the one standard deviation variation of the
200 samples was within + 0.11°C of predicting true phantom temperature at a depth of 1 cm and + 0.45°C at 5 cm depth.

Depth in Phantom (mm)

Fig. 8 – Estimated temperature profiles for two different distributions in the phantom load of Fig. 4, obtained from radiometric
measurements at 6 bands with center frequencies ranging from 1.25-3.75 GHz. (•) initial temperature profile; dashed lines represent the
average value of brightness temperatures determined from 200 samples at each of 6 bands using 1-D analysis; dotted lines represent one
standard deviation variation of the statistical sampling; solid line is LMS fit to (°) thermistor measured true phantom temperatures.

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 3.3 Large Conformal Array SAR Distributions
Previous publications have shown SAR patterns for single element and small sub-arrays of DCC aperture antennas. For the
current effort, a 15 element subsection of the large 40 x 13 cm2 array of Fig. 1 was driven with independently controlled 915
MHz sources in order to demonstrate both the uniform power deposition capabilities of multiple adjacent DCC apertures as
well as the ability to shape SAR patterns when desired to avoid heating critical tissues under the array. Using just five of the
nine rows of apertures in the large array of Fig. 1, the pattern of Fig. 9 was obtained by turning off the upper and lower
elements of the second column and the entire fourth column of DCC apertures to obtain a clearly recognizable pattern of
power deposition at this 1 cm depth measurement plane in muscle phantom. Note the close conformance of the 50% SAR
contour with the outer perimeter of DCC apertures which are shown to scale on the contour plot. As shown previously, the
area within this 50% SAR contour at 1 cm depth in muscle phantom should correspond with effectively heated area to a
depth of 1 cm in clinical use of the array7. While some power deposition occurs under the edges of non-powered apertures
due to unavoidable beam divergence with depth in tissue, the SAR is in general well-localized to the tissue underlying the
powered apertures. This precise beam shaping ability of CMA applicators should be useful in clinical applications such as
heating chestwall disease overlying the spinal cord or clavicle in thin patients. While an earlier non-optimized 3 cm DCC
array required a highly variable 15.1 + 4.2 Watts of power to the various apertures to obtain equal output, the controlled
impedance applicator of Fig. 1 required only 7.3 + 0.37 Watts to the apertures for an equivalent (therapeutic) level of SAR
output. With over twice the efficiency and one fifth the variability of older applicators, the controlled impedance array
facilitates production of uniform heating under large arrays.

25

50
75

Fig. 9 SAR pattern 1 cm deep in muscle phantom from a 3 x 5 array of 3 cm square apertures with 9 mm thick water bolus. 5 of 15
apertures were turned OFF to demonstrate the pattern shaping ability of the array which is only a portion of the complete 27 aperture 40 x
13 cm2 array. The three bold lines are 25%, 50% and 75% of SARmax, indicating that the effective heating area of the applicator extends
out a few mm past the perimeter of the driven elements.

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 During clinical use of conformal array applicators in heterogeneous tissue, the temperature distributions are unavoidably
altered from the power deposition patterns determined in homogeneous phantom studies. Even so, with independent power
control of each aperture, the distributions in superficial tissue within 5-10 mm of the surface may be quite uniform under
large CMA arrays due to thermal conduction and convection smearing of the power deposition peaks under the array. Fig. 10
gives the surface temperature distribution mapped across the array under several rows of DCC heating apertures when the
array was coupled to a chestwall recurrence tumor with a 6 mm thick water bolus vest maintained at constant 42.5°C during
the 1 hour hyperthermia treatment. Microwave power (~ 10 Watts per aperture) was delivered to the applicator with 16
independently controlled non-coherent sources at 915 MHz. With the conformal array and associated circulating water bolus
wrapped around the back and side of the patient and held in place with an overlying elastic shirt, the data demonstrate the
ability to heat large tissue regions uniformly to therapeutic temperatures between 42 and 45°C even over contoured
heterogeneous tissue.

Fig. 10. Temperatures measured on the surface of a chestwall recurrence tumor under 16 apertures of a 20 element 16 x 22 cm CMA
applicator with 6 mm thick water bolus vest. The patient was sitting comfortably in a chair reading during the heat treatment and thermal
mapping procedure.

4. SUMMARY

This presentation describes the design and performance characteristics of a prototype Dual Mode conformal array microwave
applicator that combines an array of DCC apertures for heating large superficial tissue regions with an array of spiral
antennas intended for monitoring and controlling temperature under the array. The data demonstrate feasibility of the
approach with successful results for each of the critical components. SAR scans of a single element combination antenna
show little interaction between radiated fields from the DCC and concentric Archimedian spiral structures. The DCC
antennas produce a peripherally enhanced SAR pattern extending out just beyond the aperture perimeter. The spiral antennas
produce a complimentary centrally peaked pattern which facilitates sensing of temperature from tissues located directly under
each DCC element. With only nonobtrusive electrostatic shield cloth wrapped around the test setup, the radiometer
demonstrated excellent sensitivity and an accuracy of +0.1-0.48°C for temperature measurements up to 5 cm deep in
phantom when using a one dimensional weighting function analysis and up to 6 independent radiometry bands. Large arrays
demonstrate precisely adjustable SAR patterns that extend out to the array perimeter 1 cm deep in muscle phantom, and
produce relatively uniform therapeutic steady state temperatures under the entire array during clinical use for large area
chestwall disease.

ACKNOWLEDGEMENTS
This work was supported by a grant from the National Institute of Health (RO1 CA70761). The authors would also like to
acknowledge the assistance of David Latham and Labtech LTD, Special Products Div., Presteigne UK in manufacturing the
large flexible PCB arrays.

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