基于动态光热作用模型的激光诱导肿瘤间质热疗中的参数选择

建立了描述温控加热方式下激光诱导肿瘤间质热疗过程中动态光热作用的二维圆柱坐标下的数学模型,采用基于网格的蒙特卡罗方法数值模拟热疗过程中激光能量在非均质生物组织内的传输过程,基于Pennes生物传热方程和Arrhen ius方程数值求解组织内的温度场和热损伤体积的变化。通过数值模拟的方法分析了激光波长、激光功率、温控范围等因素对激光诱导肿瘤间质热疗中热损伤体积的影响。数值模拟的结果表明,通过选择合适的治疗参数,可以得到各种不同大小的热疗区域。本文的结果和结论对于临床治疗方案的制定具有一定的理论指导意义。     

Histological evidence for the role of mechanical stress in modulating thermal denaturation of collagen

The hyperthermia and thermal denaturation literatures reveal a time-temperature equivalency when heating cells or connective tissues: thermal damage increases with increasing temperature (for the same duration) and increases with increasing duration (for the same temperature). Recent findings conversely suggest that increasing the mechanical loading on a tissue during heating decreases the thermal damage (for a given temperature and duration of heating). Surprisingly, however, there are few histological correlates of such damage. In this paper, we show that progressive light microscopic changes – swelling of collagen bands, thickening of collagen-rich layers, hyalinization, and loss of birefringence~– correlate very well with both increased heating times and decreased mechanical loading. Increased mechanical stress is thus thermally protective and should be considered in the design of clinical procedures that use heating to treat diseases or injuries. P. B. Wells and S. Thomsen contributed equally to this work.     

Alterations in tear biochemistry associated with postanesthetic chronic dry eye syndrome

Perioperative dry eye syndrome (DES) is a common ocular complication of long-term general anesthesia. Chronic DES can lead to permanent damage to the cornea and disturbance of visual function, up to total loss of vision. Here, a relationship between the duration of general anesthesia and the risk of chronic DES in patients was demonstrated. Using an experimental model of perioperative corneal abrasions in rabbits, it was found that introduction of animals to 3-h general anesthesia resulted in clinically significant chronic damage to the cornea in 50% of cases. The development of the complication was not associated with irreversible or long-term impairment of tear secretion, but it was accompanied by a decrease in tear film stability and growth of the total protein content as well as decrease in total antioxidant activity of the tear induced by low molecular weight antioxidants. In addition, anesthesia-induced changes in activity of tear antioxidant enzymes including superoxide dismutase and enzymes providing homeostasis of reduced glutathione (glutathione peroxidase, glutathione-S-transferase, glutathione reductase) were observed. All these alterations were protracted (up to 1-2 weeks) and therefore might account for transition of the perioperative DES into the chronic form. These findings can be useful in the development of novel approaches for the prevention and treatment of chronic forms of DES in the postanesthetic period.     

Theoretical analysis of thermal damage in biological tissues caused by laser irradiation

A bioheat transfer approach is proposed to study thermal damage in biological tissues caused by laser radiation. The laser light propagation in the tissue is first solved by using a robust seven-flux model in cylindrical coordinate system. The resulting spatial distribution of the absorbed laser energy is incorporated into the bioheat transfer equation for solving temperature response. Thermal damage to the tissue is assessed by the extent of denatured protein using a rate process equation. It is found that for the tissue studied, a significant protein denaturation process would take place when temperature exceeds about 53 degrees C. The effects of laser power, exposure time and beam size as well as the tissue absorption and scattering coefficients on the thermal damage process are examined and discussed. The laser conditions that cause irreversible damage to the tissue are also identified.     

A numerical model for temperature distribution and thermal damage calculations in teeth exposed to a CO2 laser

A numerical axisymmetrical model which may be used for the evaluation of laser dental treatments is presented. This model facilitates the calculations of the temperature distribution and of thermal damage to pulp tissue caused by CO₂ laser irradiation. Temperature distributions are compared with analytical, experimental, and numerical results presented in the literature. The conformity obtained is good. It is shown that this model can be used over a wider range of time intervals and physical conditions than a previous numerical model. In addition, thermal damage is calculated for the temperature distributions presented in this paper. This model can be utilized for the optimization of exposure parameters to minimize pulp damage in the application of lasers for dental treatment.     

