Design and Testing of a Reflector Mechanism for The

DESIGN AND TESTING OF A REFLECTOR MECHANISM FOR THE

AUTOTHERM 300 DIATHERMY SYSTEM TO IMPROVE THE HEATING

MECHANISM AND REDUCE HEATING TIME FOR CANCER TUMOR THERAPY

A Project

Presented to the faculty of the Department of Electrical and Electronic Engineering

California State University, Sacramento

Submitted in partial satisfaction of the requirements for the degree of

MASTER OF SCIENCE

Electrical and Electronic Engineering

Abdulaziz Alhassan

FALL 2017

Abdulaziz Alhassan

DESIGN AND TESTING OF A REFLECTOR MECHANISM FOR THE

AUTOTHERM 300 DIATHERMY SYSTEM TO IMPROVE THE HEATNG

MECHANISM AND REDUCE HEATING TIME FOR CANCER TUMOR THERAPY

A Project

Abdulaziz Alhassan

Approved by:

______, Committee Chair Dr. Preetham B. Kumar

______, Second Reader Dr. Millica Markovic

______Date

iii

Student: Abdulaziz Alhassan

I certify that this student has met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library and credit is to be awarded for the project.

______, Graduate Coordinator ______Dr. Preetham Kumar Date

Department of Electrical & Electronic Engineering

Abstract

DESIGN AND TESTING OF A REFLECTOR MECHANISM FOR THE AUTO

THERM 300 DIATHERMY SYSTEM TO IMPROVE THE HEATNG MECHANISM

AND REDUCE HEATING TIME FOR CANCER TUMOR THERAPY

Abdulaziz Alhassan

Microwave and Radio Frequency (RF) hyperthermia is an FDA approved treatment in cancer treatment, usually used as an adjuvant to boost the effects of traditional radiation or chemotherapy. Many devices, including the Mettler Autotherm 300, have been designed to produce the requisite heating to ~ 42 degrees °C in the tumor volume,

The Autotherm 300 is used to heat muscular tissues that are infected by cancer disease, the heating therapy (Hyperthermia) proved that cancer cells can be destroyed by heating therapy. The studies prove that Hyperthermia is a friendly treatment and will not cause effects either at the time of application or the future. Using the appropriate heating temperature with chemotherapy can help the blood vessels absorb the therapy and improve the healing.

However, according to the National Cancer Institute

(https://www.cancer.gov/about-cancer/treatment/types/surgery/hyperthermia-fact-sheet), many challenges remain in the wide-spread use of hyperthermia: uniform heating over the tumor volume is desirable, and also heating time should be reduced. To assist in overcoming these challenges, the goal of this project is to understand how to test and use the Autotherm machine; furthermore, to gauge the heating mechanism changes due to the surrounding environment and, from the knowledge of microwave engineering, to understand how environmental impacts can disturb the heating process. This project is focused on how to optimally use the Autotherm 300 in any environment by understanding the heating mechanism. 20 tests were performed by applying different test media to standardize the heating procedure and detect any abnormalities. Frequently, the measurements proved that the heat absorption can change from one spot to another spot in testing media, which mimicked the human or animal body tissue.

This project also includes troubleshooting the Autotherm 300 along with the instruction manual to help in the future needs, because the heat of the drum (head of the machine) can be elevated to the boiling point (93.4 °C = 200.1 °F) and that can cause components exhaustion.

In this project the design and testing of the reflector device to boost the effects of the Autotherm 300 were performed. In addition to developing mathematical model to describe performance of reflectors, considerable laboratory measurements are needed to understand the performance of the device. The reflector is a passive addition to the

Autotherm device, and is designed from dielectric material with conical shape to help in focusing the heat. One design addition in the future could be the addition of absorber material within the conical volume. The design performed increases heating efficiency, and reduces heating time to reach the requisite hyperthermia temperature of

~ 42 degrees °C.

______, Committee Chair Dr. Preetham Kumar

______Date

vii

DEDICATION

To my father Adel and my mother Fawzia

viii

ACKNOWLEDGEMENTS

First of all, I would like to thank my advisor Dr. Preetham Kumar, my mentor for all the support and the encouragement. It was a great opportunity and honor to work and learn about Communication Engineering and Biomedical Engineering.

Special thanks to Mr. Doug Wilner the owner of Sacramento Radio Expo for helping me troubleshoot the Autotherm 300 machine tubes by allowing me to use his transistor checker machine.

I would like to thank the Sacramento State’s College of Health and Human

Services (HHS), UC Davis School of Veterinary Medicine and UC Davis Department of

Radiation Oncology for their support and participation to achieve an exclusive breakthrough of developing and upgrading the existing Autotherm 300 machine for increased efficiency and shorter heating time.

Specifically, the Department of Physical Therapy in the HHS College helped us in a preparatory RCA project, which involved sending a questionnaire to more than 50 cancer centers in the Sacramento Valley and surrounding regions. This questionnaire was distributed to obtain feedback on interest at these centers to start hyperthermia therapy as an adjuvant to radiation therapy.

Also special thanks to UC Davis School of Veterinary Medicine that have provided us with the clinical data of two canine patients, which will be helpful during the pilot clinical trial that is being planned in summer 2017. This pilot trial will involve use

ix of our newly developed hyperthermia unit (with the cone focuser) to complement radiation therapy on these two patients.

The UC Davis Department of Radiation Oncology is collaborating with us for future human clinical trials involving hyperthermia in 2018, following the outcome of the veterinary trials. Both trials will be conducted according to the required Board clearances.

Also I would like to express my gratitude to Dr. Millica Markovic for allowing me to use the microwave engineering lab to do my experiment on the Autotherm 300 devise. I also want to thank her being my second reader for this project. She helped me express my points and arguments.

My thanks go to all the faculty of the Electrical and Electronic Engineering (EEE)

Department in California State University, Sacramento (CSUS) for all the help and support.

Finally, special thanks to the Ministry of Education of Saudi Arabia for funding my study at CSUS. Their encouragement and support was outstanding. I also thank the

Saudi Arabian Cultural Mission for their assistance for all the support they provide through my education years.

