Exploring and validating heating dynamics in a radio-frequency electromagnetic field-based resonant chamber for mouse hyperthermia research.

Mild whole-body hyperthermia has been shown to have anti-tumor effects through an immune-modulating mechanism. Before it is widely applied in the clinic, tremendous mechanistic research in animals is necessary to adhere to evidence-based principles. The radio frequency electromagnetic field (RF-EMF) based heating facility could be a good choice for hyperthermia treatment, but the heating characteristics of a facility, including structure design, electromagnetic and thermal dosimetry, and the biologic effects of hyperthermia, need to be well elucidated. Here, we reported the heating characteristic study on a resonant chamber (RC) excited by a 1800 MHz solid source. The EMF in the RC was stirred by 24 static reflectors, which resulted in the standard deviation of electric field intensity being below 3 dB in the EM homogeneity evaluation. For the exposure scenario, six free-moving mice were loaded into separate cases and exposed simultaneously in the RC. The EMF energy absorption and distribution in exposed mice were calculated with the 12-plane-waves method of numerical simulation. Different levels of core body temperature increment in exposed mice were achieved through regulation of the source output power. Overexpression of heat shock proteins (HSPs) was detected in the liver, lung and muscle, but not in the brain of the exposed mice. The levels of representative inflammatory cytokines in the serum, TNF-α and IL-10 increased post RC exposure. Based on the heating characteristic study and validation, the applied RC would be a qualified heating system for mild whole-body hyperthermia effect research in mice.

Mild whole-body hyperthermia has potential anti-tumor effects by modulating the immune system. A radio frequency electromagnetic field (RF-EMF)-based heating facility emerges as a suitable option for hyperthermia treatment. However, a qualified heating facility for scientific research must elucidate its heating characteristics and validate the biological effects associated with hyperthermia. In this study, we report the characteristics of a rodent heating chamber using EMF energy. The special structure of the chamber not only achieved efficient EMF usage but also ensured the homogeneity in EMF spatial distribution, animal EM absorption, and EMF-caused biological effects. Our work may offer insights for designing a low-cost yet reliable heating facility for scientific research.

Kirigami-enabled stretchable laser-induced graphene heaters for wearable thermotherapy.

Flexible and stretchable heaters are increasingly recognized for their great potential in wearable thermotherapy to treat muscle spasms, joint injuries and arthritis. However, issues like lengthy processing, high fabrication cost, and toxic chemical involvement are obstacles on the way to popularize stretchable heaters for medical use. Herein, using a single-step customizable laser fabrication method, we put forward the design of cost-effective wearable laser-induced graphene (LIG) heaters with kirigami patterns, which offer multimodal stretchability and conformal fit to the skin around the human body. First, we develop the manufacturing process of the LIG heaters with three different kirigami patterns enabling reliable stretchability by out-of-plane buckling. Then, by adjusting the laser parameters, we confirm that the LIG produced by medium laser power could maintain a balance between mechanical strength and electrical conductivity. By optimizing cutting-spacing ratios through experimental measurements of stress, resistance and temperature profiles, as well as finite element analysis (FEA), we determine that a larger cutting-spacing ratio within the machining precision will lead to better mechanical, electrical and heating performance. The optimized stretchable heater in this paper could bear significant unidirectional strain over 100% or multidirectional strain over 20% without major loss in conductivity and heating performance. On-body tests and fatigue tests also proved great robustness in practical scenarios. With the advantage of safe usage, simple and customizable fabrication, easy bonding with skin, and multidirectional stretchability, the on-skin heaters are promising to substitute the traditional heating packs/wraps for thermotherapy.

Efficacy of warm compresses in preserving perineal integrity and decreasing pain during normal labor: A systematic review and meta-Analysis.

