1
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Van Durme R, Crevecoeur G, Dupré L, Coene A. Improved magnetic drug targeting with maximized magnetic forces and limited particle spreading. Med Phys 2023; 50:1715-1727. [PMID: 36542430 DOI: 10.1002/mp.16180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In magnetic drug targeting (MDT), micro- or nanoparticles are injected into the human body to locally deliver therapeutics. These magnetic particles can be guided from a distance by external magnetic fields and gradients from electromagnets. PURPOSE During the particles' movement through the vascular network, they are affected by magnetic forces, fluid (drag) forces, particle interactions, diffusion, etc. Adequate targeting is hindered when drag forces overcome the magnetic forces and particles present in vessels are carried away from the targeted region. Moreover, the magnetic force directions and diffusion mechanisms can cause particles to scatter, while they should remain together for an effective targeting performance. In this work, these adverse effects are tackled using optimization methods. METHODS We formulate an optimization problem with respect to the currents in surrounding electromagnets that aims to maximize the magnetic force on a particle along a predefined direction. A boundary on the magnetic force divergence is introduced as a constraint to limit particle spreading. We also consider particles to be moved from an initial to a target location in a finite-time interval. To this end dynamic optimization is applied. RESULTS Simulations for particles in a bifurcated vessel show an increase of particle speed by 20% and a successful movement towards the targeted regions without spreading. For the dynamic optimization, simulation results demonstrate that particle collections are accurately guided with 10 times less scattering and 10 times more particles at the target than without the divergence constraint. CONCLUSIONS The proposed methods significantly improve the steering and capturing of particles in a region of interest. They are applicable to any magnetic drug targeting configuration with electromagnets.
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Affiliation(s)
- Rikkert Van Durme
- Department of Electromechanical, Systems and Metal Engineering, Ghent University, Ghent, Belgium
| | - Guillaume Crevecoeur
- Department of Electromechanical, Systems and Metal Engineering, Ghent University, Ghent, Belgium
- EEDT Decision & Control, core lab Flanders Make, Lommel, Belgium
| | - Luc Dupré
- Department of Electromechanical, Systems and Metal Engineering, Ghent University, Ghent, Belgium
| | - Annelies Coene
- Department of Electromechanical, Systems and Metal Engineering, Ghent University, Ghent, Belgium
- EEDT Decision & Control, core lab Flanders Make, Lommel, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
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2
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Bomberna T, Vermijs S, Lejoly M, Verslype C, Bonne L, Maleux G, Debbaut C. A Hybrid Particle-Flow CFD Modeling Approach in Truncated Hepatic Arterial Trees for Liver Radioembolization: A Patient-specific Case Study. Front Bioeng Biotechnol 2022; 10:914979. [PMID: 35711632 PMCID: PMC9197434 DOI: 10.3389/fbioe.2022.914979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/11/2022] [Indexed: 12/17/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. At its intermediate, unresectable stage, HCC is typically treated by local injection of embolizing microspheres in the hepatic arteries to selectively damage tumor tissue. Interestingly, computational fluid dynamics (CFD) has been applied increasingly to elucidate the impact of clinically variable parameters, such as injection location, on the downstream particle distribution. This study aims to reduce the computational cost of such CFD approaches by introducing a novel truncation algorithm to simplify hepatic arterial trees, and a hybrid particle-flow modeling approach which only models particles in the first few bifurcations. A patient-specific hepatic arterial geometry was pruned at three different levels, resulting in three trees: Geometry 1 (48 outlets), Geometry 2 (38 outlets), and Geometry 3 (17 outlets). In each geometry, 1 planar injection and 3 catheter injections (each with different tip locations) were performed. For the truncated geometries, it was assumed that, downstream of the truncated outlets, particles distributed themselves proportional to the blood flow. This allowed to compare the particle distribution in all 48 "outlets" for each geometry. For the planar injections, the median difference in outlet-specific particle distribution between Geometry 1 and 3 was 0.21%; while the median difference between outlet-specific flow and particle distribution in Geometry 1 was 0.40%. Comparing catheter injections, the maximum median difference in particle distribution between Geometry 1 and 3 was 0.24%, while the maximum median difference between particle and flow distribution was 0.62%. The results suggest that the hepatic arterial tree might be reliably truncated to estimate the particle distribution in the full-complexity tree. In the resulting hybrid particle-flow model, explicit particle modeling was only deemed necessary in the first few bifurcations of the arterial tree. Interestingly, using flow distribution as a surrogate for particle distribution in the entire tree was considerably less accurate than using the hybrid model, although the difference was much higher for catheter injections than for planar injections. Future work should focus on replicating and experimentally validating these results in more patient-specific geometries.
