一种针对乳腺肿瘤的高强度聚焦超声消融的全面数值程序,基于解剖学真实乳腺模型。
A comprehensive numerical procedure for high-intensity focused ultrasound ablation of breast tumour on an anatomically realistic breast phantom.
机构信息
Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
出版信息
PLoS One. 2024 Oct 1;19(10):e0310899. doi: 10.1371/journal.pone.0310899. eCollection 2024.
High-Intensity Focused Ultrasound (HIFU) as a promising and impactful modality for breast tumor ablation, entails the precise focalization of high-intensity ultrasonic waves onto the tumor site, culminating in the generation of extreme heat, thus ablation of malignant tissues. In this paper, a comprehensive three-dimensional (3D) Finite Element Method (FEM)-based numerical procedure is introduced, which provides exceptional capacity for simulating the intricate multiphysics phenomena associated with HIFU. Furthermore, the application of numerical procedures to an anatomically realistic breast phantom (ARBP) has not been explored before. The integrity of the present numerical procedure has been established through rigorous validation, incorporating comparative assessments with previous two-dimensional (2D) simulations and empirical data. For ARBP ablation, the administration of a 0.1 MPa pressure input pulse at a frequency of 1.5 MHz, sustained at the focal point for 10 seconds, manifests an ensuing temperature elevation to 80°C. It is noteworthy that, in contrast, the prior 2D simulation using a 2D phantom geometry reached just 72°C temperature under the identical treatment regimen, underscoring the insufficiency of 2D models, ascribed to their inherent limitations in spatially representing acoustic energy, which compromises their overall effectiveness. To underscore the versatility of this numerical platform, a simulation of a more clinically relevant HIFU therapy procedure has been conducted. This scenario involves the repositioning of the ultrasound focal point to three separate lesions, each spaced at 3 mm intervals, with ultrasound exposure durations of 6 seconds each and a 5-second interval for movement between focal points. This approach resulted in a more uniform high-temperature distribution at different areas of the tumour, leading to the ablation of almost all parts of the tumour, including its verges. In the end, the effects of different abnormal tissue shapes are investigated briefly as well. For solid mass tumors, 67.67% was successfully ablated with one lesion, while rim-enhancing tumors showed only 34.48% ablation and non-mass enhancement tumors exhibited 20.32% ablation, underscoring the need for multiple lesions and tailored treatment plans for more complex cases.
高强度聚焦超声(HIFU)作为一种有前途且有影响力的乳腺肿瘤消融方式,需要将高强度超声波精确聚焦到肿瘤部位,最终产生极端高温,从而消融恶性组织。在本文中,介绍了一种全面的三维(3D)有限元方法(FEM)数值程序,该程序具有模拟与 HIFU 相关的复杂多物理现象的卓越能力。此外,以前从未将数值程序应用于解剖学逼真的乳腺模型(ARBP)。通过与以前的二维(2D)模拟和经验数据进行严格的比较评估,证明了本数值程序的完整性。对于 ARBP 消融,在焦点处施加 1.5 MHz 频率的 0.1 MPa 压力输入脉冲,持续 10 秒,会导致温度升高到 80°C。值得注意的是,相比之下,在相同的治疗方案下,使用二维模型几何形状的先前 2D 模拟仅达到 72°C 的温度,这突出了 2D 模型的不足,这归因于它们在空间表示声能方面的固有局限性,这降低了它们的整体有效性。为了强调这个数值平台的多功能性,已经对更符合临床的 HIFU 治疗过程进行了模拟。该方案涉及将超声焦点重新定位到三个单独的病变部位,每个部位间隔 3 毫米,每个部位的超声暴露时间为 6 秒,焦点之间的移动时间为 5 秒。这种方法导致肿瘤不同区域的高温分布更加均匀,几乎消融了肿瘤的所有部位,包括其边缘。最后,还简要研究了不同异常组织形状的影响。对于实体肿块肿瘤,一个病灶成功消融了 67.67%,而边缘增强肿瘤仅消融了 34.48%,非肿块增强肿瘤仅消融了 20.32%,这突出了对多个病灶和更复杂病例的量身定制治疗计划的需求。