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Dantas E, Orlande HRB, Dulikravich GS. Thermal ablation effects on rotors that characterize functional re-entry cardiac arrhythmia. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3614. [PMID: 35543287 DOI: 10.1002/cnm.3614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 06/14/2023]
Abstract
Thermal ablation is a well-established successful treatment for cardiac arrhythmia, but it still presents limitations that require further studies and developments. In the rotor-driven functional re-entry arrhythmia, tissue heterogeneity results on the generation of spiral/scroll waves and wave break dynamics that may cause dangerous sustainable fibrillation. The selection of the target region to perform thermal ablation to mitigate this type of arrhythmia is challenging, since it considerably affects the local electrophysiology dynamics. This work deals with the numerical simulation of the thermal ablation of a cardiac muscle tissue and its effects on the dynamics of rotor-driven functional re-entry arrhythmia. A non-homogeneous two-dimensional rectangular region is used in the present numerical analysis, where radiofrequency ablation is performed. The electrophysiology problem for the propagation of the action potential in the cardiac tissue is simulated with the Fenton-Karma model. Thermal damage caused to the tissue by the radiofrequency heating is modeled by the Arrhenius equation. The effects of size and position of a heterogeneous region in the original muscle tissue were first analyzed, in order to verify the possible existence of the functional re-entry arrhythmia during the time period considered in the simulations. For each case that exhibited re-entry arrhythmia, six different ablation procedures were analyzed, depending on the position of the radiofrequency electrode and heating time. The obtained results revealed the effects of different model parameters on the existence and possible mitigation of the functional re-entry arrhythmia.
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Affiliation(s)
- Eber Dantas
- Department of Mechanical Engineering, Politécnica/COPPE, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, Brazil
| | - Helcio R B Orlande
- Department of Mechanical Engineering, Politécnica/COPPE, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, Brazil
| | - George S Dulikravich
- Department of Mechanical and Materials Engineering, MAIDROC Lab., Florida International University, Miami, Florida, USA
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Kho ASK, Ooi EH, Foo JJ, Ooi ET. How does saline backflow affect the treatment of saline-infused radiofrequency ablation? COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 211:106436. [PMID: 34601185 DOI: 10.1016/j.cmpb.2021.106436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Saline infusion is applied together with radiofrequency ablation (RFA) to enlarge the ablation zone. However, one of the issues with saline-infused RFA is backflow, which spreads saline along the insertion track. This raises the concern of not only thermally ablating the tissue within the backflow region, but also the loss of saline from the targeted tissue, which may affect the treatment efficacy. METHODS In the present study, 2D axisymmetric models were developed to investigate how saline backflow influence saline-infused RFA and whether the aforementioned concerns are warranted. Saline-infused RFA was described using the dual porosity-Joule heating model. The hydrodynamics of backflow was described using Poiseuille law by assuming the flow to be similar to that in a thin annulus. Backflow lengths of 3, 4.5, 6 and 9 cm were considered. RESULTS Results showed that there is no concern of thermally ablating the tissue in the backflow region. This is due to the Joule heating being inversely proportional to distance from the electrode to the fourth power. Results also indicated that larger backflow lengths led to larger growth of thermal damage along the backflow region and greater decrease in coagulation volume. Hence, backflow needs to be controlled to ensure an effective treatment of saline-infused RFA. CONCLUSIONS There is no risk of ablating tissues around the needle insertion track due to backflow. Instead, the risk of underablation as a result of the loss of saline due to backflow was found to be of greater concern.
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Affiliation(s)
- Antony S K Kho
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean H Ooi
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
| | - Ji J Foo
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean T Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, VIC 3350, Australia
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Yap S, Ooi EH, Foo JJ, Ooi ET. Bipolar radiofrequency ablation treatment of liver cancer employing monopolar needles: A comprehensive investigation on the efficacy of time-based switching. Comput Biol Med 2021; 131:104273. [PMID: 33631495 DOI: 10.1016/j.compbiomed.2021.104273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/16/2022]
Abstract
Radiofrequency ablation (RFA) is a thermal ablative treatment method that is commonly used to treat liver cancer. However, the thermal coagulation zone generated using the conventional RFA system can only successfully treat tumours up to 3 cm in diameter. Switching bipolar RFA has been proposed as a way to increase the thermal coagulation zone. Presently, the understanding of the underlying thermal processes that takes place during switching bipolar RFA remains limited. Hence, the objective of this study is to provide a comprehensive understanding on the thermal ablative effects of time-based switching bipolar RFA on liver tissue. Five switch intervals, namely 50, 100, 150, 200 and 300 s were investigated using a two-compartment 3D finite element model. The study was performed using two pairs of RF electrodes in a four-probe configuration, where the electrodes were alternated based on their respective switch interval. The physics employed in the present study were verified against experimental data from the literature. Results obtained show that using a shorter switch interval can improve the homogeneity of temperature distribution within the tissue and increase the rate of temperature rise by delaying the occurrence of roll-off. The coagulation volume obtained was the largest using switch interval of 50 s, followed by 100, 150, 200 and 300 s. The present study demonstrated that the transient thermal response of switching bipolar RFA can be improved by using shorter switch intervals.
