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在胰腺导管腺癌患者的磁热疗中加热金属胆道支架:一项 研究。

Heating of metallic biliary stents during magnetic hyperthermia of patients with pancreatic ductal adenocarcinoma: an study.

机构信息

Istituto Nazionale di Ricerca Metrologica (INRIM), Turin, Italy.

IMDEA Nanoscience, Madrid, Spain.

出版信息

Int J Hyperthermia. 2022;39(1):1222-1232. doi: 10.1080/02656736.2022.2121863.

Abstract

OBJECTIVE

To investigate the eddy current heating that occurs in metallic biliary stents during magnetic hyperthermia treatments and to assess whether these implants should continue to be an exclusion criterion for potential patients.

METHODS

Computer simulations were run on stent heating during the hyperthermia treatment of local pancreatic tumors (5-15 mT fields at 300 kHz for 30 min), considering factors such as wire diameter, type of stent alloy, and field orientation. Maxwell's equations were solved numerically in a bile duct model, including the secondary field produced by the stents. The heat exchange problem was solved through a modified version of the Pennes' bioheat equation assuming a temperature dependency of blood perfusion and metabolic heat.

RESULTS

The choice of alloy has a large impact on the stent heating, preferring those having a lower electrical conductivity. Only for low field intensities (5 mT) and for some of the bile duct tissue layers the produced heating can be considered safe. The orientation of the applied field with respect to the stent wires can give rise to the onset of regions with different heating levels depending on the shape that the stent has finally adopted according to the body's posture. Bile helps to partially dissipate the heat that is generated in the lumen of the bile duct, but not at a sufficient rate.

CONCLUSION

The safety of patients with pancreatic cancer wearing metallic biliary stents during magnetic hyperthermia treatments cannot be fully assured under the most common treatment parameters.

摘要

目的

研究在磁性热疗过程中金属胆道支架中发生的涡流加热,并评估这些植入物是否应继续作为潜在患者的排除标准。

方法

针对局部胰腺肿瘤的热疗(5-15 mT 场,300 kHz,30 min),对支架加热进行了计算机模拟,考虑了线径、支架合金类型和场方向等因素。在胆管模型中通过数值求解麦克斯韦方程,包括支架产生的二次场。通过彭内斯生物热方程的修改版本解决了热交换问题,假设血液灌注和代谢热的温度依赖性。

结果

合金的选择对支架加热有很大影响,优先选择电导率较低的合金。只有在低场强(5 mT)和一些胆管组织层中,产生的加热才被认为是安全的。施加磁场的方向相对于支架线可以导致根据身体姿势支架最终采用的形状而产生不同加热水平的区域的出现。胆汁有助于部分消散胆管腔中产生的热量,但速度不够快。

结论

在最常见的治疗参数下,不能完全保证患有胰腺癌并佩戴金属胆道支架的患者在磁性热疗期间的安全性。

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