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Role of percutaneous CT–guided radiofrequency ablation in treatment of intra-articular, in close contact with cartilage and extra-articular osteoid osteomas: comparative analysis and new classification system. Radiol Med 2022; 127:1142-1150. [DOI: 10.1007/s11547-022-01542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/17/2022] [Indexed: 10/14/2022]
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Rivas Loya R, Jutte PC, Kwee TC, van Ooijen PMA. Computer 3D modeling of radiofrequency ablation of atypical cartilaginous tumours in long bones using finite element methods and real patient anatomy. Eur Radiol Exp 2022; 6:21. [PMID: 35482168 PMCID: PMC9050991 DOI: 10.1186/s41747-022-00271-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Radiofrequency ablation (RFA) is a minimally invasive technique used for the treatment of neoplasms, with a growing interest in the treatment of bone tumours. However, the lack of data concerning the size of the resulting ablation zones in RFA of bone tumours makes prospective planning challenging, needed for safe and effective treatment. METHODS Using retrospective computed tomography and magnetic resonance imaging data from patients treated with RFA of atypical cartilaginous tumours (ACTs), the bone, tumours, and final position of the RFA electrode were segmented from the medical images and used in finite element models to simulate RFA. Tissue parameters were optimised, and boundary conditions were defined to mimic the clinical scenario. The resulting ablation diameters from postoperative images were then measured and compared to the ones from the simulations, and the error between them was calculated. RESULTS Seven cases had all the information required to create the finite element models. The resulting median error (in all three directions) was -1 mm, with interquartile ranges from -3 to 3 mm. The three-dimensional models showed that the thermal damage concentrates close to the cortical wall in the first minutes and then becomes more evenly distributed. CONCLUSIONS Computer simulations can predict the ablation diameters with acceptable accuracy and may thus be utilised for patient planning. This could allow interventional radiologists to accurately define the time, electrode length, and position required to treat ACTs with RFA and make adjustments as needed to guarantee total tumour destruction while sparing as much healthy tissue as possible.
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Affiliation(s)
- Ricardo Rivas Loya
- Department of Radiotherapy, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Paul C Jutte
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas C Kwee
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter M A van Ooijen
- Department of Radiotherapy, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Rivas R, Hijlkema RB, Cornelissen LJ, Kwee TC, Jutte PC, van Ooijen PMA. Effects of control temperature, ablation time, and background tissue in radiofrequency ablation of osteoid osteoma: A computer modeling study. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3512. [PMID: 34313015 PMCID: PMC9285497 DOI: 10.1002/cnm.3512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 06/05/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
To study the effects of the control temperature, ablation time, and the background tissue surrounding the tumor on the size of the ablation zone on radiofrequency ablation (RFA) of osteoid osteoma (OO). Finite element models of non-cooled temperature-controlled RFA of typical OOs were developed to determine the resulting ablation radius at control temperatures of 70, 80, and 90°C. Three different geometries were used, mimicking common cases of OO. The ablation radius was obtained by using the Arrhenius equation to determine cell viability. Ablation radii were larger for higher temperatures and also increased with time. All geometries and control temperatures tested had ablation radii larger than the tumor. The ablation radius developed rapidly in the first few minutes for all geometries and control temperatures tested, developing slowly towards the end of the ablation. Resistive heating and the temperature distribution showed differences depending on background tissue properties, resulting in differences in the ablation radius on each geometry. The ablation radius has a clear dependency not only on the properties of the tumor but also on the background tissue. Lower background tissue's electrical conductivity and blood perfusion rates seem to result in larger ablation zones. The differences observed between the different geometries suggest the need for patient-specific planning, as the anatomical variations could cause significantly different outcomes where models like the one here presented could help to guarantee safe and successful tumor ablations.
