肝癌激光消融治疗中扩散器长度和回拉距离对消融区影响的计算研究

Zhi Q. Tan, E. Ooi, E. Ooi
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摘要

虽然激光消融不常用于肝癌治疗,但有几个好处使它成为一个有吸引力的选择。然而,关于激光消融治疗肝癌疗效的研究仅限于少数临床试验。因此,对于该技术的功效,特别是在不同的协议和设备参数下操作时,所知不多。在这项研究中,我们进行了数值研究,探讨扩散器长度、功率密度和回拉技术对球形肝癌激光消融过程中凝血区形成的影响。目的是区分扩散器长度与功率密度的影响,并将其性能与实现回拉时的性能进行比较。考虑了四种扩散器长度(10,15,20和25mm)和三种回拉距离(5,10和15mm)。结果表明,当扩散器长度增加时,激光功率密度是限制混凝区大小的一个因素。一个更长的扩散器必须伴随着激光功率的增加,以达到预期的治疗效果。拉回技术增加了扩散器的有效长度,但在相同功率密度下获得的混凝体积小于较长的扩散器。这表明增加扩散器长度和激光功率比回拉技术更能增加凝聚区。为了获得足够大的覆盖整个肿瘤的凝血区,仔细选择扩散器的长度、功率密度和回拉距离至关重要。
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A Computational Study Evaluating the Effects of Diffuser Length and Pullback Distance on the Ablation Zone During Laser Ablation Treatment of Liver Cancer
Although laser ablation is not commonly used for liver cancer treatment, there are several benefits that make it an appealing alternative. Nevertheless, investigations on the efficacy of laser ablation for liver cancer has been limited to few clinical trials. Therefore, not much is known regarding the efficacy of the technique especially when operating under different protocols and device parameters. In this study, we performed a numerical study to investigate the effects of diffuser length, power density and the pullback technique on the coagulation zone formation during laser ablation of a spherical liver cancer. The objective is to demarcate the influence of diffuser length from power density, and to compare their performance to that when pullback is implemented. Four diffuser lengths (10, 15, 20 and 25 mm), and three pullback distances (5, 10 and 15 mm), were considered. Results showed that laser power density is a factor that limits the coagulation zone size when the diffuser length increases. A longer diffuser must be accompanied by an increase in laser power to achieve the desired treatment outcome. The pullback technique increases the effective diffuser length, but the coagulation volume obtained was smaller than that of a longer diffuser at the same power density. This suggests that increasing both the diffuser length and laser power is better at increasing the coagulation zone than the pullback technique. To obtain coagulation zone that is sufficiently large to cover the entire tumour, careful selection of the diffuser length, power density, and pullback distance is critical.
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