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Affiliation(s)
- Tim Bomberna
- IBiTech-Biommeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium.,Cancer Research Institute Ghent, Ghent University, Ghent, Belgium
| | - Saar Vermijs
- IBiTech-Biommeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium.,Cancer Research Institute Ghent, Ghent University, Ghent, Belgium
| | - Maryse Lejoly
- Department of Radiology and Medical Imaging, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Chris Verslype
- Department of Clinical Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Lawrence Bonne
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Geert Maleux
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte Debbaut
- IBiTech-Biommeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium.,Cancer Research Institute Ghent, Ghent University, Ghent, Belgium
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3
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Talaie R, Torkian P, Amili O, Aboufirass Y, Rostambeigi N, Jalaeian H, Golzarian J. Particle Distribution in Embolotherapy, How Do They Get There? A Critical Review of the Factors Affecting Arterial Distribution of Embolic Particles. Ann Biomed Eng 2022; 50:885-897. [PMID: 35524027 DOI: 10.1007/s10439-022-02965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
Embolization has tremendously evolved in recent years and has expanded to treatment of a variety of pathologic processes. There has been emerging evidence that the level of arterial occlusion and the distribution of embolic particles may play an important role in the clinical outcome. This is a comprehensive literature review to identify variables that play important role in determination of level of occlusion of blood vessels and distribution of embolic particles. The literature searches between 1996 to 2020 through PubMed and Ovid-MEDLINE yielded over 1030 articles of which 30 studies providing details on the level of occlusion are reviewed here. We divided the playing factors into characteristics of the particles, solution/injection and vascular bed. Accordingly, particle size, type and aggregation, compressibility/deformability, and biodegradability are categorized as the factors involving particles' behavioral nature. Infusion rate and concentration/dilution of the medium are related to the carrying solution. Hemodynamics and the arterial resistance are characteristics of the vascular bed that also play an important role in the distribution of embolic particles. Understanding and predicting the level of embolization is a complex multi-factor problem that requires more evidence, warranting further randomized controlled trials, and powered human and animal studies.
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Affiliation(s)
- Reza Talaie
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Pooya Torkian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA.
| | - Omid Amili
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, USA
| | | | - Nassir Rostambeigi
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jafar Golzarian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
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4
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Aramburu J, Antón R, Rodríguez-Fraile M, Sangro B, Bilbao JI. Computational Fluid Dynamics Modeling of Liver Radioembolization: A Review. Cardiovasc Intervent Radiol 2021; 45:12-20. [PMID: 34518913 PMCID: PMC8716346 DOI: 10.1007/s00270-021-02956-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022]
Abstract
Yttrium-90 radioembolization (RE) is a widely used transcatheter intraarterial therapy for patients with unresectable liver cancer. In the last decade, computer simulations of hepatic artery hemodynamics during RE have been performed with the aim of better understanding and improving the therapy. In this review, we introduce the concept of computational fluid dynamics (CFD) modeling with a clinical perspective and we review the CFD models used to study RE from the fluid mechanics point of view. Finally, we show what CFD simulations have taught us about the hemodynamics during RE, the current capabilities of CFD simulations of RE, and we suggest some future perspectives.
