研究动态
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猪肝微波消融过程中的形态特征分析与临时温度监测

Morphometric characterization and temporal temperature measurements during hepatic microwave ablation in swine.

发表日期:2023
作者: Nicole A Varble, Ivane Bakhutashvili, Sheridan L Reed, Jose Delgado, Zoi Tokoutsi, Bruno Frackowiak, Marco Baragona, John W Karanian, Bradford J Wood, William F Pritchard
来源: Cell Death & Disease

摘要:

微波消融(MWA)通过热诱导破坏癌细胞而成为一种可行的治疗原发性和转移性肝癌的方法。在存在血管情况下,预测细胞死亡发生的受影响区域是具有挑战性的,但可以通过生物物理建模来实现。为了推进和表征热MWA对局部癌症治疗的方法,创建了一种体内方法和实验数据集,用于评估用于动态预测消融区参数的生物物理模型,给定传递设备、功率、位置和与血管的接近度。在去灌注的离体肝脏和组织模拟热变色仿生样板(TMTCP)中,以两个功率设置下对MWA区域的大小、形状和温度进行了表征和监测。使用植入的热电偶在时间上监测温度,其位置由CT定义。 TMTCPs用于确定消融区域相对于探头的位置。此外,还进行了6头猪的增强CT检查,以可视化血管及其缺血状态,并进行相应的尸检大体病理学观察。台架研究表明,40W和90W消融的平均消融区域大小分别为4.13±1.56cm2和8.51±3.92cm2,固体率分别为0.96±0.06和0.99±0.01,消融中心位于探头尖端上游3.75cm和3.5cm,并且40W和90W消融的温度分别为50ºC时的时间分别为14.5±13.4s和2.5±2.1s。体内成像显示40W和90W消融的平均体积分别为9.8±4.8cm3和33.2±28.4cm3,3D固体率分别为0.87±0.02和0.75±0.15,而病理学大体观察显示40W和90W消融的出血水平面积分别为3.1±1.2cm2和9.1±3.0cm2。当温度达到50ºC时,对于40W和90W消融,时间分别为19.5±9.2s和13.0±8.3s。MWA的结果具有挑战性,比制造商提供的和台架预测更加变量,这是由于血管瘀滞,热诱导的组织变化和探头工作条件等原因。准确预测体内MWA区域和温度需要全面的热验证集。版权:本文为开放获取文章,无版权限制,任何人都可以自由复制、分发、传输、修改、构建或者用于任何合法目的。该作品在创意共享CC0 公共领域奉献下提供。
Heat-induced destruction of cancer cells via microwave ablation (MWA) is emerging as a viable treatment of primary and metastatic liver cancer. Prediction of the impacted zone where cell death occurs, especially in the presence of vasculature, is challenging but may be achieved via biophysical modeling. To advance and characterize thermal MWA for focal cancer treatment, an in vivo method and experimental dataset were created for assessment of biophysical models designed to dynamically predict ablation zone parameters, given the delivery device, power, location, and proximity to vessels.MWA zone size, shape, and temperature were characterized and monitored in the absence of perfusion in ex vivo liver and a tissue-mimicking thermochromic phantom (TMTCP) at two power settings. Temperature was monitored over time using implanted thermocouples with their locations defined by CT. TMTCPs were used to identify the location of the ablation zone relative to the probe. In 6 swine, contrast-enhanced CTs were additionally acquired to visualize vasculature and absence of perfusion along with corresponding post-mortem gross pathology.Bench studies demonstrated average ablation zone sizes of 4.13±1.56cm2 and 8.51±3.92cm2, solidity of 0.96±0.06 and 0.99±0.01, ablations centered 3.75cm and 3.5cm proximal to the probe tip, and temperatures of 50 ºC at 14.5±13.4s and 2.5±2.1s for 40W and 90W ablations, respectively. In vivo imaging showed average volumes of 9.8±4.8cm3 and 33.2±28.4cm3 and 3D solidity of 0.87±0.02 and 0.75±0.15, and gross pathology showed a hemorrhagic halo area of 3.1±1.2cm2 and 9.1±3.0cm2 for 40W and 90W ablations, respectfully. Temperatures reached 50ºC at 19.5±9.2s and 13.0±8.3s for 40W and 90W ablations, respectively.MWA results are challenging to predict and are more variable than manufacturer-provided and bench predictions due to vascular stasis, heat-induced tissue changes, and probe operating conditions. Accurate prediction of MWA zones and temperature in vivo requires comprehensive thermal validation sets.Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.