Electric, Magnetic, and Electromagnetic Fields in Biology and Medicine: From Mechanisms to Biomedical Applications: 2nd Edition

A special issue of Bioengineering (ISSN 2306-5354).

Deadline for manuscript submissions: 10 January 2025 | Viewed by 17558

Special Issue Editors


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Guest Editor
Institute for Electromagnetic Sensing of the Environment (IREA), National Research Council, 80124 Napoli, Italy
Interests: electromagnetic fields; bioelectromagnetics; electromagnetic dosimetry; electroporation; biomedical applications of electromagnetic fields; electromagnetic fields exposure assessment; systematic reviews
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Guest Editor
Institute for Electromagnetic Sensing of the Environment (IREA), National Research Council, 80124 Napoli, Italy
Interests: electromagnetic bio-effects; bioelectromagnetics; cellular and molecular biology; electroporation; fluorescence and confocal microscopy; mammalian cells exposed to electromagnetic fields in in vitro studies; systematic reviews; electromagnetic fields exposure assessment; biocompatibility of nanomaterials

Special Issue Information

Dear Colleagues,   

Electric, magnetic, and electromagnetic fields (EMF) are widely used in everyday life and in specific occupational environments. EMF-based technologies employ different parts of the spectrum, from static fields to low and high frequency electromagnetic fields encompassing millimeter waves and THz.   

Exposure to these fields raises concerns about the possible effects on human health, especially due to the diffusion of 5G networks, which are expected to have a major impact on exposure scenarios. On the other hand, biomedical applications of non-ionizing radiations are successfully employed for diagnosis and therapy (e.g., electroporation-based treatments, microwave hyperthermia, etc.). There is great interest in evaluating the associated interaction mechanisms, which are also relevant to foster the development of new biomedical applications or the optimization of the existing ones.   

This Special Issue is open to scientific studies addressing in vitro, in vivo, and epidemiological investigations on electric, magnetic, and electromagnetic exposure aimed at evaluating possible health effects, the beneficial potential of such fields for diagnosis and therapy, and studies focusing on interaction mechanisms. It includes work in any frequency range, and covers exposure assessment, dosimetry, risk assessment, communication, and management. Researchers and scholars from the industry, academia, and government are invited to submit full research and/or review, systematic review and meta-analysis papers to this Special Issue.

Dr. Stefania Romeo
Dr. Anna Sannino
Guest Editors

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Keywords

  • electromagnetic bio-effects
  • interaction mechanisms
  • environmental health
  • cooperative effects
  • electromagnetic field modelling
  • exposure assessment
  • EMF risk assessment
  • diagnostic and therapeutic applications
  • experimental studies
  • electroporation and electrochemotherapy
  • EMF measurements
  • electromagnetic dosimetry

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Published Papers (12 papers)