TABLE OF CONTENTS Page

Dedication ...... viii

Acknowledgements ...... ix

List of Tables ...... xiv

List of Figures ...... xvi

Chapter

1. INTRODUCTION ...... 1

1.1 History...... 3

2. HYPERTHERMIA MECHANISM AND RELATION WITH ULTRASOUNDS ..... 5

2.1 Devices and heating mechanism in hyperthermia treatment ...... 5

2.2 Ultrasounds and the Discovery of the Diathermy ...... 6

2.3 Shortwave Diathermy Revolution ...... 7

2.4 Ultrasound and the Discovery of Improving Diathermy Therapy ...... 8

2.5 Safety Background of Ultrasound and the Shortwave Diathermy ...... 10

2.6 Mechanism between Human Tissue and Radiation ...... 12

2.7 Shortwave Diathermy Applications ...... 14

2.8 Dominant Laws of Shortwave Diathermy and Hyperthermia ...... 15

2.9 Arndt-Schultz Law Dosage ...... 15

2.10 Grotthuss Draper Law ...... 16

2.11 Inverse Square Law...... 17

2.12 Lambert’s Cosine Law ...... 18

2.13 Different Type of Diathermy Applications ...... 19

2.14 Inductive Diathermy Vs Capacitive Diathermy ...... 20

3. HYPERTHERMIA THERAPY IN MODERN TIME ...... 23

3.1 Current State of Hyperthermia Therapy and the Challenges ...... 23

3.2 Comparison between the United States and Europe in hyperthermia

treatment development ...... 25

3.3 Mechanism behind hyperthermia therapy ...... 26

3.4 Technical Use of Hyperthermia Therapy ...... 27

3.5 Hyperthermia Therapy Challenges ...... 28

4. REFLECTOR DESIGN AND TROUBLESHOOTING OF THE

AUTOTHERM 300 DIATHERMY SYSTEM ...... 29

4.1 General Information: ...... 29

4.2 Autotherm 300 Status: ...... 31

4.3 Measurement and the testing of the Autottherm 300 Diathermy: ...... 39

4.4 Focuser/ Absorber cone modeling ...... 64

xii

5. CONCLUSION AND FUTURE WORK ...... 68

Appendix A. Autotherm 300 Data Sheet ...... 70

References ...... 89

xiii

LIST OF TABLES

Tables Page

1. Ultrasound Frequency Applications ...... 7

2. Comparison between Autotherm 300 Autotherm 390 ...... 8

3. The Electromagnetic Spectrum ...... 11

4. Comparison between Different Types of Diathermy Applications ...... 20

5. Comparison of Diathermy Applications Effectiveness on the Body

Composition ...... 20

6. Test 1 Result after Replacing the Capacitors and a Resistor (R20) ...... 40

7. Test 2 Result with Experimenting On Changing the Height between the

Absorber Material and the Autotherm 300 ...... 42

8. Test 3 Result with Increasing the Distance between the Absorber

Material and the Autotherm 300 ...... 44

9. Test 4 Result With After Increasing the Distance between the Absorber

Material and the Autotherm 300 and Increasing the Time for Every Session ...... 46

10. Test 5 Result for 20 Mins for Each Session ...... 48

11. Test 6 Result for Increasing the Water Temperature to Make It Equivalent

to the Human Body Water Temperature ...... 50

12. Result of Test 7 with a Tube Failure Doubt ...... 52

13. Result of Test 8 with a Tube Failure Confirmed ...... 54

xiv

14. Result of Test 9 after Fixing the Tubes and Increasing the Water Temperature .. 56

15. Test 10 Result with High Water Temperature and Short Distance

to the Absorber ...... 58

16. Test 11 Result with Reducing the Distance between the Absorber Material

and the Diathermy ...... 60

17. Test 12 Result under Extreme High Water Temperature and Short Distance

between the Absorber Material and the Autotherm 300 ...... 62

18. Focuser Test for the Equivalent Model ...... 67

LIST OF FIGURES

Figures Page

1. The Frequency Approximation for the Ultrasound ...... 9

2. Radiation Spectrum of a Shortwave Therapy (Diathermy) ...... 10

3. Diagram for the Reaction between the SWD and Biological Tissue ...... 13

4. Geometric Draw for the Autotherm 300 with 30 Degree Angle ...... 14

5. Arndt-Stchultz Law for Dosage ...... 16

6. Grotthuss Draper Law for Absorption ...... 17

7. Schematic Diagram for Inverse Square Law ...... 18

8. Lambert Cosine Law ...... 19

9. Comparison between Conductive and Capacitive Diathermy on Different

Body Composition ...... 21

10. Machine Conductive Diathermy and Capacitive Diathermy Effectiveness

on Body Composition ...... 22

11. Faraday's Observations Law and the Mechanism of Conductive Diathermy ...... 22

12. BSD-500 Features Made By Pyrexar Medical ...... 23

13. Map of the Hyperthermia Therapy Clinics around the World ...... 24

14. Red Blood Cells and Oxygen Transfer during Hyperthermia Therapy ...... 26

15. Expansion of Blood Vessels Due To Elevated Temperature ...... 27

16. Autotherm 300 Made By Mettler Electronics ...... 31

17. Circuit Diagram for the Autotherm 300 Drum [Mettler Electronics] ...... 32

xvi

18. Tubes Test (A) Emission (B) Shorts (C) Ground Leakage ...... 34

19. The Capacitors Appear To Be Stressed and Require To Be Removed...... 35

20. Preparing the Capacitors to Be Removed ...... 35

21. Coil after Dislodging the Old Capacitors...... 36

22. New Capacitors Been Soldered To the Coil after Replacing the Old, Stressed

Capacitors ...... 36

23. R20 Broken and Create A Short Circuit ...... 37

24. New Resistor (R20) Placed Under the Tubes Chassis ...... 38

25. First Test of the Machine Show Positive Result ...... 38

26. Plot from the Matlab for Test 1 Result ...... 41

27. Matlab Plot for Test 2 Result ...... 43

28. Matlab Plot for Test 3 Result after Increasing the Distance between

the Absorber Material and the Autotherm 300 ...... 45

29. Matlab Result for Test 4 with Increasing the Distance between the Absorber

Material and the Autotherm 300 and Increasing the Time for Every Session ...... 47

30. Matlab Result for Test 5 with 20 Min for Each Session ...... 49

31. Matlab Result for Test 6 with the Increase of the Water Temperature ...... 51

32. Matlab Result for Test 7 Failure ...... 53

33. Matlab Plot for Test 8 ...... 55

34. Matlab Plot for Test 9 after Fixing the Tubes ...... 57

35. Matlab Result for Test 10 with Short Distance to the Absorber Material ...... 59

xvii

36. Test 11 Matlab Plot for Reducing the Distance between the Absorber

Material and the Diathermy ...... 61

37. Mat Lab Plot for Test 12 Result for Extreme High Water Temperature ...... 63

38. Focuser Model for Autotherm 300 (All the Dimensions in Inches) ...... 65

39. Beams Mechanism of the Autotherm 300 Reaction ...... 66

40. Equivalent Model of the Focuser ...... 67

xviii

CHAPTER 1

INTRODUCTION

According to the American Society of Clinical Oncology (ASCO), by 2030 the number of cancer cases will rise by 45% which will increase the number of cancer cases from 1.6 million to 2.3 million. Currently, cancer is the number 1 disease in the United

States, surpassing heart disease by 30% [6]. In the same period, the number of women dying from cancer will increase all around the world by 60%, according to the American

Cancer Society. All these numbers bring us the conclusion that medical professionals and the biomedical engineers need to work together and use any treatment that can help reduce the number of cancer patients [6], [7]. One of those active treatments for oncology is called Hyperthermia Therapy; the National Institutes of Health (NIH) define

Hyperthermia Therapy as: “a cancer treatment that allows the body to absorb heat and raise the body temperature up to 41°C to kill the cancer cells”, [1]. Hyperthermia Therapy helps to expose the cancer cells by weakening cancer cells and make them more sensitive to conventional Radiation Therapy [1].

Hyperthermia has been used around the world for the last two decades.

Hyperthermia is a support therapy to increase the performance of radiation therapy and chemotherapy. Cancers clinics in the past decade started to rely on hyperthermia therapy during radiation treatment because of its effectiveness in allowing blood vessels to dilate and carry more oxygen to the tumor, which collaborates with radiation to attack the cancer cells more effectively [1].

According to Cancer Treatment Centers of America (CTCA) radiation therapy was reduced to the minimum sessions when it was used along with hyperthermia; also the

CTCA was aware of the side effects of using the radiation therapy every session, for example tissue damage, pain and anorexia. The rationale for reducing the radiation therapy and increasing hyperthermia therapy demonstrate that the hyperthermia is a friendly treatment and it safe to use during the hospital, or home session [17]. Between

1995 and 2001 hyperthermia therapy was questioned. Concern was that hyperthermia is a slow process, since the patient needs from 30-45 minutes to elevate the tumor temperature to the requisite 42 degrees °C.

