{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T04:18:15Z","timestamp":1742962695858,"version":"3.40.3"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020621","name":"Seoul St. Mary's Hospital, Catholic University of Korea","doi-asserted-by":"publisher","award":["ZC23RISI0931"],"award-info":[{"award-number":["ZC23RISI0931"]}],"id":[{"id":"10.13039\/501100020621","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nObjective\n<\/jats:title>\n<jats:p>Hyperthermia has been safely employed in conjunction with low to moderate doses of radiotherapy (RT) to achieve notable tumor responses in cases of previously treated and recurrent malignancies. However, the radiologic monitoring of combined hyperthermia and RT (HTRT) is not extensively documented. This study aimed to assess radiological changes, including alterations in Hounsfield units (HU), in patients undergoing treatment with either HTRT or RT alone for metastatic abdominal lymph nodes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>CT images were acquired from consecutive 40 patients who received HTRT or RT alone for metastatic abdominal lymph nodes. Target regions were delineated and pre- and post-treatment HU measurements were extracted from these targets. An additional independent t-test was performed to compare the change in mean HU values between the two groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>The study included 40 patients, 20 patients in the HTRT group and 20 in the RT alone group. In the HTRT group, the average HU after treatment was 58.95 HU, while in the RT-only group, it was 71.42 HU. In the HTRT-treated group, the average HU value of the tumor was lower by 9.05%, with an average of -8.47 HU. (p =\u2009 0.011), while in the RT-only treated group, it declined by 0.57% with an average of -0.41 HU.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>The HTRT group showed a greater decrease in HU both pre- and post-treatment, indicating a possible indirect marker of tumor necrosis. Sequential trends and survival analyses for comparing the two groups are warranted in subsequent investigations.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318330","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T18:52:38Z","timestamp":1742928758000},"page":"e0318330","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hounsfield unit change in metastatic abdominal lymph nodes treated with combined hyperthermia and radiotherapy"],"prefix":"10.1371","volume":"20","author":[{"given":"Young Kyu","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu Hye","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wonjoong","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bohyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In-Ho","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-nam","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0326-272X","authenticated-orcid":true,"given":"HongSeok","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"issue":"2","key":"pone.0318330.ref001","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00044067-200404000-00009","article-title":"Malignant hyperthermia: pathophysiology, clinical presentation, and treatment","volume":"15","author":"EJ McCarthy","year":"2004","journal-title":"AACN Clin Issues"},{"issue":"3","key":"pone.0318330.ref002","doi-asserted-by":"crossref","first-page":"307","DOI":"10.3109\/02656739409010273","article-title":"Dedication of the special issue of the International Journal of Hyperthermia honouring the retirement of George M. Hahn PhD","volume":"10","author":"DS Kapp","year":"1994","journal-title":"International Journal of Hyperthermia"},{"issue":"6","key":"pone.0318330.ref003","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1053\/j.seminoncol.2014.09.014","article-title":"Hyperthermia, radiation and chemotherapy: the role of heat in multidisciplinary cancer care","volume":"41","author":"M Hurwitz","year":"2014","journal-title":"Semin Oncol"},{"issue":"4","key":"pone.0318330.ref004","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/02656730701378684","article-title":"Hyperthermia, cisplatin and radiation trimodality treatment: a promising cancer treatment? A review from preclinical studies to clinical application","volume":"23","author":"JWJ Bergs","year":"2007","journal-title":"Int J Hyperthermia"},{"issue":"4","key":"pone.0318330.ref005","doi-asserted-by":"crossref","first-page":"3799","DOI":"10.3390\/cancers3043799","article-title":"Combined