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Affiliation(s)
- Jorge Aramburu
- Universidad de Navarra, TECNUN Escuela de Ingeniería, 20018, Donostia-San Sebastián, Spain.
| | - Raúl Antón
- Universidad de Navarra, TECNUN Escuela de Ingeniería, 20018, Donostia-San Sebastián, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008, Pamplona, Spain
| | - Macarena Rodríguez-Fraile
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008, Pamplona, Spain.,Department of Nuclear Medicine, Clínica Universidad de Navarra, 31008, Pamplona, Spain
| | - Bruno Sangro
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008, Pamplona, Spain.,Liver Unit, Clínica Universidad de Navarra and CIBEREHD, 31008, Pamplona, Spain
| | - José Ignacio Bilbao
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008, Pamplona, Spain.,Department of Radiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain
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5
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CFD Simulations of Radioembolization: A Proof-of-Concept Study on the Impact of the Hepatic Artery Tree Truncation. MATHEMATICS 2021. [DOI: 10.3390/math9080839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Radioembolization (RE) is a treatment for patients with liver cancer, one of the leading cause of cancer-related deaths worldwide. RE consists of the transcatheter intraarterial infusion of radioactive microspheres, which are injected at the hepatic artery level and are transported in the bloodstream, aiming to target tumors and spare healthy liver parenchyma. In paving the way towards a computer platform that allows for a treatment planning based on computational fluid dynamics (CFD) simulations, the current simulation (model preprocess, model solving, model postprocess) times (of the order of days) make the CFD-based assessment non-viable. One of the approaches to reduce the simulation time includes the reduction in size of the simulated truncated hepatic artery. In this study, we analyze for three patient-specific hepatic arteries the impact of reducing the geometry of the hepatic artery on the simulation time. Results show that geometries can be efficiently shortened without impacting greatly on the microsphere distribution.
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6
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Bomberna T, Koudehi GA, Claerebout C, Verslype C, Maleux G, Debbaut C. Transarterial drug delivery for liver cancer: numerical simulations and experimental validation of particle distribution in patient-specific livers. Expert Opin Drug Deliv 2020; 18:409-422. [PMID: 33210955 DOI: 10.1080/17425247.2021.1853702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Transarterial therapies are routinely used for the locoregional treatment of unresectable hepatocellular carcinoma (HCC). However, the impact of clinical parameters (i.e. injection location, particle size, particle density etc.) and patient-specific conditions (i.e. hepatic geometry, cancer burden) on the intrahepatic particle distribution (PD) after transarterial injection of embolizing microparticles is still unclear. Computational fluid dynamics (CFD) may help to better understand this impact.Methods: Using CFD, both the blood flow and microparticle mass transport were modeled throughout the 3D-reconstructed arterial vasculature of a patient-specific healthy and cirrhotic liver. An experimental feasibility study was performed to simulate the PD in a 3D-printed phantom of the cirrhotic arterial network.Results: Axial and in-plane injection locations were shown to be effective parameters to steer particles toward tumor tissue in both geometries. Increasing particle size or density made it more difficult for particles to exit the domain. As cancer burden increased, the catheter tip location mattered less. The in vitro study and numerical results confirmed that PD largely mimics flow distribution, but that significant differences are still possible.Conclusions: Our findings highlight that optimal parameter choice can lead to selective targeting of tumor tissue, but that targeting potential highly depends on patient-specific conditions.
