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De Vita E, Lo Presti D, Massaroni C, Iadicicco A, Schena E, Campopiano S. A review on radiofrequency, laser, and microwave ablations and their thermal monitoring through fiber Bragg gratings. iScience 2023; 26:108260. [PMID: 38026224 PMCID: PMC10660479 DOI: 10.1016/j.isci.2023.108260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Thermal ablation of tumors aims to apply extreme temperatures inside the target tissue to achieve substantial tumor destruction in a minimally invasive manner. Several techniques are comprised, classified according to the type of energy source. However, the lack of treatment selectivity still needs to be addressed, potentially causing two risks: i) incomplete tumor destruction and recurrence, or conversely, ii) damage of the surrounding healthy tissue. Therefore, the research herein reviewed seeks to develop sensing systems based on fiber Bragg gratings (FBGs) for thermal monitoring inside the lesion during radiofrequency, laser, and microwave ablation. This review shows that, mainly thanks to multiplexing and minimal invasiveness, FBGs provide an optimal sensing solution. Their temperature measurements are the feedback to control the ablation process and allow to investigate different treatments, compare their outcomes, and quantify the impact of factors such as proximity to thermal probe and blood vessels, perfusion, and tissue type.
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Affiliation(s)
- Elena De Vita
- Department of Engineering, University of Naples “Parthenope”, 80143 Naples, Italy
| | - Daniela Lo Presti
- Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Carlo Massaroni
- Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Agostino Iadicicco
- Department of Engineering, University of Naples “Parthenope”, 80143 Naples, Italy
| | - Emiliano Schena
- Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Stefania Campopiano
- Department of Engineering, University of Naples “Parthenope”, 80143 Naples, Italy
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2
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Kostyrko B, Rubarth K, Althoff C, Poch FGM, Neizert CA, Zibell M, Gebauer B, Lehmann KS, Niehues SM, Mews J, Diekhoff T, Pohlan J. Computed tomography-based thermography (CTT) in microwave ablation: prediction of the heat ablation zone in the porcine liver. Insights Imaging 2023; 14:189. [PMID: 37962712 PMCID: PMC10645839 DOI: 10.1186/s13244-023-01537-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/09/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES The aim of the study was to investigate computed tomography-based thermography (CTT) for ablation zone prediction in microwave ablation (MWA). METHODS CTT was investigated during MWA in an in vivo porcine liver. For CTT, serial volume scans were acquired every 30 s during ablations and every 60 s immediately after MWA. After the procedure, contrast-enhanced computed tomography (CECT) was performed. After euthanasia, the liver was removed for sampling and further examination. Color-coded CTT maps were created for visualization of ablation zones, which were compared with both CECT and macroscopy. Average CT attenuation values in Hounsfield units (HU) were statistically correlated with temperatures using Spearman's correlation coefficient. CTT was retrospectively evaluated in one patient who underwent radiofrequency ablation (RFA) treatment of renal cell carcinoma. RESULTS A significant correlation between HU and temperature was found with r = - 0.77 (95% confidence interval (CI), - 0.89 to - 0.57) and p < 0.001. Linear regression yielded a slope of - 1.96 HU/°C (95% CI, - 2.66 to - 1.26). Color-coded CTT maps provided superior visualization of ablation zones. CONCLUSION Our results show that CTT allows visualization of the ablation area and measurement of its size and is feasible in patients, encouraging further exploration in a clinical setting. CRITICAL RELEVANCE STATEMENT CT-based thermography research software allows visualization of the ablation zone and is feasible in patients, encouraging further exploration in a clinical setting to assess risk reduction of local recurrence.
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Affiliation(s)
- Bogdan Kostyrko
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Kerstin Rubarth
- Institute of Biometry and Clinical Epidemiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Institute of Medical Informatics, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christian Althoff
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Franz Gerd Martin Poch
- Department of General and Visceral Surgery, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Christina Ann Neizert
- Department of General and Visceral Surgery, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Miriam Zibell
- Department of General and Visceral Surgery, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Bernhard Gebauer
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Kai Siegfried Lehmann
- Department of General and Visceral Surgery, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Stefan Markus Niehues
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jürgen Mews
- Canon Medical Systems Europe BV, Global Research & Development Center, Amstelveen, the Netherlands
| | - Torsten Diekhoff
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Julian Pohlan
- Department of Radiology, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Liu LP, Pua R, Rosario-Berrios DN, Sandvold OF, Perkins AE, Cormode DP, Shapira N, Soulen MC, Noël PB. Reproducible spectral CT thermometry with liver-mimicking phantoms for image-guided thermal ablation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.04.23296423. [PMID: 37873236 PMCID: PMC10593007 DOI: 10.1101/2023.10.04.23296423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objectives Evaluate the reproducibility, temperature sensitivity, and radiation dose requirements of spectral CT thermometry in tissue-mimicking phantoms to establish its utility for non-invasive temperature monitoring of thermal ablations. Materials and Methods Three liver mimicking phantoms embedded with temperature sensors were individually scanned with a dual-layer spectral CT at different radiation dose levels during heating and cooling (35 to 80 °C). Physical density maps were reconstructed from spectral results using a range of reconstruction parameters. Thermal volumetric expansion was then measured at each temperature sensor every 5°C in order to establish a correlation between physical density and temperature. Linear regressions were applied based on thermal volumetric expansion for each phantom, and coefficient of variation for fit parameters was calculated to characterize reproducibility of spectral CT thermometry. Additionally, temperature sensitivity was determined to evaluate the effect of acquisition parameters, reconstruction parameters, and image denoising. The resulting minimum radiation dose to meet the clinical temperature sensitivity requirement was determined for each slice thickness, both with and without additional denoising. Results Thermal volumetric expansion was robustly replicated in all three phantoms, with a correlation coefficient variation of only 0.43%. Similarly, the coefficient of variation for the slope and intercept were 9.6% and 0.08%, respectively, indicating reproducibility of the spectral CT thermometry. Temperature sensitivity ranged from 2 to 23 °C, decreasing with increased radiation dose, slice thickness, and iterative reconstruction level. To meet the clinical requirement for temperature sensitivity, the minimum required radiation dose ranged from 20, 30, and 57 mGy for slice thickness of 2, 3, and 5 mm, respectively, but was reduced to 2 mGy with additional denoising. Conclusions Spectral CT thermometry demonstrated reproducibility across three liver-mimicking phantoms and illustrated the clinical requirement for temperature sensitivity can be met for different slice thicknesses. Moreover, additional denoising enables the use of more clinically relevant radiation doses, facilitating the clinical translation of spectral CT thermometry. The reproducibility and temperature accuracy of spectral CT thermometry enable its clinical application for non-invasive temperature monitoring of thermal ablation.
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Decker JA, Risch F, Schwarz F, Scheurig-Muenkler C, Kroencke TJ. Improved Thermal Sensitivity Using Virtual Monochromatic Imaging Derived from Photon Counting Detector CT Data Sets: Ex Vivo Results of CT-Guided Cryoablation in Porcine Liver. Cardiovasc Intervent Radiol 2023; 46:1385-1393. [PMID: 37700006 PMCID: PMC10547619 DOI: 10.1007/s00270-023-03546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/20/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To investigate differences in thermal sensitivity of virtual monoenergetic imaging (VMI) series generated from photon-counting detector (PCD) CT data sets, regarding their use to improve discrimination of the ablation zone during percutaneous cryoablation. MATERIALS AND METHODS CT-guided cryoablation was performed using an ex vivo model of porcine liver on a PCD-CT system. The ablation zone was imaged continuously for 8 min by acquiring a CT scan every 5 s. Tissue temperature was measured using fiberoptic temperature probes placed parallel to the cryoprobe. CT-values and noise were measured at the tip of the temperature probes on each scan and on VMI series from 40 to 130 keV. Correlation of CT-values and temperature was assessed using linear regression analyses. RESULTS For the whole temperature range of [- 40, + 20] °C, we observed a linear correlation between CT-values and temperature in reference 70 keV images (R2 = 0.60, p < 0.001) with a thermal sensitivity of 1.4HU/°C. For the most dynamic range of [- 15, + 20] °C, the sensitivity increased to 2.4HU/°C (R2 = 0.50, p < 0.001). Using VMI reconstructions, the thermal sensitivity increased from 1.4 HU/°C at 70 keV to 1.5, 1.7 and 2.0HU/°C at 60, 50 and 40 keV, respectively (range [- 40, + 20] °C). For [- 15, + 20]°C, the thermal sensitivity increased from 2.4HU/°C at 70 keV to 2.5, 2.6 and 2.7HU/°C at 60, 50 and 40 keV, respectively. Both CT-values and noise also increased with decreasing VMI keV-levels. CONCLUSION During CT-guided cryoablation of porcine liver, low-keV VMI reconstructions derived from PCD-CT data sets exhibit improved thermal sensitivity being highest between + 20 and - 15 °C.
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Affiliation(s)
- Josua A Decker
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Franka Risch
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Florian Schwarz
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
- Medical Faculty, Ludwig Maximilian University Munich, Bavariaring 19, 80336, Munich, Germany
- Diagnostic and Interventional Radiology, Donauisar Klinikum Deggendorf, Perlasberger Str. 41, 94469, Deggendorf, Germany
| | - Christian Scheurig-Muenkler
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Thomas J Kroencke
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
- Centre for Advanced Analytics and Predictive Sciences, Augsburg University, Universitätsstr. 2, 86159, Augsburg, Germany.
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5
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Longo UG, De Tommasi F, Salvatore G, Lalli A, Lo Presti D, Massaroni C, Schena E. Intra-articular temperature monitoring during radiofrequency ablation in ex-vivo bovine hip joints via Fiber Bragg grating sensors. BMC Musculoskelet Disord 2023; 24:766. [PMID: 37770871 PMCID: PMC10537081 DOI: 10.1186/s12891-023-06836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE Radiofrequency ablation is an increasingly used surgical option for ablation, resection and coagulation of soft tissues in joint arthroscopy. One of the major issues of thermal ablation is the temperature monitoring across the target areas, as cellular mortality is a direct consequence of thermal dosimetry. Temperatures from 45 °C to 50 °C are at risk of damage to chondrocytes. One of the most reliable tools for temperature monitoring is represented by fiber optic sensors, as they allow accurate and real-time temperature measurement via a minimally invasive approach. The aim of this study was to determine, by fiber Bragg grating sensors (FBGs), the safety of radiofrequency ablation in tissue heating applied to ex-vivo bovine hip joints. METHODS Ex vivo bovine hips were subjected to radiofrequency ablation, specifically in the acetabular labrum, for a total of two experiments. The WEREWOLF System (Smith + Nephew, Watford, UK) was employed in high operating mode and in a controlled ablation way. One optical fiber embedding seven FBGs was used to record multipoint temperature variations. Each sensor was 1 mm in length with a distance from edge to edge with each other of 2 mm. RESULTS The maximum variation was recorded in both the tests by the FBG1 (i.e., the closest one to the electrode tip) and was lower than to 2.8 °C. The other sensors (from FBG2 to FBG7) did not record a significant temperature change throughout the duration of the experiment (maximum up to 0.7 °C for FBG7). CONCLUSIONS No significant increase in temperature was observed at any of the seven sites. The sensor nearest to the radiofrequency source exhibited the highest temperature rise, but the variation was only 3 °C. The minimal temperature increase registered at the measurement sites, according to existing literature, is not expected to be cytotoxic. FBGs demonstrate the potential to fulfil the strict requirements for temperature measurements during arthroscopic surgery.
