Computer Methods and Programs in Biomedicine 244 (2024) 107976

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Computer Methods and Programs in Biomedicine

journal homepage: www.elsevier.com/locate/cmpb

MATLAB-based innovative 3D finite element method simulator for

optimized real-time hyperthermia analysis ✩
Zain Ul Abdin a , Syed Ahson Ali Shah a , Youngdae Cho a , Hyoungsuk Yoo b,∗
a Department of Electronic Engineering, Hanyang University, Seoul 04763, South Korea
b Department of Biomedical Engineering and Department of Electronic Engineering, Hanyang University, Seoul 04763, South Korea

A R T I C L E I N F O A B S T R A C T

Keywords: Background and Objective: Owing to the significant role of hyperthermia in enhancing the efficacy of
Finite element method chemotherapy or radiotherapy for treating malignant tissues, this study introduces a real-time hyperthermia
Hyperthermia simulator (RTHS) based on the three-dimensional finite element method (FEM) developed using the MATLAB
Hyperthermia treatment planning
App Designer.
Annular phased array
Convex optimization algorithm
Methods: The simulator consisted of operator-defined homogeneous and heterogeneous phantom models
Homogeneous model surrounded by an annular phased array (APA) of eight dipole antennas designed at 915 MHz. Electromagnetic
Heterogeneous model and thermal analyses were conducted using the RTHS. To locally raise the target temperature according to
the tumor’s location, a convex optimization algorithm (COA) was employed to excite the antennas using
optimal values of the phases to maximize the electric field at the tumor and amplitudes to achieve the required
temperature at the target position. The performance of the proposed RTHS was validated by comparing it with
similar hyperthermia setups in the FEM-based COMSOL software and finite-difference time-domain (FDTD)-
based Sim4Life software.
Results: The simulation results obtained using the RTHS were consistent, both for the homogeneous and
heterogeneous models, with those obtained using commercially available tools, demonstrating the reliability
of the proposed hyperthermia simulator. The effectiveness of the simulator was illustrated for target positions
in five different regions for both homogeneous and heterogeneous phantom models. In addition, the RTHS
was cost-effective and consumed less computational time than the available software. The proposed method
achieved 94% and 96% accuracy for element sizes of 𝜆∕26 and 𝜆∕36, respectively, for the homogeneous model.
For the heterogeneous model, the method demonstrated 93% and 95% accuracy for element sizes of 𝜆∕26 and
𝜆∕36, respectively. The accuracy can be further improved by using a more refined mesh at the cost of a higher
computational time.
Conclusions: The proposed hyperthermia simulator demonstrated reliability, cost-effectiveness, and reduced
computational time compared to commercial software, making it a potential tool for optimizing hyperthermia
treatment.

1. Introduction
Hyperthermia (HT) is a therapeutic technique wherein an increase of
40°C–45°C in temperature is used to enhance the effectiveness of radio-
therapy and/or chemotherapy in cancer treatment [1–3]. The primary
objective of HT is to raise the target temperature at the tumor location
for a considerable duration while keeping the temperature below 40°C
in healthy areas. This can be achieved using an annular phased array
(APA) of antennas that transmits microwaves that are constructively
added at the targeted position and destructively combined elsewhere,
thereby delivering focalized heating via the selective absorption of elec-
tromagnetic energy [4–6]. In APA, each antenna is placed in a circular
pattern equidistant from the center of the phantom. An individual an-
tenna can be excited with a specific phase and amplitude according

✩
This work was supported in part by Institute for Information & Communications Technology Promotion (IITP) grant funded by the Korea government (MSIP)
(No. 2021-0-00490, Development of precision analysis and imaging technology for biological radio waves).
* Corresponding author.
E-mail addresses: mughulzain464@gmail.com (Z.U. Abdin), sahsonas@gmail.com (S.A.A. Shah), chb1046@naver.com (Y. Cho), hsyoo@hanyang.ac.kr (H. Yoo).

https://doi.org/10.1016/j.cmpb.2023.107976
Received 1 September 2023; Received in revised form 7 December 2023; Accepted 8 December 2023
Available online 12 December 2023
0169-2607/© 2023 Elsevier B.V. All rights reserved.
Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