Additionally, insurance companies generally stood against this treatment because they believed it to be too time consuming (and indirectly money wasting). In the EEE

Department at CSUS a group of engineers are trying to increase the heating system efficiency of a hyperthermia therapy machine and reduce the time of the therapy. This study requires a large amount of experimental testing and also includes building a focuser that can potentially reduce the loss of the radio frequency (RF) signal and limit the time of the heating process, thereby increasing the machine efficiency.

1.1 History

Hyperthermia application goes all the way to the early Egyptian period, and this therapy was developed almost 5000 years ago. Modern studies found that Egyptian medicine healers tried to treat a breast cancer with a heating stick (no conformation if it was metal or nonmetal) [4]. Additionally, the Greek and the Roman scientists and doctors suggested using a heating metal to treat surface skin tumors. One of the Greeks

Hippocrates, wrote between 470-430BC “What the medicine doesn’t heal, the scalpel heals, what the scalpel doesn’t heal, heals the fire”. Also, Hippocrates believed in hyperthermia therapy by saying “give me the power to create fever and I can cure any disease” [3]. Chinese, Indian and Japanese cultures were not far from the Greek and the

Romans; they used stones and wool to increase the body temperature to treat liver disease, they also achieved a way do a full body hyperthermia by boiling water using stones and metal materials [1].

In the 1800s a medical reports show that patients with cancer being healed by reducing the size of the tumor using hyperthermia therapy. This news was a breakthrough in the history of tumor cancer. Unfortunately, scientist did not focus seriously on

Hyperthermia Therapy until 1970s [2].

In the middle of the 18th century Dr. William B. Coley, the father founder of the

Coley-Toxin that contained a bacteria, used his discovery to increase the body temperature and treat cancer patients. This treatment was one of the successful treatments in that period until World War II and from that time to the present, Coley-Toxin is one of the best healing therapy mankind found [2] [5] [8].

In 1900 a doctor name F. Westermark from Sweden, who was specialized in

Gynecology tried to treat a female patient who had been diagnosed with unresectable cervical carcinoma, by using a hot water running I n silvery coil (Hyperthermia Therapy).

This treatment was a long-term therapy that showed a positive reaction and healing symptoms [4] [5] [8].

Books and research papers prove that hyperthermia therapy started becoming the first priority in researches and experimenting in the late 1970s to the present. During the

1980 radiosensitization and chemosensitization were discovered by the use of hyperthermia in cancer cells and tumors [4] [8]. In the present time hyperthermia goes beyond what we imagined in the 1800s and is now included during surgery and in all stages of chemotherapy and radiation therapy. The world has become more open to this natural and patient-friendly treatment than before. Since 2001 biomedical engineers have focused on improving the treatment to achieve more efficiency. Now, there are many devices that help in treating cancer patients, whether it is a melanoma, breast cancer, or a sarcoma.

CHAPTER 2

HYPERTHERMIA MECHANISM AND RELATION WITH ULTRASOUNDS

2.1 Devices and heating mechanism in hyperthermia treatment

One of the prominent devices that help with hyperthermia treatment is the Mettle

Electronics Autotherm 300 which has been studied in the EEE Department at CSUS with focus on improving the heating efficiency and makes it more effective during the treatment by carrying out tests and experiments.

Mettler Electronics Corporation was found in 1975 by an engineer Hal Mettler.

Mettler Electronics focused on ultrasound and electro-stimulation to become one of the best in the world to work on biomedical instrumentation. In June 1975 the Corporation sold their ultrasound equipment with a reasonable price to attract more customers, and the ultrasound revolution helped the company to achieve their goal in a short time. In more recent times, Mettler Electronics Corporation extended their company and built many electronic devices from Diathermy therapy to massage therapy. Mettler Electronics has been the top provider of the Diathermy equipment since 1975, one of those popular products is Autotherm 300. According to the Mettler Electronics timeline Autotherm 300 production started in March 1975 and the Corporation broke the design into three different stages of fixing, editing and improving.

The following points will explain in detail on how Autotherm 300 been developed:

 In March 1975 schematic for Autotherm 300 for 115 volt provided.

 In July 1975 schematic for Autotherm 300 for 220 volt provided.

 In March 1977 high loads output test model provided.

 From May 1975 to August 1990 the schematic for Autotherm 300 for 115 volt

been changed and edited more than six times.

 From May 1975 to April 1988 the schematic for Autotherm 300 for 220 volt

been changed and edited more than three times.

 From October 1981 to December 1981 the loads have been tested again on high

and low mode to eliminate any chance of incident.

Through the document that Mettler Electronics Corporation provides Sacramento State

University, department of Electrical and Electronics Engineering, we found that

Autotherm (ME300) shortwave diathermy device was approved by the U.S. Food and

Drug Administration (FDA) in 1984 under a document number FDA85-8237 and Mettler

Electronics Corporation started circulating their product in February 1989.

2.2 Ultrasounds and the Discovery of the Diathermy

Sound Navigation and Ranging (SONAR) is the way to measure sounds under water and Jean Daniel Colladon in 1862, was the first Swiss physicist to discover ultrasound; his plan was to find and calculate the speed of the sound under water and he succeeded by using a bell placed in Geneva lake. Hundreds of scientists had been working and developing this new technology for over 75 years after Jean Colladon’s discovery [10].

During the 18th century ultrasound entered the medical field by developing shortwave and longwave diathermy. The word Diathermy came from a Greek word

“Therma” which means heat and “Dia” means through, and after combining them can be

7 defined as “Heat through”. Shortwave diathermy was discovered by a German physician named Karl Franz Nagelschmidt in 1908, and he also wrote a pamphlet called “Ueber

Diathermie (Transthermie, Thermopenetration)” in 1913 explaining his extensive experiments on diathermy machine built by him and its function on pain relief as well

[11]. Table 1 below shows the important applications of ultrasound.

Table 1: Ultrasound Frequency Applications

Areas Benefit

Military Mine detecting

Industry Sterilize water

Medical Treat Arthritis, Ulcers, detect Cancerous

tumors and more.

Nonindustrial Detect cracks and major damage of

bridges and oil/gas tanks

2.3 Shortwave Diathermy Revolution

In the past 40 years shortwave diathermy evolved to different stages and expanded the therapy area of muscle problems. The lead corporation Mettler Electronics developed four different shortwave diathermy models, there by adding the revolution of ultrasounds equipment. The latest device from Mettler Electronics Autotherm 390 was approved by FDA in (regulation number: 21 CFR 890.5290), and this device provided better deep heating of muscle tissues and reach deep large heating area. This device costs

$5000 with two years of warranty. The different between the Autotherm 300 and

Autotherm 390 can be found in Table 2 below [9].

Table 2: Comparison between Autotherm 300 Autotherm 390

Autotherm 300 Autotherm 390

A drum (single head) can be placed on the Two pads can be placed in the front and

muscle tissues the rear of the tissues

The machine can be control manually by The machine can be control by digital

turning the dosage control and the timer screen for both dosage control and time

switch control

Treatment frequency 27.12MHz Treatment Frequency start from 10GHz to

400GHz

Deep heat maximum 5 cm Deep heat maximum 5 cm

This comparison focuses on the important features that helped upgrading the Autotherm

300 to a better device and keep it place in this modern time, although the initial device did not lose its place in the medical field, many clinics still using it for deep heating therapy [9].

2.4 Ultrasound and the Discovery of Improving Diathermy Therapy

Ultrasound brought about big improvement in the field of medicine. It all started with Paul Langévin discovery in 1920s that it had a disruptive effect on animal tissues.

