Study of flow effects on temperature-controlled radio-frequency ablation using phantom experiments and forward simulations

bioRxiv (Cold Spring Harbor Laboratory)

Abstract

Abstract Purpose Blood perfusion is known to add variability to hepatic radiofrequency ablation (RFA) treatment outcomes. Simulation-assisted treatment planning taking into account blood perfusion may solve this problem in the future. Hence, this study aims to study perfusion effects on RFA in a controlled environment and to compare the outcome to a prediction made using finite volume simulations. Methods Ablation zones were induced in tissue-mimicking, thermochromic ablation phantoms with a single flow channel, using a RF generator with needle temperature controlled power delivery and a monopolar needle electrode. Channel radius and saline flow rate were varied and the impact of saline flow on the ablated cross-sectional area, on a potential occurrence of directional effects as well as on the delivered generator power input was studied. Finite-volume simulations reproducing the experimental geometry, flow conditions and generator power input were conducted in a second step and compared to the experimental ablation outcomes. Results Vessels of different radii affected the ablation result in different manners. For the channel radius of 0.275 mm both the ablated area and energy input reduced with increasing flow rate. For radius 0.9 mm the ablated area reduced with increasing flow rate but the energy input increased. An increasing area and energy input were observed towards larger flow rates for the channel radius of 2.3 mm. Directional effects, i.e., shrinking of the lesion upstream of the needle and an extension thereof downstream, were observed only for the smallest channel radius. The simulations qualitatively confirmed these observations. When using the simulations to make a prediction of ablation outcomes with flow, the mean absolute error between experimental and predicted ablation outcomes was reduced from 23% to 12% as compared to neglecting flow effects. Conclusion Simulations can improve the prediction of RFA ablation regions in the presence of various blood flow effects. Our findings therefore underline the potential of simulation-assisted, patient-individual RFA treatment planning and guidance for the prediction of RFA outcomes in the presence of blood flow. Additional comments -Teresa Nolte and Nikhil Vaidya contributed equally to this work. -Volkmar Schulz and Karen Veroy contributed equally to this work. -A single reference experiment, i.e., not using a flow channel, and the image in the upper left corner of Figure 4 were included into a publication submitted to Int. J. Hyperthermia for model validation purposes.

Authors 8

1. Teresa Nolte Aachen Department of Physics of Molecular Imaging Systems Institute for Experimental Molecular Imaging

   RWTH Aachen University

   Affiliation as printed

   Department of Physics of Molecular Imaging systems, Institute for Experimental Molecular Imaging, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany

2. Nikhil Vaidya corresponding Aachen Aachen Institute for Advanced Study in Computational Engineering Science (AICES)

   Aachen Institute for Advanced Study in Computational Engineering Science

   Affiliation as printed

   Aachen Institute for Advanced Study in Computational Engineering Science, Schinkelstrasse 2, 52062 Aachen, Germany

   Aachen Institute for Advanced Study in Computational Engineering Science, Schinkelstrasse , 506 Aachen, Germany

3. Marco Baragona
   Affiliation as printed

   Philips Research Europe, High Tech Campus, 5656 AE Eindhoven, The Netherlands

4. Aaldert Elevelt
   Affiliation as printed

   Philips Research Europe, High Tech Campus, 5656 AE Eindhoven, The Netherlands

5. Valentina Lavezzo
   Affiliation as printed

   Philips Research Europe, High Tech Campus, 5656 AE Eindhoven, The Netherlands

6. Ralph Maessen
   Affiliation as printed

   Philips Research Europe, High Tech Campus, 5656 AE Eindhoven, The Netherlands

7. Volkmar Schulz Aachen Department of Physics of Molecular Imaging Systems Institute for Experimental Molecular Imaging Physics Institute III B

   Fraunhofer Institute for Digital Medicine · RWTH Aachen University

   Affiliation as printed

   Department of Physics of Molecular Imaging systems, Institute for Experimental Molecular Imaging, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany

   Fraunhofer Institute for Digital Medicine MEVIS, Aachen, Germany

   Hyperion Hybrid Imaging Systems GmbH, Pauwelsstr. 19, 52074 Aachen, Germany

   Physics Institute III B, RWTH Aachen University, Aachen, Germany

   Hyperion Hybrid Imaging Systems GmbH, Pauwelsstr. 19, 5207 Aachen, Germany

8. Karen Veroy

   Eindhoven University of Technology

   Affiliation as printed

   Center for Analysis, Scientific Computing, and Applications, Eindhoven University of Technology, 5600 MB Eindhoven, Netherlands