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Affiliation(s)
- Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy.
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma, 00128, Italy.
| | - Francesca De Tommasi
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, Trigoria, Rome, 00128, Italy
| | - Giuseppe Salvatore
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy
| | - Alberto Lalli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, Roma, 00128, Italy
| | - Daniela Lo Presti
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, Trigoria, Rome, 00128, Italy
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, Trigoria, Rome, 00128, Italy
| | - Emiliano Schena
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, Roma, 00128, Italy
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, Trigoria, Rome, 00128, Italy
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6
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Kostyrko B, Rubarth K, Althoff C, Zibell M, Neizert CA, Poch F, Torsello GF, Gebauer B, Lehmann K, Niehues SM, Mews J, Diekhoff T, Pohlan J. Evaluation of Different Registration Algorithms to Reduce Motion Artifacts in CT-Thermography (CTT). Diagnostics (Basel) 2023; 13:2076. [PMID: 37370971 DOI: 10.3390/diagnostics13122076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Computed tomography (CT)-based Thermography (CTT) is currently being investigated as a non-invasive temperature monitoring method during ablation procedures. Since multiple CT scans with defined time intervals were acquired during this procedure, interscan motion artifacts can occur between the images, so registration is required. The aim of this study was to investigate different registration algorithms and their combinations for minimizing inter-scan motion artifacts during thermal ablation. Four CTT datasets were acquired using microwave ablation (MWA) of normal liver tissue performed in an in vivo porcine model. During each ablation, spectral CT volume scans were sequentially acquired. Based on initial reconstructions, rigid or elastic registration, or a combination of these, were carried out and rated by 15 radiologists. Friedman's test was used to compare rating results in reader assessments and revealed significant differences for the ablation probe movement rating only (p = 0.006; range, 5.3-6.6 points). Regarding this parameter, readers assessed rigid registration as inferior to other registrations. Quantitative analysis of ablation probe movement yielded a significantly decreased distance for combined registration as compared with unregistered data. In this study, registration was found to have the greatest influence on ablation probe movement, with connected registration being superior to only one registration process.
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Affiliation(s)
- Bogdan Kostyrko
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Kerstin Rubarth
- Institute for Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10178 Berlin, Germany
| | - Christian Althoff
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Miriam Zibell
- Department of General and Visceral Surgery, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 12203 Berlin, Germany
| | - Christina Ann Neizert
- Department of General and Visceral Surgery, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 12203 Berlin, Germany
| | - Franz Poch
- Department of General and Visceral Surgery, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 12203 Berlin, Germany
| | - Giovanni Federico Torsello
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Bernhard Gebauer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Kai Lehmann
- Department of General and Visceral Surgery, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 12203 Berlin, Germany
| | - Stefan Markus Niehues
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Jürgen Mews
- Canon Medical Systems Europe BV, Global Research & Development Center, 2718 RP Zoetermeer, The Netherlands
| | - Torsten Diekhoff
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
| | - Julian Pohlan
- Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10178 Berlin, Germany
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7
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Liu LP, Hwang M, Hung M, Soulen MC, Schaer TP, Shapira N, Noël PB. Non-invasive mass and temperature quantifications with spectral CT. Sci Rep 2023; 13:6109. [PMID: 37059839 PMCID: PMC10104802 DOI: 10.1038/s41598-023-33264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/11/2023] [Indexed: 04/16/2023] Open
Abstract
Spectral CT has been increasingly implemented clinically for its better characterization and quantification of materials through its multi-energy results. It also facilitates calculation of physical density, allowing for non-invasive mass measurements and temperature evaluations by manipulating the definition of physical density and thermal volumetric expansion, respectively. To develop spectral physical density quantifications, original and parametrized Alvarez-Macovski model and electron density-physical density model were validated with a phantom. The best physical density model was then implemented on clinical spectral CT scans of ex vivo bovine muscle to determine the accuracy and effect of acquisition parameters on mass measurements. In addition, the relationship between physical density and changes in temperature was evaluated by scanning and subjecting the tissue to a range of temperatures. The parametrized Alvarez-Macovski model performed best in both model development and validation with errors within ± 0.02 g/mL. No effect from acquisition parameters was observed in mass measurements, which demonstrated accuracy with a maximum percent error of 0.34%. Furthermore, physical density was strongly correlated (R of 0.9781) to temperature changes through thermal volumetric expansion. Accurate and precise spectral physical density quantifications enable non-invasive mass measurements for pathological detection and temperature evaluation for thermal therapy monitoring in interventional oncology.
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Affiliation(s)
- Leening P Liu
- Department of Radiology, University of Pennsylvania, Philadelphia, USA.
- Department of Bioengineering, University of Pennsylvania, Philadelphia, USA.
| | | | - Matthew Hung
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Michael C Soulen
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Thomas P Schaer
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, USA
| | - Nadav Shapira
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Peter B Noël
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
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8
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Wang N, Li M, Haverinen P. Photon-counting computed tomography thermometry via material decomposition and machine learning. Vis Comput Ind Biomed Art 2023; 6:2. [PMID: 36640198 PMCID: PMC9840722 DOI: 10.1186/s42492-022-00129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/22/2022] [Indexed: 01/15/2023] Open
Abstract
Thermal ablation procedures, such as high intensity focused ultrasound and radiofrequency ablation, are often used to eliminate tumors by minimally invasively heating a focal region. For this task, real-time 3D temperature visualization is key to target the diseased tissues while minimizing damage to the surroundings. Current computed tomography (CT) thermometry is based on energy-integrated CT, tissue-specific experimental data, and linear relationships between attenuation and temperature. In this paper, we develop a novel approach using photon-counting CT for material decomposition and a neural network to predict temperature based on thermal characteristics of base materials and spectral tomographic measurements of a volume of interest. In our feasibility study, distilled water, 50 mmol/L CaCl2, and 600 mmol/L CaCl2 are chosen as the base materials. Their attenuations are measured in four discrete energy bins at various temperatures. The neural network trained on the experimental data achieves a mean absolute error of 3.97 °C and 1.80 °C on 300 mmol/L CaCl2 and a milk-based protein shake respectively. These experimental results indicate that our approach is promising for handling non-linear thermal properties for materials that are similar or dissimilar to our base materials.
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Affiliation(s)
- Nathan Wang
- grid.21107.350000 0001 2171 9311Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Mengzhou Li
- grid.33647.350000 0001 2160 9198Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180 USA
| | - Petteri Haverinen
- grid.5373.20000000108389418Aalto Design Factory, Aalto University, Espoo, 02150 Finland
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9
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Jin X, Liu W, Li Y, Qian L, Zhu Q, Li W, Qian Z. Evaluation method of ex vivo porcine liver reduced scattering coefficient during microwave ablation based on temperature. BIOMED ENG-BIOMED TE 2022; 67:491-501. [DOI: 10.1515/bmt-2022-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
Abstract
The principle of microwave ablation (MWA) is to cause irreversible damage (protein coagulation, necrosis, etc.) to tumor cells at a certain temperature by heating, thereby destroying the tumor. We have long used functional near-infrared spectroscopy (fNIRs) to monitor clinical thermal ablation efficacy. After a lot of experimental verification, it can be found that there is a clear correlation between the reduced scattering coefficient and the degree of tissue damage. During the MWA process, the reduced scattering coefficient has a stable change. Therefore, both temperature (T) and reduced scattering coefficient (
μ
s
′
${\mu }_{s}^{\prime }$
) are related to the thermal damage of the tissue. This paper mainly studies the changing law of T and
μ
s
′
${\mu }_{s}^{\prime }$
during MWA and establishes a relationship model. The two-parameter simultaneous acquisition system was designed and used to obtain the T and
μ
s
′
${\mu }_{s}^{\prime }$
of the ex vivo porcine liver during MWA. The correlation model between T and
μ
s
′
${\mu }_{s}^{\prime }$
is established, enabling the quantitative estimation of
μ
s
′
${\mu }_{s}^{\prime }$
of porcine liver based on T. The maximum and the minimum relative errors of
μ
s
′
${\mu }_{s}^{\prime }$
are 79.01 and 0.39%, respectively. Through the electromagnetic simulation of the temperature field during MWA, 2D and 3D fields of reduced scattering coefficient can also be obtained using this correlation model. This study contributes to realize the preoperative simulation of the optical parameter field of microwave ablation and provide 2D/3D therapeutic effect for clinic.
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Affiliation(s)
- Xiaofei Jin
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Wenwen Liu
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Yiran Li
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Lu Qian
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Qiaoqiao Zhu
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Weitao Li
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
| | - Zhiyu Qian
- Department of Biomedical Engineering , College of Automation Engineering, Nanjing University of Aeronautics and Astronautics , Nanjing , China
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Castelló CM, de Carvalho MT, Bakuzis AF, Fonseca SG, Miguel MP. Local tumour nanoparticle thermal therapy: A promising immunomodulatory treatment for canine cancer. Vet Comp Oncol 2022; 20:752-766. [PMID: 35698822 DOI: 10.1111/vco.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
Distinct thermal therapies have been used for cancer therapy. For hyperthermia (HT) treatment the tumour tissue is heated to temperatures between 39 and 45°C, while during ablation (AB) temperatures above 50°C are achieved. HT is commonly used in combination with different treatment modalities, such as radiotherapy and chemotherapy, for better clinical outcomes. In contrast, AB is usually used as a single modality for direct tumour cell killing. Both thermal therapies have been shown to result in cytotoxicity as well as immune response stimulation. Immunogenic responses encompass the innate and adaptive immune systems and involve the activation of macrophages, dendritic cells, natural killer cells and T cells. Several heat technologies are used, but great interest arises from nanotechnology-based thermal therapies. Spontaneous tumours in dogs can be a model for cancer immunotherapies with several advantages. In addition, veterinary oncology represents a growing market with an important demand for new therapies. In this review, we will focus on nanoparticle-mediated thermal-induced immunogenic effects, the beneficial potential of integrating thermal nanomedicine with immunotherapies and the results of published works with thermotherapies for cancer using dogs with spontaneous tumours, highlighting the works that evaluated the effect on the immune system in order to show dogs with spontaneous cancer as a good model for evaluated the immunomodulatory effect of nanoparticle-mediated thermal therapies.