He notes a devastation of a school of fish in the sea and the pain in the hand when it is

9 placed in water tank and exposed for a long time with high intensity ultrasound. Also in

1944 J.G. Lynn and T.J. Putnam destroyed a brain tissue in an animal by using ultrasound therapy [10]. All these discoveries imply that ultrasound has a rich history of accomplishments and it is in the right path to be used as healing technique. Ultrasound and the therapies that fall under the shortwave system have had success in applications such as arthritis therapy to cancer tumor therapy. Figure 1 below shows the range of ultrasound frequencies and its applications.

Figure 1: The Frequency Approximation for the Ultrasound

Ultrasound frequencies applications operate from 20 KHz up to several MHz, and use ultrasound signals. Diathermy machine uses electromagnetic signals of shortwave frequency that operate between 13MHz-27.2MHz, with the exception of the machine

Autotherm 390 because it is an advanced device and it can generate multiple frequencies

(shortwave and longwave) at the same time to increase the effectiveness of the treatment and allow faster blood flow around the infection area.

2.5 Safety Background of Ultrasound and the Shortwave Diathermy

The public question of safety in use of radiation therapy (shortwave therapy ) is complex and the radiation can be divided to two different categories:

I. Ionizing Radiation

II. NonionizingRadiation

Figure 2 below shows the frequency range of shortware diathermy.

Figure 2: Radiation Spectrum of a Shortwave Therapy (Diathermy)

Each therapy falls in one of these categories based on the content of the energy that can be carried by the photons. The idea of ionizing a system means abolishing an electron from its orbit which will cause change in cell mitosis, and this will lead to cell death and cancerous lesions. Ionizing radiation carry more than 10 eV (Electron Volt) photon

11 energy according to the FCC (Federal Communications Commission). X-ray, ultraviolet and gamma rays are examples of ionizing radiation that might harm human tissue, and these rays fall between 90eV-120KeV. Non-ionizing radiation is logically the opposite of ionizing radiation, based on the amount of energy (less than 10 eV). Examples of this radiation are radio frequencies, microwave therapy and shortwave therapy,which are harmless and it do not effect the human tissue. Figure 2 shows the shortwave diathermy range and by using the electromagnetic spectrum calculation we found that radio waves and microwaves are less than 0.001eV (<0.001eV). This explanation puts to rest the rumors about the safety of the diathermy and the microwave therapy [12]. Details of ionizing and non-ionizing radiation are given below in Table 3.

Table 3: The Electromagnetic Spectrum

Parameter Frequency (Hz) Wavelength Energy per photon ELF < 3 × 103 > 100 km > 0.001 eV Nonionizing Radiation Radio Wave 3 × 103 > 100 km > 0.001 eV 300 × 106 1 m Microwave 300 × 106 1m > 0.001 eV 300 × 109 1 mm Infrared 3 × 1012 1 mm 0.01 eV 4 × 1014 750 nm 1.65 eV Visible 4 × 1014 750 nm 1.65 eV 7.5 × 1016 400nm 3.1 eV Ultraviolet 7.5 × 1014 400 nm 3.1 eV Ionizing 3 × 1016 10 nm 124 eV Radiation X-rays 3 × 1016 10 nm 124 eV 3 × 1019 0.01nm 124 KeV Gamma Rays > 1019 < 0.10 pm > 124 MeV

Table 3 explains ionizing and nonionizing radiation and how ionizing radiation has high electronvolt (eV). The frequency and the wavelength changes by using different radiation, also the higher the frequency the shorter the wavelength and higher chance of getting cancerous lesions (cancerous cells) [12].

2.6 Mechanism between Human Tissue and Radiation

When the Autotherm 300 (shortwave diathermy) sends electromagnetic radiation into human tissue (biological tissue), several actions can happen.

The interaction mechanisms listed below can help understand the mechanism of

Autotherm 300 and improve it to help treat cancerous tumors.

 Transmission

 Refraction

 Absorption

 Reflection

 Scattering

These interactions can have maximum effectiveness on the tissue if the angle of incidence and the room temperature meet the requirements as will be explain later in this report. Transmitting a shortwave signal to a biological tissue, as shown in Figure 3, with an angle of zero degrees can be refracted then absorbed by the tissue. This method show the tissue absorbs most of the beam power because of the effectiveness of a zero degree angle incidence [12].

Incident angle Auto*Therm 300 zero degree

Beam of shortwave Frequency

Transmitted Refracted

Tissue

Absorbed Radiation

Figure 3: Diagram for the Reaction between the SWD and Biological Tissue [12].

Figure 4 shows that the same machine with a beam incidence angle of 30 degrees at the surface of the biological tissue will also get refracted and absorbed, but most of the signal gets reflected away from the surface. This problem happens when the incidence angle is greater than zero degrees. Reflection and scattering are different mechanisms, reflection happens in Figure 4 because of the beam of radiation got deflected from the skin surface, on the other hand scattering happens because of the dispersion of the beam of the radiation which cause collision between the photons and the atoms of the radiated tissue

[12].

Zero Degree

0 30 erm Th to* Au

gle an nt ide Inc

le ng ° a 30

Beam

Transmitted Refracted

Tissue

Absorbed Radiation

Figure 4: Geometric Draw for the Autotherm 300 with 30 Degree Angle [12]

2.7 Shortwave Diathermy Applications

The diathermy machine can be bipolar (capacitive method), or Monopolar

(inductive method). The Autotherm 300 is a monopolar machine with a focusing drum.

The feature that makes the monopolar system better than bipolar is the deep heating mechanism that allows the beam to reach the deepest layer of the tissue (regardless of the under skin fat). This machine has a big effect on human tissuesuch as synovial fluid in muscles because soft tissues contain a large amount of water, or low electrical impedance

[12].

2.8 Dominant Laws of Shortwave Diathermy and Hyperthermia

Diathermy shortwave therapy laws explain the setup mechanism to achieve an optimal treatment. These laws, listed below, explain the processes of transmission, refraction, absorption, reflection and scattering

1. Arndt-Stchultz Law Dosage

2. Grotthuss Draper Law

3. Inverse Square Law

4. Lambert’s Cosine Law

2.9 Arndt-Schultz Law Dosage

In 1888 Arndt-Stchultz proposed the dosage law to prove that high chemical dosage can cause death. This idea also applies to radiation therapy. Cancer patients today are treated with radiation therapy, from which they become weak. This cause and effect can be explained Arndt Stchultz theory. In Figure 5, the Arndt-Stchultz Law Dosage explains the direct relationship between the effect/Response and the dose. The dose can be divided to three different categories therapeutic, toxic and lethal. The idea of using

Arndt-Stchultz Law on the Autotherm 300 is to alert the user about the high dose consequences. In Figure 5, which shows the heating pattern of the devices, the therapeutic temperature range of the Autotherm 300 can be between 39-41 °C. However, when the human body absorb high dose of heat, it might cause tissue damage and other risks [12].

i S Therapeutic

y r

o Toxic

n I

Lethal

Small/moderate Strong Strongest

Figure 5: Arndt-Stchultz Law for Dosage [12]

2.10 Grotthuss Draper Law

In 1822 Theodor von Grotthuss proposed a way to achieve a depth heat effect by defining the inverse relationship between the radiation energy and the human skin absorption. Grothhuss believed that radiation energy is absorbed only by the skin surface and it is not effective therapy. The inverse relationship between superficial tissue and the radiation absorption is shown in Figure 6, which compares the different absorption between drums A, B and C, and it is seen that when the biological tissue gains more radiation energy, the absorption will be deeper and the effectiveness will be higher. On the other hand, choosing either bipolar or unipolar diathermy machine (capacitive or inductive) will change the formula of deep heat and high effectiveness [12].

zero degree Incident Auto*Therm 300 angle

No effect Superficial effect

Deep effect Tissue

A B C

Figure 6: Grotthuss Draper Law for Absorption [12]

2.11 Inverse Square Law

The inverse square law shows the inversely proportional relationship between the radiation intensity (I) and distance (D) in the formula below:

1 Intensity (I) = (2-1) Distance2

They can be applied to many different applications such as light, sound and radiation.

