Thermal therapy of pancreatic tumours using endoluminal ultrasound: Parametric and patient-specific modelling

被引:20
作者
Adams, Matthew S. [1 ,2 ]
Scott, Serena J. [1 ]
Salgaonkar, Vasant A. [1 ]
Sommer, Graham [3 ]
Diederich, Chris J. [1 ,2 ]
机构
[1] Univ Calif San Francisco, Thermal Therapy Res Grp, 2340 Sutter St S341, San Francisco, CA 94115 USA
[2] Univ Calif, Univ Calif Berkeley, San Francisco Grad Program Bioengn, Berkeley, CA USA
[3] Stanford Med Ctr, Stanford, CA USA
基金
美国国家卫生研究院;
关键词
Catheter-based ultrasound; hyperthermia; pancreatic cancer; thermal ablation; thermal therapy; ultrasound; INTENSITY FOCUSED ULTRASOUND; BLOOD-FLOW; RADIOFREQUENCY ABLATION; REGIONAL HYPERTHERMIA; INTRALUMINAL ULTRASOUND; QUANTITATIVE-ANALYSIS; HDR BRACHYTHERAPY; CELIAC-DISEASE; CANCER; PROSTATE;
D O I
10.3109/02656736.2015.1119892
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The aim of this study is to investigate endoluminal ultrasound applicator configurations for volumetric thermal ablation and hyperthermia of pancreatic tumours using 3D acoustic and biothermal finite element models. Materials and methods: Parametric studies compared endoluminal heating performance for varying applicator transducer configurations (planar, curvilinear-focused, or radial-diverging), frequencies (1-5 MHz), and anatomical conditions. Patient-specific pancreatic head and body tumour models were used to evaluate feasibility of generating hyperthermia and thermal ablation using an applicator positioned in the duodenal or stomach lumen. Temperature and thermal dose were calculated to define ablation (>240 EM43 degrees C) and moderate hyperthermia (40-45 degrees C) boundaries, and to assess sparing of sensitive tissues. Proportional-integral control was incorporated to regulate maximum temperature to 70-80 degrees C for ablation and 45 degrees C for hyperthermia in target regions.Results: Parametric studies indicated that 1-3 MHz planar transducers are the most suitable for volumetric ablation, producing 5-8 cm(3) lesion volumes for a stationary 5-min sonication. Curvilinear-focused geometries produce more localised ablation to 20-45 mm depth from the GI tract and enhance thermal sparing (T-max<42 degrees C) of the luminal wall. Patient anatomy simulations show feasibility in ablating 60.1-92.9% of head/body tumour volumes (4.3-37.2 cm(3)) with dose < 15 EM43 degrees C in the luminal wall for 18-48 min treatment durations, using 1-3 applicator placements in GI lumen. For hyperthermia, planar and radial-diverging transducers could maintain up to 8 cm(3) and 15 cm(3) of tissue, respectively, between 40-45 degrees C for a single applicator placement. Conclusions: Modelling studies indicate the feasibility of endoluminal ultrasound for volumetric thermal ablation or hyperthermia treatment of pancreatic tumour tissue.
引用
收藏
页码:97 / 111
页数:15
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