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Molinari L, Zaltieri M, Massaroni C, Filippi S, Gizzi A, Schena E. Multiscale and Multiphysics Modeling of Anisotropic Cardiac RFCA: Experimental-Based Model Calibration via Multi-Point Temperature Measurements. Front Physiol 2022; 13:845896. [PMID: 35514332 PMCID: PMC9062295 DOI: 10.3389/fphys.2022.845896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Radiofrequency catheter ablation (RFCA) is the mainstream treatment for drug-refractory cardiac fibrillation. Multiple studies demonstrated that incorrect dosage of radiofrequency energy to the myocardium could lead to uncontrolled tissue damage or treatment failure, with the consequent need for unplanned reoperations. Monitoring tissue temperature during thermal therapy and predicting the extent of lesions may improve treatment efficacy. Cardiac computational modeling represents a viable tool for identifying optimal RFCA settings, though predictability issues still limit a widespread usage of such a technology in clinical scenarios. We aim to fill this gap by assessing the influence of the intrinsic myocardial microstructure on the thermo-electric behavior at the tissue level. By performing multi-point temperature measurements on ex-vivo swine cardiac tissue samples, the experimental characterization of myocardial thermal anisotropy allowed us to assemble a fine-tuned thermo-electric material model of the cardiac tissue. We implemented a multiphysics and multiscale computational framework, encompassing thermo-electric anisotropic conduction, phase-lagging for heat transfer, and a three-state dynamical system for cellular death and lesion estimation. Our analysis resulted in a remarkable agreement between ex-vivo measurements and numerical results. Accordingly, we identified myocardium anisotropy as the driving effect on the outcomes of hyperthermic treatments. Furthermore, we characterized the complex nonlinear couplings regulating tissue behavior during RFCA, discussing model calibration, limitations, and perspectives.
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Affiliation(s)
- Leonardo Molinari
- Department of Mathematics and Computer Science, Emory University, Atlanta, GA, United States
| | - Martina Zaltieri
- Laboratory of Measurement and Biomedical Instrumentation, Department of Engineering, University of Rome Campus Bio-Medico, Rome, Italy
| | - Carlo Massaroni
- Laboratory of Measurement and Biomedical Instrumentation, Department of Engineering, University of Rome Campus Bio-Medico, Rome, Italy
| | - Simonetta Filippi
- Nonlinear Physics and Mathematical Modeling Lab, Department of Engineering, University of Rome Campus Bio-Medico, Rome, Italy
| | - Alessio Gizzi
- Nonlinear Physics and Mathematical Modeling Lab, Department of Engineering, University of Rome Campus Bio-Medico, Rome, Italy
| | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Department of Engineering, University of Rome Campus Bio-Medico, Rome, Italy
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Hübner F, Schreiner R, Panahi B, Vogl TJ. Evaluation of the thermal sensitivity of porcine liver in CT-guided cryoablation: an initial study. Med Phys 2020; 47:4997-5005. [PMID: 32748398 DOI: 10.1002/mp.14432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/19/2020] [Accepted: 07/24/2020] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate computed tomography (CT)-based thermometry in cryoablation, the thermal sensitivity of an ex-vivo porcine liver was determined in an initial study design. METHODS The CT-guided cryoablation was performed in three porcine liver samples over a period of 10 min. Fiber optic temperature probes were positioned parallel to the shaft of the cryoprobe in an axial slice orientation. During ablation, temperature measurements were performed simultaneously with CT imaging at 5 s intervals. On the CT images, the average CT number was calculated for a region of interest of 3 × 3 pixels just below the tip of each temperature probe. A linear regression analysis was performed using eleven data sets to determine the dependence of the CT number on the temperature. RESULTS With decreasing temperature, an increasing hypodense area around the tip of the cryoprobe was observed on the CT images and decreasing values of the CT number were determined. Starting at a temperature of - 40°C a linear relation between the CT number and the temperature was determined and a thermal sensitivity of 0.95 HU/°C (R2 = 0.73) was obtained. The thermal sensitivity was used to calculate color-coded temperature maps. The calculated temperature distribution corresponds quantitatively to the increasing hypodense area. CONCLUSIONS A noninvasive CT-based temperature determination during cryoablation in a normal ex vivo porcine liver is feasible. A thermal sensitivity of 0.95 HU/°C was determined by linear regression analysis. A color-coded map of the temperature distribution was presented.
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Affiliation(s)
- Frank Hübner
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Roland Schreiner
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Bita Panahi
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Thomas Josef Vogl
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
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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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Singh S, Melnik R. Coupled thermo-electro-mechanical models for thermal ablation of biological tissues and heat relaxation time effects. Phys Med Biol 2019; 64:245008. [PMID: 31600740 DOI: 10.1088/1361-6560/ab4cc5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Thermal ablation is a widely applied electrosurgical process in medical treatment of soft biological tissues. Numerical modeling and simulations play an important role in prediction of temperature distribution and damage volume during the treatment planning stage of associated therapies. In this contribution we report a coupled thermo-electro-mechanical model, accounting for heat relaxation time, for more accurate and precise prediction of the temperature distribution, tissue deformation and damage volume during the thermal ablation of biological tissues. Finite element solutions are obtained for most widely used percutaneous thermal ablative techniques, viz., radiofrequency ablation (RFA) and microwave ablation (MWA). Importantly, both tissue expansion and shrinkage have been considered for modeling the tissue deformation in the coupled model of high temperature thermal ablation. The coupled model takes into account the non-Fourier effects, considering both single-phase-lag (SPL) and dual-phase-lag (DPL) models of bio-heat transfer. The temperature-dependent electrical and thermal parameters, damage-dependent blood perfusion rate and phase change effect accounting for tissue vaporization have been accounted for obtaining more clinically relevant model. The proposed model predictions are found to be in good agreement against the temperature distribution and damage volume reported by previous experimental studies. The numerical simulation results revealed that the non-Fourier effects cause a decrease in the predicted temperature distribution, tissue deformation and damage volume during the high temperature thermal ablative procedures. Furthermore, the effects of different magnitudes of phase lags of the heat flux and temperature gradient on the predicted treatment outcomes of the considered thermal ablative modalities are also quantified and discussed in detail.