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Research

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20 pages, 8537 KiB  
Article
Uncertainty Quantification in SAR Induced by Ultra-High-Field MRI RF Coil via High-Dimensional Model Representation
by Xi Wang, Shao Ying Huang and Abdulkadir C. Yucel
Bioengineering 2024, 11(7), 730; https://doi.org/10.3390/bioengineering11070730 - 18 Jul 2024
Viewed by 1111
Abstract
As magnetic field strength in Magnetic Resonance Imaging (MRI) technology increases, maintaining the specific absorption rate (SAR) within safe limits across human head tissues becomes challenging due to the formation of standing waves at a shortened wavelength. Compounding this challenge is the uncertainty [...] Read more.
As magnetic field strength in Magnetic Resonance Imaging (MRI) technology increases, maintaining the specific absorption rate (SAR) within safe limits across human head tissues becomes challenging due to the formation of standing waves at a shortened wavelength. Compounding this challenge is the uncertainty in the dielectric properties of head tissues, which notably affects the SAR induced by the radiofrequency (RF) coils in an ultra-high-field (UHF) MRI system. To this end, this study introduces a computational framework to quantify the impacts of uncertainties in head tissues’ dielectric properties on the induced SAR. The framework employs a surrogate model-assisted Monte Carlo (MC) technique, efficiently generating surrogate models of MRI observables (electric fields and SAR) and utilizing them to compute SAR statistics. Particularly, the framework leverages a high-dimensional model representation technique, which constructs the surrogate models of the MRI observables via univariate and bivariate component functions, approximated through generalized polynomial chaos expansions. The numerical results demonstrate the efficiency of the proposed technique, requiring significantly fewer deterministic simulations compared with traditional MC methods and other surrogate model-assisted MC techniques utilizing machine learning algorithms, all while maintaining high accuracy in SAR statistics. Specifically, the proposed framework constructs surrogate models of a local SAR with an average relative error of 0.28% using 289 simulations, outperforming the machine learning-based surrogate modeling techniques considered in this study. Furthermore, the SAR statistics obtained by the proposed framework reveal fluctuations of up to 30% in SAR values within specific head regions. These findings highlight the critical importance of considering dielectric property uncertainties to ensure MRI safety, particularly in 7 T MRI systems. Full article
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14 pages, 3053 KiB  
Article
Comparison of Transcranial Magnetic Stimulation Dosimetry between Structured and Unstructured Grids Using Different Solvers
by Francesca Camera, Caterina Merla and Valerio De Santis
Bioengineering 2024, 11(7), 712; https://doi.org/10.3390/bioengineering11070712 - 13 Jul 2024
Cited by 1 | Viewed by 969
Abstract
In recent years, the interest in transcranial magnetic stimulation (TMS) has surged, necessitating deeper understanding, development, and use of low-frequency (LF) numerical dosimetry for TMS studies. While various ad hoc dosimetric models exist, commercial software tools like SimNIBS v4.0 and Sim4Life v7.2.4 are [...] Read more.
In recent years, the interest in transcranial magnetic stimulation (TMS) has surged, necessitating deeper understanding, development, and use of low-frequency (LF) numerical dosimetry for TMS studies. While various ad hoc dosimetric models exist, commercial software tools like SimNIBS v4.0 and Sim4Life v7.2.4 are preferred for their user-friendliness and versatility. SimNIBS utilizes unstructured tetrahedral mesh models, while Sim4Life employs voxel-based models on a structured grid, both evaluating induced electric fields using the finite element method (FEM) with different numerical solvers. Past studies primarily focused on uniform exposures and voxelized models, lacking realism. Our study compares these LF solvers across simplified and realistic anatomical models to assess their accuracy in evaluating induced electric fields. We examined three scenarios: a single-shell sphere, a sphere with an orthogonal slab, and a MRI-derived head model. The comparison revealed small discrepancies in induced electric fields, mainly in regions of low field intensity. Overall, the differences were contained (below 2% for spherical models and below 12% for the head model), showcasing the potential of computational tools in advancing exposure assessment required for TMS protocols in different bio-medical applications. Full article
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19 pages, 1399 KiB  
Article
Exploring the Influence of Inter-Trial Interval on the Assessment of Short-Interval Intracortical Inhibition
by Lidio Lima de Albuquerque, Milan Pantovic, Erik W. Wilkins, Desiree Morris, Mitchell Clingo, Sage Boss, Zachary A. Riley and Brach Poston
Bioengineering 2024, 11(7), 645; https://doi.org/10.3390/bioengineering11070645 - 25 Jun 2024
Viewed by 825
Abstract
Short-interval intracortical inhibition (SICI) is a common paired-pulse transcranial magnetic stimulation (TMS) measure used to assess primary motor cortex (M1) interneuron activity in healthy populations and in neurological disorders. Many of the parameters of TMS stimulation to most accurately measure SICI have been [...] Read more.