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Affiliation(s)
- Tim Bomberna
- IBiTech-bioMMeda, Department of Electronics and Information Systems, Ghent University, Gent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Gent, Belgium
| | - Ghazal Adeli Koudehi
- IBiTech-bioMMeda, Department of Electronics and Information Systems, Ghent University, Gent, Belgium
| | - Charlotte Claerebout
- IBiTech-bioMMeda, Department of Electronics and Information Systems, Ghent University, Gent, Belgium
| | - Chris Verslype
- Department of Clinical Digestive Oncology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Geert Maleux
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, Leuven, Belgium
| | - Charlotte Debbaut
- IBiTech-bioMMeda, Department of Electronics and Information Systems, Ghent University, Gent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Gent, Belgium
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7
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Aramburu J, Antón R, Rivas A, Ramos JC, Sangro B, Bilbao JI. Liver Radioembolization: An Analysis of Parameters that Influence the Catheter-Based Particle-Delivery via CFD. Curr Med Chem 2020; 27:1600-1615. [DOI: 10.2174/0929867325666180622145647] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/18/2017] [Accepted: 05/25/2017] [Indexed: 12/13/2022]
Abstract
Radioembolization (RE) is a valuable treatment for liver cancer. It consists of administering
radioactive microspheres by an intra-arterially placed catheter with the aim of
lodging these microspheres, which are driven by the bloodstream, in the tumoral bed. Even
though it is a safe treatment, some radiation-induced complications may arise. In trying to
detect or solve the possible incidences that cause nontarget irradiation, simulating the particle-
hemodynamics in hepatic arteries during RE by computational fluid dynamics (CFD)
tools has become a valuable approach. This paper reviews the parameters that influence the
outcome of RE and that have been studied via numerical simulations. In this numerical approach,
the outcome of RE is regarded as successful if particles reach the artery branches that
feed tumor-bearing liver segments. Up to 10 parameters have been reviewed. The variation
of each parameter actually alters the hemodynamic pattern in the vicinities of the catheter tip
and locally alters the incorporation of the particles into the bloodstream. Therefore, in general,
the local influences of these parameters should result in global differences in terms of
particle distribution in the hepatic artery branches. However, it has been observed that under
some (qualitatively described) appropriate conditions where particles align with blood
streamlines, the local influence resulting from a variation of a given parameter vanishes and
no global differences are observed. Furthermore, the increasing number of CFD studies on
RE suggests that numerical simulations have become an invaluable research tool in the study
of RE.
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Affiliation(s)
- Jorge Aramburu
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018 Donostia-San Sebastian, Spain
| | - Raúl Antón
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018 Donostia-San Sebastian, Spain
| | - Alejandro Rivas
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018 Donostia-San Sebastian, Spain
| | - Juan C. Ramos
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018 Donostia-San Sebastian, Spain
| | - Bruno Sangro
- IdiSNA, Instituto de Investigacion Sanitaria de Navarra, 31008 Pamplona, Spain
| | - José I. Bilbao
- IdiSNA, Instituto de Investigacion Sanitaria de Navarra, 31008 Pamplona, Spain
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8
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In Vitro Study of Particle Transport in Successively Bifurcating Vessels. Ann Biomed Eng 2019; 47:2271-2283. [PMID: 31165293 DOI: 10.1007/s10439-019-02293-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/20/2019] [Indexed: 12/24/2022]
Abstract
To reach a predictive understanding of how particles travel through bifurcating vessels is of paramount importance in many biomedical settings, including embolization, thromboembolism, and drug delivery. Here we utilize an in vitro model in which solid particles are injected through a rigid vessel that symmetrically bifurcates in successive branching generations. The geometric proportion and fluid dynamics parameters are relevant to the liver embolization. The volumetric flow field is reconstructed via phase-contrast magnetic resonance imaging, from which the particle trajectories are calculated for a range of size and density using the particle equation of motion. The method is validated by directly tracking the injected particles via optical imaging. The results indicate that, opposite to the common assumption, the particles distribution is fundamentally different from the volumetric flow partition. In fact, the amount of delivered particles vary substantially between adjacent branches even when the flow is uniformly distributed. This is not due to the inertia of the particles, nor to gravity. The particle distribution is rather rooted in their different pathways, which in turn are linked to their release origin along the main vessel cross-section. Therefore, the tree geometry and the associated flow streamlines are the prime determinant of the particle fate, while local changes of volumetric flow rate to selected branches do not generally produce proportional changes of particle delivery.