Figure 7 show an application of inverse square law for biological tissue, and as it seen from the figure; the effectiveness of the therapy can collapse when the distance is increased. When the depth changes from distance 1 to distance 2, the performance of the therapy reduces by 25%, which mean the absorption spreads to four different areas.

Distance 3 shows very light absorption after applying the formula given in eqn. 2-1:

1 1 I = = = 0.0123% This mean the absorption will not show any effectiveness [12]. 92 81

Distance 1 A` 1

Distance 2 A A A A 1/4

Distance 3 A A A A A A A A A 1/9

Figure 7: Schematic Diagram for Inverse Square Law [12]

2.12 Lambert’s Cosine Law

This formula was published by Johann Heinrich Lambert in 1760 in his book

Photometria. When the beam of photon radiation energy is sent into a soft tissue, the amount of absorption depends on the cosine value of the incidence. The inverse relationship between the incident angle and the amount of the radiation energy is shown in Figure 8. Using the Lambert cosine formula, the available energy that is sent to the tissue is

(Eθ) = the energy from the drum (E)* the cosine of the incident angel (Cos θ), or:

Eθ = E × cos (θ) (2-2)

As the incident angle increases, lesser amount of energy is going to be available for absorption. This law clarifies the way to keep the incident angle at zero degree to achieve optimal therapy [12].

0° 30° 60° N N zero degree Incident Auto*Therm 300 angle

θ θ

Transmitted Refracted 100% 86% 50% Tissue Absorbed Radiation Figure 8: Lambert Cosine Law [12]

2.13 Different Type of Diathermy Applications

Diathermy, in general, has different type of applications, such as treatment of cancer disease and non-cancer disease. Shortwave, microwave and non-thermal shortwave are all types of diathermy treatment, and they have different frequency and application. Each application has different effectiveness related the frequency and the radiation field [13]. Figure 4 compares the different types of diathermy applications.

Table 4: Comparison between Different Types of Diathermy Applications

Type Thermal of short wave Diathermy Microwave Non Thermal Diathermy shortwave Diathermy Frequency 27.12MHz 2450MHz 27.12MHz Applicator Inductive coil Capacitive Magnetron Inductive coil plate drum Incident Field Electromagnetic Electric Electromagnetic Electromagnet ic Tissues most Deep and Superficial Small area Deep and effected superficial superficial

2.14 Inductive Diathermy Vs Capacitive Diathermy

Shortwave Diathermy has two types of devices: inductive diathermy and capacitive diathermy. They have different effects on fat, muscle and bone, as it shown in

Table 5 and Figure 9, which shows a comparison between all the diathermy application and the shortwave applicators as well. This comparison allows the patient to understand the effectiveness of the various devices and have an idea about the therapy process on the body composition [13].

Table 5: Comparison of Diathermy Applications Effectiveness on the Body Composition

Type of Fat Muscle Bone application Indicative Minimum Maximum None diathermy Capacitive Maximum Moderate Low diathermy Microwave Maximum Maximum None diathermy Ultrasound Slight Maximum None

Figure 9: Comparison between Conductive and Capacitive Diathermy on Different Body

Composition

In addition to previously pointed details of the effectiveness of inductive diathermy and capacitive diathermy in different body compositions, Figure 9 show how inductive diathermy focuses on the muscle and adipose tissue to help increase the blood flow to the cancer tumor [13]. This operation creates an oscillated magnetic field, as shown in Figure

10, which is related to Faraday's law (time varying magnetic field "produces" an electric field)

∇ × E⃗⃗ = − ∂tB⃗⃗ (2-3)

Also Faraday’s law explains how the voltage around a closed loop (Γ) is equal to the rate of the charge of the magnetic flux through the loop, according to the formula below:

dΦ ∮ E⃗⃗ ∙ dr = − B (2-4) Γ dt

Figure 10: Machine Conductive Diathermy and Capacitive Diathermy Effectiveness on

Body Composition

Figure 11: Faraday's Observations Law and the Mechanism of Conductive Diathermy

CHAPTER 3

HYPERTHERMIA THERAPY IN MODERN TIME

3.1 Current State of Hyperthermia Therapy and the Challenges

Starting in the 1980s, hyperthermia therapy in cancer treatment has been going through a lot of difficulties and FDA isquestioning the effectiveness of this treatment.

Many cancer clinics still believe in the old results of the hyperthermia trial tests which were significantly flawed due to the lack of RF and microwave focusing technology.

Currently, hyperthermia therapy has developed into an advanced technology, as proven by many clinical trials around the world [14-16]. For example, Pyrexar Medical is a company that manufactures hyperthermia therapy products to treat cancer, for over 30 years and sells them in US, Europe and Asia as a documented treatment [14].

Figure 12: BSD-500 Features Made By Pyrexar Medical

Figure 11 shows one of the hyperthermia units manufactured by Pyrexar Medical, the

BSD-500, for treating superficial tumors at a maximum depth of one inch below the skin surface. BSD-500 utilizes a RF frequency of 915MHz to heat superficial tumors. Also the machine has three waveguides which allow it to focus the beam on the surface tumor, and also has a thermometer to keep a track of tumor temperature. According to Pyrexar

Medical the BSD-500 is one of the popular systems used around the United States for superficial hyperthermia therapy [14].

Figure 13: Map of the Hyperthermia Therapy Clinics around the World

[Courtesy: Pyrexar Medical]

Pyrexar Medical helps cancer patients to find clinics around the world that used hyperthermia therapy, and most of those clinics are shown in figure 13 they use Pyrexar

Medical products like the BSD-500 and BSD-2000 for deep hyperthermia treatment. The persecution that Pyrexar Medical faced over the years prevented the company from

25 reaching up to different clinics around the world. The company could not be financed to help improve their clinical tests using hyperthermia machines, because the FDA and other medical communities felt that the company was very small and could not handle a large scale trial on its own. This destructive criticism in the USA made Pyrexar Medical to advertise their products and show the benefits of the hyperthermia elsewhere around the world.

3.2 Comparison between the United States and Europe in hyperthermia

treatment development

One of the most advanced countries in the European region is Germany; they have more than hundred clinics around the country which use hyperthermia therapy to treat cancer [14]. German clinics believe that not everyone who is diagnosed with cancer can be eligible for chemotherapy or radiation therapy, because of the significant number of the side effects that are caused by these conventional treatments. Many cases in

Germany involve children, senior citizens including rare type cancer patients treated only with full hyperthermia therapy and it show an overall positive acceptance of the treatment. On the other hand, the FDA in the United States only gave approval for hyperthermia therapy to be treated along with radiation therapy as an adjuvant treatment modality to enhance the tumor response, or by reducing the amount of radiation therapy and substitute with hyperthermia therapy. This technique helped reduce the radiation therapy side effects, but it is not effective as using the hyperthermia while taking the chemotherapy dose because clinical trials have proved that using hyperthermia during the

26 chemotherapy increases the concentration of the drug and increases the blood flow to the tumor cancer. This cycle increases the drug toxification to the cancer cells that have resisted many other drugs before [16].

In addition, hyperthermia therapy does not cause toxification to the tissue or harm any of the body organs. According to Pyrexar Medical, hyperthermia can cause side effects, in the range of 10% of burns, 10% of pain, 2% of infection and 9% of ulceration [14].

