Three-dimensional analysis for radio-frequency ablation of liver tumor with blood perfusion effect

A highly parallel simulation of patient-specific hepatic flows

Computational hemodynamics is being developed as an alternative approach for assisting clinical diagnosis and treatment planning for liver diseases. The technology is non-invasive, but the computational time could be high when the full geometry of the blood vessels is taken into account. Existing approaches use either one-dimensional model of the artery or simplified three-dimensional tubular geometry in order to reduce the computational time, but the accuracy is sometime compromised, for example, when simulating blood flows in arteries with plaque. In this work, we study a highly parallel method for the transient incompressible Navier-Stokes equations for the simulation of the blood flows in the full three-dimensional patient-specific hepatic artery, portal vein and hepatic vein. As applications, we also simulate the flow in a patient with hepatectomy and calculate the S (PPG). One of the advantages of simulating blood flows in all hepatic vessels is that it provides a direct estimate of the PPG, which is a gold standard value to assess the portal hypertension. Moreover, the robustness and scalability of the algorithm are also investigated. A 83% parallel efficiency is achieved for solving a problem with 7 million elements on a supercomputer with more than 1000 processor cores.

Simulation of nonlinear Westervelt equation for the investigation of acoustic streaming and nonlinear propagation effects

This study investigates the influence of blood flow on temperature distribution during high-intensity focused ultrasound (HIFU) ablation of liver tumors. A three-dimensional acoustic-thermal-hydrodynamic coupling model is developed to compute the temperature field in the hepatic cancerous region. The model is based on the nonlinear Westervelt equation, bioheat equations for the perfused tissue and blood flow domains. The nonlinear Navier-Stokes equations are employed to describe the flow in large blood vessels. The effect of acoustic streaming is also taken into account in the present HIFU simulation study. A simulation of the Westervelt equation requires a prohibitively large amount of computer resources. Therefore a sixth-order accurate acoustic scheme in three-point stencil was developed for effectively solving the nonlinear wave equation. Results show that focused ultrasound beam with the peak intensity 2470 W/cm(2) can induce acoustic streaming velocities up to 75 cm/s in the vessel with a diameter of 3 mm. The predicted temperature difference for the cases considered with and without acoustic streaming effect is 13.5 °C or 81% on the blood vessel wall for the vein. Tumor necrosis was studied in a region close to major vessels. The theoretical feasibility to safely necrotize the tumors close to major hepatic arteries and veins was shown.

Optimal applicator placement in hepatic radiofrequency ablation on the basis of rare data

In this paper, a numerical procedure to determine an optimal applicator placement for hepatic radiofrequency ablation incorporating uncertain material parameters is presented. The main focus is set on the treatment of subjective and rare data-based information. For this purpose, we employ the theory of fuzzy sets and model uncertain parameters as fuzzy quantities. While fuzzy modelling has been established in structural engineering in the recent past, it is novel in biomedical engineering. Incorporating fuzzy quantities within an optimisation task is basically innovative. In our context, fuzzy modelling allows us to determine an optimal applicator placement that maximises the therapy success under the given uncertainty conditions. The applicability of our method is demonstrated by means of an example case.

Fast Estimation of the Vascular Cooling in RFA Based on Numerical Simulation

We present a novel technique to predict the outcome of an RF ablation, including the vascular cooling effect. The main idea is to separate the problem into a patient independent part, which has to be performed only once for every applicator model and generator setting, and a patient dependent part, which can be performed very fast. The patient independent part fills a look-up table of the cooling effects of blood vessels, depending on the vessel radius and the distance of the RF applicator from the vessel, using a numerical simulation of the ablation process. The patient dependent part, on the other hand, only consists of a number of table look-up processes. The paper presents this main idea, along with the required steps for its implementation. First results of the computation and the related ex-vivo evaluation are presented and discussed. The paper concludes with future extensions and improvements of the approach.

Fast Estimation of the Vascular Cooling in RFA Based on Numerical Simulation

We present a novel technique to predict the outcome of an RF ablation, including the vascular cooling effect. The main idea is to separate the problem into a patient independent part, which has to be performed only once for every applicator model and generator setting, and a patient dependent part, which can be performed very fast. The patient independent part fills a look-up table of the cooling effects of blood vessels, depending on the vessel radius and the distance of the RF applicator from the vessel, using a numerical simulation of the ablation process. The patient dependent part, on the other hand, only consists of a number of table look-up processes. The paper presents this main idea, along with the required steps for its implementation. First results of the computation and the related ex-vivo evaluation are presented and discussed. The paper concludes with future extensions and improvements of the approach.

