Wake Radiology Oncology, Cary, NC 27518, USA.
Int J Radiat Oncol Biol Phys. 2010 Feb 1;76(2):631-7. doi: 10.1016/j.ijrobp.2009.06.069. Epub 2009 Nov 10.
Radioembolization (RE) via yttrium-90 ((90)Y) microspheres is an effective and safe treatment for unresectable liver malignancies. However, no data are available regarding the impact of local blood flow dynamics on (90)Y-microsphere transport and distribution in the human hepatic arterial system.
A three-dimensional (3-D) computer model was developed to analyze and simulate blood-microsphere flow dynamics in the hepatic arterial system with tumor. Supplemental geometric and flow data sets from patients undergoing RE were also available to validate the accuracy of the computer simulation model. Specifically, vessel diameters, curvatures, and branching patterns, as well as blood flow velocities/pressures and microsphere characteristics (i.e., diameter and specific gravity), were measured. Three-dimensional computer-aided design software was used to create the vessel geometries. Initial trials, with 10,000 noninteracting microspheres released into the hepatic artery, used resin spheres 32-microm in diameter with a density twice that of blood.
Simulations of blood flow subject to different branch-outlet pressures as well as blood-microsphere transport were successfully carried out, allowing testing of two types of microsphere release distributions in the inlet plane of the main hepatic artery. If the inlet distribution of microspheres was uniform (evenly spaced particles), a greater percentage would exit into the vessel branch feeding the tumor. Conversely, a parabolic inlet distribution of microspheres (more particles around the vessel center) showed a high percentage of microspheres exiting the branch vessel leading to the normal liver.
Computer simulations of both blood flow patterns and microsphere dynamics have the potential to provide valuable insight on how to optimize (90)Y-microsphere implantation into hepatic tumors while sparing normal tissue.
钇-90((90)Y)微球放射性栓塞术是治疗不可切除的肝脏恶性肿瘤的一种有效且安全的方法。然而,目前尚无关于局部血流动力学对人肝动脉系统中(90)Y 微球输送和分布影响的数据。
开发了一个三维(3-D)计算机模型,用于分析和模拟带有肿瘤的肝动脉系统中的血液-微球流动动力学。还可获得接受放射性栓塞术治疗的患者的补充几何形状和流量数据集,以验证计算机模拟模型的准确性。具体而言,测量了血管直径、曲率和分支模式,以及血流速度/压力和微球特性(即直径和比重)。使用三维计算机辅助设计软件创建了血管几何形状。初始试验中,将 10000 个非相互作用的微球释放到肝动脉中,使用直径为 32 微米、密度为血液两倍的树脂球。
成功进行了不同分支出口压力下的血流模拟以及血液-微球输送模拟,从而可以在主肝动脉入口平面上测试两种类型的微球释放分布。如果微球的入口分布是均匀的(粒子均匀间隔),则会有更大比例的微球进入供应肿瘤的血管分支。相反,微球的入口分布呈抛物线形(粒子集中在血管中心周围)时,会有很大比例的微球从通向正常肝脏的分支血管中排出。
血流模式和微球动力学的计算机模拟有可能提供有关如何优化(90)Y 微球植入肝脏肿瘤同时保护正常组织的宝贵见解。