A study on thermal damage during hyperthermia treatment based on DPL model for multilayer tissues using finite element Legendre wavelet Galerkin approach

Hyperthermia is a process that uses heat from the spatial heat source to kill cancerous cells without damaging the surrounding healthy tissues. Efficacy of hyperthermia technique is related to achieve temperature at the infected cells during the treatment process. A mathematical model on heat transfer in multilayer tissues in finite domain is proposed to predict the control temperature profile at hyperthermia position. The treatment technique uses dual-phase-lag model of heat transfer in multilayer tissues with modified Gaussian distribution heat source subjected to the most generalized boundary condition and interface at the adjacent layers. The complete dual-phase-lag model of bioheat transfer is solved using finite element Legendre wavelet Galerkin approach. The present solution has been verified with exact solution in a specific case and provides a good accuracy. The effect of the variability of different parameters such as lagging times, external heat source, metabolic heat source and the most generalized boundary condition on temperature profile in multilayer tissues is analyzed and also discussed the effective approach of hyperthermia treatment. Furthermore, we studied the modified thermal damage model with regeneration of healthy tissues as well. For viewpoint of thermal damage, the least thermal damage has been observed in boundary condition of second kind. The article concludes with a discussion of better opportunities for future clinical application of hyperthermia treatment.     

Experimental validation of an inverse heat transfer algorithm for optimizing hyperthermia treatments

Hyperthermia is a cancer treatment modality in which body tissue is exposed to elevated temperatures to destroy cancerous cells. Hyperthermia treatment planning refers to the use of computational models to optimize the heating protocol with the goal of isolating thermal damage to predetermined treatment areas. This paper presents an algorithm to optimize a hyperthermia treatment protocol using the conjugate gradient method with the adjoint problem. The output of the minimization algorithm is a heating protocol that will cause a desired amount of thermal damage. The transient temperature distribution in a cylindrical region is simulated using the bioheat transfer equation. Temperature and time are integrated to calculate the extent of thermal damage in the region via a first-order rate process based on the Arrhenius equation. Several validation experiments are carried out by applying the results of the minimization algorithm to an albumen tissue phantom. Comparisons of metrics describing the damage region (the height and radius of the volume of thermally ablated phantom) show good agreement between the desired extent of damage and the measured extent of damage. The sensitivity of the bioheat transfer model and the Arrhenius damage model to their constituent parameters is calculated to create a tolerable range of error between the desired and measured extent of damage. The measured height and radius of the ablated region fit well within the tolerable range of error found in the sensitivity analysis.     

Nano-assisted radiofrequency ablation of clinically extracted irregularly-shaped liver tumors

Radiofrequency ablation (RFA) for liver tumors is a minimally invasive procedure that uses electrical energy and heat to destroy cancer cells. One of the critical factors that impedes its successful outcome is the use of inappropriate radiofrequency levels that will not completely destroy the target tumor tissues, resulting in therapy failure. Additionally, the surrounding healthy tissues may suffer from serious damage due to excessive ablation. To address these challenges, this work proposes the employment of injected nanoparticles to thermally promote the ablation efficacy of conventional RFA. A three-dimensional finite difference analysis is employed to simulate the RFA treatment. Based on the data acquired from measured experiments, the simulation results have demonstrated close agreement with experimental data with a maximum discrepancy of within ±8.7%. Several types of nanoparticles were selected to evaluate their influences on liver tissue's thermal and electrical properties. We analysed the effects of nanoparticles on liver RFA via a tumor rending process incorporating several clinically-extracted tumor profiles and vascular systems. Simulations were conducted to explore the temperature difference responses between conventional RFA treatment and one with the inclusion of assisted nanoparticles on several irregularly-shaped tumors. Results have indicated that applying selected nanoparticles with high thermal conductivity and electrical conductivity on the targeted tissue zone promotes heating rate while sustaining a similar ablation zone that experiences lower maximum temperature when compared with the conventional RFA treatment. In sum, incorporating thermally-enhancing nanoparticles promotes heat transfer during the RFA treatment, resulting in improved ablation efficiency.     