The objective of the study was to assess the effect of warm compresses in preserving perineal integrity in women who delivered a single baby vaginally with cephalic presentation. We searched PubMed, Scopus, and the ISI Web of Science databases. Two researchers worked independently and conducted the study's search, selection, and extraction. We calculated the pooled risk ratio (R.R.)- for our categorical outcomes- and mean difference (M.D.)-for our continuous outcomes- using random or fixed-effect meta-analysis according to heterogenicity status. I2 test was used to detect heterogenicity. Studies were assessed for methodological quality using the Cochrane risk of bias assessment tool. Our study analyzed 13 controlled trials (n= 3947) to compare warm compresses versus not using it during vaginal delivery. The analysis revealed that warm compresses group had better outcomes regarding episiotomy, degree of perineal trauma (third and fourth degree), perineal trauma requiring suturing, and also in behavioral pain scales (severe muscle tense, being very restless, and constant grimacing) with the following R.R. and confidence intervals: (R.R.= 0.56, 95% C.I.[0.23, 1.37]), (R.R.= 0.69, 95% C.I.[0.54, 0.89], p= 0.004),( (R.R.= 0.37, 95% C.I.[0.18, 0.77], p= 0.004), and ( (R.R.= 0.42, 95% C.I.[0.23, 0.78], p= 0.006) respectively. We conclude that among primiparous women, warm compresses group showed better outcome in improving perineal comfort than a the good of women who did not receive warm compresses after delivery.

A customized 3D implant to target laser interstitial thermal therapy ablation of a posterior fossa mass.

Laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical technique that has been demonstrated to successfully ablate intracranial tumors. While LITT for supratentorial lesions can often be straightforward, ablation of infratentorial lesions can be difficult with current targeting technologies and instrumentation. The anatomical difficulty of targeting posterior fossa masses can be further complicated in patients who have had a prior craniectomy or other procedure that removed the bone that is required to set the surgical trajectory. This article describes use of a three-dimensional (3D)-printed customized surgical implant to improve and enable targeting of posterior fossa lesions using LITT, particularly in the setting of prior craniectomy. A 3D-printed implant was customized for a patient with a history of metastatic lung cancer and prior posterior fossa craniectomy who presented for treatment of a progressively enlarging contrast-enhancing lesion in the right cerebellar hemisphere. The device included a built-in bolt trajectory for LITT ablation. The temporary implant was successfully fabricated for use with laser ablation of a right cerebellar mass. Three potential trajectories for the LITT bolt were incorporated into the temporary implant, but only the primary trajectory was utilized. Laser ablation was performed with the implant and a SideFire laser probe. Customized 3D-printed implants can enable the use of LITT for patients who would not otherwise be candidates.

Effect of intra-arrest trans-nasal evaporative cooling in out-of-hospital cardiac arrest: a pooled individual participant data analysis.

BACKGROUND: Randomized trials have shown that trans-nasal evaporative cooling initiated during CPR (i.e. intra-arrest) effectively lower core body temperature in out-of-hospital cardiac arrest patients. However, these trials may have been underpowered to detect significant differences in neurologic outcome, especially in patients with initial shockable rhythm. METHODS: We conducted a post hoc pooled analysis of individual data from two randomized trials including 851 patients who eventually received the allocated intervention and with available outcome ("as-treated" analysis). Primary outcome was survival with favourable neurological outcome at hospital discharge (Cerebral Performance Category [CPC] of 1-2) according to the initial rhythm (shockable vs. non-shockable). Secondary outcomes included complete neurological recovery (CPC 1) at hospital discharge. RESULTS: Among the 325 patients with initial shockable rhythms, favourable neurological outcome was observed in 54/158 (34.2%) patients in the intervention and 40/167 (24.0%) in the control group (RR 1.43 [confidence intervals, CIs 1.01-2.02]). Complete neurological recovery was observed in 40/158 (25.3%) in the intervention and 27/167 (16.2%) in the control group (RR 1.57 [CIs 1.01-2.42]). Among the 526 patients with initial non-shockable rhythms, favourable neurological outcome was in 10/259 (3.8%) in the intervention and 13/267 (4.9%) in the control group (RR 0.88 [CIs 0.52-1.29]; p = 0.67); survival and complete neurological recovery were also similar between groups. No significant benefit was observed for the intervention in the entire population. CONCLUSIONS: In this pooled analysis of individual data, intra-arrest cooling was associated with a significant increase in favourable neurological outcome in out-of-hospital cardiac arrest patients with initial shockable rhythms. Future studies are needed to confirm the potential benefits of this intervention in this subgroup of patients.

Water vapor therapy (Rezum) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study.

