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电热疗法:采用动态温度控制算法的微秒级脉冲电场组织消融术。

Electro-thermal therapy: Microsecond duration pulsed electric field tissue ablation with dynamic temperature control algorithms.

作者信息

Sano Michael B, Petrella Ross A, Kaufman Jacob D, Fesmire Christopher C, Xing Lei, Gerber David, Fogle Callie A

机构信息

UNC/ NCSU Joint Department of Biomedical Engineering, Raleigh, NC, USA.

UNC/ NCSU Joint Department of Biomedical Engineering, Raleigh, NC, USA.

出版信息

Comput Biol Med. 2020 Jun;121:103807. doi: 10.1016/j.compbiomed.2020.103807. Epub 2020 May 11.

Abstract

Electro-thermal therapy (ETT) is a new cancer treatment modality which combines the use of high voltage pulsed electric fields, dynamic energy delivery rates, and closed loop thermal control algorithms to rapidly and reproducibly create focal ablations. This study examines the ablative potential and profile of pulsed electric field treatments delivered in conjunction with precise temperature control algorithms. An ex vivo perfused liver model was utilized to demonstrate the capability of 5000 V 2 μs duration bipolar electrical pulses and dynamic temperature control algorithms to produce ablations. Using a three applicator array, 4 cm ablation zones were created in under 27 min. In this configuration, the algorithms were able to rapidly achieve and maintain temperatures of 80 °C at the tissue-electrode interface. A simplified single applicator and grounding pad approach was used to correlate the measured ablation zones to electric field isocontours in order to determine lethal electric field thresholds of 708 V/cm and 867 V/cm for 45 °C and 60 °C treatments, respectively. These results establish ETT as a viable method for hepatic tumor treatment with ablation profiles equivalent to other energy based techniques. The single applicator and multi-applicator approaches demonstrated may enable the treatment of complex tumor geometries. The flexibility of ETT temperature control yields a malleable intervention which gives clinicians robust control over the ablation modality, treatment time, and safety profile.

摘要

电热疗法(ETT)是一种新型癌症治疗方式,它结合了高压脉冲电场的应用、动态能量输送速率以及闭环热控算法,以快速且可重复地产生局灶性消融。本研究考察了与精确温度控制算法相结合的脉冲电场治疗的消融潜力和特征。利用离体灌注肝脏模型来证明5000 V、持续时间为2 μs的双极电脉冲和动态温度控制算法产生消融的能力。使用三电极阵列,在不到27分钟内创建了4厘米的消融区。在此配置下,算法能够在组织 - 电极界面迅速达到并维持80°C的温度。采用简化的单电极和接地垫方法,将测量的消融区与电场等轮廓线相关联,以确定45°C和60°C治疗的致死电场阈值分别为708 V/cm和867 V/cm。这些结果表明,ETT是一种可行的肝肿瘤治疗方法,其消融特征与其他基于能量的技术相当。所展示的单电极和多电极方法可能使复杂肿瘤几何形状的治疗成为可能。ETT温度控制的灵活性产生了一种可灵活调整的干预措施,使临床医生能够对消融方式、治疗时间和安全性进行有力控制。

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