Numerical investigation of thermal response of laser-irradiated biological tissue phantoms embedded with gold nanoshells

The work presented in this paper focuses on numerically investigating the thermal response of gold nanoshells-embedded biological tissue phantoms with potential applications into photo-thermal therapy wherein the interest is in destroying the cancerous cells with minimum damage to the surrounding healthy cells. The tissue phantom has been irradiated with a pico-second laser. Radiative transfer equation (RTE) has been employed to model the light-tissue interaction using discrete ordinate method (DOM). For determining the temperature distribution inside the tissue phantom, the RTE has been solved in combination with a generalized non-Fourier heat conduction model namely the dual phase lag bio-heat transfer model. The numerical code comprising the coupled RTE-bio-heat transfer equation, developed as a part of the current work, has been benchmarked against the experimental as well as the numerical results available in the literature. It has been demonstrated that the temperature of the optical inhomogeneity inside the biological tissue phantom embedded with gold nanoshells is relatively higher than that of the baseline case (no nanoshells) for the same laser power and operation time. The study clearly underlines the impact of nanoshell concentration and its size on the thermal response of the biological tissue sample. The comparative study concerned with the size and concentration of nanoshells showed that 60 nm nanoshells with concentration of 5×10¹⁵ mm⁻³ result into the temperature levels that are optimum for the irreversible destruction of cancer infected cells in the context of photo-thermal therapy. To the best of the knowledge of the authors, the present study is one of the first attempts to quantify the influence of gold nanoshells on the temperature distributions inside the biological tissue phantoms upon laser irradiation using the dual phase lag heat conduction model.     

The Next Generation in Laser Treatments and the Role of the GreenLight High-Performance System Laser

Lasers have evolved over the past decade, with technical refinements that have resulted in a procedure that can achieve transurethral-like results in a safe and efficacious manner. The physics and characteristics of the laser light, such as wavelength and power densities, influence efficiency of treatment and safety profiles of various laser techniques and systems. The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate gland in men with lower urinary tract symptoms and benign prostatic hyperplasia has been shown to be a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Refinements based on clinical experience as well as progress in available technologies have produced an advanced system with improvements in beam quality and an increase in power to provide an increase in vaporization efficiency and flexibility in technique. The refinements require adjustments to current technique. The advanced technological developments enhance the utility of this laser for application in benign prostatic hyperplasia and urology.     

A parametric study of thermal therapy of skin tissue

A thermal therapy for cancer in skin tissue is numerically investigated using three bioheat conduction models, namely Pennes, thermal wave and dual-phase lag models. A laser is applied at the surface of the skin for cancer ablation, and the temperature and thermal damage distributions are predicted using the three bioheat models and two different modeling approaches of the laser effect. The first one is a prescribed surface heat flux, in which the tissue is assumed to be highly absorbent, while the second approach is a volumetric heat source, which is reasonable if the scattering and absorption skin effects are of similar magnitude. The finite volume method is applied to solve the governing bioheat equation. A parametric study is carried out to ascertain the effects of the thermophysical properties of the cancer on the thermal damage. The temperature distributions predicted by the three models exhibit significant differences, even though the temperature distributions are similar when the laser is turned off. The type of bioheat model has more influence on the predicted thermal damage than the type of modeling approach used for the laser. The phase lags of heat flux and temperature gradient have an important influence on the results, as well as the thermal conductivity of the cancer. In contrast, the uncertainty in the specific heat and blood perfusion rate has a minor influence on the thermal damage.     