PURPOSE: Rezum is the latest developed minimally invasive treatment for benign prostatic hyperplasia (BPH). We aimed to carefully assess the functional outcomes of patients treated with Rezum for BPH. METHODS: We prospectively followed 135 consecutive patients treated by Rezum at 5 institutions from June 2019 to August 2020. The International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), the Overactive Bladder Questionnaire-Short Form (OAB-q SF) score, the International Index of Erectile Function (IIEF-5) and questions 9 and 10 to assess ejaculatory dysfunction were recorded. Election criteria were age > 18, no prior prostate interventions, IPSS ≥ 13, post-void residual ≤ 250 mL, prostate volume between 30 and 120 cc. RESULTS: The median operative time was 10.5 (IQR 8.7-15) min. All patients were dismissed few hours after surgery with indwelling urinary catheter that was removed after a median of 7 (IQR 7-10) days. A significantly decrease of IPSS from baseline at first (p = 0.001) and third (p < 0.0001) month after surgery was reported. No difference was reported in terms of ICIQ-UI SF score postoperatively. A mild reduction of the OAB-q SF score was reported at 1 month from surgery (p = 0.06) that turned significant at 3 months postoperatively (p < 0.0001). A slight but statistically significant increase of the IIEF-5 score was reported from baseline at 6 months (p = 0.04). Postoperatively, patients reported a significantly decrease of ejaculatory dysfunction after alpha-blocker interruption. CONCLUSION: Rezum treatment is a feasible minimally invasive option for patients with BPH symptoms and showed optimal early functional outcomes.

Large-Volume Hyperthermia for Safe and Cost-Effective Targeted Drug Delivery Using a Clinical Ultrasound-Guided Focused Ultrasound Device.

Lyso-thermosensitive liposomes (LTSLs) are specifically designed to release chemotherapy agents under conditions of mild hyperthermia. Preclinical studies have indicated that magnetic resonance (MR)-guided focused ultrasound (FUS) systems can generate well-controlled volumetric hyperthermia using real-time thermometry. However, high-throughput clinical translation of these approaches for drug delivery is challenging, not least because of the significant cost overhead of MR guidance and the much larger volumes that need to be heated clinically. Using an ultrasound-guided extracorporeal clinical FUS device (Chongqing HAIFU, JC200) with thermistors in a non-perfused ex vivo bovine liver tissue model with ribs, we present an optimised strategy for rapidly inducing (5-15 min) and sustaining (>30 min) mild hyperthermia (ΔT <+4°C) in large tissue volumes (≤92 cm3). We describe successful clinical translation in a first-in-human clinical trial of targeted drug delivery of LTSLs (TARDOX: a phase I study to investigate drug release from thermosensitive liposomes in liver tumours), in which targeted tumour hyperthermia resulted in localised chemo-ablation. The heating strategy is potentially applicable to other indications and ultrasound-guided FUS devices.

Laser Treatment of Pancreatic Cancer with Immunostimulating Interstitial Laser Thermotherapy Protocol: Safety and Feasibility Results From Two Phase 2a Studies.

PURPOSE: Ablative techniques have emerged as new potential therapeutic options for patients with locally advanced pancreatic cancer (LAPC). We explored the safety and feasibility of using TRANBERG|Thermal Therapy System (Clinical Laserthermia Systems AB, Lund, Sweden) in feedback mode for immunostimulating Interstitial Laser Thermotherapy (imILT) protocol, the newest ablative technique introduced for the treatment of LAPC. METHODS: The safety and feasibility results after the use of imILT protocol treatment in 15 patients of a prospective series of postsystemic therapy LAPC in two high-volume European institutions, the General and Pancreatic Unit of the Pancreas Institute, of the University of Verona, Italy, and the Department of Surgical Oncology of the Institut Paoli-Calmettes of Marseille, France, were assessed. RESULTS: The mean age was 66 ± 5 years, with a mean tumor size of 34.6 (±8) mm. The median number of cycles of pre-imILT chemotherapy was 6 (6-12). The procedure was performed in 13 of 15 (86.6%) cases; indeed, in two cases, the procedure was not performed; in one, the procedure was considered technically demanding; in the other, liver metastases were found intraoperatively. In all treated cases, the procedure was completed. Three late pancreatic fistulas developed over four overall adverse events (26.6%) and were attributed to imILT. Mortality was nil. A learning curve is necessary to interpret and manage the laser parameters. CONCLUSIONS: Safety, feasibility, and device handling outcomes of using TRANBERG|Thermal Therapy System with temperature probes in feedback mode and imILT protocol on LAPC were not satisfactory. The metastatic setting may be appropriate to evaluate the hypothetic abscopal effect.#NCT02702986 and #NCT02973217.