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Affiliation(s)
- Carla Martí Castelló
- Programa de pós-graduação em Ciência Animal, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Goiânia, Brazil
| | - Mara Taís de Carvalho
- Programa de pós-graduação em Ciência Animal, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Simone Gonçalves Fonseca
- Setor de Imunologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
| | - Marina Pacheco Miguel
- Programa de pós-graduação em Ciência Animal, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Goiânia, Brazil.,Setor de Patologia Geral, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
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11
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Fite BZ, Wang J, Ghanouni P, Ferrara KW. A Review of Imaging Methods to Assess Ultrasound-Mediated Ablation. BME FRONTIERS 2022; 2022:9758652. [PMID: 35957844 PMCID: PMC9364780 DOI: 10.34133/2022/9758652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/21/2022] [Indexed: 12/18/2022] Open
Abstract
Ultrasound ablation techniques are minimally invasive alternatives to surgical resection and have rapidly increased in use. The response of tissue to HIFU ablation differs based on the relative contributions of thermal and mechanical effects, which can be varied to achieve optimal ablation parameters for a given tissue type and location. In tumor ablation, similar to surgical resection, it is desirable to include a safety margin of ablated tissue around the entirety of the tumor. A factor in optimizing ablative techniques is minimizing the recurrence rate, which can be due to incomplete ablation of the target tissue. Further, combining focal ablation with immunotherapy is likely to be key for effective treatment of metastatic cancer, and therefore characterizing the impact of ablation on the tumor microenvironment will be important. Thus, visualization and quantification of the extent of ablation is an integral component of ablative procedures. The aim of this review article is to describe the radiological findings after ultrasound ablation across multiple imaging modalities. This review presents readers with a general overview of the current and emerging imaging methods to assess the efficacy of ultrasound ablative treatments.
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Affiliation(s)
- Brett Z. Fite
- Department of Radiology, Stanford University, Palo Alto, CA 94305, USA
| | - James Wang
- Department of Radiology, Stanford University, Palo Alto, CA 94305, USA
| | - Pejman Ghanouni
- Department of Radiology, Stanford University, Palo Alto, CA 94305, USA
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12
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Geoghegan R, Ter Haar G, Nightingale K, Marks L, Natarajan S. Methods of monitoring thermal ablation of soft tissue tumors - A comprehensive review. Med Phys 2022; 49:769-791. [PMID: 34965307 DOI: 10.1002/mp.15439] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 11/30/2020] [Accepted: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
Thermal ablation is a form of hyperthermia in which oncologic control can be achieved by briefly inducing elevated temperatures, typically in the range 50-80°C, within a target tissue. Ablation modalities include high intensity focused ultrasound, radiofrequency ablation, microwave ablation, and laser interstitial thermal therapy which are all capable of generating confined zones of tissue destruction, resulting in fewer complications than conventional cancer therapies. Oncologic control is contingent upon achieving predefined coagulation zones; therefore, intraoperative assessment of treatment progress is highly desirable. Consequently, there is a growing interest in the development of ablation monitoring modalities. The first section of this review presents the mechanism of action and common applications of the primary ablation modalities. The following section outlines the state-of-the-art in thermal dosimetry which includes interstitial thermal probes and radiologic imaging. Both the physical mechanism of measurement and clinical or pre-clinical performance are discussed for each ablation modality. Thermal dosimetry must be coupled with a thermal damage model as outlined in Section 4. These models estimate cell death based on temperature-time history and are inherently tissue specific. In the absence of a reliable thermal model, the utility of thermal monitoring is greatly reduced. The final section of this review paper covers technologies that have been developed to directly assess tissue conditions. These approaches include visualization of non-perfused tissue with contrast-enhanced imaging, assessment of tissue mechanical properties using ultrasound and magnetic resonance elastography, and finally interrogation of tissue optical properties with interstitial probes. In summary, monitoring thermal ablation is critical for consistent clinical success and many promising technologies are under development but an optimal solution has yet to achieve widespread adoption.
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Affiliation(s)
- Rory Geoghegan
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Gail Ter Haar
- Department of Physics, Institute of Cancer Research, University of London, Sutton, UK
| | - Kathryn Nightingale
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Leonard Marks
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Shyam Natarajan
- Departments of Urology & Bioengineering, University of California Los Angeles, Los Angeles, California, USA
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13
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Portable, handheld, and affordable blood perfusion imager for screening of subsurface cancer in resource-limited settings. Proc Natl Acad Sci U S A 2022; 119:2026201119. [PMID: 34983869 PMCID: PMC8764675 DOI: 10.1073/pnas.2026201119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 12/11/2022] Open
Abstract
Existing procedures of screening subsurface cancers are either prohibitively resource-intensive and expensive or are unable to provide direct quantitative estimates of the relevant physiological parameters for accurate classification accommodating interpatient variabilities and overlapping clinical manifestations. Here, we introduce a handheld and inexpensive blood perfusion imager that provides a noninvasive in situ screening approach for distinguishing precancer, cancer, and normal scenarios by precise quantitative estimation of the localized blood circulation in the tissue over an unrestricted region of interest without any unwarranted noise in the data, augmented by machine learning–based classification. Clinical trials in minimally resourced settings have established the efficacy of the method in differentiating cancerous and precancerous stages of suspected oral abnormalities, as verified by gold-standard biopsy reports. Precise information on localized variations in blood circulation holds the key for noninvasive diagnostics and therapeutic assessment of various forms of cancer. While thermal imaging by itself may provide significant insights on the combined implications of the relevant physiological parameters, viz. local blood perfusion and metabolic balance due to active tumors as well as the ambient conditions, knowledge of the tissue surface temperature alone may be somewhat inadequate in distinguishing between some ambiguous manifestations of precancer and cancerous lesions, resulting in compromise of the selectivity in detection. This, along with the lack of availability of a user-friendly and inexpensive portable device for thermal-image acquisition, blood perfusion mapping, and data integration acts as a deterrent against the emergence of an inexpensive, contact-free, and accurate in situ screening and diagnostic approach for cancer detection and management. Circumventing these constraints, here we report a portable noninvasive blood perfusion imager augmented with machine learning–based quantitative analytics for screening precancerous and cancerous traits in oral lesions, by probing the localized alterations in microcirculation. With a proven overall sensitivity >96.66% and specificity of 100% as compared to gold-standard biopsy-based tests, the method successfully classified oral cancer and precancer in a resource-limited clinical setting in a double-blinded patient trial and exhibited favorable predictive capabilities considering other complementary modes of medical image analysis as well. The method holds further potential to achieve contrast-free, accurate, and low-cost diagnosis of abnormal microvascular physiology and other clinically vulnerable conditions, when interpreted along with complementary clinically evidenced decision-making perspectives.
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14
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De Tommasi F, Massaroni C, Grasso RF, Carassiti M, Schena E. Temperature Monitoring in Hyperthermia Treatments of Bone Tumors: State-of-the-Art and Future Challenges. SENSORS (BASEL, SWITZERLAND) 2021; 21:5470. [PMID: 34450911 PMCID: PMC8400360 DOI: 10.3390/s21165470] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 12/22/2022]
Abstract
Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions in many organs. Radiotherapy has long been the standard choice for these patients, performed as stand-alone or in conjunction with surgery. However, the needs of these patients have never been fully met, especially in the ones with low life expectancy, where treatments devoted to pain reduction are pivotal. New techniques as hyperthermia treatments (HTs) are emerging to reduce the associated pain of bone metastases and OO. Temperature monitoring during HTs may significantly improve the clinical outcomes since the amount of thermal injury depends on the tissue temperature and the exposure time. This is particularly relevant in bone tumors due to the adjacent vulnerable structures (e.g., spinal cord and nerve roots). In this Review, we focus on the potential of temperature monitoring on HT of bone cancer. Preclinical and clinical studies have been proposed and are underway to investigate the use of different thermometric techniques in this scenario. We review these studies, the principle of work of the thermometric techniques used in HTs, their strengths, weaknesses, and pitfalls, as well as the strategies and the potential of improving the HTs outcomes.
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Affiliation(s)
- Francesca De Tommasi
- Unit of Measurements and Biomedical Instrumentations, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (F.D.T.); (C.M.)
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentations, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (F.D.T.); (C.M.)
| | - Rosario Francesco Grasso
- Unit of Interventional Radiology, School of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy;
| | - Massimiliano Carassiti
- Unit of Anesthesia, Intensive Care and Pain Management, School of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy;
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentations, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (F.D.T.); (C.M.)
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15
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Heinrich A, Schenkl S, Buckreus D, Güttler FV, Teichgräber UKM. CT-based thermometry with virtual monoenergetic images by dual-energy of fat, muscle and bone using FBP, iterative and deep learning-based reconstruction. Eur Radiol 2021; 32:424-431. [PMID: 34327575 PMCID: PMC8660750 DOI: 10.1007/s00330-021-08206-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Objectives The aim of this study was to evaluate the sensitivity of CT-based thermometry for clinical applications regarding a three-component tissue phantom of fat, muscle and bone. Virtual monoenergetic images (VMI) by dual-energy measurements and conventional polychromatic 120-kVp images with modern reconstruction algorithms adaptive statistical iterative reconstruction-Volume (ASIR-V) and deep learning image reconstruction (DLIR) were compared. Methods A temperature-regulating water circuit system was developed for the systematic evaluation of the correlation between temperature and Hounsfield units (HU). The measurements were performed on a Revolution CT with gemstone spectral imaging technology (GSI). Complementary measurements were performed without GSI (voltage 120 kVp, current 130–545 mA). The measured object was a tissue equivalent phantom in a temperature range of 18 to 50°C. The evaluation was carried out for VMI at 40 to 140 keV and polychromatic 120-kVp images. Results The regression analysis showed a significant inverse linear dependency between temperature and average HU regardless of ASIR-V and DLIR. VMI show a higher temperature sensitivity compared to polychromatic images. The temperature sensitivities were 1.25 HU/°C (120 kVp) and 1.35 HU/°C (VMI at 140 keV) for fat, 0.38 HU/°C (120 kVp) and 0.47 HU/°C (VMI at 40 keV) for muscle and 1.15 HU/°C (120 kVp) and 3.58 HU/°C (VMI at 50 keV) for bone. Conclusions Dual-energy with VMI enables a higher temperature sensitivity for fat, muscle and bone. The reconstruction with ASIR-V and DLIR has no significant influence on CT-based thermometry, which opens up the potential of drastic dose reductions. Key Points • Virtual monoenergetic images (VMI) enable a higher temperature sensitivity for fat (8%), muscle (24%) and bone (211%) compared to conventional polychromatic 120-kVp images. • With VMI, there are parameters, e.g. monoenergy and reconstruction kernel, to modulate the temperature sensitivity. In contrast, there are no parameters to influence the temperature sensitivity for conventional polychromatic 120-kVp images. • The application of adaptive statistical iterative reconstruction-Volume (ASIR-V) and deep learning–based image reconstruction (DLIR) has no effect on CT-based thermometry, opening up the potential of drastic dose reductions in clinical applications.