hyperthermia and radiotherapy for the treatment of cancer","volume":"3","author":"P Kaur","year":"2011","journal-title":"Cancers (Basel)"},{"issue":"37","key":"pone.0318330.ref006","doi-asserted-by":"crossref","first-page":"12692","DOI":"10.1039\/C7DT02139A","article-title":"Folic acid on iron oxide nanoparticles: platform with high potential for simultaneous targeting, MRI detection and hyperthermia treatment of lymph node metastases of prostate cancer","volume":"46","author":"D Bonvin","year":"2017","journal-title":"Dalton Trans"},{"issue":"1","key":"pone.0318330.ref007","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1186\/s12951-021-01186-8","article-title":"A novel targeted multifunctional nanoplatform for visual chemo-hyperthermia synergy therapy on metastatic lymph nodes via lymphatic delivery","volume":"19","author":"W Liu","year":"2021","journal-title":"J Nanobiotechnology"},{"issue":"2","key":"pone.0318330.ref008","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.soc.2017.11.011","article-title":"Lymph Node Metastasis in Colorectal Cancer","volume":"27","author":"M Jin","year":"2018","journal-title":"Surg Oncol Clin N Am"},{"issue":"1","key":"pone.0318330.ref009","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ygyno.2004.04.023","article-title":"Lymphatic mapping and sentinel node identification as related to the primary sites of lymph node metastasis in early stage ovarian cancer","volume":"94","author":"H Negishi","year":"2004","journal-title":"Gynecol Oncol"},{"issue":"6","key":"pone.0318330.ref010","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1097\/MPA.0b013e3182148342","article-title":"Pattern of lymph node metastasis spread in pancreatic cancer","volume":"40","author":"M Kanda","year":"2011","journal-title":"Pancreas"},{"issue":"3","key":"pone.0318330.ref011","first-page":"3409","article-title":"Molecular background of the regional lymph node metastasis of gastric cancer","volume":"15","author":"T Zhu","year":"2018","journal-title":"Oncol Lett"},{"issue":"3","key":"pone.0318330.ref012","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s00262-005-0049-y","article-title":"Cancer immunotherapy based on intracellular hyperthermia using magnetite nanoparticles: a novel concept of \u201cheat-controlled necrosis\u201d with heat shock protein expression","volume":"55","author":"A Ito","year":"2006","journal-title":"Cancer Immunol Immunother"},{"issue":"7","key":"pone.0318330.ref013","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/bjs.1800830713","article-title":"Early localization of necrosis by contrast-enhanced computed tomography can predict outcome in severe acute pancreatitis","volume":"83","author":"E Kemppainen","year":"1996","journal-title":"Br J Surg"},{"issue":"9","key":"pone.0318330.ref014","doi-asserted-by":"crossref","first-page":"e0223140","DOI":"10.1371\/journal.pone.0223140","article-title":"Correlation of CT texture changes with treatment response during radiation therapy for esophageal cancer: An exploratory study","volume":"14","author":"Z Yan","year":"2019","journal-title":"PLoS One"},{"issue":"4","key":"pone.0318330.ref015","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/BF02602962","article-title":"Lipiodol retention and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: correlation between computed tomography and histopathology","volume":"16","author":"T Imaeda","year":"1993","journal-title":"Cardiovasc Intervent Radiol"},{"key":"pone.0318330.ref016","first-page":"799","article-title":"Use of CT Hounsfield unit density to identify ablated tumor after laparoscopic radiofrequency ablation of hepatic tumors","volume":"14","author":"E Berber","year":"2000","journal-title":"Surgical Endoscopy"},{"issue":"5","key":"pone.0318330.ref017","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1038\/sj.bjc.6605567","article-title":"Choi response criteria for early prediction of clinical outcome in patients with metastatic renal cell cancer treated with sunitinib","volume":"102","author":"AAM van der Veldt","year":"2010","journal-title":"Br J Cancer"},{"issue":"8","key":"pone.0318330.ref018","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1109\/TMTT.1978.1129438","article-title":"Evaluation of a Therapeutic Direct-Contact 915-MHz Microwave Applicator for Effective Deep-Tissue Heating in