Reasons to go for Rezum steam therapy: an effective and durable outpatient minimally invasive procedure.

PURPOSE: In this review, we will discuss the state of the literature regarding Rezum and opportunities for its application in the treatment of BPH. METHODS: A comprehensive review of original research on convective water vapor thermal therapy (Rezum) was conducted. Articles related to transurethral resection of the prostate, holmium laser enucleation of the prostate, Aquablation, and greenlight photoselective vaporization of the prostate were reviewed for discussion. RESULTS: Rezum distinguishes itself from other treatment options by its durable improvement in objective clinical outcomes such as IPSS and BPH Impact Index, while being cost-effective and versatile in its ability to treat a variety of prostate gland morphologies. This treatment option shows good lower urinary tract symptom relief, especially in small-to-moderate prostate sizes (30-80 cc). The use of convective heat transfer is unique and allows for localized treatment, avoiding damage to surrounding structures, thus providing an excellent safety profile and sexual function preservation. CONCLUSION: The current evidence on Rezum warrants its consideration as a therapeutic alternative to transurethral surgery in selected patients.

Effectiveness of skin-heating using a water-perfused suit as passive and post-exercise heat acclimation strategies.

The purpose of the present study was to evaluate the effectiveness of passive and post-exercise heat acclimation strategies through directly heating the skin with a water-perfused suit. Nineteen young males participated in the heat acclimation (HA) protocols for 10 days, which were conducted at an air temperature of 33oC with 60%RH. The exercise-only condition (N = 6) conducted 1-h treadmill walking (6 km·h-1) followed by 1-h rest. The post-exercise passive-heating condition (N = 6) wore the suit (inflow water temperature 44.2oC) for 1-h after 1-h walking. The passive-heating condition (N = 7) donned the suit for 2 h. Heat tolerance tests (leg immersion in 42oC water for 60 min) were conducted before and after the training to evaluate changes due to the 10-day intervention. Reflecting that suit-wearing for 10 days as both passive and post-exercise HA strategies can effectively induce adaptive changes, significant interaction effects appeared in: increase or decrease in mean skin temperature (P < 0.05) and elevation in whole-body sweat rate (P < 0.05). Reduction in rectal temperature (P < 0.05) and blood pressure (P < 0.05) were found most prominently in the passive-heating condition. These results indicate that this new method of heat acclimation training, donning a skin-heating water-perfused suit, can generate thermoregulatory benefits. The passive HA intervention could be applied to individuals for whom doing exercise regularly are not feasible.

Genetically engineered magnetic nanocages for cancer magneto-catalytic theranostics.

The clinical applications of magnetic hyperthermia therapy (MHT) have been largely hindered by the poor magnetic-to-thermal conversion efficiency of MHT agents. Herein, we develop a facile and efficient strategy for engineering encapsulin-produced magnetic iron oxide nanocomposites (eMIONs) via a green biomineralization procedure. We demonstrate that eMIONs have excellent magnetic saturation and remnant magnetization properties, featuring superior magnetic-to-thermal conversion efficiency with an ultrahigh specific absorption rate of 2390 W/g to overcome the critical issues of MHT. We also show that eMIONs act as a nanozyme and have enhanced catalase-like activity in the presence of an alternative magnetic field, leading to tumor angiogenesis inhibition with a corresponding sharp decrease in the expression of HIF-1α. The inherent excellent magnetic-heat capability, coupled with catalysis-triggered tumor suppression, allows eMIONs to provide an MRI-guided magneto-catalytic combination therapy, which may open up a new avenue for bench-to-bed translational research of MHT.

Assessing magnetic and inductive thermal properties of various surfactants functionalised Fe3O4 nanoparticles for hyperthermia.