to the location of the tumor, providing flexibility in steering the beam

of electromagnetic waves, and consequently, the resultant power dis-
sipation pattern according to the region of interest (ROI) [7]. In the
last two decades, several research strategies have been proposed for
the treatment of cancer in different parts of the body [8,9]. This study
highlights the utilization of the finite element method (FEM) to cre-
ate a real-time simulator for HT treatment, capitalizing on its potential
to enhance treatment outcomes when combined with chemotherapy or
radiotherapy.
Hyperthermia treatment planning (HTP) is an important technique
and essential instrument to improve the efficacy of cancer treatment
[10,11]. It provides the simulated electric field and the resultant tem-
perature distribution inside the phantom model, thereby helping the
operator visualize the effect of multiple steering of the electromag-
netic beam. Currently, for real-time clinical HT applications, several
evaluation tools are available to obtain high-resolution magnetic res-
onance imaging (MRI), specific absorption rate (SAR), and thermal
distribution [12,13]. Furthermore, commercially available software ef-
fectively assists in HTP, enabling operators to visualize the effects of
electrical and thermal distributions inside phantom models before con-
ducting real-time clinical trials, thus ensuring precise treatment of the
targeted ROI. Two of the most prominent and widely used simulation
tools for clinical HT are COMSOL [14] and Sim4Life [15]. The COM-
Fig. 1. General overview of clinical hyperthermia using the proposed real-time
SOL Multiphysics simulator is based on the FEM, whereas Sim4Life is
hyperthermia simulator.
based on the finite difference time domain (FDTD) technique. The FDTD
method is a widely used numerical technique in electromagnetics. It
discretizes both time and space, allowing the time-domain simulation
tailored for HTP has been developed. This study introduces an opti-
of electromagnetic fields. FDTD is particularly advantageous for mod-
mized hybrid-model-based HT simulator created using MATLAB App
eling wave propagation and interactions with complex structures, but
Designer, followed by the generation of its standalone executable file.
it may require higher computational effort than FEM for handling ir-
The proposed simulator offers several advantages, including efficient
regular geometries and inhomogeneous media. Detailed studies of HTP
computation, cost-effectiveness, a user-friendly interface, and ease of
based on FDTD can be observed in [16–18]. HT applications necessitate
use. It becomes easily accessible to operators upon installing the MAT-
faster real-time simulators because of the need for dynamic adaptation
LAB Runtime Compiler on their computers. The real-time hyperthermia
of treatment parameters during therapy sessions. While treatment plan-
simulator (RTHS) functions seamlessly on the operator’s computer, fa-
ning using patient models is important, real-time simulations enable
cilitating HTP tasks (Fig. 1).
medical professionals to make informed decisions on-the-fly, enhancing
In this paper, the introduced RTHS was built using MATLAB App
patient safety and optimizing treatment outcomes. Although Sim4Life
Designer and the 3D FEM. The HT applicator comprised eight dipole
and COMSOL are viable software options for HTP, they require sub-
stantial computational resources, technical expertise, and extensive op- antennas arranged in a circular pattern around the phantom. The ap-
erator training. The proposed simulator addresses these requirements plicator was designed to operate at a frequency of 915 MHz, which
by providing real-time insights and striking a balance between accu- is considered an appropriate frequency because of its ability to pen-
racy and computational efficiency, as compared to HT setups based on etrate deep inside the body, steer the beam according to the tumor
COMSOL and Sim4Life. location, and focus heat on small or large tumors [24]. Each dipole an-
Over the past decade, many studies have been conducted on the tenna in the array is equidistant from the others along a circular path.
FEM because it plays a major role in solving electromagnetic prob- The cylindrical shape of the phantom model, a single cylinder in the ho-
lems [19,20]. FEM-based computer-aided design (CAD) tools, including mogeneous model (HMM) and a layered cylinder in the heterogeneous
COMSOL and the ANSYS high-frequency structure simulator (HFSS), model (HTM), was selected to mimic the human knee model [25,26].
have been extensively utilized to determine solutions to scattering prob- For simplicity, at first, the knee model was assumed to be homoge-
lems as well as to develop antennas and microwave elements. The FEM neous, and the electrical properties of the muscles were assigned to
is an efficient method in various applications because of its flexibility the phantom. Different tumor locations were analyzed inside the HMM,
in handling any shape of geometry and material inhomogeneity without assuming that the tumor location was already known using imaging
the need to redrive the formulation or update the computer code. An- techniques [27,28]. Notably, in this study, the electric field and tem-
other reason is that the FEM requires less computational effort because perature analyses were performed only for various ROIs. To achieve
it utilizes a highly sparse matrix structure. The most crucial advantage the maximum electric field and consequently the target temperature
of FEM is the discretization of the computational domain into a set of at different locations of the tumor, the convex optimization algorithm
subdomains known as finite elements. A finite element mesh is a ge- (COA) was integrated with the proposed technique to determine the
ometry constructed from a combination of finite elements [20]. This optimum values of the dipole antenna excitation parameters [29,30].
representation of finite elements has several advantages such as mod- Subsequently, a more realistic HT analysis was performed with HTM
eling inhomogeneous media by defining distinct material properties in- using the RTHS. The analysis involved studying the tumor location in
side each element, precise geometric representation of complex-shaped different parts of the heterogeneous knee model, and the APA was then
objects, convincing local effects such as suddenly changing field intensi- excited via COA to effectively heat the tumor tissue. Finally, the results
ties or modeling small-scale features, and superposing the contribution from MATLAB were validated by modeling and simulating the same
of all elements to represent a global solution [20–23]. In-depth studies HT setups using commercially available software. The proposed RTHS
of the FEM and its importance in the field of electromagnetics can be showed balanced performance in both homogeneous and heterogeneous
observed in [19,20]. Despite the advantages of the FEM, to the best of HT analysis while utilizing fewer computational and financial resources.
the authors’ knowledge, no real-time MATLAB-based 3D FEM simulator Consequently, the proposed HT simulator offers an alternative to exist-

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Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

ing software tools, highlighting the effectiveness of the RTHS in the

field of HTP.
The remainder of the article is organized as follows: Section 2 pro-
vides the entire procedure adopted in this study; Section 3 describes and
compares the results obtained using the proposed method and available
techniques; and Section 4 concludes this article.

2. Methodology

In this section, a detailed description of the HT process imposed in

this work is provided. In order to find an approximate solution to the
HT problem, FEM is adopted and applied for both electromagnetic and
thermal simulations [20,31].