The spectrum of cytokeratins expressed in the adult human cornea, limbus and perilimbal conjunctiva

The aim of this study was to detect a spectrum of cytokeratins (CK) present in the adult human cornea, limbus and perilimbal conjunctiva. Cryosections from seven corneo-scleral discs were fixed, and indirect immunofluorescent staining was performed using antibodies directed against CK1-CK10 and CK13-CK20. The percentage of positive cells was calculated in the epithelium of the cornea, limbus and perilimbal conjunctiva. Quantitative real time RT-PCR (qRT-PCR) was used to detect CK6 and CK18 expression in the corneal and conjunctival epithelium. The most intense staining present throughout the cornea was observed for CK3, CK5 and CK14; CK19 was found at the corneal periphery only. CK4 and CK10/13 revealed mild to moderate positivity mostly in the superficial layers of the cornea. The suprabasal cell layers of all examined areas showed a strong positivity for CK16. A heterogeneous staining pattern with a centrifugal decrease in the signal was observed for CK8 and CK18. CK5/6, CK14 and CK19 were present in the limbus, where a positive signal for CK3 was observed in the suprabasal and superficial cells only. In contrast to the cornea, CK15 appeared in the basal and suprabasal layers of the limbus. The perilimbal conjunctiva showed strong immunostaining for CK10/13, CK14 and CK19. A moderate signal for CK7 was detected in the superficial layers of the conjunctiva. qRT-PCR confirmed CK6 and CK18 expression in the corneal and conjunctival epithelium. The detailed characterization of the corneal, limbal and perilimbal conjunctival epithelium under normal circumstances may be useful for characterizing the changes occurring under pathological conditions.     

A two-state cell damage model under hyperthermic conditions: theory and in vitro experiments

The ultimate goal of cancer treatment utilizing thermotherapy is to eradicate tumors and minimize damage to surrounding host tissues. To achieve this goal, it is important to develop an accurate cell damage model to characterize the population of cell death under various thermal conditions. The traditional Arrhenius model is often used to characterize the damaged cell population under the assumption that the rate of cell damage is proportional to exp(-EaRT), where Ea is the activation energy, R is the universal gas constant, and T is the absolute temperature. However, this model is unable to capture transition phenomena over the entire hyperthermia and ablation temperature range, particularly during the initial stage of heating. Inspired by classical statistical thermodynamic principles, we propose a general two-state model to characterize the entire cell population with two distinct and measurable subpopulations of cells, in which each cell is in one of the two microstates, viable (live) and damaged (dead), respectively. The resulting cell viability can be expressed as C(tau,T)=exp(-Phi(tau,T)kT)(1+exp(-Phi(tau,T)kT)), where k is a constant. The in vitro cell viability experiments revealed that the function Phi(tau,T) can be defined as a function that is linear in exposure time tau when the temperature T is fixed, and linear as well in terms of the reciprocal of temperature T when the variable tau is held as constant. To determine parameters in the function Phi(tau,T), we use in vitro cell viability data from the experiments conducted with human prostate cancerous (PC3) and normal (RWPE-1) cells exposed to thermotherapeutic protocols to correlate with the proposed cell damage model. Very good agreement between experimental data and the derived damage model is obtained. In addition, the new two-state model has the advantage that is less sensitive and more robust due to its well behaved model parameters.     

Modeling the thermal responses of the skin surface during hand-object interactions

The objective of this research is to analyze and model the decreases in skin temperature when the hand makes contact with an object at room temperature so that thermal feedback can be incorporated into haptic displays. A thermal model is proposed that predicts the thermal responses of the skin and object surface as well as the heat flux exchanged during hand-object interactions. The model was evaluated by comparing the theoretical predictions of temperature changes to those experimentally measured using an infrared thermal measurement system. The thermal measurement system was designed to overcome the limitations imposed by contact thermal sensors, and was able to measure skin temperature during contact, together with the contact area and contact force. The experimental results indicated that over the pressure range of 0.73-10.98 kPa, changes in skin temperature were well localized to the contact area and were affected by contact pressure. The pressure in turn influenced both thermal contact resistance and blood flow. Over the range of contact forces typically used in manual exploration, blood perfusion and metabolic heat generation do not appear to have a significant effect on the skin's thermal responses. The theoretical predictions and the measured data were consistent in characterizing the time course and amplitude of the skin temperature change during contact with differences typically being less than 1 degrees C between the two for pressures greater than 4 kPa. These findings indicate that the proposed thermal model is able to characterize and predict the skin temperature responses during hand-object interactions and could be used in a thermal display that simulates the properties of different materials.     

