{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:27:25Z","timestamp":1789522045825,"version":"build-2803163510"},"reference-count":75,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,1,10]],"date-time":"2011-01-10T00:00:00Z","timestamp":1294617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA122276"],"award-info":[{"award-number":["R01CA122276"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2011,2]]},"abstract":"\n Purpose:<\/jats:title>\n The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3\u2010D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter\u2010based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6\u20137.4 MHz that are unsectored (360\u00b0), bisectored\n \n , or trisectored\n \n for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The CTV in HDR brachytherapy plans extends\n \n from the endocervical tandem with the rectum and bladder typically\n \n from the target boundary. The GTV extends\n \n from the tandem. Simulations indicate that for 60 min treatments the applicator can heat to\n \n and deliver\n \n over 4\u20135 cm diameter with\n \n and\n \n blood perfusion. The\n \n contour diameter is reduced to 3\u20134 cm at\n \n perfusion. Differential power control to transducer elements and sectors demonstrates tailoring of heating along the device length and in angle. Sector cuts are associated with a 14\u201347\u00b0 acoustic dead zone, depending on cut width, resulting in a\n \n temperature reduction within the dead zone below\n \n . Dead zones can be oriented for thermal protection of the rectum and bladder. Fabricated devices have acoustic efficiencies of 33.4%\u201351.8% with acoustic output that is well collimated in length, reflects the sectoring strategy, and is strongly correlated with temperature distributions.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n A catheter\u2010based ultrasound applicator was developed for endocervical implantation with locally targeted, 3\u2010D conformal thermal delivery to the uterine cervix. Feasibility of heating clinically relevant target volumes was demonstrated with power control along the device length and in angle to treat the cervix with minimal thermal dose delivery to the rectum and bladder.<\/jats:p>\n <\/jats:sec>","DOI":"10.1118\/1.3512803","type":"journal-article","created":{"date-parts":[[2011,2,2]],"date-time":"2011-02-02T18:28:13Z","timestamp":1296671293000},"page":"598-611","source":"Crossref","is-referenced-by-count":20,"title":["Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma"],"prefix":"10.1002","volume":"38","author":[{"given":"Jeffery H.","family":"Wootton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Chow Joe","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J.","family":"Diederich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,1,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.55.2.74"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020\u20107292(06)60030\u20101"},{"key":"e_1_2_7_4_1","first-page":"4509","article-title":"Association between tumor hypoxia and malignant progression in advanced cancer of the uterine cervix","volume":"56","author":"Hockel M.","year":"1996","journal-title":"Cancer Res."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167\u20108140(98)00044\u20109"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167\u20108140(99)00139\u20105"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02656730500271668"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040\u20108428(01)00179\u20102"},{"key":"e_1_2_7_9_1","first-page":"68","article-title":"Thermoradiotherapy in the management of carcinoma of the cervix (IIIB): A controlled clinical study","volume":"121","author":"Datta N.","year":"1987","journal-title":"Ind. 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