Short-interval intracortical inhibition (SICI) is a common paired-pulse transcranial magnetic stimulation (TMS) measure used to assess primary motor cortex (M1) interneuron activity in healthy populations and in neurological disorders. Many of the parameters of TMS stimulation to most accurately measure SICI have been determined. However, one TMS parameter that has not been investigated is the time between SICI trials (termed inter-trial interval; ITI). This is despite a series of single-pulse TMS studies which have reported that motor evoked potential (MEP) amplitude were suppressed for short, but not long ITIs in approximately the initial ten trials of a TMS block of 20–30 trials. The primary purpose was to examine the effects of ITI on the quantification of SICI at rest. A total of 23 healthy adults completed an experimental session that included four SICI trial blocks. Each block utilized a different ITI (4, 6, 8, and 10 s) and was comprised of a total of 26 SICI trials divided into three epochs. ANOVA revealed that the main effects for ITI and epoch as well as their interaction were all non-statistically significant for SICI. We conclude that the shorter (4–6 s) ITIs used in studies investigating SICI should not alter the interpretation of M1 activity, while having the advantages of being more comfortable to participants and reducing the experimental time needed to evaluate perform single and paired-pulse TMS experiments. Full article
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18 pages, 2565 KiB  
Article
Rapid, Point-of-Care Microwave Lysis and Electrochemical Detection of Clostridioides difficile Directly from Stool Samples
by Lovleen Tina Joshi, Emmanuel Brousseau, Trefor Morris, Jonathan Lees, Adrian Porch and Les Baillie
Bioengineering 2024, 11(6), 632; https://doi.org/10.3390/bioengineering11060632 - 20 Jun 2024
Viewed by 1102
Abstract
The rapid detection of the spore form of Clostridioides difficile has remained a challenge for clinicians. To address this, we have developed a novel, precise, microwave-enhanced approach for near-spontaneous release of DNA from C. difficile spores via a bespoke microwave lysis platform. C. difficile [...] Read more.
The rapid detection of the spore form of Clostridioides difficile has remained a challenge for clinicians. To address this, we have developed a novel, precise, microwave-enhanced approach for near-spontaneous release of DNA from C. difficile spores via a bespoke microwave lysis platform. C. difficile spores were microwave-irradiated for 5 s in a pulsed microwave electric field at 2.45 GHz to lyse the spore and bacteria in each sample, which was then added to a screen-printed electrode and electrochemical DNA biosensor assay system to identify presence of the pathogen’s two toxin genes. The microwave lysis method released both single-stranded and double-stranded genome DNA from the bacterium at quantifiable concentrations between 0.02 μg/mL to 250 μg/mL allowing for subsequent downstream detection in the biosensor. The electrochemical bench-top system comprises of oligonucleotide probes specific to conserved regions within tcdA and tcdB toxin genes of C. difficile and was able to detect 800 spores of C. difficile within 300 µL of unprocessed human stool samples in under 10 min. These results demonstrate the feasibility of using a solid-state power generated, pulsed microwave electric field to lyse and release DNA from human stool infected with C. difficile spores. This rapid microwave lysis method enhanced the rapidity of subsequent electrochemical detection in the development of a rapid point-of-care biosensor platform for C. difficile. Full article
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18 pages, 2467 KiB  
Article
Modeling of Magnetic Scaffolds as Drug Delivery Platforms for Tissue Engineering and Cancer Therapy
by Matteo B. Lodi, Eleonora M. A. Corda, Francesco Desogus, Alessandro Fanti and Giuseppe Mazzarella
Bioengineering 2024, 11(6), 573; https://doi.org/10.3390/bioengineering11060573 - 6 Jun 2024
Cited by 2 | Viewed by 1504
Abstract
Magnetic scaffolds (MagSs) are magneto-responsive devices obtained by the combination of traditional biomaterials (e.g., polymers, bioceramics, and bioglasses) and magnetic nanoparticles. This work analyzes the literature about MagSs used as drug delivery systems for tissue repair and cancer treatment. These devices can be [...] Read more.
Magnetic scaffolds (MagSs) are magneto-responsive devices obtained by the combination of traditional biomaterials (e.g., polymers, bioceramics, and bioglasses) and magnetic nanoparticles. This work analyzes the literature about MagSs used as drug delivery systems for tissue repair and cancer treatment. These devices can be used as innovative drugs and/or biomolecules delivery systems. Through the application of a static or dynamic stimulus, MagSs can trigger drug release in a controlled and remote way. However, most of MagSs used as drug delivery systems are not optimized and properly modeled, causing a local inhomogeneous distribution of the drug’s concentration and burst release. Few physical–mathematical models have been presented to study and analyze different MagSs, with the lack of a systematic vision. In this work, we propose a modeling framework. We modeled the experimental data of drug release from different MagSs, under various magnetic field types, taken from the literature. The data were fitted to a modified Gompertz equation and to the Korsmeyer–Peppas model (KPM). The correlation coefficient (R2) and the root mean square error (RMSE) were the figures of merit used to evaluate the fitting quality. It has been found that the Gompertz model can fit most of the drug delivery cases, with an average RMSE below 0.01 and R2>0.9. This quantitative interpretation of existing experimental data can foster the design and use of MagSs for drug delivery applications. Full article