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9
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Xu Z, Kleinstreuer C. Direct nanodrug delivery for tumor targeting subject to shear-augmented diffusion in blood flow. Med Biol Eng Comput 2018; 56:1949-1958. [DOI: 10.1007/s11517-018-1818-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/15/2018] [Indexed: 12/15/2022]
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10
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Aramburu J, Antón R, Rivas A, Ramos JC, Sangro B, Bilbao JI. The role of angled-tip microcatheter and microsphere injection velocity in liver radioembolization: A computational particle-hemodynamics study. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33. [PMID: 28474382 DOI: 10.1002/cnm.2895] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Jorge Aramburu
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018, San Sebastián, Spain
| | - Raúl Antón
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018, San Sebastián, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Spain
| | - Alejandro Rivas
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018, San Sebastián, Spain
| | - Juan Carlos Ramos
- Universidad de Navarra, TECNUN Escuela de Ingenieros, 20018, San Sebastián, Spain
| | - Bruno Sangro
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Spain
- Clínica Universidad de Navarra, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029, Madrid, Spain
| | - José Ignacio Bilbao
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008, Pamplona, Spain
- Clínica Universidad de Navarra, 31008, Pamplona, Spain
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11
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Aramburu J, Antón R, Rivas A, Ramos JC, Sangro B, Bilbao JI. Computational particle-haemodynamics analysis of liver radioembolization pretreatment as an actual treatment surrogate. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2017; 33:e02791. [PMID: 27038438 DOI: 10.1002/cnm.2791] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/23/2016] [Accepted: 03/24/2016] [Indexed: 06/05/2023]
Abstract
Liver radioembolization (RE) is a treatment option for patients with unresectable and chemorefractory primary and metastatic liver tumours. RE consists of intra-arterially administering via catheter radioactive microspheres that locally attack the tumours, sparing healthy tissue. Prior to RE, the standard practice is to conduct a treatment-mimicking pretreatment assessment via the infusion of 99m Tc-labelled macroaggregated albumin microparticles. The usefulness of this pretreatment has been debated in the literature, and thus, the aim of the present study is to shed light on this issue by numerically simulating the liver RE pretreatment and actual treatment particle-haemodynamics in a patient-specific hepatic artery under two different literature-based cancer scenarios and two different placements of a realistic end-hole microcatheter in the proper hepatic artery. The parameters that are analysed are the following: microagent quantity and size (accounting for RE pretreatment and treatment), catheter-tip position (near the proper hepatic artery bifurcation and away from it), and cancer burden (10% and 30% liver involvement). The conclusion that can be reached from the simulations is that when it comes to mimicking RE in terms of delivering particles to tumour-bearing segments, the catheter-tip position is much more important (because of the importance of local haemodynamic pattern alteration) than the infused microagents (i.e. quantity and size). Cancer burden is another important feature because the increase in blood flow rate to tumour-bearing segments increases the power to drag particles. These numerical simulation-based conclusions are in agreement with clinically observed events reported in the literature. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jorge Aramburu
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, P° Manuel Lardizabal 13, 20018, Donostia-San Sebastián, Spain
| | - Raúl Antón
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, P° Manuel Lardizabal 13, 20018, Donostia-San Sebastián, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pío XII 36, 31008, Pamplona, Spain
| | - Alejandro Rivas
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, P° Manuel Lardizabal 13, 20018, Donostia-San Sebastián, Spain
| | - Juan Carlos Ramos
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, P° Manuel Lardizabal 13, 20018, Donostia-San Sebastián, Spain
| | - Bruno Sangro
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pío XII 36, 31008, Pamplona, Spain
- Clínica Universidad de Navarra, Av. Pío XII 36, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Av. Pío XII 36, 31008, Pamplona, Spain
| | - José Ignacio Bilbao
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pío XII 36, 31008, Pamplona, Spain
- Clínica Universidad de Navarra, Av. Pío XII 36, 31008, Pamplona, Spain
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12
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Audebert C, Bekheit M, Bucur P, Vibert E, Vignon-Clementel IE. Partial hepatectomy hemodynamics changes: Experimental data explained by closed-loop lumped modeling. J Biomech 2017; 50:202-208. [PMID: 27890535 DOI: 10.1016/j.jbiomech.2016.11.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/02/2016] [Indexed: 02/06/2023]