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Affiliation(s)
- Ricardo Rivas
- Department of RadiotherapyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Rudy B. Hijlkema
- Faculty of Mathematics and Natural SciencesUniversity of GroningenGroningenThe Netherlands
| | - Ludo J. Cornelissen
- Department of RadiotherapyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Thomas C. Kwee
- Department of RadiologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Paul C. Jutte
- Department of OrthopedicsUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Peter M. A. van Ooijen
- Department of RadiotherapyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
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Yan S, Gu K, Wu X, Wang W. Computer simulation study on the effect of electrode-tissue contact force on thermal lesion size in cardiac radiofrequency ablation. Int J Hyperthermia 2020; 37:37-48. [PMID: 31918588 DOI: 10.1080/02656736.2019.1708482] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Purpose: In cardiac radiofrequency (RF) ablation, RF energy is often used to create a series of transmural lesions for blocking accessory conduction pathways. Electrode-tissue contact force (CF) is one of the key determinants of lesion formation during RF ablation. Low electrode-tissue CF is associated with ineffective RF lesion formation, whereas excessive CF may increase the risk of steam pop and perforation. By using finite element analysis, we studied lesion size and features at different values of electrode-tissue CF in cardiac RF ablation.Materials and methods: A computer-model-coupled electrode-tissue CF field, RF electric field, and thermal field were developed to study temperature distribution and lesion dimensions in cardiac tissue subjected to CF of 2, 5, 10, 20, 30, and 40 g with identical RF voltage and duration.Results: Increasing CF was associated with an increase in lesion depth, width, and cross-section area. The lesion cross-section area exhibited a linear increase, and the lesion width was significantly greater than lesion depth under the identical ablation condition. The relationship between CF value and lesion size is a power function: Lesion Size = a × CFb (Lesion Depth = 3.17 × CF0.14 and Lesion Width = 5.17 × CF0.14).Conclusions: This study confirmed that CF is a major determinant of RF lesion size and that electrode-tissue CF affects the amount of power dissipated in tissue. At a constant RF voltage and application time, RF lesion size increases as CF increases.
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Affiliation(s)
- Shengjie Yan
- Electronic Engineering Department, Fudan University, Shanghai, China
| | - Kaihao Gu
- Electronic Engineering Department, Fudan University, Shanghai, China
| | - Xiaomei Wu
- Electronic Engineering Department, Fudan University, Shanghai, China.,Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Fudan University, Shanghai, China.,Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Weiqi Wang
- Electronic Engineering Department, Fudan University, Shanghai, China
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Fajardo JE, Carlevaro CM, Vericat F, Berjano E, Irastorza RM. Effect of the trabecular bone microstructure on measuring its thermal conductivity: A computer modeling-based study. J Therm Biol 2018; 77:131-136. [PMID: 30196891 DOI: 10.1016/j.jtherbio.2018.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/08/2018] [Accepted: 08/17/2018] [Indexed: 11/25/2022]
Abstract
The objective of this work is to quantify the relation between the value of the effective thermal conductivity of trabecular bone and its microstructure and marrow content. The thermal conductivity of twenty bovine trabecular bone samples was measured prior to and after defatting at 37, 47, and 57 °C. Computer models were built including the microstructure geometry and the gap between the tissue and measurement probe. The thermal conductivity (k) measured was 0.39 ± 0.06 W m-1 K-1 at 37 °C, with a temperature dependence of + 0.2%°C-1. Replacing marrow by phosphate-buffered saline (defatting) increased both the computer simulations and measurement results by 0.04 W m-1 K-1. The computer simulations showed that k increases by 0.02-0.04 W m-1 K-1 when the model includes a gap filled by phosphate-buffered saline between the tissue and measurement probe. In the presence of microstructure and fatty red marrow, k varies by ± 0.01 W m-1 K-1 compared with the case considering matrix only, which suggests that there are no significant differences between cortical and trabecular bone in terms of k. The computer results showed that the presence of a gap filled by phosphate-buffered saline around the energy applicator changes maximum temperature by < 0.7 °C, while including the bone microstructure involved a variation of < 0.2 mm in the isotherm location. Future experimental studies on measuring the value of k involving the insertion of a probe into the bone through a drill hole should consider the bias found in the simulations. Thermal models based on a homogeneous geometry (i.e. ignoring the microstructure) could provide sufficient accuracy.
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Affiliation(s)
- Jesús E Fajardo
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), La Plata, Argentina
| | - C Manuel Carlevaro
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), La Plata, Argentina; Universidad Tecnológica Nacional, Facultad Regional Buenos Aires, Buenos Aires, Argentina
| | - Fernando Vericat
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), La Plata, Argentina
| | - Enrique Berjano
- BioMIT, Department of Electronic Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Ramiro M Irastorza
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), La Plata, Argentina; Instituto de Ingeniería y Agronomía, Universidad Nacional Arturo Jauretche, Argentina.
