Int J Comput Assist Radiol Surg - Image-based 3D modeling and validation of radiofrequency interstitial tumor ablation using a tissue-mimicking breast phantom.


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RPOSE: Minimally invasive treatment of solid cancers, especially in the breast and liver, remains clinically challenging, despite a variety of treatment modalities, including radiofrequency ablation (RFA), microwave ablation or high-intensity focused ultrasound. Each treatment modality has advantages and disadvantages, but all are limited by placement of a probe or US beam in the target tissue for tumor ablation and monitoring. The placement is difficult when the tumor is surrounded by large blood vessels or organs. Patient-specific image-based 3D modeling for thermal ablation simulation was developed to optimize treatment protocols that improve treatment efficacy.METHODS: A tissue-mimicking breast gel phantom was used to develop an image-based 3D computer-aided design (CAD) model for the evaluation of a planned RF ablation. First, the tissue-mimicking gel was cast in a breast mold to create a 3D breast phantom, which contained a simulated solid tumor. Second, the phantom was imaged in a medical MRI scanner using a standard breast imaging MR sequence. Third, the MR images were converted into a 3D CAD model using commercial software (ScanIP, Simpleware), which was input into another commercial package (COMSOL Multiphysics) for RFA simulation and treatment planning using a finite element method (FEM). For validation of the model, the breast phantom was experimentally ablated using a commercial (RITA) RFA electrode and a bipolar needle with an electrosurgical generator (DRE ASG-300). The RFA results obtained by pre-treatment simulation were compared with actual experimental ablation.RESULTS: A 3D CAD model, created from MR images of the complex breast phantom, was successfully integrated with an RFA electrode to perform FEM ablation simulation. The ablation volumes achieved both in the FEM simulation and the experimental test were equivalent, indicating that patient-specific models can be implemented for pre-treatment planning of solid tumor ablation.CONCLUSION: A tissue-mimicking breast gel phantom and its MR images were used to perform FEM 3D modeling and validation by experimental thermal ablation of the tumor. Similar patient-specific models can be created from preoperative images and used to perform finite element analysis to plan radiofrequency ablation. Clinically, the method can be implemented for pre-treatment planning to predict the effect of an individual's tissue environment on the ablation process, and this may improve the therapeutic efficacy.

Resumo Limpo

rpose minim invas treatment solid cancer especi breast liver remain clinic challeng despit varieti treatment modal includ radiofrequ ablat rfa microwav ablat highintens focus ultrasound treatment modal advantag disadvantag limit placement probe us beam target tissu tumor ablat monitor placement difficult tumor surround larg blood vessel organ patientspecif imagebas d model thermal ablat simul develop optim treatment protocol improv treatment efficacymethod tissuemimick breast gel phantom use develop imagebas d computeraid design cad model evalu plan rf ablat first tissuemimick gel cast breast mold creat d breast phantom contain simul solid tumor second phantom imag medic mri scanner use standard breast imag mr sequenc third mr imag convert d cad model use commerci softwar scanip simplewar input anoth commerci packag comsol multiphys rfa simul treatment plan use finit element method fem valid model breast phantom experiment ablat use commerci rita rfa electrod bipolar needl electrosurg generat dre asg rfa result obtain pretreat simul compar actual experiment ablationresult d cad model creat mr imag complex breast phantom success integr rfa electrod perform fem ablat simul ablat volum achiev fem simul experiment test equival indic patientspecif model can implement pretreat plan solid tumor ablationconclus tissuemimick breast gel phantom mr imag use perform fem d model valid experiment thermal ablat tumor similar patientspecif model can creat preoper imag use perform finit element analysi plan radiofrequ ablat clinic method can implement pretreat plan predict effect individu tissu environ ablat process may improv therapeut efficaci

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