2.1. Modeling and phased-array dipole antenna design

The modeling of the RTHS began by creating a computational do-

main or mesh. Various freely accessible software programs are available
for automated 3D mesh generation, and their comprehensive listings
can be noted in [32]. The 3D FEM mesh created in this study was
discretized using linear tetrahedral elements, each comprising four tri-
angular faces, four nodes, and six edges. The homogeneous and hetero-
geneous knee phantoms, as well as the tumor structure, were modeled
by determining the elements using mathematical formulas for cylinders
and spheres and by applying logical techniques such as intersection,
union, addition, and subtraction. For example, in the case of the HMM,
a cylindrical model was generated using a mathematical formula for a
cylinder to determine the nodes and elements within it. Subsequently,
the tumor was formed using the formula for a sphere at the center, and
finally, the sphere was subtracted from the cylinder to create a complete
phantom model with the tumor at its center. The electrical properties
Fig. 2. Overview of the flowchart illustrating the hyperthermia treatment plan-
of the tissues were assigned to the midpoint within each element of ning using the proposed RTHS.
the corresponding tissue and assumed to be constant-valued in each el-
ement, ensuring reliable results, especially when the functions do not
the applied electric field can be easily computed. The thermal simu-
rapidly change within an element [20].
lations are described in Section 2.4. The suggested technique can be
In this work, the applicator used for HT treatment consisted of eight
employed for different boundary value problems by adjusting the mesh
dipole antennas confined in a circular frame. To obtain the homoge-
according to the specific electromagnetic scenario and implementing
neous electric field distribution, each radiating element was placed
the steps of the FEM.
equidistant from the center of the phantom and had a length of 𝜆∕2
(16.4 cm), radius of 0.2 cm, and finite gap between the terminals. For
2.2. Electromagnetic simulations
simplicity, a homogeneous cylindrical phantom with dielectric prop-
erties of muscle was initially used as the knee model [25,26]. There-
Electromagnetic modeling was performed using the proposed RTHS.
after, a four-layered heterogeneous cylindrical model was designed
The generic form of the boundary value problem (BVP), which was used
for a more realistic scenario and HTP was performed. The simulation
to determine the solution to the electromagnetic problem considered in
setup (30 × 30 × 30 mm3 ) consisted of homogeneous and heterogeneous
this study, is as follows:
cylindrical phantoms surrounded by dipole antennas at a distance (D)
from the center of the phantom (Fig. 5(a) and Fig. 8(a)). To truncate ∇ × (𝑛.∇ × 𝐄𝑡 ) + 𝑚.𝐄𝑡 = −∇ × (𝑛.∇ × 𝐼) − 𝑚.𝐼 (1)
the computational domain, a locally-conformal perfectly matched layer
(LC-PML) was used that was located at a distance 𝜆∕4 from the an- for (𝑥, 𝑦, 𝑧) ∈ ℧𝑐
tenna array [33]. The LC-PML has several advantages such as providing
flexibility in the modeling of any arbitrarily shaped PML region and where 𝑚 and 𝑛 denote the material parameters, 𝐄𝑡 denotes the unknown
confirming the decay of outgoing waves away from the computational total electric field radiated by the dipole antenna array and 𝐼 is the
interface [34]. input current distribution along the length of the dipole antenna array
The flowchart in Fig. 2 summarizes the HT treatment process for and is given by Eqn. (2) [35,36]. The computational domain (℧𝑐 ) was
the knee models considered in this study. After constructing the com- the union of the phantom (℧𝑝 ), free space (℧𝑓 𝑠 ), and the PML (℧𝑝𝑚𝑙 )
putational domain and implementing LC-PML, an element matrix was regions.
formed, and the material properties were assigned to all the tissues
⎧ ( ( ) )
based on the considered phantom. Next, the element matrix was as- 𝐿
⎪𝐼𝑖 𝑐𝑜𝑠(𝜙𝑛 )𝑠𝑖𝑛 𝛽 2 − 𝑧 − Φ𝑖 𝑧>0
sembled, and boundary conditions were applied to obtain the global 𝐼 =⎨ ( ( ) ) (2)
𝐿
matrix. Note that the modeling of electric current sources along the ⎪−𝐼𝑖 𝑐𝑜𝑠(𝜙𝑛 + 𝜋)𝑠𝑖𝑛 𝛽 2 + 𝑧 − Φ𝑖 𝑧<0
length of dipole antennas in an array was achieved by imposing the cur- ⎩
rent source expression as a Dirichlet boundary condition at the nodes Here 𝐼𝑖 denotes the amplitude of the current, 𝜙𝑛 denotes the phase
along the length of the dipole antennas in the APA [20]. The system was shift that shows the orientation of the nth dipole antenna relative to a
then solved to determine a solution to the partial differential equation reference axis, 𝛽 denotes the wavenumber, 𝐿 denotes the length of the
representing the total electric field radiated by the APA in this study. dipole antenna, Φ𝑖 denotes the phase of the current (𝐼𝑖 ), and i denotes
Once the electric field is computed, the temperature increase owing to the antenna index along the circular array. The negative sign in Eqn.