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Affiliation(s)
- Shelley Yap
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean H Ooi
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
| | - Ji J Foo
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean T Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, VIC, 3350, Australia
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Castro-López DL, Berjano E, Romero-Mendez R. Radiofrequency ablation combined with conductive fluid-based dopants (saline normal and colloidal gold): computer modeling and ex vivo experiments. Biomed Eng Online 2021; 20:4. [PMID: 33407532 PMCID: PMC7788784 DOI: 10.1186/s12938-020-00842-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/15/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The volume of the coagulation zones created during radiofrequency ablation (RFA) is limited by the appearance of roll-off. Doping the tissue with conductive fluids, e.g., gold nanoparticles (AuNPs) could enlarge these zones by delaying roll-off. Our goal was to characterize the electrical conductivity of a substrate doped with AuNPs in a computer modeling study and ex vivo experiments to investigate their effect on coagulation zone volumes. METHODS The electrical conductivity of substrates doped with normal saline or AuNPs was assessed experimentally on agar phantoms. The computer models, built and solved on COMSOL Multiphysics, consisted of a cylindrical domain mimicking liver tissue and a spherical domain mimicking a doped zone with 2, 3 and 4 cm diameters. Ex vivo experiments were conducted on bovine liver fragments under three different conditions: non-doped tissue (ND Group), 2 mL of 0.9% NaCl (NaCl Group), and 2 mL of AuNPs 0.1 wt% (AuNPs Group). RESULTS The theoretical analysis showed that adding normal saline or colloidal gold in concentrations lower than 10% only modifies the electrical conductivity of the doped substrate with practically no change in the thermal characteristics. The computer results showed a relationship between doped zone size and electrode length regarding the created coagulation zone. There was good agreement between the ex vivo and computational results in terms of transverse diameter of the coagulation zone. CONCLUSIONS Both the computer and ex vivo experiments showed that doping with AuNPs can enlarge the coagulation zone, especially the transverse diameter and hence enhance sphericity.
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Affiliation(s)
- Dora Luz Castro-López
- Facultad de Ingeniería, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP 78290, México
| | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, 46018, Valencia, Spain
| | - Ricardo Romero-Mendez
- Facultad de Ingeniería, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP 78290, México.
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Role of saline concentration during saline-infused radiofrequency ablation: Observation of secondary Joule heating along the saline-tissue interface. Comput Biol Med 2020; 128:104112. [PMID: 33212331 DOI: 10.1016/j.compbiomed.2020.104112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 01/17/2023]
Abstract
Infusion of saline prior to radiofrequency ablation (RFA) is known to enlarge the thermal coagulation zone. The abundance of ions in saline elevate the electrical conductivity of the saline-saturated region. This promotes greater electric current flow inside the tissue, which increases the amount of RF energy deposition and subsequently enlarges the coagulation zone. In theory, infusion of higher concentration of saline should lead to larger coagulation zone due to the greater number of ions. Nevertheless, existing studies on the effects of concentration on saline-infused RFA have been conflicting, with the exact role of saline concentration yet to be fully elucidated. In this paper, computational models of saline-infused RFA were developed to investigate the role of saline concentration on the outcome of saline-infused RFA. The elevation in tissue electrical conductivity was modelled using the microscopic mixture model, while RFA was modelled using the coupled dual porosity-Joule heating model. Results obtained indicated that the presence of a concentration threshold to which no further elevation in tissue electrical conductivity and enlargement in thermal coagulation can occur. This threshold was determined to be at 15% NaCl. Analysis of the Joule heating distribution revealed the presence of a secondary Joule heating site located along the interface between wet and dry tissue. This secondary Joule heating was responsible for the enlargement in coagulation volume and its rapid growth phase during ablation.
