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Focal Laser Ablation of Prostate Cancer: Numerical Simulation of Temperature and Damage Distribution.

Abstract : ABSTRACT: BACKGROUND: The use of minimally invasive ablative techniques in the management of patients with low grade and localized prostate tumours could represent a treatment option between active surveillance and radical therapy. Focal laser ablation (FLA) could be one of these treatment modalities. Dosimetry planning and conformation of the treated area to the tumor remain major issues, especially when, several fibers are required. An effective method to perform pre-treatment planning of this therapy is computer simulation. In this study we present an in-vivo validation of a mathematical model. METHODS: The simulation model used the finite elements method (FEM) to solve the bio-heat and the thermal damage equations. Laser irradiation was performed with a 980nm laser diode system (5 W, 75 s). Light was transmitted using a cylindrical diffusing fiber inserted inside a preclinical animal model induced in Copenhagen rats. Non-enhanced T2-weighted and dynamic gadolinium-enhanced T1-weighted MR imaging examinations were performed at baseline, 48 hours days after the procedure. The model was validated by comparing the simulated necrosis volume to the results obtained in-vivo on (MRI) and by histological analysis. 3 iso-damage temperatures were considered: 43 degrees C, 45 degrees C and 50 degrees C. RESULTS: The mean volume of the tissue necrosis, estimated from the histological analyses was 0.974cc and 0.980 cc on the 48h MR images. For the simulation model, volumes were: 1.38 cc when T=43 degrees C, 1.10 cc for T=45 degrees C and 0.99 cc when T=50 degrees C. CONCLUSIONS: In this study, a clear correlation was established between simulation and in-vivo experiments of FLA for prostate cancer. Simulation is a promising planning technique for this therapy. It needs further more evaluation to allow to FLA to become a widely applied surgical method.
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Submitted on : Thursday, June 16, 2011 - 8:03:58 PM
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Mohamad-Feras Marqa, Pierre Colin, Pierre Nevoux, Serge Mordon, Nacim Betrouni. Focal Laser Ablation of Prostate Cancer: Numerical Simulation of Temperature and Damage Distribution.. BioMedical Engineering OnLine, BioMed Central, 2011, 10 (1), pp.45. ⟨10.1186/1475-925X-10-45⟩. ⟨inserm-00601150⟩



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