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Z.U. Abdin, S.A.A. Shah, Y. Cho et al.
Fig. 3. Overview of the dipole antenna placed at the center of the mesh. (a)
915 MHz dipole antenna. (b) Current distribution on the two arms of the dipole
antenna (half wavelength). (c) E-field distribution (zx-slice) at x = 0. (d) E-field
distribution (xy-slice) at 𝑧 = 0.
(2) indicates that the current on the lower arm flows in the opposite
direction to that on the upper arm of the dipole antennas [35].
An FEM based on nodal elements was employed to determine the
solution to the BVP [37]. Nodal FEM tends to be more intuitive and
simpler to implement, especially for problems where the geometry is
represented by nodes and elements [20]. The simulation domain was
discretized into tetrahedral elements. An approximate solution was
expressed for each element as a linear combination of shape (basis)
functions and unknown nodal field values to be determined. The weak
variational form of the equation was obtained by applying the weighted
residual method to each element [34]. This method multiplies both
sides of the equation using a weight function and integrates over the
domain. The weak form weak derived using the integration-by-parts
technique and can be expressed as follows:
˚ ˚ ˚ minimize
(𝑛 ⋅ ∇𝐄𝐭 ) ⋅ ∇𝑤d𝑣 + 𝑚𝑤𝐄𝐭 d𝑣 = 𝑤𝑔 d𝑣 = 0 (3)
℧𝑒 ℧𝑒 ℧𝑒
where 𝑤 denotes the weight function, (℧𝑒 ) denotes the elemental do-
main, and g is the function on the right-hand side of Eqn. (1). The
remaining steps involved are as follows: creating the element matrix, as-
sembling the element matrix to form the global system of equations, im-
posing the boundary conditions, and finally solving the global system of
equations as follows: [𝑋][𝐸𝑡 ] = [𝑌 ], where 𝑋 denotes the global matrix,
𝑌 is the known right side function, and 𝐸𝑡 denotes the unknown total
electric field. A detailed 3D FEM analysis of Eqn. (1) is available in [20].
In this study, a single dipole antenna was designed firstly at an oper-
ating frequency of 915 MHz and simulated in free space. The technique
used to model the dipole antenna was the same as that used in [20] to
design a horn antenna. Fig. 3 shows the dipole antenna located at the
center of the mesh and the corresponding electric field slices. To verify
the symmetry of the dipole antenna, two spherical objects with electri-
cal properties of muscle (𝜖𝑟 = 54.9 and 𝜎 = 0.94 (S/m)) were placed
on both sides of the dipole antenna. The simulation results, as pre-
sented in Fig. 4, verified the symmetry of the electric field on either
side of the dipole antenna. Subsequently, finite element meshes for HTP
of the HMM and HTM were created, in which the tumor at different
4
Computer Methods and Programs in Biomedicine 244 (2024) 107976
Fig. 4. Two spherical objects with radii 40 mm placed on both sides of a dipole
antenna. (a) 3D mesh design. (b) Total E-field (zx-slice) at 𝑦 = 0. (c) Electric
field penetration inside objects (zx-slice) at 𝑦 = 0. (d) Electric field penetration
inside objects (xy-slice) at 𝑧 = 0.
locations inside the cylindrical knee phantom models were analyzed.
Using the convex optimization technique, antennas were excited with
the optimum value of amplitude and phase of the current to obtain the
maximum electric field at the target position.
2.3. Convex optimization algorithm
To achieve a homogeneous electric field distribution and conse-
quently localized heating, a convex formulation was used to obtain the
excitation parameters for the antenna array. The advantage of using
this approach is that it provides focalized heating at the tumor loca-
tion while avoiding the unintended heat spot that could occur because
of an inhomogeneous field distribution. The basic equation used in the
convex optimization technique is as follows:
}
max|𝐸𝑡,𝑜 | o ∈ outside of ROI
(4)
subject to |𝐸𝑡,𝑐 | = 1 c ∈ center of ROI
where 𝐸𝑡,𝑜 denotes the electric field outside the ROI, and 𝐸𝑡,𝑐 denotes
the total electric field at the center of the ROI.
In this study, an RTHS was employed to train the COA. Initially,
the COA underwent training for the HMM. This was achieved by excit-
ing each dipole antenna individually with a one-ampere input current
and zero phase, while maintaining the remaining antennas in the APA
turned-off. Subsequently, this process yielded eight electric field slices
that were then input into the COA to derive the optimal excitation pa-
rameters that would focus the electric field at the target location. The
same procedure was replicated for the HTM to determine the optimal
excitation parameters tailored to the desired ROIs. The values of these
excitation parameters, as obtained through the convex optimization tool
using the RTHS, were subsequently utilized as inputs for the APA across
all three HT setups. The specific excitation parameters for the HMM and
HTM are described in Section 3 (Table 4 and Table 5).
2.4. Thermal simulation
Once electric field is computed, using Eqn. (1), the thermal analysis
of the model could be performed using the Pennes bioheat equation
Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

Table 1 Table 3
Thermal properties of the tissues and tumor. Comparison between the proposed RTHS-, COMSOL-, and Sim4Life-Based HT
Setups.
Tissue 𝜌 𝑐𝑝 𝑘 ℎ𝑚
(kg/m3 ) (J∕kg∕◦C) (W∕m∕◦C) (W∕kg) S. No Description RTHS COMSOL Sim4Life
Skin 1109 3390 0.37 1.65 1 Open source Yes No No
Fat 911 2348 0.21 0.51
2 Meshing FEM FEM FDTD
Muscle 1090 3421 0.49 0.91
technique
Bone 1908 1313 0.32 0.15
Tumor 1043 3621 0.5 6.81 3 Dimension 3D 3D 3D
4 Element type Tetrahedral Tetrahedral Tetrahedral