This work reports the fabrication of magnetite (Fe3O4) nanoparticles (NPs) coated with various biocompatible surfactants such as glutamic acid (GA), citric acid (CA), polyethylene glycol (PEG), polyvinylpyrrolidine (PVP), ethylene diamine (EDA) and cetyl-trimethyl ammonium bromide (CTAB) via co-precipitation method and their comparative inductive heating ability for hyperthermia (HT) applications. X-ray and electron diffraction analyses validated the formation of well crystallined inverse spinel structured Fe3O4 NPs (crystallite size of ~ 8-10 nm). Magnetic studies confirmed the superparamagnetic (SPM) behaviour for all the NPs with substantial magnetisation (63-68 emu/g) and enhanced magnetic susceptibility is attributed to the greater number of occupations of Fe2+ ions in the lattice as revealed by X-ray photoelectron spectroscopy (XPS). Moreover, distinctive heating response (specific absorption rate, SAR from 130 to 44 W/g) of NPs with similar size and magnetisation is observed. The present study was successful in establishing a direct correlation between relaxation time (~ 9.42-15.92 ns) and heating efficiency of each surface functionalised NPs. Moreover, heat dissipated in different surface grafted NPs is found to be dependent on magnetic susceptibility, magnetic anisotropy and magnetic relaxation time. These results open very promising avenues to design surface functionalised magnetite NPs for effective HT applications.

Design of Site-Specific Microwave Phased Array Hyperthermia Applicators Using 434 MHz Reduced Cavity-Backed Patch Antenna.

Cancers of the neck, breast, and lower extremities are common malignancies diagnosed in India with a higher incidence of advanced-stage disease. Phased array (PA) applicators reported for hyperthermia treatment (HT) of the breast have small focal region and high cross-coupling, and those reported for lower extremities provide regional heating and limited steering. In this study, we present the numerical design of site-specific PA applicators for HT of large solid tumors in the neck, breast, and lower extremities using a miniaturized 434 MHz cavity-backed water-loaded patch antenna. The fabricated antenna has 38 × 36 mm2 aperture, more than 90% power coupling, 25 MHz bandwidth, and good agreement between simulated and measured specific absorption rate (SAR) in phantom. The site-specific applicators demonstrated less power reflection (<-17.9 dB) and cross-coupling (<-26.8 dB) for 5 mm inter-ring spacing. SAR indicators for 64 cc tumor at varying locations in simplified layered three-dimensional (3D) tissue models of the neck, breast, and leg showed average power absorption ratio (aPAratio ) ≥ 3.16, target to hotspot quotient (THQ) ≥ 0.57, 25% iso-SAR coverage (TC25 ) ≥ 81%, and 50% iso-SAR coverage (TC50 ) ≥51.8%. Simulation results of site-specific applicators for 3D inhomogeneous patient models showed aPAratio ≥ 5.98, THQ ≥ 0.9, TC50 ≥ 86%, and 100% TC25 for all sites. It is concluded that the 434 MHz miniaturized cavity-backed patch antenna can be used to develop high-density PA applicators with 12-24 antennas for HT of large solid tumors (≥4 cm) in the neck, breast, and lower extremities with 3D steering ability and less cross-coupling (≤-26.8 dB). © 2020 Bioelectromagnetics Society.

Optimization of the Preparation of Magnetic Liposomes for the Combined Use of Magnetic Hyperthermia and Photothermia in Dual Magneto-Photothermal Cancer Therapy.

In this work, we aimed to develop liposomal nanocomposites containing citric-acid-coated iron oxide magnetic nanoparticles (CMNPs) for dual magneto-photothermal cancer therapy induced by alternating magnetic field (AMF) and near-infrared (NIR) lasers. Toward this end, CMNPs were encapsulated in cationic liposomes to form nano-sized magnetic liposomes (MLs) for simultaneous magnetic hyperthermia (MH) in the presence of AMF and photothermia (PT) induced by NIR laser exposure, which amplified the heating efficiency for dual-mode cancer cell killing and tumor therapy. Since the heating capability is directly related to the amount of entrapped CMNPs in MLs, while the liposome size is important to allow internalization by cancer cells, response surface methodology was utilized to optimize the preparation of MLs by simultaneously maximizing the encapsulation efficiency (EE) of CMNPs in MLs and minimizing the size of MLs. The experimental design was performed based on the central composite rotatable design. The accuracy of the model was verified from the validation experiments, providing a simple and effective method for fabricating the best MLs, with an EE of 87% and liposome size of 121 nm. The CMNPs and the optimized MLs were fully characterized from chemical and physical perspectives. In the presence of dual AMF and NIR laser treatment, a suspension of MLs demonstrated amplified heat generation from dual hyperthermia (MH)-photothermia (PT) in comparison with single MH or PT. In vitro cell culture experiments confirmed the efficient cellular uptake of the MLs from confocal laser scanning microscopy due to passive accumulation in human glioblastoma U87 cells originated from the cationic nature of MLs. The inducible thermal effects mediated by MLs after endocytosis also led to enhanced cytotoxicity and cumulative cell death of cancer cells in the presence of AMF-NIR lasers. This functional nanocomposite will be a potential candidate for bimodal MH-PT dual magneto-photothermal cancer therapy.