Abstract
The liver function may be degraded after partial liver ablation surgery. Adverse liver hemodynamics have been shown to be associated to liver failure. The link between these hemodynamics changes and ablation size is however poorly understood. This article proposes to explain with a closed-loop lumped model the hemodynamics changes observed during twelve surgeries in pigs. The portal venous tree is modeled with a pressure-dependent variable resistor. The variables measured, before liver ablation, are used to tune the model parameters. Then, the liver partial ablation is simulated with the model and the simulated pressures and flows are compared with post-operative measurements. Fluid infusion and blood losses occur during the surgery. The closed-loop model presented accounts for these blood volume changes. Moreover, the impact of blood volume changes and the liver lobe mass estimations on the simulated variables is studied. The typical increase of portal pressure, increase of liver pressure loss, slight decrease of portal flow and major decrease in arterial flow are quantitatively captured by the model for a 75% hepatectomy. It appears that the 75% decrease in hepatic arterial flow can be explained by the resistance increase induced by the surgery, and that no hepatic arterial buffer response (HABR) mechanism is needed to account for this change. The different post-operative states, observed in experiments, are reproduced with the proposed model. Thus, an explanation for inter-subjects post-operative variability is proposed. The presented framework can easily be adapted to other species circulations and to different pathologies for clinical hepatic applications.
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Affiliation(s)
- Chloe Audebert
- Inria, Paris, France; Sorbonne Universités UPMC Univ Paris 6, Laboratoire Jacques-Louis Lions, France
| | | | - Petru Bucur
- Inserm Unité 1193, Villejuif, France; CHRU, hôpitaux de Tours,Chirurgie Hépato-biliaire et Pancréatique, Transplantation Hépatique, Tours, France
| | - Eric Vibert
- Inserm Unité 1193, Villejuif, France; AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France
| | - Irene E Vignon-Clementel
- Inria, Paris, France; Sorbonne Universités UPMC Univ Paris 6, Laboratoire Jacques-Louis Lions, France.
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Numerical investigation of liver radioembolization via computational particle–hemodynamics: The role of the microcatheter distal direction and microsphere injection point and velocity. J Biomech 2016; 49:3714-3721. [DOI: 10.1016/j.jbiomech.2016.09.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/15/2016] [Accepted: 09/30/2016] [Indexed: 11/18/2022]
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Aramburu J, Antón R, Rivas A, Ramos JC, Sangro B, Bilbao JI. Liver cancer arterial perfusion modelling and CFD boundary conditions methodology: a case study of the haemodynamics of a patient-specific hepatic artery in literature-based healthy and tumour-bearing liver scenarios. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2016; 32:e02764. [PMID: 26727946 DOI: 10.1002/cnm.2764] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
Some of the latest treatments for unresectable liver malignancies (primary or metastatic tumours), which include bland embolisation, chemoembolisation, and radioembolisation, among others, take advantage of the increased arterial blood supply to the tumours to locally attack them. A better understanding of the factors that influence this transport may help improve the therapeutic procedures by taking advantage of flow patterns or by designing catheters and infusion systems that result in the injected beads having increased access to the tumour vasculature. Computational analyses may help understand the haemodynamic patterns and embolic-microsphere transport through the hepatic arteries. In addition, physiological inflow and outflow boundary conditions are essential in order to reliably represent the blood flow through arteries. This study presents a liver cancer arterial perfusion model based on a literature review and derives boundary conditions for tumour-bearing liver-feeding hepatic arteries based on the arterial perfusion characteristics of normal and tumorous liver segment tissue masses and the hepatic artery branching configuration. Literature-based healthy and tumour-bearing realistic scenarios are created and haemodynamically analysed for the same patient-specific hepatic artery. As a result, this study provides boundary conditions for computational fluid dynamics simulations that will allow researchers to numerically study, for example, various intravascular devices used for liver disease intra-arterial treatments with different cancer scenarios. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jorge Aramburu
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, Pº Manuel Lardizabal, 13, 20018, Donostia-San Sebastián, Spain
| | - Raúl Antón
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, Pº Manuel Lardizabal, 13, 20018, Donostia-San Sebastián, Spain.