Table 2 5 𝑇𝑐 for element HMM HTM HMM HTM HMM HTM

size (𝜆∕36) 13.5 13.6 18 15 135 140
Model parameters and tissue properties at 915 MHz.
min min min min min min
Parameter Value Unit Parameter Value Unit 6 𝑇𝑐 for element 2.5 2.6 11 4.2 128 135
ℎ𝑝 26 cm 𝑤𝑃 𝑀𝐿 3.3 cm size (𝜆∕26) min min min min min min
𝑑𝑝 13 cm 𝑤𝑓 𝑠 0.05 cm 7 𝑇𝑐 for element 12.25 13.29 4 1.44 124 128
𝐷 8.5 cm 𝑟𝑡𝑢𝑚𝑜𝑟 15 mm size (𝜆∕16) sec sec min min min min
𝜖𝑟(𝑠𝑘𝑖𝑛) 41.33 - 𝜎𝑠𝑘𝑖𝑛 0.87 S/m
𝜖𝑟(𝑓 𝑎𝑡) 5.45 - 𝜎𝑓 𝑎𝑡 0.05 S/m 8 𝑇𝑐 for element 2.06 2.98 2.5 1.25 120 45
𝜖𝑟(𝑚𝑢𝑠𝑐𝑙𝑒) 54.99 - 𝜎𝑚𝑢𝑠𝑐𝑙𝑒 0.94 S/m size (𝜆∕10) sec sec min min min min
𝜖𝑟(𝑏𝑜𝑛𝑒) 12.44 - 𝜎𝑏𝑜𝑛𝑒 0.15 S/m
𝜖𝑟(𝑡𝑢𝑚𝑜𝑟) 66 - 𝜎𝑡𝑢𝑚𝑜𝑟 0.98 S/m
permittivity) and 𝜎 (conductivity), as well as the tumor, are also listed
in Table 2 [41,42]. 𝑤𝑃 𝑀𝐿 and 𝑤𝑓 𝑠 denote the widths of the perfectly
[38]. This equation, commonly known as the bioheat transfer equation matched layer and the free-space region, respectively. Furthermore, a
(BHTE), can be written as follows: comparison analysis using several parameters was conducted, as illus-
𝜕 trated in Table 3, where the proposed RTHS was compared with the
𝜌𝑐𝑝 𝑇 = ∇.𝑘∇𝑇 + 𝜔𝑏 𝑐𝑏 (𝑇𝑎 − 𝑇 ) + ℎ𝑒 + ℎ𝑚 (5)
𝜕𝑡 COMSOL- and Sim4Life-based HT setups in terms of software availabil-
where 𝑇 , 𝜌, and 𝑐𝑝 denote the increase in temperature (°C), material ity, meshing technique, computational dimensions, element type, and
density (𝑘𝑔∕𝑚3 ), and specific heat of tissue (J/kg/°C), respectively. time consumption (𝑇𝑐 ) for four different values of the element size in
𝑘 denotes thermal conductivity (W/m/°C), 𝑐𝑏 denotes the blood spe- both HMM and HTM, respectively.
cific heat (3617 J/kg/°C), 𝜔𝑏 denotes volumetric tissue perfusion rate To explain the reduction in the computational time achieved by
(26.6 𝑘𝑔∕𝑚3 ∕𝑠), 𝑇𝑎 represents the increase in the average temperature the RTHS, the methodology behind this efficiency must be highlighted.
of the arteries (39 °C), ℎ𝑒 represents the heat generated owing to the ex- The reduction in the computation time was directly attributed to the
ternal applied electric field and is given by Eqn. (7), and ℎ𝑚 represents utilization of the FEM within the MATLAB environment. The inher-
the metabolic heat generation (W/m3 ). Table 1 lists the thermal prop- ent proficiency of MATLAB in efficiently managing complex matrices
erties of the skin, fat, muscle, bone, and tumor used in this study [39], played a crucial role in achieving this reduction. Furthermore, to en-
[40]. The FEM solution to Eqn. (5) to determine the temperature eleva- sure the versatility of the simulator across different scenarios, including
tion owing to the external heat source is provided in Eqn. (6); however, those with varying material properties, this approach was extended to
a detailed numerical analysis can be observed in [31]. encompass a wide range of material characteristics. Although the de-
gree of time reduction might vary based on the complexity of the model,
Δ𝑡 (
𝐓(𝑡 + Δ𝑡) = 𝐅(𝑇 , 𝑡) − 𝐊𝑏 𝑇 (𝑡) + 𝐐𝑏 + 𝐇𝑒 (𝑡)+ the proposed RTHS consistently demonstrated efficiency, as exemplified
𝐂(𝑇 ) ) (6) by the data presented in Table 3. In the context of the FEM, the size of
𝐇𝑚 (𝑡) + 𝐓(𝑡) the elements employed in the mesh discretization directly impacts the
𝜎 computational time. Smaller element sizes yield more accurate solu-
ℎ𝑒 = |𝐸|2 (7)
2𝜌 tions by capturing finer details; however, they require additional com-
where Δ𝑡 denotes the time step and 𝐊𝑏 and 𝐂(𝑇 ) denote the blood putational resources because of the increased number of calculations.
perfusion and lumped thermal mass matrices, respectively. As can be Achieving a balance between accuracy and computational efficiency is
seen in Eqn. (6), only He(t) represents the unknown component that pivotal because smaller elements enhance precision but extend process-
describes the SAR (Eqn. (7)). Therefore, the electric field calculated us- ing times.
ing the FEM solution of Eqn. (1) was used in Eqn. (6) to determine the The accuracy assessment of the proposed RTHS involved comparing
thermal distribution inside the homogeneous and heterogeneous phan- the xy-slices of the electric field and temperature from the RTHS with
toms. those obtained from the COMSOL- and Sim4Life-based HT setups, as
illustrated in Fig. 5(d) and (e) and Fig. 8(d) and (e). This process began
2.5. Methodology validation by normalizing all slices (electric field and temperature) to a common
peak value, followed by computing the mean values within the ROIs.
To verify the simulation results obtained using the proposed RTHS, The accuracy was determined using the following formula:
in both homogeneous and heterogeneous phantom models, similar HT ( |Mean |)
RTHS − MeanOther |
systems were designed using COMSOL and Sim4Life software. In COM- Accuracy = 1− | × 100 (8)
MeanOther
SOL, frequency domain and time-dependent bioheat transfer studies
were used to perform the electromagnetic and thermal analysis. In Here, MeanRTHS represents the mean electric field or temperature value
Sim4Life, multiport electromagnetic FDTD (EM FDTD) and transient from the RTHS simulator in the ROI, and MeanOther represents the
thermal setup were used to obtain the electric field and corresponding mean electric field or temperature value from COMSOL or Sim4Life, de-
temperature distribution. A description of the simulation environment pending on the comparison. The accuracy for the HMM and HTM was
is presented in Table 2, where ℎ𝑝 , 𝑑𝑝 , and 𝑟𝑡𝑢𝑚𝑜𝑟 denote the height computed with element sizes of 𝜆∕26 and 𝜆∕36, resulting in 94% and
of the phantom, diameter of the phantom, and radius of the tumor, 96% accuracy, respectively, for the HMM, and 93% and 95% accuracy,
respectively. The electrical properties of the tissues, i.e., 𝜖𝑟 (relative respectively, for the HTM, when compared with those for COMSOL

