>Purpose: This paper investigates overall theoretical requirements for reducing the times required for the iterative learning of a real-time image-guided adaptive control routine for multiple-source heat applicators, as used in hyperthermia and thermal ablative therapy for cancer.>Methods: Methods for partial reconstruction of the physical system with and without model reduction to find solutions within a clinically practical timeframe were analyzed. A mathematical analysis based on the Fredholm alternative theorem (FAT) was used to compactly analyze the existence and uniqueness of the optimal heating vector under two fundamental situations: (1) noiseless partial reconstruction and (2) noisy partial reconstruction. These results were coupled with a method for further acceleration of the solution using virtual source (VS) model reduction. The matrix approximation theorem (MAT) was used to choose the optimal vectors spanning the reduced-order subspace to reduce the time for system reconstruction and to determine the associated approximation error. Numerical simulations of the adaptive control of hyperthermia using VS were also performed to test the predictions derived from the theoretical analysis. A thigh sarcoma patient model surrounded by a ten-antenna phased-array applicator was retained for this purpose. The impacts of the convective cooling from blood flow and the presence of sudden increase of perfusion in muscle and tumor were also simulated.>Results: By FAT, partial system reconstruction directly conducted in the full space of the physical variables such as phases and magnitudes of the heat sources cannot guarantee reconstructing the optimal system to determine the global optimal setting of the heat sources. A remedy for this limitation is to conduct the partial reconstruction within a reduced-order subspace spanned by the first few maximum eigenvectors of the true system matrix. By MAT, this VS subspace is the optimal one when the goal is to maximize the average tumor temperature. When more than 6 sources present, the steps required for a nonlinear learning scheme is theoretically fewer than that of a linear one, however, finite number of iterative corrections is necessary for a single learning step of a nonlinear algorithm. Thus, the actual computational workload for a nonlinear algorithm is not necessarily less than that required by a linear algorithm.>Conclusions: Based on the analysis presented herein, obtaining a unique global optimal heating vector for a multiple-source applicator within the constraints of real-time clinical hyperthermia treatments and thermal ablative therapies appears attainable using partial reconstruction with minimum norm least-squares method with supplemental equations. One way to supplement equations is the inclusion of a method of model reduction.
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