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pio XII, 36, 31008, Pamplona, Spain.
| | - Alejandro Rivas
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, Pº Manuel Lardizabal, 13, 20018, Donostia-San Sebastián, Spain
| | - Juan Carlos Ramos
- Thermal and Fluids Engineering Division, Mechanical Department, Tecnun-University of Navarra, Pº Manuel Lardizabal, 13, 20018, Donostia-San Sebastián, Spain
| | - Bruno Sangro
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pio XII, 36, 31008, Pamplona, Spain
- Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Av. Pio XII, 36, 31008, Pamplona, Spain
| | - José Ignacio Bilbao
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Av. Pio XII, 36, 31008, Pamplona, Spain
- Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain
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15
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Computational assessment of the effects of the catheter type on particle–hemodynamics during liver radioembolization. J Biomech 2016; 49:3705-3713. [DOI: 10.1016/j.jbiomech.2016.09.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/19/2016] [Accepted: 09/30/2016] [Indexed: 01/04/2023]
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16
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Xu Z, Jernigan S, Kleinstreuer C, Buckner GD. Solid Tumor Embolotherapy in Hepatic Arteries with an Anti-reflux Catheter System. Ann Biomed Eng 2015; 44:1036-46. [DOI: 10.1007/s10439-015-1411-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/24/2015] [Indexed: 12/30/2022]
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Kleinstreuer C, Feng Y, Childress E. Drug-targeting methodologies with applications: A review. World J Clin Cases 2014; 2:742-756. [PMID: 25516850 PMCID: PMC4266823 DOI: 10.12998/wjcc.v2.i12.742] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/23/2014] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
Targeted drug delivery to solid tumors is a very active research area, focusing mainly on improved drug formulation and associated best delivery methods/devices. Drug-targeting has the potential to greatly improve drug-delivery efficacy, reduce side effects, and lower the treatment costs. However, the vast majority of drug-targeting studies assume that the drug-particles are already at the target site or at least in its direct vicinity. In this review, drug-delivery methodologies, drug types and drug-delivery devices are discussed with examples in two major application areas: (1) inhaled drug-aerosol delivery into human lung-airways; and (2) intravascular drug-delivery for solid tumor targeting. The major problem addressed is how to deliver efficiently the drug-particles from the entry/infusion point to the target site. So far, most experimental results are based on animal studies. Concerning pulmonary drug delivery, the focus is on the pros and cons of three inhaler types, i.e., pressurized metered dose inhaler, dry powder inhaler and nebulizer, in addition to drug-aerosol formulations. Computational fluid-particle dynamics techniques and the underlying methodology for a smart inhaler system are discussed as well. Concerning intravascular drug-delivery for solid tumor targeting, passive and active targeting are reviewed as well as direct drug-targeting, using optimal delivery of radioactive microspheres to liver tumors as an example. The review concludes with suggestions for future work, considereing both pulmonary drug targeting and direct drug delivery to solid tumors in the vascular system.
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