5
Z.U. Abdin, S.A.A. Shah, Y. Cho et al.
Fig. 5. Overview of HT setups for the homogeneous model, accompanied by 3D
slices illustrating the distribution of electric fields and thermal effects. XY-slices
are taken at z = 0 (circular) and YZ-slices are taken at x = 0 (rectangular). (a)
Design of the 3D mesh for the RTHS. (b) Configuration of the simulation using
COMSOL. (c) Model representation within Sim4Life. (d) Concentrated electric
field at the center of the phantom across all three setups. (e) Thermal energy
elevation resulting from the applied electric field at the target location, as simu-
lated in all three thermal setups. (f) Comparison of the normalized electric field
along the y-axis (dotted line) for all HT setups. (g) Comparative analysis of the
temperature distribution along the dotted lines across all HT setups.
and Sim4Life. The computed accuracy for electric field and tempera-
ture with respect to both COMSOL and Sim4Life was identical. Whereas
the RTHS is not 100% accurate owing to varying computational envi-
ronments and sources in COMSOL and Sim4Life, its accuracy can be
enhanced using smaller elements in the mesh at a higher computational
cost. Hence, a balance between accuracy and computational effort can
be tailored to the requirements when compared to existing software
tools.
3. Results and discussions
In this section, the validation of the introduced RTHS is described by
comparing the results obtained from the RTHS with those of commer-
cially available software. First, the tumor was assumed to be located at
the center of the homogeneous cylindrical model. Therefore, to achieve
the maximum field at the tumor location, all antennas were assigned
a zero phase and constant amplitude of the excitation signal. Fig. 5
shows a cylindrical knee model with a tumor located at the center of
the phantom. Fig. 5(a) shows the simulation model for the RTHS, and
Figs. 5(b) and (c) show the simulation environments in COMSOL and
Sim4Life, respectively. Fig. 5(d) shows the electric field focused on the
tumor region, and Fig. 5(e) shows the temperature rise at the target
6
Computer Methods and Programs in Biomedicine 244 (2024) 107976
Fig. 6. Overview of the localized electric field and thermal distribution slices.
(a) and (b) E-field and its resultant temperature slices at z = 0 mm (xy-slice,
circular) and y = -13 mm (xz-slice, rectangular). (c) and (d) E-field and its
resultant temperature slices at z = 0 mm (xy-slice, circular) and x = 5 mm
(yz-slice, rectangular).
area. As can be seen in Fig. 5(d) and (e), the results (electric field and
temperature) obtained using the proposed RTHS were identical to those
of the COMSOL- and Sim4Life-based electromagnetic and thermal sim-
ulations. Moreover, the temperature distribution plots clearly showed
that the target temperature was attained in the malignant tissue, while
avoiding a temperature rise in the surrounding normal tissues. The elec-
tric field and temperature distribution xy-slices obtained from the RTHS
were also compared, along a suitably chosen line, with those obtained
from COMSOL and Sim4Life. This was achieved by selecting a straight
line along the y-axis at the center of the HMM and plotting the elec-
tric field and temperature amplitudes along that line. Fig. 5(f) and (g)
present this comparison, demonstrating that the proposed RTHS, COM-
SOL, and Sim4Life exhibit similar electric and thermal profiles within
the ROI.
Second, because the tumor can be located anywhere within the
phantom model [43,44], for localized thermal heating, the phase and
amplitude of the applicator were varied using the convex optimiza-
tion method to achieve the required temperature at the target location.
Table 4 presents the values of the excitation parameters, wherein Ta-
ble 4(a) lists the optimum values used in the case of Fig. 6(a), and Ta-
bles 4(b), (c), and (d) list the input parameter values for Figs. 6(c), 7(a)
and 7(c), respectively. Notably, all figures show the 3D electric field
(V/m) and temperature (°C), with the xy- and yz-/xz-slices shown in
each figure. Figs. 6 and 7 show the simulation results for localized elec-
tric and thermal dispensations inside the HMM. To validate the obtained
localized results using the RTHS, the applicators designed in COMSOL
and Sim4Life were also excited with the same phase and amplitude, as
presented in Table 4. As shown in Fig. 6(a) and (c) and Fig. 7(a) and (c),
the equivalent focusing of the electric field was obtained via available
software tools, as achieved from the proposed RTHS. Furthermore, ther-
mal analysis using the introduced simulator and the models developed
using the available software showed similar patterns of temperature dis-
tribution (see Figs. 6(b) and (d) and 7(b) and (d)). This validated the
successful integration of the convex optimization algorithm with the
proposed HT simulator.
Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

Table 4 Table 5
Phase and amplitude variations using the convex optimization method for the Phase and amplitude variations using the convex optimization method for the
homogeneous model. heterogeneous model.
(a) Excitation parameters for ROI (b) Excitation parameters for ROI (a) Excitation parameters for ROI (b) Excitation parameters for ROI
in Fig. 6(a). in Fig. 6(c). in Fig. 9(a). in Fig. 9(c).

