有无颅内记录电极的神经外科激光间质热疗建模

Daniel W. Keefe , David T. Christianson , Greyson W. Davis , Hiroyuki Oya , Matthew A. Howard III , Christopher I. Petkov , Fatima Toor
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摘要

激光热消融已成为一种重要的神经外科治疗方法,但在癫痫患者中,目前还不能安全地使用用于研究发作间期或癫痫样活动的颅内记录电极。目前迫切需要建立有无颅内电极的激光间质热疗(LITT)计算模型,以提高光学神经疗法的疗效和安全性。在本文中,我们旨在建立一个生物物理生物热和射线光学模型,以研究在 LITT 过程中,在消融区附近有无颅内电极的情况下,激光加热对大脑的影响。我们使用 COMSOL 多物理场有限元法(FEM)求解软件创建了脑组织生物热量模型,并通过 Penne 模型将血流纳入模型或不纳入模型,以模拟神经组织对激光加热的反应。我们的报告显示,如果颅内电极与激光耦合漫射光纤尖端放置得太近,会增加脑组织体积的最高温度,并影响坏死区域的体积。模型显示,电极位移 4 毫米可视为颅内电极放置与 LITT 探头治疗区域的安全距离。这项研究首次建立了 LITT 治疗过程中颅内植入记录电极影响的模型,从而可以更好地了解 LITT 治疗过程对大脑神经网络的影响,并与颅内植入记录电极保持足够的安全距离。我们建议模拟电极与红外激光耦合漫射光纤尖端之间的安全距离。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Modeling for neurosurgical laser interstitial thermal therapy with and without intracranial recording electrodes

Laser thermal ablation has become a prominent neurosurgical treatment approach, but in epilepsy patients it cannot currently be safely implemented with intracranial recording electrodes that are used to study interictal or epileptiform activity. There is a pressing need for computational models of laser interstitial thermal therapy (LITT) with and without intracranial electrodes to enhance the efficacy and safety of optical neurotherapies. In this paper, we aimed to build a biophysical bioheat and ray optics model to study the effects of laser heating in the brain, with and without intracranial electrodes in the vicinity of the ablation zone during the LITT procedure. COMSOL Multiphysics finite element method (FEM) solver software was used to create a bioheat thermal model of brain tissue, with and without blood flow incorporation via Penne's model, to model neural tissue response to laser heating. We report that the close placement of intracranial electrodes can increase the maximum temperature of the brain tissue volume as well as impact the necrosis region volume if the electrodes are placed too closely to the laser coupled diffuse fiber tip. The model shows that an electrode displacement of 4 mm could be considered a safe distance of intracranial electrode placement away from the LITT probe treatment area. This work, for the first time, models the impact of intracranially implanted recording electrodes during LITT, which could improve the understanding of the LITT treatment procedure on the brain's neural networks a sufficient safe distance to the implanted intracranial recording electrodes. We recommend modeling safe distances for placing the electrodes with respect to the infrared laser coupled diffuse fiber tip.

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