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Affiliation(s)
- Andreas Heinrich
- Department of Radiology, Jena University Hospital - Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany.
| | - Sebastian Schenkl
- Institute of Forensic Medicine, Jena University Hospital - Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
| | - David Buckreus
- Department of Radiology, Jena University Hospital - Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
| | - Felix V Güttler
- Department of Radiology, Jena University Hospital - Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
| | - Ulf K-M Teichgräber
- Department of Radiology, Jena University Hospital - Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
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16
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Kok HP, Cressman ENK, Ceelen W, Brace CL, Ivkov R, Grüll H, Ter Haar G, Wust P, Crezee J. Heating technology for malignant tumors: a review. Int J Hyperthermia 2021; 37:711-741. [PMID: 32579419 DOI: 10.1080/02656736.2020.1779357] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The therapeutic application of heat is very effective in cancer treatment. Both hyperthermia, i.e., heating to 39-45 °C to induce sensitization to radiotherapy and chemotherapy, and thermal ablation, where temperatures beyond 50 °C destroy tumor cells directly are frequently applied in the clinic. Achievement of an effective treatment requires high quality heating equipment, precise thermal dosimetry, and adequate quality assurance. Several types of devices, antennas and heating or power delivery systems have been proposed and developed in recent decades. These vary considerably in technique, heating depth, ability to focus, and in the size of the heating focus. Clinically used heating techniques involve electromagnetic and ultrasonic heating, hyperthermic perfusion and conductive heating. Depending on clinical objectives and available technology, thermal therapies can be subdivided into three broad categories: local, locoregional, or whole body heating. Clinically used local heating techniques include interstitial hyperthermia and ablation, high intensity focused ultrasound (HIFU), scanned focused ultrasound (SFUS), electroporation, nanoparticle heating, intraluminal heating and superficial heating. Locoregional heating techniques include phased array systems, capacitive systems and isolated perfusion. Whole body techniques focus on prevention of heat loss supplemented with energy deposition in the body, e.g., by infrared radiation. This review presents an overview of clinical hyperthermia and ablation devices used for local, locoregional, and whole body therapy. Proven and experimental clinical applications of thermal ablation and hyperthermia are listed. Methods for temperature measurement and the role of treatment planning to control treatments are discussed briefly, as well as future perspectives for heating technology for the treatment of tumors.
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Affiliation(s)
- H Petra Kok
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Erik N K Cressman
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wim Ceelen
- Department of GI Surgery, Ghent University Hospital, Ghent, Belgium
| | - Christopher L Brace
- Department of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Robert Ivkov
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Mechanical Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.,Department of Materials Science and Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Holger Grüll
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Gail Ter Haar
- Department of Physics, The Institute of Cancer Research, London, UK
| | - Peter Wust
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Crezee
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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17
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Huang PC, Chaney EJ, Aksamitiene E, Barkalifa R, Spillman DR, Bogan BJ, Boppart SA. Biomechanical sensing of in vivo magnetic nanoparticle hyperthermia-treated melanoma using magnetomotive optical coherence elastography. Theranostics 2021; 11:5620-5633. [PMID: 33897871 PMCID: PMC8058715 DOI: 10.7150/thno.55333] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
Rationale: Magnetic nanoparticle hyperthermia (MH) therapy is capable of thermally damaging tumor cells, yet a biomechanically-sensitive monitoring method for the applied thermal dosage has not been established. Biomechanical changes to tissue are known indicators for tumor diagnosis due to its association with the structural organization and composition of tissues at the cellular and molecular level. Here, by exploiting the theranostic functionality of magnetic nanoparticles (MNPs), we aim to explore the potential of using stiffness-based metrics that reveal the intrinsic biophysical changes of in vivo melanoma tumors after MH therapy. Methods: A total of 14 melanoma-bearing mice were intratumorally injected with dextran-coated MNPs, enabling MH treatment upon the application of an alternating magnetic field (AMF) at 64.7 kHz. The presence of the MNP heating sources was detected by magnetomotive optical coherence tomography (MM-OCT). For the first time, the elasticity alterations of the hyperthermia-treated, MNP-laden, in vivo tumors were also measured with magnetomotive optical coherence elastography (MM-OCE), based on the mechanical resonant frequency detected. To investigate the correlation between stiffness changes and the intrinsic biological changes, histopathology was performed on the excised tumor after the in vivo measurements. Results: Distinct shifts in mechanical resonant frequency were observed only in the MH-treated group, suggesting a heat-induced stiffness change in the melanoma tumor. Moreover, tumor cellularity, protein conformation, and temperature rise all play a role in tumor stiffness changes after MH treatment. With low cellularity, tumor softens after MH even with low temperature elevation. In contrast, with high cellularity, tumor softening occurs only with a low temperature rise, which is potentially due to protein unfolding, whereas tumor stiffening was seen with a higher temperature rise, likely due to protein denaturation. Conclusions: This study exploits the theranostic functionality of MNPs and investigates the MH-induced stiffness change on in vivo melanoma-bearing mice with MM-OCT and MM-OCE for the first time. It was discovered that the elasticity alteration of the melanoma tumor after MH treatment depends on both thermal dosage and the morphological features of the tumor. In summary, changes in tissue-level elasticity can potentially be a physically and physiologically meaningful metric and integrative therapeutic marker for MH treatment, while MM-OCE can be a suitable dosimetry technique.
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Affiliation(s)
- Pin-Chieh Huang
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, USA
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
| | - Edita Aksamitiene
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
| | - Ronit Barkalifa
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
| | - Bethany J. Bogan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, USA
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, USA
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18
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Zaltieri M, Massaroni C, Cauti FM, Schena E. Techniques for Temperature Monitoring of Myocardial Tissue Undergoing Radiofrequency Ablation Treatments: An Overview. SENSORS (BASEL, SWITZERLAND) 2021; 21:1453. [PMID: 33669692 PMCID: PMC7922285 DOI: 10.3390/s21041453] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 12/18/2022]
Abstract
Cardiac radiofrequency ablation (RFA) has received substantial attention for the treatment of multiple arrhythmias. In this scenario, there is an ever-growing demand for monitoring the temperature trend inside the tissue as it may allow an accurate control of the treatment effects, with a consequent improvement of the clinical outcomes. There are many methods for monitoring temperature in tissues undergoing RFA, which can be divided into invasive and non-invasive. This paper aims to provide an overview of the currently available techniques for temperature detection in this clinical scenario. Firstly, we describe the heat generation during RFA, then we report the principle of work of the most popular thermometric techniques and their features. Finally, we introduce their main applications in the field of cardiac RFA to explore the applicability in clinical settings of each method.
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Affiliation(s)
- Martina Zaltieri
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
| | - Carlo Massaroni
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
| | - Filippo Maria Cauti
- Arrhythmology Unit, Cardiology Division, S. Giovanni Calibita Hospital, Isola Tiberina, 00186 Rome, Italy;
| | - Emiliano Schena
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
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19
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Asadi S, Bianchi L, De Landro M, Korganbayev S, Schena E, Saccomandi P. Laser-induced optothermal response of gold nanoparticles: From a physical viewpoint to cancer treatment application. JOURNAL OF BIOPHOTONICS 2021; 14:e202000161. [PMID: 32761778 DOI: 10.1002/jbio.202000161] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
Gold nanoparticles (GNPs)-based photothermal therapy (PTT) is a promising minimally invasive thermal therapy for the treatment of focal malignancies. Although GNPs-based PTT has been known for over two decades and GNPs possess unique properties as therapeutic agents, the delivery of a safe and effective therapy is still an open question. This review aims at providing relevant and recent information on the usage of GNPs in combination with the laser to treat cancers, pointing out the practical aspects that bear on the therapy outcome. Emphasis is given to the assessment of the GNPs' properties and the physical mechanisms underlying the laser-induced heat generation in GNPs-loaded tissues. The main techniques available for temperature measurement and the current theoretical simulation approaches predicting the therapeutic outcome are reviewed. Topical challenges in delivering safe thermal dosage are also presented with the aim to discuss the state-of-the-art and the future perspective in the field of GNPs-mediated PTT.
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Affiliation(s)
- Somayeh Asadi
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Leonardo Bianchi
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | - Martina De Landro
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
| | | | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Paola Saccomandi
- Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy
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20
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Rodrigues HF, Capistrano G, Bakuzis AF. In vivo magnetic nanoparticle hyperthermia: a review on preclinical studies, low-field nano-heaters, noninvasive thermometry and computer simulations for treatment planning. Int J Hyperthermia 2021; 37:76-99. [PMID: 33426989 DOI: 10.1080/02656736.2020.1800831] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Magnetic nanoparticle hyperthermia (MNH) is a promising nanotechnology-based cancer thermal therapy that has been approved for clinical use, together with radiation therapy, for treating brain tumors. Almost ten years after approval, few new clinical applications had appeared, perhaps because it cannot benefit from the gold standard noninvasive MRI thermometry technique, since static magnetic fields inhibit heat generation. This might limit its clinical use, in particular as a single therapeutic modality. In this article, we review the in vivo MNH preclinical studies, discussing results of the last two decades with emphasis on safety as a clinical criteria, the need for low-field nano-heaters and noninvasive thermal dosimetry, and the state of the art of computational modeling for treatment planning using MNH. Limitations to more effective clinical use are discussed, together with suggestions for future directions, such as the development of ultrasound-based, computed tomography-based or magnetic nanoparticle-based thermometry to achieve greater impact on clinical translation of MNH.
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Affiliation(s)
- Harley F Rodrigues
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil.,Curso de Licenciatura em Física, Instituto Federal de Goiás, Goiânia, Brasil
| | - Gustavo Capistrano
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil.,Campus Fronteira Oeste, Instituto Federal de Mato Grosso, Pontes e Lacerda, Brasil
| | - Andris F Bakuzis
- Instituto de Física, Universidade Federal de Goiás, Goiânia, Brasil
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21
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Non-contact monitoring of the depth temperature profile for medical laser scanning technologies. Sci Rep 2020; 10:20242. [PMID: 33219279 PMCID: PMC7679450 DOI: 10.1038/s41598-020-77283-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
Medical treatments such as high-intensity focused ultrasound, hyperthermic laser lipolysis or radiofrequency are employed as a minimally invasive alternatives for targeted tissue therapies. The increased temperature of the tissue triggers various thermal effects and leads to an unavoidable damage. As targeted tissues are generally located below the surface, various approaches are utilized to prevent skin layers from overheating and irreparable thermal damages. These procedures are often accompanied by cooling systems and protective layers accounting for a non-trivial detection of the subsurface temperature peak. Here, we show a temperature peak estimation method based on infrared thermography recording of the surface temperature evolution coupled with a thermal-diffusion-based model and a time-dependent data matching algorithm. The performance of the newly developed method was further showcased by employing hyperthermic laser lipolysis on an ex-vivo porcine fat tissue. Deviations of the estimated peak temperature remained below 1 °C, as validated by simultaneous measurement of depth temperature field within the tissue. Reconstruction of the depth profile shows a good reproducibility of the real temperature distribution with a small deviation of the peak temperature position. A thermal camera in combination with the time-dependent matching bears the scope for non-contact monitoring of the depth temperature profile as fast as 30 s. The latest demand for miniaturization of thermal cameras provides the possibility to embed the model in portable thermal scanners or medical laser technologies for improving safety and efficiency.
