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Background: Hyperthermia, i.e., raising tissue temperature to 40-45°C for 60 min, has been demonstrated to increase the effectiveness of radiation and chemotherapy for cancer. Although multi-element conformal heat applicators are under development to provide more adjustable heating of contoured anatomy, to date the most often used applicator to heat superficial disease is the simple microwave waveguide. With only a single power input, the operator must be resourceful to adjust heat treatment to accommodate variable size and shape tumors spreading across contoured anatomy. Methods: We used multiphysics simulation software that couples electromagnetic, thermal and fluid dynamics physics to simulate heating patterns in superficial tumors from commercially available microwave waveguide applicators. Temperature distributions were calculated inside homogenous muscle and layered skin-fat-muscle-tumor-bone tissue loads for a typical range of applicator coupling configurations and size of waterbolus. Variable thickness waterbolus was simulated as necessary to accommodate contoured anatomy. Physical models of several treatment configurations were constructed for comparison of simulation results with experimental specific absorption rate (SAR) measurements in homogenous muscle phantom. Results: Accuracy of the simulation model was confirmed with experimental SAR measurements of three unique applicator setups. Simulations demonstrated the ability to generate a wide range of power deposition patterns with commercially available waveguide antennas by controllably varying size and thickness of the waterbolus layer. Conclusion: Heating characteristics of 915 MHz waveguide antennas can be varied over a wide range by controlled adjustment of microwave power, coupling configuration, and waterbolus lateral size and thickness. The uniformity of thermal dose delivered to superficial tumors can be improved by cyclic switching of waterbolus thickness during treatment to proactively shift heat peaks and nulls around under the aperture, thereby reducing patient pain while increasing minimum thermal dose by end of treatment.
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