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14 pages, 3401 KiB  
Article
Pulsed Radiofrequency Electromagnetic Fields as Modulators of Inflammation and Wound Healing in Primary Dermal Fibroblasts of Ulcers
by Erica Costantini, Lisa Aielli, Giulio Gualdi, Manuela Baronio, Paola Monari, Paolo Amerio and Marcella Reale
Bioengineering 2024, 11(4), 357; https://doi.org/10.3390/bioengineering11040357 - 5 Apr 2024
Cited by 1 | Viewed by 1559
Abstract
Venous leg ulcers are one of the most common nonhealing conditions and represent an important clinical problem. The application of pulsed radiofrequency electromagnetic fields (PRF-EMFs), already applied for pain, inflammation, and new tissue formation, can represent a promising approach for venous leg ulcer [...] Read more.
Venous leg ulcers are one of the most common nonhealing conditions and represent an important clinical problem. The application of pulsed radiofrequency electromagnetic fields (PRF-EMFs), already applied for pain, inflammation, and new tissue formation, can represent a promising approach for venous leg ulcer amelioration. This study aims to evaluate the effect of PRF-EMF exposure on the inflammatory, antioxidant, cell proliferation, and wound healing characteristics of human primary dermal fibroblasts collected from venous leg ulcer patients. The cells’ proliferative and migratory abilities were evaluated by means of a BrdU assay and scratch assay, respectively. The inflammatory response was investigated through TNFα, TGFβ, COX2, IL6, and IL1β gene expression analysis and PGE2 and IL1β production, while the antioxidant activity was tested by measuring GSH, GSSG, tGSH, and GR levels. This study emphasizes the ability of PRF-EMFs to modulate the TGFβ, COX2, IL6, IL1β, and TNFα gene expression in exposed ulcers. Moreover, it confirms the improvement of the proliferative index and wound healing ability presented by PRF-EMFs. In conclusion, exposure to PRF-EMFs can represent a strategy to help tissue repair, regulating mediators involved in the wound healing process. Full article
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20 pages, 30763 KiB  
Article
Electric Field Characteristics of Rotating Permanent Magnet Stimulation
by Pei L. Robins, Sergey N. Makaroff, Michael Dib, Sarah H. Lisanby and Zhi-De Deng
Bioengineering 2024, 11(3), 258; https://doi.org/10.3390/bioengineering11030258 - 6 Mar 2024
Viewed by 2204
Abstract
Neurostimulation devices that use rotating permanent magnets are being explored for their potential therapeutic benefits in patients with psychiatric and neurological disorders. This study aims to characterize the electric field (E-field) for ten configurations of rotating magnets using finite element analysis and phantom [...] Read more.
Neurostimulation devices that use rotating permanent magnets are being explored for their potential therapeutic benefits in patients with psychiatric and neurological disorders. This study aims to characterize the electric field (E-field) for ten configurations of rotating magnets using finite element analysis and phantom measurements. Various configurations were modeled, including single or multiple magnets, and bipolar or multipolar magnets, rotated at 10, 13.3, and 350 revolutions per second (rps). E-field strengths were also measured using a hollow sphere (r=9.2 cm) filled with a 0.9% sodium chloride solution and with a dipole probe. The E-field spatial distribution is determined by the magnets’ dimensions, number of poles, direction of the magnetization, and axis of rotation, while the E-field strength is determined by the magnets’ rotational frequency and magnetic field strength. The induced E-field strength on the surface of the head ranged between 0.0092 and 0.52 V/m. In the range of rotational frequencies applied, the induced E-field strengths were approximately an order or two of magnitude lower than those delivered by conventional transcranial magnetic stimulation. The impact of rotational frequency on E-field strength represents a confound in clinical trials that seek to tailor rotational frequency to individual neural oscillations. This factor could explain some of the variability observed in clinical trial outcomes. Full article
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20 pages, 2727 KiB  
Article
The Influence of Different Inter-Trial Intervals on the Quantification of Intracortical Facilitation in the Primary Motor Cortex
by Milan Pantovic, Rhett Boss, Kevin J. Noorda, Mario I. Premyanov, Daniel G. Aynlender, Erik W. Wilkins, Sage Boss, Zachary A. Riley and Brach Poston
Bioengineering 2023, 10(11), 1278; https://doi.org/10.3390/bioengineering10111278 - 2 Nov 2023
Cited by 1 | Viewed by 1403
Abstract
Intracortical facilitation (ICF) is a paired-pulse transcranial magnetic stimulation (TMS) measurement used to quantify interneuron activity in the primary motor cortex (M1) in healthy populations and motor disorders. Due to the prevalence of the technique, most of the stimulation parameters to optimize ICF [...] Read more.
Intracortical facilitation (ICF) is a paired-pulse transcranial magnetic stimulation (TMS) measurement used to quantify interneuron activity in the primary motor cortex (M1) in healthy populations and motor disorders. Due to the prevalence of the technique, most of the stimulation parameters to optimize ICF quantification have been established. However, the underappreciated methodological issue of the time between ICF trials (inter-trial interval; ITI) has been unstandardized, and different ITIs have never been compared in a paired-pulse TMS study. This is important because single-pulse TMS studies have found motor evoked potential (MEP) amplitude reductions over time during TMS trial blocks for short, but not long ITIs. The primary purpose was to determine the influence of different ITIs on the measurement of ICF. Twenty adults completed one experimental session that involved 4 separate ICF trial blocks with each utilizing a different ITI (4, 6, 8, and 10 s). Two-way ANOVAs indicated no significant ITI main effects for test MEP amplitudes, condition-test MEP amplitudes, and therefore ICF. Accordingly, all ITIs studied provided nearly identical ICF values when averaged over entire trial blocks. Therefore, it is recommended that ITIs of 4–6 s be utilized for ICF quantification to optimize participant comfort and experiment time efficiency. Full article