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Fiber Bragg Grating Sensors for Millimetric-Scale Temperature Monitoring of Cardiac Tissue Undergoing Radiofrequency Ablation: A Feasibility Assessment. SENSORS 2020; 20:s20226490. [PMID: 33202980 PMCID: PMC7698062 DOI: 10.3390/s20226490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/21/2022]
Abstract
Radiofrequency ablation (RFA) is the most widely used technique for the treatment of cardiac arrhythmias. A variety of factors, such as the electrode tip shape, the force exerted on the tissue by the catheter and the delivered power, combine to determine the temperature distribution, and as consequence, the lesion shape and size. In this context, being able to know the temperature reached in the myocardium during the RFA can be helpful for predicting the lesion dimensions to prevent the occurrence of undesired tissue damage. The catheters used so far in such procedures provide single-point temperature measurements within the probe (by means of embedded thermocouples or thermistors), so no information regarding the temperature changes occurring in myocardial tissues can be retrieved. The aim of this study was to assess the feasibility of fiber Bragg grating sensors (FBGs) to perform multi-point and millimetric-scale temperature measurements within myocardium subjected to RFA. The assessment has been performed on ex vivo porcine myocardium specimens undergoing RFA. Data show the feasibility of the proposed solution in providing spatial temperature distribution within the myocardial tissue during the entire RFA. These high-resolved measurements may allow reconstructing the temperature distribution in the tissue. This study lays the foundations for the implementation of 3D thermal maps to investigate how the supplied power, treatment time, force of contact and irrigation flow of the catheter influence the thermal effects within the tissue.
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Computed Tomography Thermography for Ablation Zone Prediction in Microwave Ablation and Cryoablation: Advantages and Challenges in an Ex Vivo Porcine Liver Model. J Comput Assist Tomogr 2020; 44:744-749. [PMID: 32842063 DOI: 10.1097/rct.0000000000001081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the diagnostic accuracy of computed tomography (CT) for the prediction of ablation zones from microwave ablation (MWA) and cryoablation (CA) in an ex vivo porcine liver model. METHODS Sequential (30 seconds) CT scans were acquired during and after MWA and CA in an ex vivo porcine liver model. We generated 120-kVp equivalent reconstructions of generic dual-energy CT data sets, and comprehensive region-of-interest measurements were statistically correlated with invasive temperature monitoring using Pearson correlation coefficient. Binary logistic regression was performed for prediction of successful ablation. RESULTS With the use of pooled data from 6 lesions in 2 separate experiments, correlation analysis of attenuation in Hounsfield units (HU) and temperature yielded r = -0.79 [confidence interval (CI), -0.85 to -0.71] for MWA and r = 0.62 (CI, 0.55 to 0.67) for CA.For MWA, there was a linear association between attenuation and temperature up to 75°C; thus, linear regression yielded a slope of -2.00 HU/°C (95% CI, -1.58 to -2.41). For CA, a linear association between attenuation and temperature was observed in the cooling phase with a slope of 2.11 HU/°C (95% CI, 1.79 to 2.58). In MWA treatment, binary logistic regression separated less than 70°C and greater than 70°C with 89.2% accuracy. Within the ice ball, temperatures above and below -20°C were distinguished with 65.3% accuracy. CONCLUSIONS Our experiments reveal several difficulties in predicting ablation zone temperature from CT attenuation. Microwave ablation leads to gas production in the tissue, which degrades the accuracy of noninvasive temperature measurement, especially at higher temperatures. In CA, CT thermometry is limited by ice ball formation, which leads to homogeneous attenuation, nearly independent of temperature. Further research is needed to define the role of CT thermography in ablation zone monitoring in liver malignancies.
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Etoz S, Brace CL. Computed Tomography-Based Modeling of Water Vapor-Induced Changes in Permittivity During Microwave Ablation. IEEE Trans Biomed Eng 2020; 67:2427-2433. [DOI: 10.1109/tbme.2019.2962363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hübner F, Schreiner R, Panahi B, Vogl TJ. Evaluation of the thermal sensitivity of porcine liver in CT-guided cryoablation: an initial study. Med Phys 2020; 47:4997-5005. [PMID: 32748398 DOI: 10.1002/mp.14432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/19/2020] [Accepted: 07/24/2020] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate computed tomography (CT)-based thermometry in cryoablation, the thermal sensitivity of an ex-vivo porcine liver was determined in an initial study design. METHODS The CT-guided cryoablation was performed in three porcine liver samples over a period of 10 min. Fiber optic temperature probes were positioned parallel to the shaft of the cryoprobe in an axial slice orientation. During ablation, temperature measurements were performed simultaneously with CT imaging at 5 s intervals. On the CT images, the average CT number was calculated for a region of interest of 3 × 3 pixels just below the tip of each temperature probe. A linear regression analysis was performed using eleven data sets to determine the dependence of the CT number on the temperature. RESULTS With decreasing temperature, an increasing hypodense area around the tip of the cryoprobe was observed on the CT images and decreasing values of the CT number were determined. Starting at a temperature of - 40°C a linear relation between the CT number and the temperature was determined and a thermal sensitivity of 0.95 HU/°C (R2 = 0.73) was obtained. The thermal sensitivity was used to calculate color-coded temperature maps. The calculated temperature distribution corresponds quantitatively to the increasing hypodense area. CONCLUSIONS A noninvasive CT-based temperature determination during cryoablation in a normal ex vivo porcine liver is feasible. A thermal sensitivity of 0.95 HU/°C was determined by linear regression analysis. A color-coded map of the temperature distribution was presented.
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Affiliation(s)
- Frank Hübner
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Roland Schreiner
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Bita Panahi
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
| | - Thomas Josef Vogl
- Institute of Diagnostic and Interventional Radiology, University Hospital, Theodor-Stern-Kai 7, Frankfurt, 60590, Germany
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Ziv O, Goldberg SN, Nissenbaum Y, Sosna J, Weiss N, Azhari H. In vivo noninvasive three-dimensional (3D) assessment of microwave thermal ablation zone using non-contrast-enhanced x-ray CT. Med Phys 2020; 47:4721-4734. [PMID: 32745257 DOI: 10.1002/mp.14428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To develop an image processing methodology for noninvasive three-dimensional (3D) quantification of microwave thermal ablation zones in vivo using x-ray computed tomography (CT) imaging without injection of a contrast enhancing material. METHODS Six microwave (MW) thermal ablation procedures were performed in three pigs. The ablations were performed with a constant heating duration of 8 min and power level of 30 W. During the procedure images from sixty 1 mm thick slices were acquired every 30 s. At the end of all ablation procedures for each pig, a contrast-enhanced scan was acquired for reference. Special algorithms for addressing challenges stemming from the 3D in vivo setup and processing the acquired images were prepared. The algorithms first rearranged the data to account for the oblique needle orientation and for breathing motion. Then, the gray level variance changes were analyzed, and optical flow analysis was applied to the treated volume in order to obtain the ablation contours and reconstruct the ablation zone in 3D. The analysis also included a special correction algorithm for eliminating artifacts caused by proximal major blood vessels and blood flow. Finally, 3D reference reconstructions from the contrast-enhanced scan were obtained for quantitative comparison. RESULTS For four ablations located >3 mm from a large blood vessel, the mean dice similarity coefficient (DSC) and the mean absolute radial discrepancy between the contours obtained from the reference contrast-enhanced images and the contours produced by the algorithm were 0.82 ± 0.03 and 1.92 ± 1.47 mm, respectively. In two cases of ablation adjacent to large blood vessels, the average DSC and discrepancy were: 0.67 ± 0.6 and 2.96 ± 2.15 mm, respectively. The addition of the special correction algorithm utilizing blood vessels mapping improved the mean DSC and the mean absolute discrepancy to 0.85 ± 0.02 and 1.19 ± 1.00 mm, respectively. CONCLUSIONS The developed algorithms provide highly accurate detailed contours in vivo (average error < 2.5 mm) and cope well with the challenges listed above. Clinical implementation of the developed methodology could potentially provide real time noninvasive 3D accurate monitoring of MW thermal ablation in-vivo, provided that the radiation dose can be reduced.
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Affiliation(s)
- Omri Ziv
- Department of Biomedical Engineering, Technion - IIT, Haifa, 32000, Israel
| | - S Nahum Goldberg
- Department of Radiology, Hadassah Medical Center, Hebrew University, Jerusalem, 91120, Israel.,Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Yitzhak Nissenbaum
- Department of Radiology, Hadassah Medical Center, Hebrew University, Jerusalem, 91120, Israel
| | - Jacob Sosna
- Department of Radiology, Hadassah Medical Center, Hebrew University, Jerusalem, 91120, Israel.,Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Noam Weiss
- Department of Biomedical Engineering, Technion - IIT, Haifa, 32000, Israel
| | - Haim Azhari
- Department of Biomedical Engineering, Technion - IIT, Haifa, 32000, Israel
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Franz PL, Wang H. Development of hypothermia measurable fiber radiometric thermometer for thermotherapy. JOURNAL OF BIOPHOTONICS 2020; 13:e201960205. [PMID: 32077211 DOI: 10.1002/jbio.201960205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 05/11/2023]
Abstract
Temperature monitoring is extremely important during thermotherapy. Fiber-optic temperature sensors are preferred because of their flexibility and immunity to electromagnetic interference. Although many types of fiber-optic sensors have been developed, clinically adopting them remains challenging. Here, we report a silica fiber-based radiometric thermometer using a low-cost extended InGaAs detector to detect black body radiation between 1.7 and 2.4 μm. For the first time, this silica fiber-based thermometer is capable of measuring temperatures down to 35°C, making it suitable for monitoring hyperthermia during surgery. In particular, the thermometer has potential for seamless integration with current silica fiber catheters, which are widely used in laser interstitial thermotherapy. The feasibility, capability and sensitivity of tracking tissue temperature variation were proved through ex vivo tissue studies. After further improvement, the technology has the potential to be translated into clinics for monitoring tissue temperature.
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Affiliation(s)
- Paris L Franz
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, Ohio, USA
- Currently associated with the Department of Applied Physics, Stanford University, Stanford, California, USA
| | - Hui Wang
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, Ohio, USA
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Kokuryo D, Kumamoto E, Kuroda K. Recent technological advancements in thermometry. Adv Drug Deliv Rev 2020; 163-164:19-39. [PMID: 33217482 DOI: 10.1016/j.addr.2020.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/25/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.
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Affiliation(s)
- Daisuke Kokuryo
- Graduate School of System Informatics, Kobe University, Japan
| | - Etsuko Kumamoto
- Information Science and Technology Center, Kobe University, Japan
| | - Kagayaki Kuroda
- School of Information Science and Technology, Tokai University, Japan; Center for Frontier Medical Engineering, Chiba University, Japan.
