Aramburu Jorge, Antón Raúl, Rivas Alejandro, Ramos Juan Carlos, Sangro Bruno, Bilbao José Ignacio
Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018, San Sebastián, Spain.
Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Spain.
Int J Numer Method Biomed Eng. 2017 Dec;33(12). doi: 10.1002/cnm.2895. Epub 2017 Jul 27.
Liver radioembolization is a promising treatment option for combating liver tumors. It is performed by placing a microcatheter in the hepatic artery and administering radiation-emitting microspheres through the arterial bloodstream so that they get lodged in the tumoral bed. In avoiding nontarget radiation, the standard practice is to conduct a pretreatment, in which the microcatheter location and injection velocity are decided. However, between pretreatment and actual treatment, some of the parameters that influence the particle distribution in the liver can vary, resulting in radiation-induced complications. The present study aims to analyze the influence of a commercially available microcatheter with an angled tip and particle injection velocity in terms of segment-to-segment particle distribution. Specifically, 4 tip orientations and 2 injection velocities are combined to yield a set of 8 numerical simulations of the particle-hemodynamics in a patient-specific truncated hepatic artery. For each simulation, 4 cardiac pulses are simulated. Particles are injected during the first cycle, and the remaining pulses enable the majority of the injected particles to exit the computational domain. Results indicate that, in terms of injection velocity, particles are more spread out in the cross-sectional lumen areas as the injection velocity increases. The tip's orientation also plays a role because it influences the near-tip hemodynamics, therefore altering the particle travel through the hepatic artery. However, results suggest that particle distribution tries to match the blood flow split, therefore particle injection velocity and microcatheter tip orientation playing a minor role in segment-to-segment particle distribution.
肝脏放射性栓塞是一种很有前景的治疗肝脏肿瘤的方法。它是通过将微导管置于肝动脉，并通过动脉血流注入发射辐射的微球，使其滞留在肿瘤床。为避免非靶向辐射，标准做法是进行预处理，确定微导管位置和注射速度。然而，在预处理和实际治疗之间，一些影响肝脏内粒子分布的参数可能会发生变化，从而导致放射性并发症。本研究旨在分析一种具有成角尖端的市售微导管和粒子注射速度对各段粒子分布的影响。具体而言，将4种尖端方向和2种注射速度相结合，对特定患者的截断肝动脉内的粒子血液动力学进行8组数值模拟。对于每组模拟，模拟4个心动周期。在第一个周期注入粒子，其余周期使大部分注入的粒子离开计算域。结果表明，就注射速度而言，随着注射速度的增加，粒子在横截面管腔区域分布得更分散。尖端的方向也起作用，因为它影响尖端附近的血液动力学，从而改变粒子在肝动脉中的行进。然而，结果表明粒子分布试图与血流分配相匹配，因此粒子注射速度和微导管尖端方向在各段粒子分布中起次要作用。