Computer oriented image acquisition of the liver: Toward a better numerical model for radiofrequency ablation

Simulating physiological interventions for planning purposes requires an accurate virtual liver model as computation input. To best meet the demands the data acquisition has to be oriented on image processing purposes. We provide a CT imaging protocol which makes it possible to extract much more vessels with the same segmentation algorithms than when using them on data sets from the clinical routine. Medical evaluation of physiological models demand a statistical evaluation in a pre-clinical study, that means in a first step reproducible results for a large number of subjects. So data acquisition should be as automatic as possible without neglecting modeling demands. Image quality should be reproducible to guarantee an ongoing high quality of image processing results. We evaluate the protocol by comparison of segmentation results with results achieved on standard data sets from clinical routine using the same segmentation methods. Results show that typically up to ten times more vessels can be extracted and the surface accuracy is improved.

Thermal characteristics of microwave ablation in the vicinity of an arterial bifurcation

PURPOSE

The objective of this research was to reveal the thermal characteristics of microwave ablations in the vicinity of an arterial bifurcation.

METHODS

The temperature distribution after microwave heating of a liver-like material in the close proximity of an arterial bifurcation was simulated using the finite element method. Coupled fluid flow and solid heat transfer were taken into consideration and a three-dimensional analysis was performed. An experimentally determined SAR (specific absorption rate) generated by the absorption of microwaves in liver-like material was used in the analysis instead of utilizing electromagnetic calculations. Several different tests of time-controlled ablations with varying distances between the microwave antenna and the bifurcation were performed and detailed temperature distributions near the bifurcation were obtained.

RESULTS

The interaction between the recirculation flow in the bifurcation and the heat transfer in the surrounding tissue makes the temperature distribution near the bifurcation complicated. Most importantly, after a period of continuous heating with constant microwave output power, the maximum temperatures caused by the ablation did not always increase with the distance between the antenna and the bifurcation.

CONCLUSION

It can be concluded that inadequate ablations can be the result not only from a close proximity between the antenna and the blood vessel, but also from a complicated blood flow in large vessels whose structure causes recirculation flow.

Optimizing electrode placement using finite-element models in radiofrequency ablation treatment planning

Conventional radiofrequency ablation (RFA) planning methods for identifying suitable electrode placements typically use geometric shapes to model ablation outcomes. A method is presented for searching electrode placements that couples finite-element models (FEMs) of RFA together with a novel optimization strategy. The method was designed to reduce the need for model solutions per local search step. The optimization strategy was tested against scenarios requiring single and multiple ablations. In particular, for a scenario requiring multiple ablations, a domain decomposition strategy was described to minimize the complexity of simultaneously searching multiple electrode placements. The effects of nearby vasculature on optimal electrode placement were also studied. Compared with geometric planning approaches, FEMs could potentially deliver electrode placement plans that provide more physically meaningful predictions of therapeutic outcomes.

Characterization of tracked radiofrequency ablation in phantom

In radiofrequency ablation (RFA), successful therapy requires accurate, image-guided placement of the ablation device in a location selected by a predictive treatment plan. Current planning methods rely on geometric models of ablations that are not sensitive to underlying physical processes in RFA. Implementing plans based on computational models of RFA with image-guided techniques, however, has not been well characterized. To study the use of computational models of RFA in planning needle placement, this work compared ablations performed with an optically tracked RFA device with corresponding models of the ablations. The calibration of the tracked device allowed the positions of distal features of the device, particularly the tips of the needle electrodes, to be determined to within 1.4 +/- 0.6 mm of uncertainty. Ablations were then performed using the tracked device in a phantom system based on an agarose-albumin mixture. Images of the sliced phantom obtained from the ablation experiments were then compared with the predictions of a bioheat transfer model of RFA, which used the positional data of the tracked device obtained during ablation. The model was demonstrated to predict 90% of imaged pixels classified as being ablated. The discrepancies between model predictions and observations were analyzed and attributed to needle tracking inaccuracy as well as to uncertainties in model parameters. The results suggest the feasibility of using finite element modeling to plan ablations with predictable outcomes when implemented using tracked RFA.