Effect of applicator diameter on lesion size from high temperature interstitial ultrasound thermal therapy.
Effect of applicator diameter on lesion size from high temperature interstitial ultrasound thermal therapy.
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施源器直径对高温间质超声热疗病变大小的影响。
DOI：
10.1118/1.1584125
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发表时间：
2003
期刊：
影响因子：
3.8
通讯作者：
C. Diederich
中科院分区：
文献类型：
--
作者：
P. Tyreus;W. Nau;C. Diederich
采用组织间和外部途径的高温超声热疗作为一种治疗癌症和良性疾病的微创临床治疗方法正变得越来越为人所接受。组织间敷贴器的直径大小会影响其临床实用性、有效性和应用部位。这项研究的目的是确定使用更大的超声换能器和固有的增加涂抹器尺寸是否可以通过潜在地产生更大的病变直径来证明是合理的。通过肝脏和牛肉的体外组织实验以及声学和生物热模拟，研究了四种涂抹器的结构和尺寸。外径2.2~4.0 mm的导管冷却和内冷涂抹器在20~40W/cm照射10min时，在体外肝脏产生直径3.5~5.0 cm的病变，在体外牛肉产生3.0~3.5 cm的病变。在20-40W/cm的功率范围内，较大的敷贴器产生的损伤的径向穿透深度优于较小的敷贴器。直径较大的涂抹器由于表面积较大，其外表面的冷却速度较快，这是导致病变大小增加的主要因素。较高的冷却速度使最高温度远离涂布器表面，并减少了高声衰减组织带的形成。在所研究的范围内，涂抹器的配置和频率(6.7-8.2 MHz)对病灶大小的影响小于直径。声学和生物热模拟与实验数据很好地匹配，并被应用于临床上感兴趣的部位，如前列腺、子宫肌瘤、脑和正常肝脏内对这些涂抹器进行建模。直径3.9到4.7厘米的病变被预测为中等灌流的组织，如前列腺和肌瘤，2.8到3.2厘米的高灌流的组织，如正常肝脏。在子宫肌瘤等可以容忍使用内窥镜方法放置较大敷贴器的部位，预计当敷贴器直径从2.4 mm增加到4.0 mm时，治疗量将增加37%。
High temperature ultrasound thermal therapy using interstitial and external approaches is becoming increasingly acceptable as a minimally invasive clinical treatment for cancerous and benign disease. The diameter of an interstitial applicator can influence its clinical practicality and effectiveness as well as application site. The purpose of this study was to determine whether the use of larger ultrasound transducers and the inherent increase in applicator size could be justified by potentially producing larger lesion diameters. Four applicator configurations and sizes were studied using ex vivo tissue experiments in liver and beef and using acoustic and biothermal simulations. Catheter-cooled and internally cooled applicators with outer diameters between 2.2 and 4.0 mm produced 3.5 to 5.0 cm diameter lesions in ex vivo liver and 3.0 to 3.5 cm lesions in ex vivo beef muscle with 20-40 W/cm applied for 10 min. Larger applicators produced lesions with radial penetration depths superior to their smaller counterparts at power levels in the 20-40 W/cm range. The higher cooling rates along the outer surface of the larger diameter applicators due to their greater surface area was a dominant factor in increasing lesion size. The higher cooling rates pushed the maximum temperature farther from the applicator surface and reduced the formation of high acoustic attenuation tissue zones. Applicator configuration and frequency (6.7-8.2 MHz) had less influence on lesion size than diameter in the ranges studied. Acoustic and biothermal simulations matched the experimental data well and were applied to model these applicators within sites of clinical interest such as prostate, uterine fibroid, brain, and normal liver. Lesions of 3.9 to 4.7 cm diameter were predicted for moderately perfused tissues such as prostate and fibroid and 2.8 to 3.2 cm for highly perfused tissues such as normal liver. In sites such as uterine fibroid where larger applicators placed using an endoscopic approach could be tolerated, treatment volume increases of 37% were predicted for an applicator diameter increase from 2.4 to 4.0 mm.
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影响因子：
19.7
作者：
Hynynen, K;Pomeroy, O;Jolesz, FA
通讯作者：
Jolesz, FA
使用风冷直接耦合间质超声探头的热凝固角方向性。
影响因子：
2.9
作者：
Deardorff,DL;Diederich,CJ
通讯作者：
Diederich,CJ
影响因子：
3.8
作者：
Deardorff, DL;Diederich, CJ;Nau, WH
通讯作者：
Nau, WH
DOI：
10.1016/0360-3016(84)90379-1
发表时间：
1984-01-01
影响因子：
7
作者：
SAPARETO, SA;DEWEY, WC
通讯作者：
DEWEY, WC