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Auloge P, Cazzato RL, Koch G, Caudrelier J, De Marini P, Garnon J, Gangi A. Destruction tumorale percutanée. Presse Med 2019; 48:1146-1155. [DOI: 10.1016/j.lpm.2019.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023] Open
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Giurazza F, Massaroni C, Silvestri S, Zobel BB, Schena E. Preliminary analysis of ultrasound elastography imaging-based thermometry on non-perfused ex vivo swine liver. J Ultrasound 2019; 23:69-75. [PMID: 31541360 DOI: 10.1007/s40477-019-00407-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 09/11/2019] [Indexed: 01/20/2023] Open
Abstract
AIMS Real-time monitoring of tissue temperature during percutaneous tumor ablation improves treatment efficacy, leading clinicians in adjustment of treatment settings. This study aims at assessing feasibility of ultrasound thermometry during laser ablation of biological tissue using a specific ultrasound imaging techniques based on elastography acoustic radiation force impulse (ARFI). METHODS ARFI uses high-intensity focused ultrasound pulses to generate 'radiation force' in tissue; this provokes tissue displacements trackable using correlation-based ultrasound methods: the sensitivity of shear waves velocity is able to detect temperature changes. Experiments were carried out using a Nd:YAG laser (power: 5 W) in three non-perfused ex vivo pig livers. In each organ, a thermocouple was placed close to the applicator tip (distance range 1.5-2.5 cm) used to record a reference temperature. Positioning of laser applicator and thermocouple was eco-guided. The organ was scanned by an echography system equipped with ARFI; propagation velocity was measured in a region of interest of 1 × 0.5 cm located close to thermocouple, to investigate influence of tissue temperature on shear waves velocity. RESULTS Shear wave velocity has a very low sensitivity to temperature up to 55-60 °C, and in all cases, velocity is < 5 m s-1; for temperature > 55-60 °C, velocity shows a steep increment. The system measures a value "over limit", meaning a velocity > 5 m s-1. CONCLUSIONS Ultrasound thermometry during laser ablation of biological tissue based on elastography shows an abrupt output change at temperatures > 55-60 °C. This issue can have a relevant clinical impact, considering tumor necrosis when temperature crosses 55 °C to define the boundary of damaged volume.
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Affiliation(s)
- Francesco Giurazza
- Interventional Radiology Department, Cardarelli Hospital, Via Cardarelli 9, 80100, Naples, Italy.
| | - Carlo Massaroni
- Measurement and Biomedical Instrumentation Lab, Università Campus Bio-Medico di Roma, Via A. Del Portillo 200, 00198, Rome, Italy
| | - Sergio Silvestri
- Measurement and Biomedical Instrumentation Lab, Università Campus Bio-Medico di Roma, Via A. Del Portillo 200, 00198, Rome, Italy
| | - Bruno Beomonte Zobel
- Radiology Department, Università Campus Bio-Medico di Roma, Via A. Del Portillo 200, 00198, Rome, Italy
| | - Emiliano Schena
- Measurement and Biomedical Instrumentation Lab, Università Campus Bio-Medico di Roma, Via A. Del Portillo 200, 00198, Rome, Italy
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Morris J, Michalak G, Leng S, Moynagh M, Kurup AN, McCollough C, Fletcher J. Dual-Energy CT Monitoring of Cryoablation Zone Growth in the Spinal Column and Bony Pelvis: A Laboratory Study. J Vasc Interv Radiol 2019; 30:1496-1503. [DOI: 10.1016/j.jvir.2019.01.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 12/25/2022] Open
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Strigari L, Minosse S, D'Alessio D, Farina L, Cavagnaro M, Cassano B, Pinto R, Vallati G, Lopresto V. Microwave thermal ablation using CT-scanner for predicting the variation of ablated region over time: advantages and limitations. Phys Med Biol 2019; 64:115021. [PMID: 30995620 DOI: 10.1088/1361-6560/ab1a67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aims at investigating in real-time the structural and dynamical changes occurring in an ex vivo tissue during a microwave thermal ablation (MTA) procedure. The experimental set-up was based on ex vivo liver tissue inserted in a dedicated box, in which 3 fibre-optic (FO) temperature probes were introduced to measure the temperature increase over time. Computed tomography (CT) imaging technique was exploited to experimentally study in real-time the Hounsfield Units (HU) modification occurring during MTA. The collected image data were processed with a dedicated MATLAB tool, developed to analyse the FO positions and HU modifications from the CT images acquired over time before and during the ablation procedures. The radial position of a FO temperature probe (rFO) and the value of HU in the region of interest (ROI) containing the probe (HUo), along with the corresponding value of HU in the contralateral ROI with respect to the MTA antenna applicator (HUc), were determined and registered over time during and after the MTA procedure. Six experiments were conducted to confirm results. The correlation between temperature and the above listed predictors was investigated using univariate and multivariate analysis. At the multivariate analysis, the time, rFO and HUc resulted significant predictive factors of the logarithm of measured temperature. The correlation between predicted and measured temperatures was 0.934 (p < 0.001). The developed tool allows identifying and registering the image-based parameters useful for predicting the temperature variation over time in each investigated voxel by taking into consideration the HU variation.
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Affiliation(s)
- L Strigari
- Laboratory of Medical Physics and Expert Systems, IRCCS Regina Elena National Cancer Institute, IFO, via Elio Chianesi, 53, 00144, Rome, Italy. Current address: Department of Medical Physics, St. Orsola-Malpighi University Hospital, via Massarenti 9 40138 Bologna, Italy
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Tan D, Mohamad NA, Wong YH, Yeong CH, Cheah PL, Sulaiman N, Abdullah BJJ, Fabell MK, Lim KS. Experimental assessment on feasibility of computed tomography-based thermometry for radiofrequency ablation on tissue equivalent polyacrylamide phantom. Int J Hyperthermia 2019; 36:554-561. [DOI: 10.1080/02656736.2019.1610800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Daryl Tan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Nurul Ashikin Mohamad
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yin How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Peng Loon Cheah
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norshazriman Sulaiman
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Basri Johan Jeet Abdullah
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Kamil Fabell
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Sing Lim
- Photonics Research Centre, University of Malaya, Kuala Lumpur, Malaysia
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Zhu L, Altman MB, Laszlo A, Straube W, Zoberi I, Hallahan DE, Chen H. Ultrasound Hyperthermia Technology for Radiosensitization. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1025-1043. [PMID: 30773377 PMCID: PMC6475527 DOI: 10.1016/j.ultrasmedbio.2018.12.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/28/2018] [Accepted: 12/17/2018] [Indexed: 05/08/2023]
Abstract
Hyperthermia therapy (HT) raises tissue temperature to 40-45°C for up to 60 min. Hyperthermia is one of the most potent sensitizers of radiation therapy (RT). Ultrasound-mediated HT for radiosensitization has been used clinically since the 1960s. Recently, magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU), which has been approved by the United States Food and Drug Administration for thermal ablation therapy, has been adapted for HT. With emerging clinical trials using MRgHIFU HT for radiosensitization, there is a pressing need to review the ultrasound HT technology. The objective of this review is to overview existing HT technology, summarize available ultrasound HT devices, evaluate clinical studies combining ultrasound HT with RT and discuss challenges and future directions.
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Affiliation(s)
- Lifei Zhu
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Michael B Altman
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Andrei Laszlo
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - William Straube
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Imran Zoberi
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Dennis E Hallahan
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Hong Chen
- Department of Biomedical Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA; Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, Missouri, USA.
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Landa FJO, Penacoba SR, de Espinosa FM, Razansky D, Deán-Ben XL. Four-dimensional optoacoustic monitoring of tissue heating with medium intensity focused ultrasound. ULTRASONICS 2019; 94:117-123. [PMID: 30580815 DOI: 10.1016/j.ultras.2018.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/01/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
Medium-intensity focused ultrasound (MIFU) concerns therapeutic ultrasound interventions aimed at stimulating physiological mechanisms to reinforce healing responses without reaching temperatures that can cause permanent tissue damage. The therapeutic outcome is strongly affected by the temperature distribution in the treated region and its accurate monitoring represents an unmet clinical need. In this work, we investigate on the capacities of four-dimensional optoacoustic tomography to monitor tissue heating with MIFU. Calibration experiments in a tissue-mimicking phantom have confirmed that the optoacoustically-estimated temperature variations accurately match the simultaneously acquired thermocouple readings. The performance of the suggested approach in real tissues was further shown with bovine muscle samples. Volumetric temperature maps were rendered in real time, allowing for dynamic monitoring of the ultrasound focal region, estimation of the peak temperature and the size of the heat-affected volume.
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Affiliation(s)
- Francisco Javier Oyaga Landa
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany; School of Medicine, Technical University of Munich, Germany
| | | | | | - Daniel Razansky
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany; School of Medicine, Technical University of Munich, Germany
| | - Xosé Luís Deán-Ben
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany.
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Beisenova A, Issatayeva A, Sovetov S, Korganbayev S, Jelbuldina M, Ashikbayeva Z, Blanc W, Schena E, Sales S, Molardi C, Tosi D. Multi-fiber distributed thermal profiling of minimally invasive thermal ablation with scattering-level multiplexing in MgO-doped fibers. BIOMEDICAL OPTICS EXPRESS 2019; 10:1282-1296. [PMID: 30891346 PMCID: PMC6420269 DOI: 10.1364/boe.10.001282] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 05/03/2023]
Abstract
We propose a setup for multiplexed distributed optical fiber sensors capable of resolving temperature distribution in thermo-therapies, with a spatial resolution of 2.5 mm over multiple fibers interrogated simultaneously. The setup is based on optical backscatter reflectometry (OBR) applied to optical fibers having backscattered power significantly larger than standard fibers (36.5 dB), obtained through MgO doping. The setup is based on a scattering-level multiplexing, which allows interrogating all the sensing fibers simultaneously, thanks to the fact that the backscattered power can be unambiguously associated to each fiber. The setup has been validated for the planar measurement of temperature profiles in ex vivo radiofrequency ablation, obtaining the measurement of temperature over a surface of 96 total points (4 fibers, 8 sensing points per cm2). The spatial resolution obtained for the planar measurement allows extending distributed sensing to surface, or even three-dimensional, geometries performing temperature sensing in the tissue with millimeter resolution in multiple dimensions.
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Affiliation(s)
- Aidana Beisenova
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
| | - Aizhan Issatayeva
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
| | - Sultan Sovetov
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
| | - Sanzhar Korganbayev
- Laboratory of Biosensors and Bioinstruments, National Laboratory Astana, 010000 Astana, Kazakhstan
| | - Madina Jelbuldina
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
- Laboratory of Biosensors and Bioinstruments, National Laboratory Astana, 010000 Astana, Kazakhstan
| | - Zhannat Ashikbayeva
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
- Laboratory of Biosensors and Bioinstruments, National Laboratory Astana, 010000 Astana, Kazakhstan
| | - Wilfried Blanc
- Université Côte d’Azur, INPHYNI–CNRS UMR 7010, Parc Valrose, 06108 Nice, France
| | - Emiliano Schena
- E. Unit of Measurements and Biomedical Instrumentation, University Campus Bio-Medico of Rome, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Salvador Sales
- Institute of Telecommunications and Multimedia Applications (iTEAM), Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Carlo Molardi
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
| | - Daniele Tosi
- Nazarbayev University, Department of Electrical and Computer Engineering, 010000 Astana, Kazakhstan
- Laboratory of Biosensors and Bioinstruments, National Laboratory Astana, 010000 Astana, Kazakhstan
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Scapaticci R, Lopresto V, Pinto R, Cavagnaro M, Crocco L. Monitoring Thermal Ablation via Microwave Tomography: An Ex Vivo Experimental Assessment. Diagnostics (Basel) 2018; 8:E81. [PMID: 30563280 PMCID: PMC6316129 DOI: 10.3390/diagnostics8040081] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 11/27/2018] [Accepted: 12/02/2018] [Indexed: 12/19/2022] Open
Abstract
Thermal ablation treatments are gaining a lot of attention in the clinics thanks to their reduced invasiveness and their capability of treating non-surgical patients. The effectiveness of these treatments and their impact in the hospital's routine would significantly increase if paired with a monitoring technique able to control the evolution of the treated area in real-time. This is particularly relevant in microwave thermal ablation, wherein the capability of treating larger tumors in a shorter time needs proper monitoring. Current diagnostic imaging techniques do not provide effective solutions to this issue for a number of reasons, including economical sustainability and safety. Hence, the development of alternative modalities is of interest. Microwave tomography, which aims at imaging the electromagnetic properties of a target under test, has been recently proposed for this scope, given the significant temperature-dependent changes of the dielectric properties of human tissues induced by thermal ablation. In this paper, the outcomes of the first ex vivo experimental study, performed to assess the expected potentialities of microwave tomography, are presented. The paper describes the validation study dealing with the imaging of the changes occurring in thermal ablation treatments. The experimental test was carried out on two ex vivo bovine liver samples and the reported results show the capability of microwave tomography of imaging the transition between ablated and untreated tissue. Moreover, the discussion section provides some guidelines to follow in order to improve the achievable performances.
