Institute for Medical Science and Technology, University of Dundee, Wilson House, 1 Wurzburg Loan, Dundee, DD2 1FD, UK.
Int J Comput Assist Radiol Surg. 2012 Nov;7(6):941-8. doi: 10.1007/s11548-012-0769-3. Epub 2012 Jun 12.
Minimally invasive treatment of solid cancers, especially in the breast and liver, remains clinically challenging, despite a variety of treatment modalities, including radiofrequency ablation (RFA), microwave ablation or high-intensity focused ultrasound. Each treatment modality has advantages and disadvantages, but all are limited by placement of a probe or US beam in the target tissue for tumor ablation and monitoring. The placement is difficult when the tumor is surrounded by large blood vessels or organs. Patient-specific image-based 3D modeling for thermal ablation simulation was developed to optimize treatment protocols that improve treatment efficacy.
A tissue-mimicking breast gel phantom was used to develop an image-based 3D computer-aided design (CAD) model for the evaluation of a planned RF ablation. First, the tissue-mimicking gel was cast in a breast mold to create a 3D breast phantom, which contained a simulated solid tumor. Second, the phantom was imaged in a medical MRI scanner using a standard breast imaging MR sequence. Third, the MR images were converted into a 3D CAD model using commercial software (ScanIP, Simpleware), which was input into another commercial package (COMSOL Multiphysics) for RFA simulation and treatment planning using a finite element method (FEM). For validation of the model, the breast phantom was experimentally ablated using a commercial (RITA) RFA electrode and a bipolar needle with an electrosurgical generator (DRE ASG-300). The RFA results obtained by pre-treatment simulation were compared with actual experimental ablation.
A 3D CAD model, created from MR images of the complex breast phantom, was successfully integrated with an RFA electrode to perform FEM ablation simulation. The ablation volumes achieved both in the FEM simulation and the experimental test were equivalent, indicating that patient-specific models can be implemented for pre-treatment planning of solid tumor ablation.
A tissue-mimicking breast gel phantom and its MR images were used to perform FEM 3D modeling and validation by experimental thermal ablation of the tumor. Similar patient-specific models can be created from preoperative images and used to perform finite element analysis to plan radiofrequency ablation. Clinically, the method can be implemented for pre-treatment planning to predict the effect of an individual's tissue environment on the ablation process, and this may improve the therapeutic efficacy.
尽管有多种治疗方式，包括射频消融（RFA）、微波消融或高强度聚焦超声，微创治疗实体瘤，尤其是乳腺和肝脏的实体瘤，仍然具有临床挑战性。每种治疗方式都有其优点和缺点，但所有方式都受到在目标组织中放置探针或 US 束以进行肿瘤消融和监测的限制。当肿瘤被大血管或器官包围时，放置探针或 US 束会很困难。开发基于患者特定图像的 3D 建模用于热消融模拟，以优化提高治疗效果的治疗方案。
使用组织模拟乳腺凝胶体模来开发基于图像的 3D 计算机辅助设计（CAD）模型，以评估计划的射频消融。首先，将组织模拟凝胶体模铸在乳腺模具中，以创建包含模拟实体瘤的 3D 乳腺体模。其次，使用标准乳腺成像 MR 序列在医学 MRI 扫描仪中对体模进行成像。然后，使用商业软件（ScanIP、Simpleware）将 MR 图像转换为 3D CAD 模型，该模型被输入到另一个商业软件包（COMSOL Multiphysics）中，用于使用有限元法（FEM）进行 RFA 模拟和治疗规划。为了验证模型，使用商业（RITA）RFA 电极和带有电外科发生器（DRE ASG-300）的双极针对乳腺体模进行了实验性消融。通过预处理模拟获得的 RFA 结果与实际实验消融进行了比较。
成功地将来自复杂乳腺体模的 MR 图像创建的 3D CAD 模型与 RFA 电极集成在一起，以执行 FEM 消融模拟。在 FEM 模拟和实验测试中获得的消融体积相等，表明可以为实体瘤消融的术前计划实施患者特异性模型。
使用组织模拟乳腺凝胶体模及其 MR 图像进行了 FEM 3D 建模，并通过对肿瘤进行实验性热消融进行了验证。可以从术前图像创建类似的患者特异性模型，并用于执行有限元分析来规划射频消融。在临床上，可以实施该方法进行术前计划，以预测个体组织环境对消融过程的影响，从而可能提高治疗效果。
