Microwave ablation of lung tumors: A probabilistic approach for simulation-based treatment planning.
Microwave ablation of lung tumors: A probabilistic approach for simulation-based treatment planning.
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DOI：
10.1002/mp.14923
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发表时间：
2021-07
期刊：
影响因子：
3.8
通讯作者：
Prakash P
中科院分区：
文献类型：
--
作者：
Sebek J;Taeprasartsit P;Wibowo H;Beard WL;Bortel R;Prakash P
微波消融术（MWA）是一种临床公认的治疗肺部肿瘤的方法。然而，现有MWA应用的一个挑战是局部肿瘤进展，可能是由于未能建立足够的治疗范围。该研究提出了一种强大的基于模拟的处理计划方法，以帮助作业者比较评估热剖面和作为候选应用能量参数的函数实现指定最小裕度的可能性。我们采用基于生物物理模拟的概率治疗计划方法来评估候选治疗参数（即肿瘤内给定涂抹器位置的施加功率和消融持续时间）达到指定最小裕度的可能性。一组具有不同组织特性的模拟对功率和消融时间的每种考虑组合进行评估，并对肿瘤和正常肺之间组织生物物理特性的四种不同情况进行对比。然后组装治疗计划图，其中可以评估候选应用功率和治疗持续时间组合的最小消融区边缘和附带损伤体积的分布。对于每个选择的功率和时间组合，操作者还可以可视化覆盖在肿瘤和靶体积上的消融区边界的直方图。我们收集了直径为1厘米、2厘米和2.5厘米的球形肿瘤的治疗计划图，并说明了组织异质性对治疗计划和消融直方图的影响。最后，我们举例说明了治疗计划方法的两个例子患者特异性的肿瘤与不规则形状。综合治疗计划图显示，对于直径为1厘米的球形肿瘤，在所有模拟病例中，30 W、6分钟的消融可实现5毫米的最小切缘；对于直径为2.5厘米的球形肿瘤，在90%的模拟病例中，70 W、10分钟的消融可实现3毫米的最小切缘。肿瘤和肺组织间组织异质性的不同情况下，消融时间总体差异为2min，以可靠地实现直径为2cm的球形肿瘤每次最小切缘≥4mm。本文阐述了一种基于模拟的肺肿瘤微波消融治疗计划方法，以考虑治疗部位的特定几何形状、组织性质的不确定性以及肿瘤和正常肺之间的异质性的影响。
Microwave ablation (MWA) is a clinically established modality for treatment of lung tumors. A challenge with existing application of MWA, however, is local tumor progression, potentially due to failure to establish an adequate treatment margin. This study presents a robust simulation-based treatment planning methodology to assist operators in comparatively assessing thermal profiles and likelihood of achieving a specified minimum margin as a function of candidate applied energy parameters. We employed a biophysical simulation-based probabilistic treatment planning methodology to evaluate the likelihood of achieving a specified minimum margin for candidate treatment parameters (i.e., applied power and ablation duration for a given applicator position within a tumor). A set of simulations with varying tissue properties was evaluated for each considered combination of power and ablation duration, and for four different scenarios of contrast in tissue biophysical properties between tumor and normal lung. A treatment planning graph was then assembled, where distributions of achieved minimum ablation zone margins and collateral damage volumes can be assessed for candidate applied power and treatment duration combinations. For each chosen power and time combination, the operator can also visualize the histogram of ablation zone boundaries overlaid on the tumor and target volumes. We assembled treatment planning graphs for generic 1, 2, and 2.5 cm diameter spherically shaped tumors and also illustrated the impact of tissue heterogeneity on delivered treatment plans and resulting ablation histograms. Finally, we illustrated the treatment planning methodology on two example patient-specific cases of tumors with irregular shapes. The assembled treatment planning graphs indicate that 30 W, 6 min ablations achieve a 5-mm minimum margin across all simulated cases for 1-cm diameter spherical tumors, and 70 W, 10 min ablations achieve a 3-mm minimum margin across 90% of simulations for a 2.5-cm diameter spherical tumor. Different scenarios of tissue heterogeneity between tumor and lung tissue revealed 2 min overall difference in ablation duration, in order to reliably achieve a 4-mm minimum margin or larger each time for 2-cm diameter spherical tumor. An approach for simulation-based treatment planning for microwave ablation of lung tumors is illustrated to account for the impact of specific geometry of the treatment site, tissue property uncertainty, and heterogeneity between the tumor and normal lung.
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影响因子：
3.1
作者：
Liu, Zhengjun;Ahmed, Muneeb;Goldberg, S. Nahum
通讯作者：
Goldberg, S. Nahum
影响因子：
3.9
作者：
Jarrard, Jerry;Wizeman, Bill;Mitzner, Wayne
通讯作者：
Mitzner, Wayne
影响因子：
3.8
作者：
Deshazer, Garron;Merck, Derek;Prakash, Punit
通讯作者：
Prakash, Punit
DOI：
10.1053/j.tvir.2018.10.005
发表时间：
2019-03-01
影响因子：
1.7
作者：
Lyons, Gray R.;Pua, Bradley B.
通讯作者：
Pua, Bradley B.
DOI：
10.1016/j.jvir.2010.07.022
发表时间：
2010-11-01
影响因子：
2.9
作者：
Fuentes, David;Cardan, Rex;Feng, Yusheng
通讯作者：
Feng, Yusheng