Antenna Current Phase Antenna Current Phase Antenna Current Phase Antenna Current Phase
No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°)
1 0.73 173.9 1 0.78 177.94 1 0.98 135.2 1 0.68 -31.4
2 1 -144.5 2 0.84 129.62 2 0.53 68.19 2 0.91 129.62
3 0.79 167.9 3 0.69 54.12 3 0.79 17.51 3 1 86.2
4 0.61 110.6 4 0.97 15.81 4 0.35 -99.96 4 0.62 51.23
5 0.9 9.96 5 1 4.3 5 1 18.01 5 0.68 51.52
6 1 23.16 6 0.99 40.45 6 0.61 18 6 0.99 79.19
7 0.9 12.44 7 0.72 142.55 7 0.69 74.63 7 0.85 35.91
8 0.59 92.49 8 0.9 169.94 8 0.49 49.21 8 0.98 18.67

(c) Excitation parameters for ROI (d) Excitation parameters for ROI (c) Excitation parameters for ROI (d) Excitation parameters for ROI
in Fig. 7(a). in Fig. 7(c). in Fig. 10(a). in Fig. 10(c).

Antenna Current Phase Antenna Current Phase Antenna Current Phase Antenna Current Phase
No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°) No. 𝐼𝑖 (A) Φ𝑖 (°)
1 1 -177.09 1 0.8 61.06 1 0.94 -2.202 1 0.82 128.28
2 0.62 -176.09 2 0.75 130.8 2 0.87 102.98 2 0.78 -177.43
3 0.83 116.32 3 0.99 -178.95 3 0.58 104.76 3 0.96 137.93
4 0.71 54.78 4 0.85 168.46 4 0.48 95.64 4 0.71 20.75
5 0.89 3.35 5 0.73 139.01 5 1 137.38 5 0.88 -8.19
6 0.87 15 6 0.95 46.12 6 0.76 30.89 6 0.39 -155.94
7 0.74 66.62 7 1 -2.12 7 0.73 -54.69 7 1 -31.87
8 0.62 129.59 8 0.91 10.01 8 0.26 -34.93 8 0.7 57.06

Fig. 7. Focalized electric field and temperature dissemination slices. (a) and (b)
E-field and its corresponding temperature slices at z = 0 mm (xy-slice, circular)
and x = -5 mm (yz-slice, rectangular). (c) and (d) E-field and its corresponding
temperature slices at z = 0 mm (xy-slice, circular) and x = -15 mm (yz-slice,
rectangular).
Subsequently, a four-layered heterogeneous cylindrical model was
constructed to introduce a more realistic scenario. HT treatment was
conducted to focus the electric field and consequently the target temper-
ature at the tumor at five distinct positions. The HT setups for the HTM
are depicted in Fig. 8(a), (b), and (c). Fig. 8(a) portrays the simulation
domain in the proposed RTHS, Fig. 8(b) illustrates the computational
domain in COMSOL, and Fig. 8(c) presents the simulation domain in
Sim4Life. The HTM comprised four layers: skin (0.3 cm), fat (1.5 cm),
muscle (4 cm), and bone (0.7 cm). Electric field focusing was achieved
at five different locations according to the tumor’s position using the
COA. The results obtained from the proposed RTHS were validated by
exciting the APA in both COMSOL and Sim4Life with the same excita-
tion parameters, as listed in Table 5. Specifically, Table 5(a), (b), (c),
and (d) outline the input excitation parameters for Fig. 9(a), Fig. 9(c),
Fig. 10(a), and Fig. 10(c), respectively. As evident from Fig. 8, the elec-
tromagnetic and thermal simulation outcomes from the RTHS closely
aligned with those produced by COMSOL and Sim4Life. Furthermore,
a comparison was performed by selecting a line passing through the
center of the ROI and plotting the electric field and temperature ampli-
tudes along that line for the proposed RTHS, COMSOL, and Sim4Life.
As illustrated in Fig. 8(f), the electric field comparison demonstrated
the similarity between RTHS and COMSOL/Sim4Life-based electric field
plots within the ROI. Similarly, Fig. 8(g) shows the temperature results
from the RTHS-, COMSOL-, and Sim4Life-based HT setups, revealing
significant agreement between the results within the ROI.
A comparison of the RTHS was subsequently performed for the four
distinct target regions within the HTM. The APA was activated in all the
HT setups with consistent excitation parameters. As depicted in Fig. 9(a)
and (c) and Fig. 10(a) and (c), the electric field slices, including both xy-
and zy-slices, obtained using the RTHS showed focused electric fields on
the target regions that closely matched with electric field distributions
obtained from the COMSOL- and Sim4Life-based simulations. Further-
more, Fig. 9(b) and (d) and Fig. 10(b) and (d) illustrate the resulting
temperature elevation within the HTM owing to the applied electric
field. The thermal slices, including both xy- and zy-slices, obtained from
RTHS for all four target regions exhibited remarkable similarity to those
generated using the COMSOL- and Sim4Life-based thermal setups. No-
tably, as explained in Section 2.3, the COA was trained using the RTHS
to determine the optimal excitation parameters that were consistently
employed across all the HT setups. This highlighted that the integra-
tion of the COA with the proposed RTHS for the HTM proved to be
successful and yielded coherent results.
Finally, to offer an interactive and user-friendly environment for
clinical HT treatment, a graphical user interface (GUI) for the RTHS

7
Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

Fig. 9. Focused electric field and thermal distribution comparison between the
RTHS, COMSOL, and Sim4Life corresponding to the excitation parameters out-
lined in Tables 5(a) and (b). (a) and (b) Depiction of the E-field and resulting
temperature distributions in the xy-plane at z = 0 (circular) and in the yz-plane
at x = 7 mm (rectangular). (c) and (d) Visualization of the E-field and its as-
sociated temperature distribution in the xy-plane at z = 0 (circular) and in the
yz-plane at x = 5 mm (rectangular).