Thermal responses to 5.6-GHz radiofrequency radiation in anesthetized rats: effect of chlorpromazine

Anesthetized rats were exposed to 5.6-GHz continuous wave radiofrequency radiation at an average power density of 60 mW/cm2 (average specific absorption rate 12 W/kg). Exposure was performed to raise colonic temperature from 38.5 to 39.5 degrees C. Following acute administration of chlorpromazine, body temperature exhibited a faster return to baseline temperature when exposure was discontinued. When exposure was initiated at 38.5 degrees C and continued until lethal temperatures resulted, chlorpromazine-treated animals exhibited significantly shorter survival times than saline-treated animals. Thus, although chlorpromazine enhanced thermo-regulatory efficiency at colonic temperatures below 39.5 degrees C, the drug caused increased susceptibility to terminal radiofrequency radiation exposure. The present results, when compared to previous studies of irradiation at 2.8 GHz, indicate that the effects of chlorpromazine on thermal responses to RFR during intermittent and terminal exposure are similar at both 2.8 and 5.6 GHz.     

A new model of thermal inactivation and its application to clonogenic survival data for WiDr human colonic adenocarcinoma cells

Based on the analysis of clonogenic survival data for human colonic adenocarcinoma cells (WiDr) after a single heating, a new model is proposed to describe cell survival after hyperthermia quantitatively. The effects of heat are explained as heat-induced cell damage assuming a first-order (single-hit) and a second-order (cumulative damage) process. Thus cell survival at a specified temperature can be described by the linear-quadratic (LQ) model. The proposed model is based on an alternative definition of the (single) thermal dose, given as the (normalized) product of heating time and a specified nonlinear function of the increase in temperature (relative to a threshold temperature) to be interpreted as the thermal dose rate. In further analogy to the modeling of the effects of low-dose-rate radiation, an inherent capacity of the cells to repair sublethal damage is assumed, and these effects are quantified by the usual g factor measuring incomplete repair effects. The model defines thermal dose-response and isoeffect dose relationships, enabling a direct (i. e. single-step) analysis of the available thermal response data. Additionally, the analysis of our data based on heating times in the range from 0 to 360 min and temperatures from 41 to 46 degrees C and covering a broad spectrum of different densities of cells seeded for colony formation did not yield any evidence of the existence of a breaking point usually derived from Arrhenius plots based on the single-hit, multitarget model and the Arrhenius equation. The model includes no specific assumptions describing the development of thermotolerance, which can be assumed to be negligible under our experimental conditions. The proposed thermal dose-response model correlates satisfactorily with the in vitro survival data for WiDr adenocarcinoma cells.     

Studying the thermal effects of a clinically-extracted vascular tissue during cryo-freezing

Cryosurgery is known to be a suitable treatment for unresectable tumors by employing extremely low temperature to induce cryo-lesion. However, large blood vessels in the tissue may induce insufficient freezing at the targeted area. In this work, we have developed a cryo-freezing model specifically dedicated to tumors with a complex blood vessel network taken from CT-scanned images. The model was validated with in-vitro experimental data. Adopting an appropriate mesh size, the simulated results achieved an excellent agreement with the experimental data at a maximum error of 3.4%. The validated model was applied to study an optimal cryotherapy in the treatment of a human liver. The movement of 265 K isotherm and the thermal influence of blood flow were investigated. Key results indicated that large neighboring vessels could significantly influence the shape of the ice fronts, but they exerted less impact on the development of the lethal temperature boundary. The freezing duration, distance to the vessel, blood flow rate and blood vessel size were observed to be key parameters in determining the optimal cryoablation. A case study further demonstrated that by precisely controlling the cryo-freezing process, up to 44.6% of the unintended tissue freezing could be achieved. Pragmatically, this work provides surgeons with essential information on how to precisely tune key parameters to promote greater surgical success.     