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Affiliation(s)
- Sundeep Singh
- MS2Discovery Interdisciplinary Research Institute, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario N2L 3C5, Canada. Author to whom any correspondence should be addressed
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Lopresto V, Argentieri A, Pinto R, Cavagnaro M. Temperature dependence of thermal properties of ex vivo liver tissue up to ablative temperatures. ACTA ACUST UNITED AC 2019; 64:105016. [DOI: 10.1088/1361-6560/ab1663] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Temporal evaluation of the microwave ablation zone and comparison of CT and gross sizes during the first month post-ablation in swine lung. Diagn Interv Imaging 2019; 100:279-285. [DOI: 10.1016/j.diii.2018.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/22/2022]
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Hübner F, Schreiner R, Reimann C, Bazrafshan B, Kaltenbach B, Schüßler M, Jakoby R, Vogl TJ. Ex vivo validation of microwave thermal ablation simulation using different flow coefficients in the porcine liver. Med Eng Phys 2019; 66:56-64. [PMID: 30826254 DOI: 10.1016/j.medengphy.2019.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 12/25/2022]
Abstract
The purpose of the study was to validate the simulation model for a microwave thermal ablation in ex vivo liver tissue. The study aims to show that heat transfer due to the flow of tissue water during ablation in ex vivo tissue is not negligible. Ablation experiments were performed in ex vivo porcine liver with microwave powers of 60 W to 100 W. During the procedure, the temperature was recorded in the liver sample at different distances to the applicator using a fiber-optic thermometer. The position of the probes was identified by CT imaging and transferred to the simulation. The simulation of the heat distribution in the liver tissue was carried out with the software CST Studio Suite. The results of the simulation with different flow coefficients were compared with the results of the ablation experiments using the Bland-Altman analysis. The analysis showed that the flow coefficient of 90,000 W/(K*m3) can be considered as the most suitable value for clinically used powers. The presented simulation model can be used to calculate the temperature distribution for microwave ablation in ex vivo liver tissue.
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Affiliation(s)
- Frank Hübner
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
| | - Roland Schreiner
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Carolin Reimann
- Institute for Microwave Engineering and Photonics, Technische Universität Darmstadt, Merckstrasse 25, 64283 Darmstadt, Germany
| | - Babak Bazrafshan
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Benjamin Kaltenbach
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Martin Schüßler
- Institute for Microwave Engineering and Photonics, Technische Universität Darmstadt, Merckstrasse 25, 64283 Darmstadt, Germany
| | - Rolf Jakoby
- Institute for Microwave Engineering and Photonics, Technische Universität Darmstadt, Merckstrasse 25, 64283 Darmstadt, Germany
| | - Thomas Josef Vogl
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe - University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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Lopresto V, Strigari L, Farina L, Minosse S, Pinto R, D’Alessio D, Cassano B, Cavagnaro M. CT-based investigation of the contraction ofex vivotissue undergoing microwave thermal ablation. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1361-6560/aaaf07] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Park CS, Liu C, Hall SK, Payne SJ. A thermoelastic deformation model of tissue contraction during thermal ablation. Int J Hyperthermia 2017; 34:221-228. [DOI: 10.1080/02656736.2017.1335441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Chang Sub Park
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Cong Liu
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Sheldon K. Hall
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Stephen J. Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
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Liu D, Brace CL. Numerical simulation of microwave ablation incorporating tissue contraction based on thermal dose. Phys Med Biol 2017; 62:2070-2086. [PMID: 28151729 DOI: 10.1088/1361-6560/aa5de4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Tissue contraction plays an important role during high temperature tumor ablation, particularly during device characterization, treatment planning and imaging follow up. We measured such contraction in 18 ex vivo bovine liver samples during microwave ablation by tracking fiducial motion on CT imaging. Contraction was then described using a thermal dose dependent model and a negative thermal expansion coefficient based on the empirical data. FEM simulations with integrated electromagnetic wave propagation, heat transfer, and structural mechanics were evaluated using temperature-dependent dielectric properties and the negative thermal expansion models. Simulated temperature and displacement curves were then compared with the ex vivo experimental results on different continuous output powers. The optimized thermal dose model indicated over 50% volumetric contraction occurred at the temperature over 102.1 °C. The numerical simulation results on temperature and contraction-induced displacement showed a good agreement with experimental results. At microwave powers of 55 W, the mean errors on temperature between simulation and experimental results were 8.25%, 2.19% and 5.67% at 5 mm, 10 mm and 20 mm radially from the antenna, respectively. The simulated displacements had mean errors of 16.60%, 14.08% and 23.45% at the same radial locations. Compared to the experimental results, the simulations at the other microwave powers had larger errors with 10-40% mean errors at 40 W, and 10-30% mean errors at 25 W. The proposed model is able to predict temperature elevation and simulate tissue deformation during microwave ablation, and therefore may be incorporated into treatment planning and clinical translation from numerical simulations.
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Affiliation(s)
- Dong Liu
- Department of Radiology and Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, Madison WI 53705, United States of America
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