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18 pages, 1257 KiB  
Article
Cerebellar Transcranial Direct Current Stimulation Applied over Multiple Days Does Not Enhance Motor Learning of a Complex Overhand Throwing Task in Young Adults
by Milan Pantovic, Daniel E. Lidstone, Lidio Lima de Albuquerque, Erik W. Wilkins, Irwin A. Munoz, Daniel G. Aynlender, Desiree Morris, Janet S. Dufek and Brach Poston
Bioengineering 2023, 10(11), 1265; https://doi.org/10.3390/bioengineering10111265 - 30 Oct 2023
Cited by 3 | Viewed by 1430
Abstract
Cerebellar transcranial direct current stimulation (tDCS) enhances motor skill and learning in relatively simple motor tasks, but it is unclear if c-tDCS can improve motor performance in complex motor tasks. The purpose of this study was to determine the influence of c-tDCS applied [...] Read more.
Cerebellar transcranial direct current stimulation (tDCS) enhances motor skill and learning in relatively simple motor tasks, but it is unclear if c-tDCS can improve motor performance in complex motor tasks. The purpose of this study was to determine the influence of c-tDCS applied over multiple days on motor learning in a complex overhand throwing task. In a double-blind, randomized, between-subjects, SHAM-controlled, experimental design, 30 young adults were assigned to either a c-tDCS or a SHAM group. Participants completed three identical experiments on consecutive days that involved overhand throwing in a pre-test block, five practice blocks with concurrent c-tDCS, and a post-test block. Overhand throwing endpoint accuracy was quantified as the endpoint error. The first dorsal interosseous muscle motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation was used to quantify primary motor cortex (M1) excitability modulations via c-tDCS. Endpoint error significantly decreased over the 3 days of practice, but the magnitude of decrease was not significantly different between the c-tDCS and SHAM group. Similarly, MEP amplitude slightly increased from the pre-tests to the post-tests, but these increases did not differ between groups. These results indicate that multi-day c-tDCS does not improve motor learning in an overhand throwing task or increase M1 excitability. Full article
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18 pages, 5301 KiB  
Article
Ultra-Low Intensity Post-Pulse Affects Cellular Responses Caused by Nanosecond Pulsed Electric Fields
by Kamal Asadipour, Carol Zhou, Vincent Yi, Stephen J. Beebe and Shu Xiao
Bioengineering 2023, 10(9), 1069; https://doi.org/10.3390/bioengineering10091069 - 10 Sep 2023
Cited by 4 | Viewed by 1843
Abstract
High-intensity nanosecond pulse electric fields (nsPEF) can preferentially induce various effects, most notably regulated cell death and tumor elimination. These effects have almost exclusively been shown to be associated with nsPEF waveforms defined by pulse duration, rise time, amplitude (electric field), and pulse [...] Read more.
High-intensity nanosecond pulse electric fields (nsPEF) can preferentially induce various effects, most notably regulated cell death and tumor elimination. These effects have almost exclusively been shown to be associated with nsPEF waveforms defined by pulse duration, rise time, amplitude (electric field), and pulse number. Other factors, such as low-intensity post-pulse waveform, have been completely overlooked. In this study, we show that post-pulse waveforms can alter the cell responses produced by the primary pulse waveform and can even elicit unique cellular responses, despite the primary pulse waveform being nearly identical. We employed two commonly used pulse generator designs, namely the Blumlein line (BL) and the pulse forming line (PFL), both featuring nearly identical 100 ns pulse durations, to investigate various cellular effects. Although the primary pulse waveforms were nearly identical in electric field and frequency distribution, the post-pulses differed between the two designs. The BL’s post-pulse was relatively long-lasting (~50 µs) and had an opposite polarity to the main pulse, whereas the PFL’s post-pulse was much shorter (~2 µs) and had the same polarity as the main pulse. Both post-pulse amplitudes were less than 5% of the main pulse, but the different post-pulses caused distinctly different cellular responses. The thresholds for dissipation of the mitochondrial membrane potential, loss of viability, and increase in plasma membrane PI permeability all occurred at lower pulsing numbers for the PFL than the BL, while mitochondrial reactive oxygen species generation occurred at similar pulsing numbers for both pulser designs. The PFL decreased spare respiratory capacity (SRC), whereas the BL increased SRC. Only the PFL caused a biphasic effect on trans-plasma membrane electron transport (tPMET). These studies demonstrate, for the first time, that conditions resulting from low post-pulse intensity charging have a significant impact on cell responses and should be considered when comparing the results from similar pulse waveforms. Full article
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Review

