Verhey J F, Mohammed Y, Ludwig A, Giese K
Department of Medical Informatics, University of Goettingen, Robert-Koch-Str. 40, D-37075 Goettingen, Germany.
Phys Med Biol. 2003 Nov 7;48(21):3595-610. doi: 10.1088/0031-9155/48/21/010.
This paper introduces a simulation model for light and heat transport in tissues including perfusion effects. The model enables an efficient simulation of the damaged zone induced with an optical fibre for laser interstitial thermotherapy (LITT). It is designed specially for, but not limited to, tissue ablation in the neck region near to vessels. We describe in detail the effects of the rise in temperature caused by the absorption of light in tissue, using the heat equation and including the cooling effects of flow in vessels and of microperfusion in tissue in order to determine the extent of thermal damage. The extent of the necrosis zone is calculated with a damage function at each point of a finite element method (FEM) mesh. The FEM mesh is implemented with FEMLAB 2.3 as an add-on for finite element modelling for Matlab 6.5. LITT for tumour ablation in liver and some other anatomical regions is a well-known and established method (Bundesärztekammer und Kassenärztliche Bundesvereinigung 2002 Assessment der Bundesärztekammer und der Kassenärztlichen Bundesvereinigung, Köln). Investigations of treatments using LITT in the neck region are still in progress. We propose a refined model to validate the LITT method in the future in another anatomic region, e.g., in the highly sensitive region of the neck. Our calculations show that in order to induce a lesion with a maximum diameter of about 1 cm near to a large vessel, an application time between 3 and 4 min is needed using a laser power of about 10 W with a Nd:YAG 1064 nm radiation wavelength.
本文介绍了一种用于模拟组织中光热传输(包括灌注效应)的模型。该模型能够高效模拟激光间质热疗(LITT)中光纤诱导的损伤区域。它是专门为靠近血管的颈部区域的组织消融设计的,但不限于该区域。我们使用热方程详细描述了组织中光吸收引起的温度升高的影响,并考虑了血管内血流和组织微灌注的冷却效应,以确定热损伤的程度。坏死区域的范围通过有限元方法(FEM)网格中每个点的损伤函数来计算。FEM网格是使用FEMLAB 2.3作为Matlab 6.5有限元建模的插件实现的。LITT用于肝脏和其他一些解剖区域的肿瘤消融是一种众所周知且成熟的方法(德国医师协会和德国法定医疗保险医师联合会2002年评估,科隆)。在颈部区域使用LITT进行治疗的研究仍在进行中。我们提出了一个改进的模型,以便将来在另一个解剖区域,例如在颈部高度敏感区域验证LITT方法。我们的计算表明,为了在靠近大血管处诱导出最大直径约为1 cm的病变,使用波长为1064 nm的Nd:YAG激光,功率约为10 W时,需要3至4分钟的照射时间。