3.3 Mechanism behind hyperthermia therapy

Hyperthermia therapy raises the body temperature to ~ 42 degrees °C and let the red blood cells carry more oxygen through the vessels and to the tumor as shown below in figure 14 [14].

Figure 14: Red Blood Cells and Oxygen Transfer during Hyperthermia Therapy

This therapy simply targets the blood vessels and expands them when the hyperthermia beams frequency focuses on the cancer spot. This expansion gives more opportunity to the chemotherapy to attack the cancer cells as it show below in figure 15. Hyperthermia makes cancer cells weak, critical and easy to target [14].

Figure 15: Expansion of Blood Vessels Due To Elevated Temperature

This process is also found to have an added benefit of reducing the amount of radiation therapy to cancer patients. The US FDA approved this therapy primarily for this reason, recently radiation therapy has been causing tissue damage, blood poisoning and can potentially change the stage of cancer to a higher level [14].

3.4 Technical Use of Hyperthermia Therapy

Clinical trials advise cancer clinics to give radiation therapy after an hour of hyperthermia therapy for more effectiveness and enhanced attack on cancer cells. Also, hyperthermia cannot be given every day; it needs at least two days between successive treatments, to avoid the state of thermotolerance, when the body no longer responds to heat. Further studies showed that hyperthermia cannot be given every day also because of the biological structure of the human body’s systems. Human body’s systems have the ability to create a shield for its cells against heat alleviation. In addition, tumor physiology studies show a strong bond between the tumor cells and the thermotolerance,

28 and the cells can maximally survive between 4-24 hours. The study also shows that thermotolerance can be developed quickly and decays slowly in the next five days.

Thermotolerance can stress the human cells and cause tissue poisoning in the long term.Thermotolerance problem changes the application schedule of hyperthermia therapy

[15].

3.5 Hyperthermia Therapy Challenges

The most dissatisfying factor in hyperthermia therapy is the mechanism of heating, since hyperthermia devices lose heat when the temperature changes. At that moment, the device has to deal with two issues: human body temperature and room temperature both of which resist the heat and weaken the device efficiency. This project effort is focused on the following goals:

 Understanding how the heat gets absorbed to the human body, and how the

thickness of the human tissues affects the absorption

 How to reduce the heating time while using the hyperthermia device, and also to

study the efficiency of the device after long term of use, by reviewing the result

of studies that have been done by other hyperthermia clinics and agencies

 Overall the important task is how to improve the heating mechanism and

overcome most, if not all the resisting problems that hyperthermia devices are

facing. The next chapter discusses the improvement of the heating system and

step taken to reduce the heating time and increase the machine efficiency.

CHAPTER 4

REFLECTOR DESIGN AND TROUBLESHOOTING OF THE AUTOTHERM 300

DIATHERMY SYSTEM

4.1 General Information:

For many years, shortwave diathermy has been a very popular treatment for producing deep heating in body tissues. Most diathermy units operate at a frequency of

27.12 megahertz with a wavelength of about 11 meters, generating a high frequency oscillating field. This field is introduced into the body by means of various styled electrodes in the form of pads, drums, and cables. Heat is generated as the body tissues

"resist" the passage of high frequency induced by these fields. This application is termed

MEDICAL DIATHERMY when the rise in tissue temperature is within tolerable limits and deep heating occurs. Various electrodes have been used as condenser pads, cuff electrodes, air-spaced plates, drum, and induction field diathermy. Depth of penetration and selective heating of tissues depend on the electrodes. Condenser pads and cuffs produce mainly superficial heat, while the performance of air-spaced electrodes is affected by the necessity of critical spacing and placement. Drum electrodes have been extremely popular because of the flexibility use and deep heating effect.

Ordinary shortwave diathermy units generate high applicator voltages which can result to increase heating on the skin. The Mettler Autotherm has a unique patented circuit which generates an electromagnetic field that produces a deeper and more comfortable heating pattern. Studies performed at an independent medical centers

30 demonstrated tissue temperature rise to 40.5 °C at a depth of 2 inches in 20 minutes. The

Mettler Autotherm is lean in appearance in comparison with the bulky styling of ordinary units. Mettler patents include placement of the oscillator and output circuitry within the induction coil drum head assembly, eliminating cable applicator problems associated with ordinary diathermy.

There are advantages and benefits resulting from this approach detailed above.

The heavy insulated arm necessary to hold other drum applicators has been replaced by a lightweight, spring-balanced, all-metal treatment arm and hence shoulder, back, chest, ankle, etc. are easily reached and treated. Stray radiation from cables is greatly reduced, and more of the energy is emitted to the body under the drum. With other cable methods, cables may make contact with another surface or each other, resulting in the possibility of tissue burn from the concentration of energy at that point. With the Autotherm, the danger of cables crossing and touching each other as well as the danger of a single cable touching the patient is eliminated. The heating pattern is localized under the drum, and therefore, depth of penetration and effective heating current are assured (for more detail check appendix a page 75).

4.2 Autotherm 300 Status:

In the beginning of 2015 the Autotherm 300 machine that was installed in our laboratory was unusable, and the machine went through different stages of troubleshooting from checking the head (drum), intensity control and time switch, as show in figure 16. A data sheet and a service manual were requested from Mettler

Electronics Corporation to have a closer look at the issue.

Figure 16: Autotherm 300 Made By Mettler Electronics

After looking at the circuit diagram of the Autotherm 300 drum, as shown in

Figure 17, the transistor tubes of the machine (6HF5) could be the problem, and these tubes require a special device to be checked. The testing device name is Sencore TC28

Tube-Transistor Checker and each tube needs to pass three (3) different tests: emission, shorts and ground leakage, as shown in Figures 18 a, b and c respectively. Those tests determine if the tubes are valid to be used or not. The Sencore TC28 device was available out the university range. Mr. Doug Wilner the owner of Sacramento Radio Expo helped testing the tubes and explained how to use the Sencore TC28 device as it shown in

Figure 18.

Figure 17: Circuit Diagram for the Autotherm 300 Drum [Mettler Electronics]

(A)

(B)

(C)

Figure 18: Tubes Test (A) Emission (B) Shorts (C) Ground Leakage

The next step was to check the capacitors of the Autotherm 300 drum, which are connected to the coil and removing them for checking their functionality was difficult and required a lot of heat to melt the solder. After examining the capacitors, as shown in figure 19, they appeared to be stressed and needed to be checked by a capacitor meter.

The capacitors were swelling because of the heavy load of power went through the capacitors. Figures 19-22 show the steps in replacing the damaged capacitors with the new ones

Figure 19: The Capacitors Appear To Be Stressed and Require To Be Removed

Figure 20: Preparing the Capacitors to Be Removed

Figure 21: Coil after Dislodging the Old Capacitors

Figure 22: New Capacitors Been Soldered To the Coil after Replacing the Old, Stressed

Capacitors

After finishing phase 1 (replacing old capacitors with new capacitors) the Autotherm 300 still could not function normally, hence the depth troubleshooting moved on to phase two

(2). In the circuit diagram of Figure 16 a resistor (R20 = 5.6KΩ, 2 watt) was found broken in a small circuit under the tubes chassis, one end of this resistor is contacted to junction point between the tubes and the other end connected to a conductor (L2). Figures

23 - 24 show the steps of replacing the damaged resistor, Figure 25 show the completely repaired Mettler Autotherm unit.

