Department of Radiotherapy, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur Radiol Exp. 2022 Apr 28;6(1):21. doi: 10.1186/s41747-022-00271-3.
Radiofrequency ablation (RFA) is a minimally invasive technique used for the treatment of neoplasms, with a growing interest in the treatment of bone tumours. However, the lack of data concerning the size of the resulting ablation zones in RFA of bone tumours makes prospective planning challenging, needed for safe and effective treatment.
Using retrospective computed tomography and magnetic resonance imaging data from patients treated with RFA of atypical cartilaginous tumours (ACTs), the bone, tumours, and final position of the RFA electrode were segmented from the medical images and used in finite element models to simulate RFA. Tissue parameters were optimised, and boundary conditions were defined to mimic the clinical scenario. The resulting ablation diameters from postoperative images were then measured and compared to the ones from the simulations, and the error between them was calculated.
Seven cases had all the information required to create the finite element models. The resulting median error (in all three directions) was -1 mm, with interquartile ranges from -3 to 3 mm. The three-dimensional models showed that the thermal damage concentrates close to the cortical wall in the first minutes and then becomes more evenly distributed.
Computer simulations can predict the ablation diameters with acceptable accuracy and may thus be utilised for patient planning. This could allow interventional radiologists to accurately define the time, electrode length, and position required to treat ACTs with RFA and make adjustments as needed to guarantee total tumour destruction while sparing as much healthy tissue as possible.
射频消融（RFA）是一种用于治疗肿瘤的微创技术，对于骨肿瘤的治疗越来越受到关注。然而，由于缺乏关于 RFA 治疗骨肿瘤时产生的消融区域大小的数据，使得前瞻性规划具有挑战性，这对于安全有效的治疗是必要的。
使用接受 RFA 治疗非典型软骨肿瘤（ACT）的患者的回顾性计算机断层扫描和磁共振成像数据，从医学图像中分割出骨、肿瘤和 RFA 电极的最终位置，并将其用于有限元模型中模拟 RFA。优化组织参数，并定义边界条件以模拟临床情况。然后测量术后图像中的消融直径，并将其与模拟结果进行比较，并计算它们之间的误差。
有 7 个病例具有创建有限元模型所需的所有信息。得到的中位数误差（在所有三个方向）为-1 毫米，四分位间距为-3 到 3 毫米。三维模型显示，热损伤在最初的几分钟内集中在皮质壁附近，然后分布得更加均匀。
计算机模拟可以以可接受的精度预测消融直径，因此可以用于患者规划。这可以使介入放射科医生能够准确地定义 RFA 治疗 ACT 所需的时间、电极长度和位置，并进行必要的调整，以确保完全破坏肿瘤，同时尽可能多地保留健康组织。
