Key issues in bioheat transfer simulations for the application of cryosurgery planning

Abstract

The bioheat transfer simulation is undoubtedly the foundation for developing computerized tools for cryosurgery planning and analysis. While a large variety of techniques for bioheat transfer simulations are available in the literature of the past several decades, it is only their integration with clinical criteria and constraints which can make computerized planning a practical reality. This brief communication outlines (in the opinion of this author) the key issues that must be addressed in the application of bioheat transfer to cryosurgery planning and analysis, while drawing attention to recent and relevant publications in other journals, with reference to the most recent publication on the topic in the Journal of Cryobiology [3]. KeywordsCryosurgery; Simulation; Planning; Bioheat Transfer Dramatic developments in imaging, instrumentation, and computational techniques in recent years have opened new horizons for the application of multi-probe and minimally-invasive cryosurgery. Commercial cryoprobes are now available that are as narrow as 1 mm in diameter, and in a wide range of active lengths. These small diameters, and the variability in active length, can potentially improve the surgeon's control over the minimally-invasive procedure. In prostate cryosurgery for example, up to 14 small diameter cryoprobes are routinely used, where the most appropriate active length can be selected according to the actual dimensions of the particular organ. One negative aspect of using this large number of cryoprobes is the increased complexity of surgical planning: consider the difficulty of visualizing the 3D shape of the organ (i.e., the target region), while seeking an optimal layout for as many as 14 cryoprobes, in order to best match the transient temperature field with the imaged freezing front and criteria for cryosurgery success.It is the opinion of this author that the optimal cryoprobe layout must be obtained with the aid of computerized planning tools, relying upon bioheat transfer simulations of the procedure. While numerical techniques for bioheat transfer are well documented in the literature of the past several decades, only a few studies have systematically addressed the critical problem of the best cryoprobe layout for cryosurgery [1,2]; Magalov et al. [3] is the most recent publication concerning this problem-although in a simplistic setup-in the Journal of Cryobiology. While 1rabin@cmu.edu; Phone/Fax: 412 268 2204. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

Anatomical model-based finite element analysis of the combined cryosurgical and hyperthermic ablation for knee bone tumor

“…For probes configuration, parallel insertion may not always be possible and would need to be determined for individual cases. The optimization design of treatment planning based on the numerical analysis for a real tissue structure is a valuable method for improving the treatment [36][37][38][39][40][41]. The anatomical model could provide accurate position of complex tissues structure and their mutual relations [42][43][44], which are very important for evaluating the temperature distribution during freezing and heating.…”

“…A similar pull-back method is considered here to perform the conformal treatment. This method is to use one time's insertion while multiple moving back along its axis for generating new freezing cycle so that a larger ablation volume can be obtained [20,[36][37][38]. Compared with conventional pull-back method, the probe pulling back during AFH process is more easily due to a rapid and strong heating [20].…”

An efficient thermal evolution model for cryoablation with arbitrary multi-cryoprobe configuration

“…A typical optimizing process is to repeatedly adjust the cryoprobe configuration (including its size, position, number and holding time) based on the temperature field from bioheat transfer simulation until an optimum cryoprobe layout is found. One of the key critical factors in making planning tool clinically relevant is to develop a fast and accurate numerical simulation method of bioheat transfer for the freezing process [19].…”

“…The computerized planning system based on bioheat transfer simulation is a promising method for optimizing cryoprobe configuration and freezing process [26]. In recent years many efforts have been made aiming to develop computerized planning tool for clinical cryosurgery treatments [1,12], such as the contribution from Rabin group about prostate cryoablation [13,19,22,24,25,27]. A typical optimizing process is to repeatedly adjust the cryoprobe configuration (including its size, position, number and holding time) based on the temperature field from bioheat transfer simulation until an optimum cryoprobe layout is found.…”

Numerical Prediction of the Intracellular ICE Formation Zone during Cryosurgery on a Nodular Basal Cell Carcinoma Using Liquid Nitrogen Spray

“…Ismail et al [10] presented a novel approach to increase the sensitivity to cryotherapy using combined treatment of tumor necrosis factor related apoptosis-inducing ligand and cryotherapy in an in vitro cryotherapy model. Rabin [11] outlined the key issues that must be addressed in bioheat transfer simulations for the application of cryosurgery planning. Liu et al [12] performed experiments where freezing was immediately followed by a rapid and strong heating of the target tissues in order to significantly improve the treatment effect.…”