Intraoperative Ablation Control Based on Real-Time Necrosis Monitoring Feedback: Numerical Evaluation.

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL Annals of Biomedical Engineering Pub Date : 2024-08-12 DOI:10.1007/s10439-024-03599-6
Ryo Murakami, Satoshi Mori, Haichong K Zhang
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Abstract

Ablation therapy is a type of minimally invasive treatment, utilized for various organs including the brain, heart, and kidneys. The accuracy of the ablation process is critically important to avoid both insufficient and excessive ablation, which may result in compromised efficacy or complications. The thermal ablation is formulated by two theoretical models: the heat transfer (HT) and necrosis formation (NF) models. In modern medical practices, feed-forward (FF) and temperature feedback (TFB) controls are primarily used as ablation control methodologies. FF involves pre-therapy procedure planning based on previous experiences and theoretical knowledge without monitoring the intraoperative tissue response, hence, it can't compensate for discrepancies in the assumed HT or NF models. These discrepancies can arise due to individual patient's tissue characteristic differences and specific environmental conditions. Conversely, TFB control is based on the intraoperative temperature profile. It estimates the resulting heat damage based on the monitored temperature distribution and assumed NF model. Therefore, TFB can make necessary adjustments even if there is an error in the assumed HT model. TFB is thus seen as a more robust control method against modeling errors in the HT model. Still, TFB is limited as it assumes a fixed NF model, irrespective of the patient or the ablation technique used. An ideal solution to these limitations would be to actively monitor heat damage to the tissue during the operation and utilize this data to control ablation. This strategy is defined as necrosis feedback (NFB) in this study. Such real-time necrosis monitoring modalities making NFB possible are emerging, however, there is an absence of a generalized study that discusses the integration and quantifies the significance of the real-time necrosis monitor techniques for ablation therapy. Such an investigation is expected to clarify the universal principles of how these techniques would improve ablation therapy. In this study, we examine the potential of NFB in suppressing errors associated with the NF model as NFB is theoretically capable of monitoring and suppressing the errors associated with the NF models in its closed control loop. We simulate and compare the performances of TFB and NFB with artificially generated modeling errors using the finite element method (FEM). The results show that NFB provides more accurate ablation control than TFB when NF-oriented errors are applied, indicating NFB's potential to improve the ablation control accuracy and highlighting the value of the ongoing research to make real-time necrosis monitoring a clinically viable option.

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基于实时坏死监测反馈的术中消融控制:数值评估。
消融治疗是一种微创疗法,适用于包括大脑、心脏和肾脏在内的各种器官。消融过程的准确性至关重要,可避免消融不足或消融过度,从而影响疗效或导致并发症。热消融有两个理论模型:热传递模型(HT)和坏死形成模型(NF)。在现代医学实践中,前馈(FF)和温度反馈(TFB)控制主要用作消融控制方法。前馈控制涉及基于以往经验和理论知识的治疗前程序规划,无需监测术中组织反应,因此无法弥补假定 HT 或 NF 模型的差异。这些差异可能是由于患者个体的组织特征差异和特定的环境条件造成的。相反,TFB 控制基于术中温度曲线。它根据监测到的温度分布和假定的 NF 模型来估计所产生的热损伤。因此,即使假定的 HT 模型有误,TFB 也能做出必要的调整。因此,TFB 被视为一种更稳健的控制方法,可以避免高温模型中的建模错误。尽管如此,TFB 仍有其局限性,因为它假设了一个固定的 NF 模型,与患者或所使用的消融技术无关。解决这些局限性的理想方法是在手术过程中主动监测组织的热损伤,并利用这些数据来控制消融。本研究将这种策略定义为坏死反馈(NFB)。这种实时坏死监测模式使 NFB 成为可能,但目前还没有一项全面的研究来讨论实时坏死监测技术在消融治疗中的整合和量化意义。这种研究有望阐明这些技术如何改善消融治疗的普遍原则。在本研究中,我们研究了 NFB 在抑制与 NF 模型相关的误差方面的潜力,因为理论上 NFB 能够在其闭合控制环中监测和抑制与 NF 模型相关的误差。我们使用有限元法 (FEM) 模拟并比较了 TFB 和 NFB 在人为产生建模误差的情况下的性能。结果表明,当应用面向 NF 的误差时,NFB 比 TFB 提供了更精确的消融控制,这表明 NFB 有潜力提高消融控制精度,并突出了正在进行的研究的价值,即让实时坏死监测成为临床上可行的选择。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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