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Affiliation(s)
- Rosa Scapaticci
- National Research Council of Italy-Institute for the Electromagnetic Sensing of the Environment, 80124 Napoli, Italy.
| | - Vanni Lopresto
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Division of Health Protection Technologies, Casaccia Research Center, 00123 Rome, Italy.
| | - Rosanna Pinto
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Division of Health Protection Technologies, Casaccia Research Center, 00123 Rome, Italy.
| | - Marta Cavagnaro
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy.
| | - Lorenzo Crocco
- National Research Council of Italy-Institute for the Electromagnetic Sensing of the Environment, 80124 Napoli, Italy.
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Schena E, Saccomandi P, Tosi D, Davrieux F, Gassino R, Massaroni C, Presti DL, Costamagna G, Perrone G, Vallan A, Diana M, Marescaux J. Solutions to Improve the Outcomes of Thermal Treatments in Oncology: Multipoint Temperature Monitoring. ACTA ACUST UNITED AC 2018. [DOI: 10.1109/jerm.2018.2838341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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V. V. N. Kothapalli S, Altman MB, Zhu L, Partanen A, Cheng G, Gach HM, Straube W, Zoberi I, Hallahan DE, Chen H. Evaluation and selection of anatomic sites for magnetic resonance imaging-guided mild hyperthermia therapy: a healthy volunteer study. Int J Hyperthermia 2018; 34:1381-1389. [DOI: 10.1080/02656736.2017.1418536] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Michael B. Altman
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lifei Zhu
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Ari Partanen
- Clinical Science MR Therapy, Philips Healthcare, Andover, MA, USA
| | - Galen Cheng
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - H. Michael Gach
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - William Straube
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Imran Zoberi
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Dennis E. Hallahan
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hong Chen
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
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Granchi S, Vannacci E, Breschi L, Biagi E. Advantages of cooled fiber for monitoring laser tissue ablation through temporal and spectral analysis of RF ultrasound signal: A case study. ULTRASONICS 2018; 82:49-56. [PMID: 28750317 DOI: 10.1016/j.ultras.2017.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/14/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
The promising minimally invasive laser thermal therapy technique may be improved if thermal lesions induced into the tissue can be carefully monitored in extension and morphology during the treatment. According to results obtained in several recent experimentations, solutions that avoid tissue carbonization during the treatment have been proposed, in order to allow deeper and longer lasting light penetration in treated tissue and to reduce failures of the applicator tip and fiber optic, dangerous for patients. In the work the advantages in using a cooled fiber are shown, in order not only to induce efficient lesions but also in performing an accurate monitoring by ultrasound. Indeed, one important limit of the ultrasound control is caused by the gas bubbles generation, which represent an acoustic barrier that invalidate the ultrasonic image representation of the treated tissue. Ultrasonic radiofrequency signals were acquired from the same bovine liver ex vivo sample by using both bare and cooled fiber and processed to produce B-mode and spectral parametric images by implementing TUV (Thermotherapy Ultrasonic View) algorithm. Radiofrequency signals, B-mode and TUV images were analysed and compared in order to evaluate the different tissue heating processes during ablation and the different lesion extensions induced into the tissue after the treatment. Cooled fiber avoided carbonization and strongly reduced gas bubbles generation inducing a larger lesion and allowing a more effective ultrasound monitoring. Moreover by correlating optical images of the lesions and the corresponding Integral TUV images, by using Dice and Jaccard coefficients, it was proven that TUV algorithm is able to characterize the tissue portions differently modified by ablation exhibiting better performances in the case of cooled fiber and revealing to be a potential tool capable to improve the laser delivery settings control.
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Affiliation(s)
- Simona Granchi
- Department of Information Engineering (DINFO), University of Florence, Via Santa Marta 3, 50139 Florence, Italy.
| | - Enrico Vannacci
- Department of Information Engineering (DINFO), University of Florence, Via Santa Marta 3, 50139 Florence, Italy
| | | | - Elena Biagi
- Department of Information Engineering (DINFO), University of Florence, Via Santa Marta 3, 50139 Florence, Italy
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Ziv O, Goldberg SN, Nissenbaum Y, Sosna J, Weiss N, Azhari H. Optical flow and image segmentation analysis for noninvasive precise mapping of microwave thermal ablation in X-ray CT scans - ex vivo study. Int J Hyperthermia 2017; 34:744-755. [PMID: 28866952 DOI: 10.1080/02656736.2017.1375160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To develop image processing algorithms for noninvasive mapping of microwave thermal ablation using X-ray CT. METHODS Ten specimens of bovine liver were subjected to microwave ablation (20-80 W, 8 min) while scanned by X-ray CT at 5 s intervals. Specimens were cut and manually traced by two observers. Two algorithms were developed and implemented to map the ablation zone. The first algorithm utilises images segmentation of Hounsfield units changes (ISHU). The second algorithm utilises radial optical flow (ROF). Algorithm sensitivity to spatiotemporal under-sampling was assessed by decreasing the acquisition rate and reducing the number of acquired projections used for image reconstruction in order to evaluate the feasibility of implementing radiation reduction techniques. RESULTS The average radial discrepancy between the ISHU and ROF contours and the manual tracing were 1.04±0.74 and 1.16±0.79mm, respectively. When diluting the input data, the ISHU algorithm retained its accuracy, ranging from 1.04 to 1.79mm. By contrast, the ROF algorithm performance became inconsistent at low acquisition rates. Both algorithms were not sensitive to projections reduction, (ISHU: 1.24±0.83mm, ROF: 1.53±1.15mm, for reduction by eight fold). Ablations near large blood vessels affected the ROF algorithm performance (1.83±1.30mm; p < 0.01), whereas ISHU performance remained the same. CONCLUSION The two suggested noninvasive ablation mapping algorithms can provide highly accurate contouring of the ablation zone at low scan rates. The ISHU algorithm may be more suitable for clinical practice as it appears more robust when radiation dose reduction strategies are employed and when the ablation zone is near large blood vessels.
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Affiliation(s)
- Omri Ziv
- a Department of Biomedical Engineering , Technion - IIT , Haifa , Israel
| | - S Nahum Goldberg
- b Department of Radiology , Hadassah Medical Center, Hebrew University , Jerusalem , Israel.,c Department of Radiology , Beth Israel Deaconess Medical Center , Boston , MA , USA
| | - Yitzhak Nissenbaum
- b Department of Radiology , Hadassah Medical Center, Hebrew University , Jerusalem , Israel
| | - Jacob Sosna
- b Department of Radiology , Hadassah Medical Center, Hebrew University , Jerusalem , Israel.,c Department of Radiology , Beth Israel Deaconess Medical Center , Boston , MA , USA
| | - Noam Weiss
- a Department of Biomedical Engineering , Technion - IIT , Haifa , Israel
| | - Haim Azhari
- a Department of Biomedical Engineering , Technion - IIT , Haifa , Israel
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Liu S, Doughty A, West C, Tang Z, Zhou F, Chen WR. Determination of temperature distribution in tissue for interstitial cancer photothermal therapy. Int J Hyperthermia 2017; 34:756-763. [PMID: 28826269 DOI: 10.1080/02656736.2017.1370136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Temperature increase in tumour tissue during photothermal therapy (PTT) is a significant factor in determining the outcomes of the treatment. Therefore, controlling and optimising temperature distribution in target tissue is crucial for PTT. In this study, we developed a unique ex vivo device to study the temperature distribution during PTT to be used as a guide for the desired photothermal effects for cancer treatment. METHODS Bovine liver tissue buried inside agarose gel served as a phantom tumour surrounded by normal tissue. A thermostatic incubator was used to simulate tissue environment in live animals. The temperature distributions were measured by thermocouples with needle probes at different locations inside the target tissue, during laser irradiation using an 805-nm laser. RESULTS The results obtained using the ex vivo device were verified by comparing the tissue temperature directly measured in animal tumours irradiated under the same conditions. With this model, the spatial distribution of temperature in target tissue can be monitored in real time. A two-dimensional temperature distribution in target tissue allows us to establish the correlations among laser parameters, temperature distribution and tumour size. In addition, the optimal temperature range for tumour destruction and immunological stimulation was determined using metastatic rat mammary tumour model. CONCLUSION The device and method developed in this study can provide guidance for choosing the appropriate treatment parameters for optimal photothermal effects, particularly when combined with immunotherapy, for cancer treatment.
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Affiliation(s)
- Shaojie Liu
- a School of Physics and Telecommunication Engineering , South China Normal University , Guangzhou , Guangdong , China.,b Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research , University of Central Oklahoma , Edmond , OK , USA
| | - Austin Doughty
- b Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research , University of Central Oklahoma , Edmond , OK , USA
| | - Connor West
- b Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research , University of Central Oklahoma , Edmond , OK , USA
| | - Zhilie Tang
- a School of Physics and Telecommunication Engineering , South China Normal University , Guangzhou , Guangdong , China
| | - Feifan Zhou
- b Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research , University of Central Oklahoma , Edmond , OK , USA
| | - Wei R Chen
- b Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research , University of Central Oklahoma , Edmond , OK , USA.,c Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Optoelectronic Engineering , Shenzhen University , Shenzhen , China
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Landa FJO, Deán-Ben XL, Sroka R, Razansky D. Volumetric Optoacoustic Temperature Mapping in Photothermal Therapy. Sci Rep 2017; 7:9695. [PMID: 28851968 PMCID: PMC5575057 DOI: 10.1038/s41598-017-09069-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 07/21/2017] [Indexed: 12/27/2022] Open
Abstract
Photothermal therapy and ablation are commonplace medical procedures employed for treatment of tumors, vascular and brain abnormalities as well as other disorders that require selective destruction of tissues. Yet, accurate mapping of the dynamic temperature field distribution in the treated region represents an unmet clinical need, strongly affecting the clinical outcome of these interventions. We introduce a fast three-dimensional temperature mapping method based on real-time optoacoustic sensing of the treated region coupled with a thermal-diffusion-based model of heat distribution in tissues. Deviations of the optoacoustic temperature readings provided at 40 ms intervals remained below 10% in tissue-mimicking phantom experiments for temperature elevations above 3 °C, as validated by simultaneous thermocouple measurements. Performance of the new method to dynamically estimate the volumetric temperature distribution was further showcased in post-mortem mouse imaging experiments. The newly discovered capacity to non-invasively measure the temperature map in an entire treated volume with both high spatial and temporal resolutions holds potential for improving safety and efficacy of light-based therapeutic interventions.