Enhanced Percutaneous Delivery of Beta-Blockers Using Thermal Resurfacing Drug Delivery System for Topical Treatment of Infantile Hemangiomas.

BACKGROUND: Infantile hemangiomas (IHs) are the most common vascular tumors in children. In the past few years, topical beta-blockers (bBs) have been reported to be an effective treatment of superficial IHs. OBJECTIVE: We sought to evaluate the clinical effectiveness and safety profile of enhanced percutaneous delivery of bBs for the treatment of IH. METHODS: A retrospective study of all cases of IHs treated with enhanced percutaneous delivery of bBs between 2018 and 2019 was performed. Epidemiologic, clinical, and treatment data, including effectiveness score and safety, were reviewed. RESULTS: The study included 11 patients with a total of 11 IHs. Of the total number of IHs, 7 (63.7%) showed a good response to treatment and 4 (36.3%) had a partial response; thus all patients (100%) had good or partial response to treatment. No systemic or local adverse effects were reported. LIMITATIONS: This is an uncontrolled retrospective study. CONCLUSION: Enhanced percutaneous delivery of bBs is a safe and efficient topical therapy for IH.

Magnetic nanowires in biomedical applications.

Magnetic nanostructures and nanomaterials play essential roles in modern bio medicine and technology. Proper surface functionalization of nanoparticles (NPs) allows the selective bonding thus application of magnetic forces to a vast range of cellular structures and biomolecules. However, the spherical geometry of NPs poises a series of limitations in various potential applications. Mostly, typical spherical core shell structure consists of magnetic and non-magnetic layers have little tunability in terms of magnetic responses, and their single surface functionality also limits chemical activity and selectivity. In comparison to spherical NPs, nanowires (NWs) possess more degrees of freedom in achieving magnetic and surface chemical tenability. In addition to adjustment of magnetic anisotropy and inter-layer interactions, another important feature of NWs is their ability to combine different components along their length, which can result in diverse bio-magnetic applications. Magnetic NWs have become the candidate material for biomedical applications owing to their high magnetization, cheapness and cost effective synthesis. With large magnetic moment, anisotropy, biocompatibility and low toxicity, magnetic NWs have been recently used in living cell manipulation, magnetic cell separation and magnetic hyperthermia. In this review, the basic concepts of magnetic characteristics of nanoscale objects and the influences of aspect ratio, composition and diameter on magnetic properties of NWs are addressed. Some underpinning physical principles of magnetic hyperthermia (MH), magnetic resonance imaging (MRI) and magnetic separation (MS) have been discussed. Finally, recent studies on magnetic NWs for the applications in MH, MRI and MS were discussed in detail.

Using magnetic particle imaging systems to localize and guide magnetic hyperthermia treatment: tracers, hardware, and future medical applications.

Magnetic fluid hyperthermia (MFH) treatment makes use of a suspension of superparamagnetic iron oxide nanoparticles, administered systemically or locally, in combination with an externally applied alternating magnetic field, to ablate target tissue by generating heat through a process called induction. The heat generated above the mammalian euthermic temperature of 37°C induces apoptotic cell death and/or enhances the susceptibility of the target tissue to other therapies such as radiation and chemotherapy. While most hyperthermia techniques currently in development are targeted towards cancer treatment, hyperthermia is also used to treat restenosis, to remove plaques, to ablate nerves and to alleviate pain by increasing regional blood flow. While RF hyperthermia can be directed invasively towards the site of treatment, non-invasive localization of heat through induction is challenging. In this review, we discuss recent progress in the field of RF magnetic fluid hyperthermia and introduce a new diagnostic imaging modality called magnetic particle imaging that allows for a focused theranostic approach encompassing treatment planning, treatment monitoring and spatially localized inductive heating.

Tumour shape-dependent microwave hyperthermia using a novel coaxial micro-cut slot antenna.

