PubMed · 13135745
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J Dj ZUJOVIC. 1953. [Hyperthermia e medio].. https://pubmed.ncbi.nlm.nih.gov/13135745/
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In this paper, a method for the determination of spatially varying thermal conductivity and perfusion coefficients of tissue is proposed. The temperature evolution in tissue is modelled with the Pennes bioheat equation. The main motivation here is a model-based optimal control for ultrasound surgery, in which the tissue properties are needed when the treatment is planned. The overview of the method is as follows. The same ultrasound transducers, which are eventually used for the treatment, are used to inflict small temperature changes in tissue. This temperature evolution is monitored using MR thermal imaging, and the tissue properties are then estimated on the basis of these measurements. Furthermore, an approach to choose transducer excitations for the determination procedure is also considered. The purpose of this paper is to introduce a method and therefore simulations are used to verify the method. Furthermore, computations are accomplished in a 2D spatial domain.
The application of thermal modelling for hyperthermia and thermal ablation is severely hampered by lack of information about perfusion and vasculature. However, recently, with the advent of sophisticated angiography and dynamic contrast enhanced (DCE) imaging techniques, it has become possible to image small vessels and blood perfusion bringing the ultimate goal of patient specific thermal modelling closer within reach. In this study dynamic contrast enhanced multi-slice CT imaging techniques are employed to investigate the feasibility of this concept for regional hyperthermia treatment of the prostate. The results are retrospectively compared with clinical thermometry data of a patient group from an earlier trial. Furthermore, the role of the prostate vasculature in the establishment of the prostate temperature distribution is studied. Quantitative 3D perfusion maps of the prostate were constructed for five patients using a distributed-parameter tracer kinetics model to analyse dynamic CT data. CT angiography was applied to construct a discrete vessel model of the pelvis. Additionally, a discrete vessel model of the prostate vasculature was constructed of a prostate taken from a human corpse. Three thermal modelling schemes with increasing inclusion of the patient specific physiological information were used to simulate the temperature distribution of the prostate during regional hyperthermia. Prostate perfusion was found to be heterogeneous and T3 prostate carcinomas are often characterized by a strongly elevated tumour perfusion (up to 70-80 ml 100 g(-1) min(-1)). This elevated tumour perfusion leads to 1-2 degrees C lower tumour temperatures than thermal simulations based on a homogeneous prostate perfusion. Furthermore, the comparison has shown that the simulations with the measured perfusion maps result in consistently lower prostate temperatures than clinically achieved. The simulations with the discrete vessel model indicate that significant pre-heating takes place in the prostate capsule vasculature which forms a possible explanation for the discrepancy. Pre-heating in the larger pelvic vessels is very moderate, approximately 0.1-0.3 degrees C. In conclusion, perfusion imaging provides important input for thermal modelling and can be used to obtain a lower limit on the prostate and tumour temperature in regional hyperthermia. However, it is not sufficient to calculate in detail the prostate temperature distribution in individual patients. The prostate vasculature plays such a crucial role that a patient specific discrete vessel model of the prostate vasculature is required.