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Affiliation(s)
- Francisco Javier Oyaga Landa
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany
- Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Xosé Luís Deán-Ben
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany
| | - Ronald Sroka
- Laser Research Laboratory/LIFE Center, Ludwig-Maximilian-University, Munich, Germany
| | - Daniel Razansky
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, Neuherberg, Germany.
- Faculty of Medicine, Technical University of Munich, Munich, Germany.
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Curto S, Faridi P, Shrestha TB, Pyle M, Maurmann L, Troyer D, Bossmann SH, Prakash P. An integrated platform for small-animal hyperthermia investigations under ultra-high-field MRI guidance. Int J Hyperthermia 2017; 34:341-351. [PMID: 28728442 DOI: 10.1080/02656736.2017.1339126] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Integrating small-animal experimental hyperthermia instrumentation with magnetic resonance imaging (MRI) affords real-time monitoring of spatial temperature profiles. This study reports on the development and preliminary in vivo characterisation of a 2.45 GHz microwave hyperthermia system for pre-clinical small animal investigations, integrated within a 14 T ultra-high-field MRI scanner. MATERIALS AND METHODS The presented system incorporates a 3.5 mm (OD) directional microwave hyperthermia antenna, positioned adjacent to the small-animal target, radiating microwave energy for localised heating of subcutaneous tumours. The applicator is integrated within the 30 mm bore of the MRI system. 3D electromagnetic and biothermal simulations were implemented to characterise hyperthermia profiles from the directional microwave antenna. Experiments in tissue mimicking phantoms were performed to assess hyperthermia profiles and validate MR thermometry against fibre-optic temperature measurements. The feasibility of delivering in vivo hyperthermia exposures to subcutaneous 4T1 tumours in experimental mice under simultaneous MR thermometry guidance was assessed. RESULTS Simulations and experiments in tissue mimicking phantoms demonstrated the feasibility of heating 21-982 mm3 targets with 8-12 W input power. Minimal susceptibility and electrical artefacts introduced by the hyperthermia applicator were observed on MR imaging. MR thermometry was in excellent agreement with fibre-optic temperatures measurements (max. discrepancy ≤0.6 °C). Heating experiments with the reported system demonstrated the feasibility of heating subcutaneous tumours in vivo with simultaneous MR thermometry. CONCLUSIONS A platform for small-animal hyperthermia investigations under ultra-high-field MR thermometry was developed and applied to heating subcutaneous tumours in vivo.
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Affiliation(s)
- Sergio Curto
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
| | - Pegah Faridi
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
| | - Tej B Shrestha
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Marla Pyle
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Leila Maurmann
- c Department of Chemistry , Kansas State University , Manhattan , KS , USA
| | - Deryl Troyer
- b Department of Anatomy and Physiology , Kansas State University , Manhattan , KS , USA
| | - Stefan H Bossmann
- c Department of Chemistry , Kansas State University , Manhattan , KS , USA
| | - Punit Prakash
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
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Saccomandi P, Schena E, Caponero MA, Gassino R, Hernandez J, Perrone G, Vallan A, Diana M, Costamagna G, Marescaux J. Novel carbon fiber probe for temperature monitoring during thermal therapies. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:873-876. [PMID: 29060011 DOI: 10.1109/embc.2017.8036963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Thermal treatments are a valid clinical option in the management of several solid tumors. The difficulties to perform an accurate prediction improve the selectivity of the treatment effects represent the main hurdles in the spread of these techniques. Among other solutions, thermometric techniques are gaining acceptance in monitoring the effects of thermal treatments because they provide a clear end-point to obtain the complete removal of cancer without damaging the surrounding healthy tissue. This paper proposes a custom needle-like probe made of carbon fibers to embed seven fiber Bragg grating (FBG) sensors. This tool aims at a multiple points monitoring the tissue temperature during the thermal procedures, streamlining the FBG sensors insertion within the organ. After the description of the probe manufacturing, we reported the calibration of the seven sensors embedded within the probe, their step response, and the feasibility assessment of the probe for temperature monitoring during laser ablation on animal model (both in vivo and ex vivo). Results show that the proposed probe is easily maneuverable by the clinician, the sensors have a linear response with the temperature and a short step response; moreover, the probe allows measuring the temperature in seven points of the tissue; finally, it can be used during CTand MR-guided procedures without causing any artifact to the images. Thanks to these features the probe may be an useful solution to improve the safety and the outcomes of minimally invasive thermal ablation procedures, so to spread these procedures in the clinical field.
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Laser Ablation for Cancer: Past, Present and Future. J Funct Biomater 2017; 8:jfb8020019. [PMID: 28613248 PMCID: PMC5492000 DOI: 10.3390/jfb8020019] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/30/2017] [Accepted: 06/13/2017] [Indexed: 12/27/2022] Open
Abstract
Laser ablation (LA) is gaining acceptance for the treatment of tumors as an alternative to surgical resection. This paper reviews the use of lasers for ablative and surgical applications. Also reviewed are solutions aimed at improving LA outcomes: hyperthermal treatment planning tools and thermometric techniques during LA, used to guide the surgeon in the choice and adjustment of the optimal laser settings, and the potential use of nanoparticles to allow biologic selectivity of ablative treatments. Promising technical solutions and a better knowledge of laser-tissue interaction should allow LA to be used in a safe and effective manner as a cancer treatment.
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Wang W, Liu Y, Liu H, An Y, Wang Q, Liu J. NaK alloy-induced in vivo tumor ablation therapy. MINIM INVASIV THER 2017; 27:90-96. [PMID: 28604147 DOI: 10.1080/13645706.2017.1330758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Alkali metal ablation is newly emerging as an effective, economic and minimally invasive ablation therapy. This study is dedicated to demonstrate the high efficiency of NaK alloy ablation on in vivo tumors with different stages in mice. MATERIAL AND METHODS Panc02 tumor cells were injected into 21 female C57B/L mice, which were divided into three groups. Two experimental groups of mice received the same percutaneous NaK alloy injection for a week apart. The inner temperature response and surface temperature distribution were measured using a thermal couple and an infrared camera. After each ablation experiment, two mice in each group were chosen randomly to make pathological sections. The tumor volumes were measured once every two days. At the end, all tumors were cut off to calculate the tumor inhibition rates. RESULTS The NaK alloy-induced ablation therapy produced an obvious temperature increase (85 °C) in the ablation region and the high temperature distribution was relatively concentrated. The histopathology sections showed that developing stage tumors received incomplete destruction of the malignant cells compared with early stage tumors. The tumor inhibition rate in the early and developing tumor treatment groups were 88.5% and 67.6%, respectively. CONCLUSIONS This technology provides a nearly thorough ablation treatment for early stage tumors and also a palliative treatment for developing tumors.
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Affiliation(s)
- Wei Wang
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Ying Liu
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Huan Liu
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Yonghui An
- a The First Hospital of Hebei Medical University , Shijiazhuang , China
| | - Qian Wang
- b Technical Institute of Physics and Chemistry, Chinese Academy of Sciences , Beijing , China
| | - Jing Liu
- b Technical Institute of Physics and Chemistry, Chinese Academy of Sciences , Beijing , China.,c Department of Biomedical Engineering, School of Medicine , Tsinghua University , Beijing , China
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Poch FGM, Rieder C, Ballhausen H, Knappe V, Ritz JP, Gemeinhardt O, Kreis ME, Lehmann KS. Finding Optimal Ablation Parameters for Multipolar Radiofrequency Ablation. Surg Innov 2017; 24:205-213. [PMID: 28193132 DOI: 10.1177/1553350617692492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Radiofrequency ablation (RFA) for primary liver tumors and liver metastases is restricted by a limited ablation size. Multipolar RFA is a technical advancement of RFA, which is able to achieve larger ablations. The aim of this ex vivo study was to determine optimal ablation parameters for multipolar RFA depending on applicator distance and energy input. METHODS RFA was carried out ex vivo in porcine livers with three internally cooled, bipolar applicators in multipolar ablation mode. Three different applicator distances were used and five different energy inputs were examined. Ablation zones were sliced along the cross-sectional area at the largest ablation diameter, orthogonally to the applicators. These slices were digitally measured and analyzed. RESULTS Sixty RFA were carried out. A limited growth of ablation area was seen in all test series. This increase was dependent on ablation time, but not on applicator distance. A steady state between energy input and energy loss was not observed. A saturation of the minimum radius of the ablation zone was reached. Differences in ablation radius between the three test series were seen for lowest and highest energy input ( P < .05). No differences were seen for medium amounts of energy ( P > .05). CONCLUSIONS The ablation parameters applicator distance and energy input can be chosen in such a way, that minor deviations of the preplanned ablation parameters have no influence on the size of the ablation area.
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Affiliation(s)
| | - Christian Rieder
- 2 Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany
| | - Hanne Ballhausen
- 2 Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany
| | - Verena Knappe
- 3 Laser- und Medizin-Technologie GmbH, Berlin, Germany
| | - Jörg Peter Ritz
- 4 Klinik für Allgemein- und Viszeralchirurgie, HELIOS Kliniken Schwerin, Schwerin, Germany
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Lopresto V, Pinto R, Farina L, Cavagnaro M. Treatment planning in microwave thermal ablation: clinical gaps and recent research advances. Int J Hyperthermia 2016; 33:83-100. [PMID: 27431328 DOI: 10.1080/02656736.2016.1214883] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Microwave thermal ablation (MTA) is a minimally invasive therapeutic technique aimed at destroying pathologic tissues through a very high temperature increase induced by the absorption of an electromagnetic field at microwave (MW) frequencies. Open problems, which are delaying MTA applications in clinical practice, are mainly linked to the extremely high temperatures, up to 120 °C, reached by the tissue close to the antenna applicator, as well as to the ability of foreseeing and controlling the shape and dimension of the thermally ablated area. Recent research was devoted to the characterisation of dielectric, thermal and physical properties of tissue looking at their changes with the increasing temperature, looking for possible developments of reliable, automatic and personalised treatment planning. In this paper, a review of the recently obtained results as well as new unpublished data will be presented and discussed.
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Affiliation(s)
- V Lopresto
- a Division of Health Protection Technologies , Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) , Rome , Italy
| | - R Pinto
- a Division of Health Protection Technologies , Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) , Rome , Italy
| | - L Farina
- b Department of Information Engineering, Electronics and Telecommunications , Sapienza University of Rome , Rome , Italy
| | - M Cavagnaro
- b Department of Information Engineering, Electronics and Telecommunications , Sapienza University of Rome , Rome , Italy
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