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Irastorza RM, Trujillo M, Berjano E. How coagulation zone size is underestimated in computer modeling of RF ablation by ignoring the cooling phase just after RF power is switched off. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e2869. [PMID: 28146314 DOI: 10.1002/cnm.2869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/29/2017] [Indexed: 06/06/2023]
Abstract
All the numerical models developed for radiofrequency ablation so far have ignored the possible effect of the cooling phase (just after radiofrequency power is switched off) on the dimensions of the coagulation zone. Our objective was thus to quantify the differences in the minor radius of the coagulation zone computed by including and ignoring the cooling phase. We built models of RF tumor ablation with 2 needle-like electrodes: a dry electrode (5 mm long and 17G in diameter) with a constant temperature protocol (70°C) and a cooled electrode (30 mm long and 17G in diameter) with a protocol of impedance control. We observed that the computed coagulation zone dimensions were always underestimated when the cooling phase was ignored. The mean values of the differences computed along the electrode axis were always lower than 0.15 mm for the dry electrode and 1.5 mm for the cooled electrode, which implied a value lower than 5% of the minor radius of the coagulation zone (which was 3 mm for the dry electrode and 30 mm for the cooled electrode). The underestimation was found to be dependent on the tissue characteristics: being more marked for higher values of specific heat and blood perfusion and less marked for higher values of thermal conductivity.
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Affiliation(s)
- Ramiro M Irastorza
- Instituto de Física de Líquidos y Sistemas Biológicos (CONICET), Calle 59 No 789, B1900BTE, La Plata, Argentina
- Instituto de Ingeniería y Agronomía, Universidad Nacional Arturo Jauretche, Avenida Calchaquí No 6200, 1888, Florencio Varela, Argentina
| | - Macarena Trujillo
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, Camí de Vera, 46022, València, Spain
| | - Enrique Berjano
- Biomedical Synergy, Electronic Engineering Department, Universitat Politècnica de València, Camí de Vera, 46022, València, Spain
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Arrigoni F, Barile A, Zugaro L, Fascetti E, Zappia M, Brunese L, Masciocchi C. CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up. Int J Hyperthermia 2017; 34:321-327. [PMID: 28597707 DOI: 10.1080/02656736.2017.1334168] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Osteoblastoma (OB) is a painful, rare, benign bone tumour usually observed in young populations, and this condition involves the spine in up to one-third of cases. We sought to focus on the minimally invasive treatment of spinal OB with radiofrequency ablation (RFA) under computed tomography (CT) guidance. When performed near the spinal cord, surgery can lead to instability of the spine, sometimes requiring additional interventions to stabilise the segments involved, and can cause the precocious onset of arthrosis or other degenerative diseases. The results were evaluated both clinically and with the aid of diagnostic imaging techniques during a 5-year follow-up study. MATERIALS AND METHODS Eleven patients affected by spinal OB were treated in a single session with biopsy and CT-guided RFA. Pre- and post-evaluations of the patients were performed both clinically and with CT and magnetic resonance imaging (MRI). RESULTS Complete success in terms of pain relief was achieved in all patients. Additional treatments were not required in any patients. There were no complications. During follow-up, neither complications nor pathological findings related to the treatment were observed. CONCLUSIONS Our experience demonstrates that RFA for spinal OB is safe and effective. One of the main advantages of this technique is represented by its lower grade of invasiveness compared with that for potentially hazardous surgical manoeuvres.
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Affiliation(s)
| | - Antonio Barile
- b Dipartimento di Scienze Cliniche Applicate e Biotecnologiche , Universita degli Studi dell'Aquila , L'Aquila , Italy
| | | | - Eva Fascetti
- b Dipartimento di Scienze Cliniche Applicate e Biotecnologiche , Universita degli Studi dell'Aquila , L'Aquila , Italy
| | - Marcello Zappia
- c Dipartimento di Medicina e di Scienze della Salute , Universita degli Studi del Molise , Campobasso , Italy
| | - Luca Brunese
- c Dipartimento di Medicina e di Scienze della Salute , Universita degli Studi del Molise , Campobasso , Italy
| | - Carlo Masciocchi
- b Dipartimento di Scienze Cliniche Applicate e Biotecnologiche , Universita degli Studi dell'Aquila , L'Aquila , Italy
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Filippiadis DK, Velonakis G, Kostantos C, Kouloulias V, Brountzos E, Kelekis N, Kelekis A. Computed tomography-guided radiofrequency ablation of intra-articular osteoid osteoma: a single centre’s experience. Int J Hyperthermia 2017; 33:670-674. [DOI: 10.1080/02656736.2017.1294711] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- D. K. Filippiadis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - G. Velonakis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - C. Kostantos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - V. Kouloulias
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - E. Brountzos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - N. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
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