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Agnass P, van Veldhuisen E, van Gemert MJC, van der Geld CWM, van Lienden KP, van Gulik TM, Meijerink MR, Besselink MG, Kok HP, Crezee J. Mathematical modeling of the thermal effects of irreversible electroporation for in vitro, in vivo, and clinical use: a systematic review. Int J Hyperthermia 2020; 37:486-505. [DOI: 10.1080/02656736.2020.1753828] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Pierre Agnass
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Eran van Veldhuisen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Martin J. C. van Gemert
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Cees W. M. van der Geld
- Department of Chemical Engineering and Chemistry, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Krijn P. van Lienden
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Thomas M. van Gulik
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Martijn R. Meijerink
- Department of Radiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marc G. Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - H. Petra Kok
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Johannes Crezee
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Singh S, Melnik R. Thermal ablation of biological tissues in disease treatment: A review of computational models and future directions. Electromagn Biol Med 2020; 39:49-88. [PMID: 32233691 DOI: 10.1080/15368378.2020.1741383] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Percutaneous thermal ablation has proven to be an effective modality for treating both benign and malignant tumours in various tissues. Among these modalities, radiofrequency ablation (RFA) is the most promising and widely adopted approach that has been extensively studied in the past decades. Microwave ablation (MWA) is a newly emerging modality that is gaining rapid momentum due to its capability of inducing rapid heating and attaining larger ablation volumes, and its lesser susceptibility to the heat sink effects as compared to RFA. Although the goal of both these therapies is to attain cell death in the target tissue by virtue of heating above 50°C, their underlying mechanism of action and principles greatly differs. Computational modelling is a powerful tool for studying the effect of electromagnetic interactions within the biological tissues and predicting the treatment outcomes during thermal ablative therapies. Such a priori estimation can assist the clinical practitioners during treatment planning with the goal of attaining successful tumour destruction and preservation of the surrounding healthy tissue and critical structures. This review provides current state-of-the-art developments and associated challenges in the computational modelling of thermal ablative techniques, viz., RFA and MWA, as well as touch upon several promising avenues in the modelling of laser ablation, nanoparticles assisted magnetic hyperthermia and non-invasive RFA. The application of RFA in pain relief has been extensively reviewed from modelling point of view. Additionally, future directions have also been provided to improve these models for their successful translation and integration into the hospital work flow.
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Affiliation(s)
- Sundeep Singh
- MS2Discovery Interdisciplinary Research Institute, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Roderick Melnik
- MS2Discovery Interdisciplinary Research Institute, Wilfrid Laurier University, Waterloo, Ontario, Canada.,BCAM - Basque Center for Applied Mathematics, Bilbao, Spain
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Ooi EH, Lee KW, Yap S, Khattab MA, Liao IY, Ooi ET, Foo JJ, Nair SR, Mohd Ali AF. The effects of electrical and thermal boundary condition on the simulation of radiofrequency ablation of liver cancer for tumours located near to the liver boundary. Comput Biol Med 2019; 106:12-23. [DOI: 10.1016/j.compbiomed.2019.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/04/2019] [Accepted: 01/05/2019] [Indexed: 01/12/2023]
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9
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Ewertowska E, Quesada R, Radosevic A, Andaluz A, Moll X, Arnas FG, Berjano E, Burdío F, Trujillo M. A clinically oriented computer model for radiofrequency ablation of hepatic tissue with internally cooled wet electrode. Int J Hyperthermia 2018; 35:194-204. [DOI: 10.1080/02656736.2018.1489071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- E. Ewertowska
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| | - R. Quesada
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - A. Radosevic
- Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - A. Andaluz
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X. Moll
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F. García Arnas
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E. Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| | - F. Burdío
- Department of Surgery, Hospital del Mar, Barcelona, Spain
| | - M. Trujillo
- BioMIT, Department of Applied Mathematics, Universitat Politècnica de València, Valencia, Spain
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Ooi EH, J. Y. Chia N, Ooi ET, Foo JJ, Liao IY, R. Nair S, Mohd Ali AF. Comparison between single- and dual-porosity models for fluid transport in predicting lesion volume following saline-infused radiofrequency ablation. Int J Hyperthermia 2018; 34:1142-1156. [DOI: 10.1080/02656736.2018.1437282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Ean H. Ooi
- School of Engineering, Monash University Malaysia, Selangor, Malaysia
- Advanced Engineering Platform, Monash University Malaysia, Selangor, Malaysia
| | | | - Ean T. Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, Ballarat, VIC, Australia
| | - Ji J. Foo
- School of Engineering, Monash University Malaysia, Selangor, Malaysia
| | - Iman Y. Liao
- School of Computer Science, University of Nottingham Malaysia Campus, Selangor, Malaysia
| | - Shalini R. Nair
- Department of Radiology, National Cancer Institute, Putrajaya, Malaysia
| | - Ahmad F. Mohd Ali
- Department of Radiology, National Cancer Institute, Putrajaya, Malaysia
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