Given that the effectiveness of interstitial hyperthermia for cancer treatment is related to the temperature achieved during the ablation process, there is a need for an accurate understanding of the required temperature distribution which is affected by the physical shape and form of tumours. Although a maximum peak temperature value and minimum backward heating are desired, the temperature distribution needs to be not only high but also uniformly extended over a section instead of at one peak point, especially when a roughly oval-shaped tumour is aligned with the antenna. In this case, achieving a high temperature peak destroys only the central cancerous cells after the first minutes of ablation, leaving the cells on the side alive. In this paper, a complex model was extended for the study of the heat distribution of an antenna over a porous liver composed of blood, cancerous cells, and normal tissue. Three different types of antenna were analysed: single-slot, double-slot, and dipole-tip. A novel structure made up of the single-slot antenna with a micron cut, named the micro-cut slot (MCS) antenna, was proposed and analysed. Thanks to the new structure, high uniform temperature distribution with minimum backward heating was achieved. The extended model equations, which encompass a coupled nonlinear set of transient Maxwell's electromagnetic equations, extended Darcy-Brinkman equation, and local thermal non-equilibrium equations for porous medium approximation, were solved numerically using the novel alternating direction implicit, finite-difference time-domain approach. The results showed that each type of antenna could be useful if chosen according to the shape of the tumour. In comparison with previously used antennas, the MCS antenna presented a good combination of the required goals of achieving uniform high temperature distribution and minimum backward heating.

Hyperthermia and smart drug delivery systems for solid tumor therapy.

Chemotherapy is a cornerstone of cancer therapy. Irrespective of the administered drug, it is crucial that adequate drug amounts reach all cancer cells. To achieve this, drugs first need to be absorbed, then enter the blood circulation, diffuse into the tumor interstitial space and finally reach the tumor cells. Next to chemoresistance, one of the most important factors for effective chemotherapy is adequate tumor drug uptake and penetration. Unfortunately, most chemotherapeutic agents do not have favorable properties. These compounds are cleared rapidly, distribute throughout all tissues in the body, with only low tumor drug uptake that is heterogeneously distributed within the tumor. Moreover, the typical microenvironment of solid cancers provides additional hurdles for drug delivery, such as heterogeneous vascular density and perfusion, high interstitial fluid pressure, and abundant stroma. The hope was that nanotechnology will solve most, if not all, of these drug delivery barriers. However, in spite of advances and decades of nanoparticle development, results are unsatisfactory. One promising recent development are nanoparticles which can be steered, and release content triggered by internal or external signals. Here we discuss these so-called smart drug delivery systems in cancer therapy with emphasis on mild hyperthermia as a trigger signal for drug delivery.

Cancer Therapy and Imaging Through Functionalized Carbon Nanotubes Decorated with Magnetite and Gold Nanoparticles as a Multimodal Tool.

Pharmacotherapy and imaging are two critical facets of cancer therapy. Carbon nanotubes and their modified species such as magnetic or gold nanoparticle conjugated ones they have been introduced as good candidates for both purposes. Gold nanoparticles enhance effects of X-rays during radiotherapy. Nanomaterial-mediated radiofrequency (RF) hyperthermia refers to using RF to heat tumors treated with nanomaterials for cancer therapy. The combination of hyperthermia and radiotherapy, synergistically, causes a significant reduction in X-ray doses. The present study was conducted to investigate the ability and efficiency of the multi-walled carbon nanotubes functionalized with magnetic Fe3O4 and gold nanoparticles (mf-MWCNT/AuNPs) for imaging and cancer therapy. The mf-MWCNT/AuNPs were utilized for imaging approaches such as ultrasounds, CT scan, and MRI. They were also examined in thermotherapy and radiotherapy. The MCF-7 cell line was used as an in vitro model to study thermotherapy and radiotherapy. The mf-MWCNT/AuNPs are beneficial as a contrast agent in imaging by ultrasounds, CT scan, and MRI. They are also radio waves and X-rays absorbent and enhance the efficiency of thermotherapy and radiotherapy in the elimination of cancer cells. The valuable properties of mf-MWCNT/AuNPs in radio- and thermotherapies and imaging strategies make them a good candidate as a multimodal tool in cancer therapy. Graphical Abstract The mf-MWCNT/AuNPs are beneficial as a contrast agent in imaging by US (ultrasounds), CT scan, and MRI. They are also radio waves and X-rays absorbent and enhance the efficiency of thermotherapy and radiotherapy in the elimination of cancer cells. The valuable properties of the mf-MWCNT/AuNPs in radio- and thermotherapies and imaging strategies make them a good candidate as a multimodal tool in cancer therapy.