Jump to: Research

18 pages, 2281 KiB  
Review
Augmentation of Deficient Bone Healing by Pulsed Electromagnetic Fields—From Mechanisms to Clinical Outcomes
by Amr Kaadan, Simona Salati, Stefania Setti and Roy Aaron
Bioengineering 2024, 11(12), 1223; https://doi.org/10.3390/bioengineering11121223 - 3 Dec 2024
Viewed by 484
Abstract
Pulsed Electromagnetic Fields (PEMF) are widely used, with excellent clinical outcomes. However, their mechanism of action has not yet been completely understood. The purpose of this review is to describe current observations on the mechanisms of PEMF, together with its clinical efficacy. Osteoblast [...] Read more.
Pulsed Electromagnetic Fields (PEMF) are widely used, with excellent clinical outcomes. However, their mechanism of action has not yet been completely understood. The purpose of this review is to describe current observations on the mechanisms of PEMF, together with its clinical efficacy. Osteoblast responsiveness to PEMF is described on several scales, from the cell membrane to clinically relevant bone formation. PEMF has been shown to activate membrane adenosine receptors. The role of adenosine receptors in activating intracellular second messenger pathways, such as the canonical Wnt/β-catenin pathway and the mitogen-activated protein kinases (MAPK) pathway, is described. The responsiveness of osteoblasts and the synthesis of structural and signaling proteins constitute the role of PEMFs in promoting osteogenesis and bone matrix synthesis, and they are described. Multiple studies, ranging from observational and randomized to meta-analyses that investigate the clinical efficacy of PEMF, are described. This review presents a favorable conclusion on the clinical effects of PEMF while unlocking the “black box” of PEMF’s mechanism of action, thus improving confidence in the clinical utility of PEMF in bone repair. Full article
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28 pages, 18319 KiB  
Review
Pulsing Addition to Modulated Electro-Hyperthermia
by Andras Szasz
Bioengineering 2024, 11(7), 725; https://doi.org/10.3390/bioengineering11070725 - 17 Jul 2024
Cited by 1 | Viewed by 1110
Abstract
Numerous preclinical results have been verified, and clinical results have validated the advantages of modulated electro-hyperthermia (mEHT). This method uses the nonthermal effects of the electric field in addition to thermal energy absorption. Modulation helps with precisely targeting and immunogenically destroying malignant cells, [...] Read more.
Numerous preclinical results have been verified, and clinical results have validated the advantages of modulated electro-hyperthermia (mEHT). This method uses the nonthermal effects of the electric field in addition to thermal energy absorption. Modulation helps with precisely targeting and immunogenically destroying malignant cells, which could have a vaccination-like abscopal effect. A new additional modulation (high-power pulsing) further develops the abilities of the mEHT. My objective is to present the advantages of pulsed treatment and how it fits into the mEHT therapy. Pulsed treatment increases the efficacy of destroying the selected tumor cells; it is active deeper in the body, at least tripling the penetration of the energy delivery. Due to the constant pulse amplitude, the dosing of the absorbed energy is more controllable. The induced blood flow for reoxygenation and drug delivery is high enough but not as high as increasing the risk of the dissemination of malignant cells. The short pulses have reduced surface absorption, making the treatment safer, and the increased power in the pulses allows the reduction of the treatment time needed to provide the necessary dose. Full article
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