Fig. 8. Overview of HT setups for the heterogeneous phantom and 3D slices

depicting the distribution of the electric field and thermal effects. xy-slices at
z = 0 (circular) and yz-slices at x = -12 mm (rectangular). (a) Design of the
3D mesh for the RTHS. (b) Configuration of the simulation in COMSOL. (c)
Model representation in Sim4Life. (d) Localized electric field focusing within
the phantom across the three setups. (e) Thermal energy elevation owing to the
applied electric field from all three thermal simulation setups. (f) Normalized
electric field comparison plotted along the dotted line for all HT setups. (g)
Temperature distribution comparison along the dotted line for all HT setups.

was designed using the MATLAB App Designer simulation tool. Fig. 11
shows the implemented RTHS interface, focusing initially on the homo-
geneous phantom model. The knee model dimensions were set to the
default values as used in this study. However, users have the flexibil-
ity to input different thicknesses of tissue (skin, fat, muscle, and bone)
according to the approximated cylindrical knee model and tumor loca-
tion. The RTHS GUI initiates the creation of a mesh that encompasses
the HMM surrounded by the APA in accordance with the parameters
provided by the operator (Fig. 11(a)). Subsequently, users can manipu-
late the phase and amplitude of individual antennas within the GUI to
achieve the desired localized electric and thermal focusing. The result-
ing electric and thermal simulation results corresponding to Fig. 5 are
shown in Fig. 11.
Fig. 12 shows the RTHS interface configured for the heterogeneous
phantom model. The default tissue thicknesses were adopted in line
with the considerations of this study, and the tumor location remained
Fig. 10. Overview of the focused electric field and thermal distribution compar-
consistent with the description provided in Fig. 8. Fig. 12(b) shows the ison between the RTHS, COMSOL, and Sim4Life for the excitation parameters
electrical and thermal simulation environments within the RTHS GUI. listed in Tables 5(c) and (d). (a) and (b) Demonstration of the E-field and re-
Here, operators can input the excitation parameters and the electric sultant temperature distributions in the xy-plane at z = 0 (circular) and in the
and thermal properties of the tissues and tumor. The optimal excitation yz-plane at x = -16 mm (rectangular). (c) and (d) Visualization of the E-field
parameters were configured to align with the tumor location illustrated and its corresponding temperature distribution in the xy-plane at z = 0 (circu-
in Fig. 8, whereas the electric and thermal properties were maintained lar) and in the yz-plane at x = 11 mm (rectangular).

8
Z.U. Abdin, S.A.A. Shah, Y. Cho et al. Computer Methods and Programs in Biomedicine 244 (2024) 107976

Fig. 11. Overview of the proposed RTHS GUI for the homogeneous model.

at the default values, as stipulated in this study. Fig. 12(c) offers insights
into the 3D electric field and corresponding temperature elevation slices
within the HTM. In addition, operators can visualize 3D slices of the
electric field and temperature by utilizing a rotation icon within the
RTHS GUI.
In light of the study, it is acknowledged that the utilization of
cylindrical models can be perceived as a limitation of the RTHS in
comparison to the available COMSOL and Sim4Life software, both of
which offer more realistic knee models. However, for the purpose of
this study, cylindrical models were chosen for their simplicity, aiming
to demonstrate and validate the performance of the introduced RTHS.
In the future, more advanced functionalities will be incorporated, in-
cluding patient-specific knee model designs based on medical images
and the expansion of model designs for various body regions. Whereas
this study showcased cylindrical models (HMM and HTM) to demon-
strate the performance of the proposed HT simulator, these forthcoming Fig. 12. Overview of the proposed RTHS GUI for the heterogeneous model.
enhancements will further enrich the RTHS capabilities.
time, emphasizing its reliability and cost-effectiveness compared with
4. Conclusion COMSOL- and Sim4Life-based HT setups. It achieved favorable accuracy
with various element sizes, suggesting potential improvement through
In conclusion, this study introduced the RTHS developed through mesh refinement. The RTHS provides a practical platform for optimiz-
3D FEM and MATLAB App Designer. The RTHS aims to enhance ing hyperthermia treatment and offers a viable alternative to current
chemotherapy and radiotherapy effectiveness for treating malignant tis- software tools in HT therapy. In the future, more advanced features
sues. Operator-defined homogeneous and heterogeneous phantom mod- should be considered, such as designing patient-specific knee models
els, including an APA with eight dipole antennas, were utilized for based on medical images and expanding model designs to cover dif-
electric and thermal analyses, demonstrating consistent performance ferent body regions. Although this study primarily utilized cylindrical
across HMM and HTM. The integration of a COA optimized antenna models (HMM and HTM) to showcase the capabilities of the proposed
excitation parameters for localized temperature elevation. The RTHS HT simulator, these planned enhancements further extend the function-
exhibited consistent performance while consuming less computational ality of the RTHS.

9
Z.U. Abdin, S.A.A. Shah, Y. Cho et al.
CRediT authorship contribution statement
Zain Ul Abdin: Writing – review & editing, Writing – original draft,
Visualization, Validation, Software, Resources, Methodology, Investiga-
tion, Data curation. Syed Ahson Ali Shah: Writing – review & editing,
Formal analysis, Conceptualization. Youngdae Cho: Writing – review
& editing, Software, Visualization. Hyoungsuk Yoo: Supervision, Con-
ceptualization.
Declaration of competing interest
There is no competing financial interest.
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