Figure 23: R20 Broken and Create A Short Circuit

Figure 24: New Resistor (R20) Placed Under the Tubes Chassis

Figure 25: First Test of the Machine Show Positive Result

4.3 Measurement and the testing of the Autotherm 300 Diathermy:

Preparing the Autotherm 300 requires good room temperature between 23-25 °C, appropriate absorber material, and accurate thermostat to measure the heating in the absorber material dampened with room temperature water. These conditions were applied because of the school regulations and test guide from third party companies involved in shortwave testing instruments. The overall heating experiment involves 12 different tests, and each test has different focus area. For instance, test number 1 focuses on the function of the machine.to check if it is providing the heating Mettler Labs advised to use water with the foam absorber material to test the shortwave diathermy machine and the most interesting part of the testing is finding how heat can be very sensitive to any variation of the parameters. The heating process can be disturbed by moving the machine drum away from the absorber material, or changing the angle of the drum. The achievement of all the initial tests was to find how the heat absorption can be affected by the room temperature. In other words, the air conditioner can be a big challenge for the Autotherm

300 diathermy to achieve the target temperature. During the test Autotherm 300 show a positive result when the water temperature was close to the human body temperature

(35.1 °C - 36.6 °C). For satisfactory heating of the absorber material, it was found that the maximum distance between the absorber material and the machine drum cannot be more than 3 cm, and also the minimum distance cannot be smaller than 0.5 cm. It was concluded that the issue of parameter variation can be solved by building a focuser (cone shape) to help reduce the interference and redirect the beam to the absorber material by

40 application of an earlier theory like inverse square law, Grotthuss Draper law, Lambert’s cosine law and Arndt-Schultz law dosage. All those hypotheses can help achieve comforting the patients and reduce the heating time of the diathermy machine.

The following Tables 6-17 illustrate the heating results at various stages of the diathermy machine testing, and Figures 26-37 show the graphical variation of the heating in the absorber material as a function of time.

Table 6: Test 1 Result after Replacing the Capacitors and a Resistor (R20)

Test Number Water temperature = 21.6 °C / Room temperature = 26.1 °C

1 Height between Autotherm 300 and the absorber material= 1.0 cm

A/C ON 1st 2nd 3rd 4th

Temperature

change every 37.5 °C 51.83 °C 49.11 °C 43.0 °C 15 min for 1

hour testing

Matlab for Test 1:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.0 cm

%Water temperature 21.6 °C

%Room temperature 26.1 °C

% A/C ON clc, clear all, close all

%Test 1 temp = [37.5,51.83,49.11,43.0]; t = [15,30,45,60]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 26: Plot from the Matlab for Test 1 Result

Table 7: Test 2 Result with Experimenting On Changing the Height between the

Absorber Material and the Autotherm 300

Test Number Water temperature = 23.88 °C / Room temperature = 25.55°C 2 Height between Autotherm 300 and the absorber material= 1.30 cm A/C OFF 1st 2nd 3rd 4th Temperature change every 31.5 °C 33.33 °C 46.66 °C 47.77 °C 15 min for 1 hour testing

Matlab for Test 2:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.30 cm

%Water temperature 23.88 °C

%Room temperature 25.55 °C

% A/C OFF clc, clear all, close all

%Test 2 temp = [31.5,33.33,46.66,47.77]; t = [15,30,45,60]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 27: Matlab Plot for Test 2 Result

Table 8: Test 3 Result with Increasing the Distance between the Absorber Material and

the Autotherm 300

Test Number Water temperature = 21.66 °C / Room temperature = 26.11°C 3 Height between Autotherm 300 and the absorber material= 2.54 cm A/C OFF 1st 2nd 3rd 4th Temperature change every 29.44 °C 32.22 °C 34.0 °C 36.11 °C 15 min for 1 hour testing

Matlab for Test 3:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.30 cm

%Water temperature 21.66 °C

%Room temperature 26.11 °C

% A/C OFF clc, clear all, close all

%Test 3 temp = [29.44,32.22,34.0,36.11]; t = [15,30,45,60]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 28: Matlab Plot for Test 3 Result after Increasing the Distance between the

Absorber Material and the Autotherm 300

Table 9: Test 4 Result With After Increasing the Distance between the Absorber Material

and the Autotherm 300 and Increasing the Time for Every Session

Test Number Water temperature = 20.94 °C / Room temperature = 25.55°C 4 Height between Autotherm 300 and the absorber material= 5.0 cm A/C OFF 1st 2nd 3rd 4th Temperature change every 26.11 °C 28.0 °C 28.3 °C 29.66 °C 30 min for 2 hour testing

Matlab for Test 4:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 5.0 cm

%Water temperature 20.94 °C

%Room temperature 25.55 °C

% A/C OFF clc, clear all, close all

%Test 4 temp = [26.11,28.0,28.3,29.66]; t = [30,60,90,120]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 29: Matlab Result for Test 4 with Increasing the Distance between the Absorber

Material and the Autotherm 300 and Increasing the Time for Every Session

Table 10: Test 5 Result for 20 Mins for Each Session

Test Number Water temperature = 21.94 °C / Room temperature = 24.16°C 5 Height between Autotherm 300 and the absorb material= 2.54cm A/C OFF 1st 2nd 3rd Temperature change every 36.16 °C 40.38 °C 44.5 °C 20 min for 1 hour testing

Matlab for Test 5:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 2.54 cm

%Water temperature 21.94 °C

%Room temperature 24.16 °C

% A/C OFF clc, clear all, close all

%Test 5 temp = [97.1,104.7,112.1]; t = [20 40 60]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 30: Matlab Result for Test 5 with 20 Min for Each Session

Table 11: Test 6 Result for Increasing the Water Temperature to Make It Equivalent to

the Human Body Water Temperature

Test Number Water temperature = 27.77 °C / Room temperature = 25.95°C

6 Height between Autotherm 300 and the absorber material= 1.30 cm

A/C ON 1st 2nd 3rd 4th

Temperature

change every 27.77 °C 31.11 °C 42.22 °C 42.22 °C 30 min for 2

hour testing

Matlab for Test 6:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.30 cm

%Water temperature 27.77 °C

%Room temperature 25.95 °C

% A/C ON clc, clear all, close all

%Test 6 temp = [27.77,31.11,42.22,42.221]; t = [30 60 90 120]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 31: Matlab Result for Test 6 with the Increase of the Water Temperature

Table 12: Result of Test 7 with a Tube Failure Doubt

Test Number Water temperature = 36.7 °C / Room temperature = 26.1°C

7 Height between Autotherm 300 and the absorber material= 1.30 cm

A/C ON 1st 2nd 3rd 4th

Temperature Experiment

change every stopped 33.4 °C 31.6 °C 32.1 °C 30 min for 2 because no

hour testing improvement

Matlab for Test 7:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.30 cm

%Water temperature 36.7 °C

%Room temperature 26.1 °C

% A/C ON clc, clear all, close all

%Test 7 temp = [33.4,31.6,32.1,0]; t = [30 60 90 120]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 32: Matlab Result for Test 7 Failure

Table 13: Result of Test 8 with a Tube Failure Confirmed

Test Number Water temperature = 36.0 °C / Room temperature = 23.0 °C

8 Height between Autotherm 300 and the absorber material= 1.30 cm

A/C OFF 1st 2nd 3rd 4th

Temperature Experiment

change every stopped Tubes 31.4 °C 28.8 °C 29.5 °C 30 min for 2 need to be

hour testing changed

Matlab for Test 8:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.30 cm

%Water temperature 36.0 °C

%Room temperature 23.0 °C

% A/C OFF clc, clear all, close all

%Test 8 temp = [31.4,28.8,29.5,0]; t = [30 60 90 120]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 33: Matlab Plot for Test 8

Table 14: Result of Test 9 after Fixing the Tubes and Increasing the Water Temperature