Humans","volume":"26","author":"JF Lehmann","year":"1978","journal-title":"IEEE Trans Microwave Theory Techn"},{"issue":"51","key":"pone.0318330.ref019","doi-asserted-by":"crossref","first-page":"84082","DOI":"10.18632\/oncotarget.11444","article-title":"In vitro comparison of conventional hyperthermia and modulated electro-hyperthermia","volume":"7","author":"K-L Yang","year":"2016","journal-title":"Oncotarget"},{"issue":"3","key":"pone.0318330.ref020","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/0360-3016(89)90470-7","article-title":"The current and potential role of hyperthermia in radiotherapy","volume":"16","author":"J Overgaard","year":"1989","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"pone.0318330.ref021","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S1040-8428(01)00179-2","article-title":"The cellular and molecular basis of hyperthermia","volume":"43","author":"B Hildebrandt","year":"2002","journal-title":"Crit Rev Oncol Hematol"},{"issue":"10","key":"pone.0318330.ref022","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s00066-011-1145-x","article-title":"Quality assurance for clinical studies in regional deep hyperthermia","volume":"187","author":"G Bruggmoser","year":"2011","journal-title":"Strahlenther Onkol"},{"issue":"4","key":"pone.0318330.ref023","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s10238-022-00846-9","article-title":"Systematic review about complementary medical hyperthermia in oncology","volume":"22","author":"CM Liebl","year":"2022","journal-title":"Clin Exp Med"},{"issue":"8","key":"pone.0318330.ref024","first-page":"3408","article-title":"Hyperthermia in cancer therapy: the biological basis and unresolved questions","volume":"45","author":"LE Gerweck","year":"1985","journal-title":"Cancer Res"},{"issue":"3","key":"pone.0318330.ref025","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s40778-022-00215-y","article-title":"Interaction of Radiotherapy and Hyperthermia with the Immune System: a Brief Current Overview","volume":"8","author":"A Sengedorj","year":"2022","journal-title":"Curr Stem Cell Rep"},{"issue":"10","key":"pone.0318330.ref026","doi-asserted-by":"crossref","first-page":"218","DOI":"10.20517\/2394-4722.2017.35","article-title":"Cancer immunity and therapy using hyperthermia with immunotherapy, radiotherapy, chemotherapy, and surgery","volume":"3","author":"Y Yagawa","year":"2017","journal-title":"JCMT"},{"issue":"9","key":"pone.0318330.ref027","doi-asserted-by":"crossref","first-page":"2795","DOI":"10.3390\/ijms19092795","article-title":"Immunogenic Effect of Hyperthermia on Enhancing Radiotherapeutic Efficacy","volume":"19","author":"S Lee","year":"2018","journal-title":"Int J Mol Sci"},{"issue":"3","key":"pone.0318330.ref028","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.ejrad.2014.12.009","article-title":"Prognostic value of tumor necrosis at CT in diffuse large B-cell lymphoma","volume":"84","author":"HJA Adams","year":"2015","journal-title":"Eur J Radiol"},{"issue":"5","key":"pone.0318330.ref029","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/MPA.0000000000001539","article-title":"Clinical Utility of Histological and Radiological Evaluations of Tumor Necrosis for Predicting Prognosis in Pancreatic Cancer","volume":"49","author":"M Kudo","year":"2020","journal-title":"Pancreas"},{"issue":"2","key":"pone.0318330.ref030","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3109\/02656736.2015.1117661","article-title":"Long-term local control and survival after preoperative radiochemotherapy in combination with deep regional hyperthermia in locally advanced rectal cancer","volume":"32","author":"C Gani","year":"2016","journal-title":"Int J Hyperthermia"},{"issue":"2","key":"pone.0318330.ref031","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.radonc.2015.04.019","article-title":"Local control rate after the combination of re-irradiation and hyperthermia for irresectable recurrent breast cancer: Results in 248 patients","volume":"117","author":"M Linthorst","year":"2015","journal-title":"Radiother Oncol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T18:53:33Z","timestamp":1742928813000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318330"}},"subtitle":[],"editor":[{"given":"Shuai","family":"Ren","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318330","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,25]]}}}