Straw Mulching Reduces the Harmful Effects of Extreme Hydrological and Temperature Conditions in Citrus Orchards

Extreme weather conditions with negative impacts can strongly affect agricultural production. In the Danjiangkou reservoir area, citrus yields were greatly influenced by cold weather conditions and drought stress in 2011. Soil straw mulching (SM) practices have a major effect on soil water and thermal regimes. A two-year field experiment was conducted to evaluate whether the SM practices can help achieve favorable citrus fruit yields. Results showed that the annual total runoff was significantly (P<0.05) reduced with SM as compared to the control (CK). Correspondingly, mean soil water storage in the top 100 cm of the soil profile was increased in the SM as compared to the CK treatment. However, this result was significant only in the dry season (Jan to Mar), and not in the wet season (Jul to Sep) for both years. Interestingly, the SM treatment did not significantly increase citrus fruit yield in 2010 but did so in 2011, when the citrus crop was completely destroyed (zero fruit yield) in the CK treatment plot due to extremely low temperatures during the citrus overwintering stage. The mulch probably acted as an insulator, resulting in smaller fluctuations in soil temperature in the SM than in the CK treatment. The results suggested that the small effects on soil water and temperature changes created by surface mulch had limited impact on citrus fruit yield in a normal year (e.g., in 2010). However, SM practices can positively impact citrus fruit yield in extreme weather conditions.     

Predicting effects of blood flow rate and size of vessels in a vasculature on hyperthermia treatments using computer simulation

Background

Pennes Bio Heat Transfer Equation (PBHTE) has been widely used to approximate the overall temperature distribution in tissue using a perfusion parameter term in the equation during hyperthermia treatment. In the similar modeling, effective thermal conductivity (K_eff) model uses thermal conductivity as a parameter to predict temperatures. However the equations do not describe the thermal contribution of blood vessels. A countercurrent vascular network model which represents a more fundamental approach to modeling temperatures in tissue than do the generally used approximate equations such as the Pennes BHTE or effective thermal conductivity equations was presented in 1996. This type of model is capable of calculating the blood temperature in vessels and describing a vasculature in the tissue regions.

Methods

In this paper, a countercurrent blood vessel network (CBVN) model for calculating tissue temperatures has been developed for studying hyperthermia cancer treatment. We use a systematic approach to reveal the impact of a vasculature of blood vessels against a single vessel which most studies have presented. A vasculature illustrates branching vessels at the periphery of the tumor volume. The general trends present in this vascular model are similar to those shown for physiological systems in Green and Whitmore. The 3-D temperature distributions are obtained by solving the conduction equation in the tissue and the convective energy equation with specified Nusselt number in the vessels.

Results

This paper investigates effects of size of blood vessels in the CBVN model on total absorbed power in the treated region and blood flow rates (or perfusion rate) in the CBVN on temperature distributions during hyperthermia cancer treatment. Also, the same optimized power distribution during hyperthermia treatment is used to illustrate the differences between PBHTE and CBVN models. K_eff (effective thermal conductivity model) delivers the same difference as compared to the CBVN model. The optimization used here is adjusting power based on the local temperature in the treated region in an attempt to reach the ideal therapeutic temperature of 43°C. The scheme can be used (or adapted) in a non-invasive power supply application such as high-intensity focused ultrasound (HIFU). Results show that, for low perfusion rates in CBVN model vessels, impacts on tissue temperature becomes insignificant. Uniform temperature in the treated region is obtained.

Conclusion

Therefore, any method that could decrease or prevent blood flow rates into the tumorous region is recommended as a pre-process to hyperthermia cancer treatment. Second, the size of vessels in vasculatures does not significantly affect on total power consumption during hyperthermia therapy when the total blood flow rate is constant. It is about 0.8% decreasing in total optimized absorbed power in the heated region as γ (the ratio of diameters of successive vessel generations) increases from 0.6 to 0.7, or from 0.7 to 0.8, or from 0.8 to 0.9. Last, in hyperthermia treatments, when the heated region consists of thermally significant vessels, much of absorbed power is required to heat the region and (provided that finer spatial power deposition exists) to heat vessels which could lead to higher blood temperatures than tissue temperatures when modeled them using PBHTE.