Test Number Water temperature = 27.27 °C / Room temperature = 22.27 °C

9 Height between Autotherm 300 and the absorber material= 1.4 cm

A/C OFF 1st 2nd 3rd

Temperature

change every 27.27 °C 34.05 °C 58.55 °C 30 min for 90

mins testing

Matlab for Test 9:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.40 cm

%Water temperature 27.27 °C

%Room temperature 22.27 °C

% A/C OFF clc, clear all, close all

%Test 9 temp = [27.27,34.05,58.55]; t = [30 60 90]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 34: Matlab Plot for Test 9 after Fixing the Tubes

Table 15: Test 10 Result with High Water Temperature and Short Distance to the

Absorber

Test Number Water temperature = 27.77 °C / Room temperature = 22.83 °C

10 Height between Autotherm 300 and the absorber material= 1.50 cm

A/C ON 1st 2nd 3rd

30 min for 90

mins testing + 29.66 °C 54.0 °C 32.16 °C a delay for 20

second

Matlab for Test 10:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.50 cm

%Water temperature 27.77 °C

%Room temperature 22.83 °C

% A/C ON clc, clear all, close all

%Test 10 temp = [29.66,54.0,32.16]; t = [30 60 90]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)'

Figure 35: Matlab Result for Test 10 with Short Distance to the Absorber Material

Table 16: Test 11 Result with Reducing the Distance between the Absorber Material and

the Diathermy

Test Number Water temperature = 20.44 °C / Room temperature = 21.11 °C

11 Height between Autotherm 300 and the absorber material= 0.5 cm

A/C ON 1st 2nd 3rd 4th

30 min for 2

hour testing 25.88 °C 29.11 °C 34.72 °C 33.88°C with a delay of

15 second

Matlab for Test 11:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 0.50 cm

%Water temperature 20.44 °C

%Room temperature 21.11 °C

% A/C ON clc, clear all, close all

%Test 11 temp = [25.88,29.11,34.72,33.88]; t = [30 60 90 120]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 36: Test 11 Matlab Plot for Reducing the Distance between the Absorber Material

and the Diathermy

Table 17: Test 12 Result under Extreme High Water Temperature and Short Distance

between the Absorber Material and the Autotherm 300

Test Number Water temperature = 41.1°C / Room temperature = 22.88 °C

12 Height between Autotherm 300 and the absorber material= 1 cm

A/C OFF 1st 2nd 3rd

Temperature

change every 51.38 °C 53.05 °C 54.05 °C 30 min for 90

mins testing

Matlab for Test 12:

%% Abdulaziz's Project

%Height between Autotherm and the Sponge = 1.0 cm

%Water temperature 41.1 °C

%Room temperature 22.88 °C

% A/C OFF clc, clear all, close all

%Test 12 temp = [51.38,53.05,54.05]; t = [30 60 90]; stairs(t,temp,'r'), xlabel('Time (mins)'), ylabel('Temperature (°C)')

Figure 37: Mat Lab Plot for Test 12 Result for Extreme High Water Temperature

4.4 Focuser/ Absorber cone modeling

This section explains the design of the cone absorber and the theoretical basis to build the focuser. As was discussed in Chapter 2 the performances of shortwave devices rely on laws like the Arndt-Stchultz Law Dosage, Grotthuss Draper Law, Inverse Square

Law and Lambert’s Cosine Law. These laws helped understanding the heating mechanism within the animal body; additionally we can also use the knowledge of the signal processing and apply it to shortwave diathermy systems. The previous tests helped find the maximum distance between the Autotherm 300 and the absorber material for effective heating. This hypothesis was arrived after testing the heating distance on hot water, cold water and room temperature water.

The dimensions of the focuser were based on the drum diameter, and the cone was built to fit into the drum, and to allow applying the absorber material around the focuser. The most important part of the design is the angle of the cone, Solidworks© software determined the angle of the cone after adding all the dimensions of the design.

The idea of the inclined angle of the focuser is to minimize the distance between the drum and the cancer tumor, while avoiding any discomfort for the patient like pain and dizziness. Additionally, the shape of the focuser was designed to be easy to target any spot in the body; otherwise the specialist will have difficulty in applying the therapy with the big drum to the patient.

Figure 38 shows the design of the focuser with an angle of 68.74° degree to position the drum as close as possible to the cancer tumor spot without discomfort to the patient.

Figure 38: Focuser Model for Autotherm 300 (All the Dimensions in Inches)

The idea in figure 39 of the focuser is to direct the RF beam (pull the signal) to a different direction by applying the absorption material outside the focuser. This technique called

Directivity, according to Balanis in his book on Antenna Theory [18] is defined as “the ratio of the radiation intensity in a given direction from the antenna to the radiation intensity averaged over all directions. The average radiation intensity is equal to the total power radiated by the antenna divided by 4π. If the direction is not specified, the direction of maximum radiation intensity is implied.” The mathematical equation for

Directivity is given below in eqn. (4-1)

U 4 πU D = = (4-1) U0 Prad

D = directivity (dimensionless)

U = radiation intensity (W/unit solid angle)

U0 = radiation intensity of isotropic source (W/unit solid angle)

Prad = total radiated power (W)

coil

Focuser Auto*Therm 300 Drum Beams

Figure 39: Beams Mechanism of the Autotherm 300 Reaction

The cone focuser was designed using Solidworks© software; however the design could not be printed at the 3D lab in the Sacramento public library because the shape is too large and the printer could not print a shape with 9 inch diameter. Also, the 3D hub website could not help either to find a way to print the shape, hence finding an equivalent shape was the only way to fix this problem temporally till we find a printer for the model.

Figure 40: Equivalent Model of the Focuser

Figure 40 shown the equivalent model of the actual focuser, and one test was applied on the focuser and the result is shown below in table 18

Table 18: Focuser Test for the Equivalent Model

Water temperature = 41.1°C / Room temperature = 22.88 °C Focuser test Height between Autotherm 300 and the absorber material= 6.5cm

A/C ON 1st 2nd 3rd

Temperature change every 35.88 °C 36.5 °C 37.16 °C 30 min for 90 mins testing

CHAPTER 5

CONCLUSION AND FUTURE WORK

Hyperthermia therapy shows promise of positive results in cancer treatment, and with lesser side effects than other standard treatment like radiation and chemotherapy. All the research that been focused on the use of hyperthermia therapy and its effectiveness, prove that this treatment has no toxicity to the patient. This project helps in overcoming some of the challenges in Hyperthermia treatment, and put new ideas together to upgrade the heating system for the Autotherm 300 device. This was achieved by hypothesizing that the heating system needs to contain the heat and direct it as is explained in the end of chapter 4. One important discovery of this project was the room temperature interference, and the finding that the Autotherm 300 cannot focus heat while the air conditioning pushes the room temperature below 25°C, thus weaken the device and increasing the components’ temperature which will harm the device in the long term.

Additionally, we found that since shortwave therapy run on 27.2MHz, this require an absorbing material that can be tuned at that frequency, after talking with Lee Hill, founder partner of SILENT solution LLC, interference from other signals can be very complicated especially in the era of technology. The solution to contain and redirect a RF signal at 27 MHz would require an absorber material with 15 cm thickness. This material needs to be placed around the beam source (the drum of the machine) to maintain the RF signal instead of losing it.

Future work has been planned on a pilot trial using the improved Mettler

Autotherm 300 system, along with the focuser. This pilot trial will involve a few patients at the UC Davis School of Veterinary Medicine. Additionally, efforts will also be made to fabricate an improved focuser design using 3D printing technology, with advanced absorber material that will be placed around, or inside the focuser.

Appendix A. Autotherm 300 Data Sheet

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