COMPUTER MODELING OF YTTRIUM-90-MICROSPHERE TRANSPORT IN THE HEPATIC ARTERIAL TREE TO IMPROVE CLINICAL OUTCOMES
COMPUTER MODELING OF YTTRIUM-90-MICROSPHERE TRANSPORT IN THE HEPATIC ARTERIAL TREE TO IMPROVE CLINICAL OUTCOMES
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DOI：
10.1016/j.ijrobp.2009.06.069
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发表时间：
2010-02-01
影响因子：
7
通讯作者：
Dezarn, William A.
中科院分区：
文献类型：
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作者：
Kennedy, Andrew S.;Kleinstreuer, Clement;Dezarn, William A.
目的：Y-90微球放射栓塞术是治疗不能切除的肝脏恶性肿瘤的一种安全有效的治疗方法。然而，目前还没有关于局部血流动力学对Y-94微球在人肝动脉系统中传输和分布的影响的数据。方法与材料：建立了一个三维(3-D)计算机模型来分析和模拟肿瘤患者肝动脉系统中血液-微球的流动动力学。补充的几何和血流数据集也可用于验证计算机模拟模型的准确性。具体地说，测量了血管直径、曲率和分支模式，以及血液流速/压力和微球特性(即直径和比重)。使用三维计算机辅助设计软件创建血管几何形状。初步试验中，10,000个无相互作用的微球被释放到肝动脉，使用的树脂球的直径为32微米，密度是血液的两倍。结果：成功地模拟了不同分支出口压力下的血流以及血液微球的传输，允许测试两种类型的微球在肝动脉主动脉入口平面的释放分布。如果微球的入口分布是均匀的(均匀分布的颗粒)，则更大比例的微球会进入供肿瘤生长的血管分支。相反，微球的入口呈抛物线分布(血管中心周围的颗粒较多)，显示有高比例的微球离开分支血管通向正常肝脏。结论：计算机模拟血流模式和微球动力学有助于在保留正常组织的同时优化Y-90微球植入肝脏肿瘤的方法。(C)2010年爱思唯尔公司。
Purpose: Radioembolization (RE) via yttrium-90 (Y-90) microspheres is an effective and safe treatment for unresectable liver malignancies. However, no data are available regarding the impact of local blood flow dynamics on Y-94-microsphere transport and distribution in the human hepatic arterial system.Methods and Materials: A three-dimensional (3-D) computer model was developed to analyze and simulate blood-microsphere flow dynamics in the hepatic arterial system with tumor. Supplemental geometric and flow data sets from patients undergoing RE were also available to validate the accuracy of the computer simulation model. Specifically, vessel diameters, curvatures, and branching patterns, as well as blood How velocities/pressures and microsphere characteristics (i.e., diameter and specific gravity), were measured. Three-dimensional computer-aided design software was used to create the vessel geometries. Initial trials, with 10,000 noninteracting microspheres released into the hepatic artery, used resin spheres 32-mu m in diameter with a density twice that of blood.Results: Simulations of blood flow subject to different branch-outlet pressures as well as blood-microsphere transport were successfully carried out, allowing testing of two types of microsphere release distributions in the inlet plane of the main hepatic artery. If the inlet distribution of microspheres was uniform (evenly spaced particles), a greater percentage would exit into the vessel branch feeding the tumor. Conversely, a parabolic inlet distribution of microspheres (more particles around the vessel center) showed a high percentage of microspheres exiting the branch vessel leading to the normal liver.Conclusions: Computer simulations of both blood flow patterns and microsphere dynamics have the potential to provide valuable insight on how to optimize Y-90-microsphere implantation into hepatic tumors while sparing normal tissue. (C) 2010 Elsevier Inc.