Towards intra‐operative computerized planning of prostate cryosurgery

Tanaka, Daigo; Shimada, Kenji; Rossi, Michael R.; Rabin, Yoed

doi:10.1002/rcs.124

Cited by 21 publications

(39 citation statements)

References 19 publications

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“…Suboptimal cryoprobe localization may leave areas in the target region untreated, may lead to cryoinjury of healthy surrounding tissues, may require an unnecessarily large number of cryoprobes, may increase the duration of the surgical procedure, and may increase the likelihood of post cryosurgery complications, all of which affect the quality and cost of the medical treatment. Computerized planning tools would help to alleviate these difficulties, which is the subject matter of this ongoing research program at the Biothermal Technology Laboratory Rabin et al 2004;Rabin and Stahovich 2003;Rossi et al 2007;Tanaka et al 2006Tanaka et al , 2007.…”

Section: Introductionmentioning

confidence: 99%

Experimental verification of numerical simulations of cryosurgery with application to computerized planning

Rossi¹,

Rabin²

2007

Phys. Med. Biol.

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As a part of an ongoing effort to develop computerized planning tools for cryosurgery, an experimental study has been conducted to verify a recently developed numerical technique for bioheat transfer simulations. Experiments were performed on gelatin solution as a phantom material, using proprietary liquid-nitrogen cryoprobes. Urethral warming was simulated with the application of a cryoheater, which is a proprietary temperature-controlled electrical heater. The experimental design was aimed at creating a 2D heat-transfer problem. Analysis of experimental results was based on reconstruction of the frozen region from video recordings, using a region-growing segmentation algorithm. Results of this study show an average disagreement of 2.9% in the size of the frozen region, between experimental data and numerical simulation of the same experiment, which validates both the recently developed algorithm for numerical simulations and the newly developed algorithm for segmentation from video recordings.

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Section: Introductionmentioning

confidence: 99%

Experimental verification of numerical simulations of cryosurgery with application to computerized planning

Rossi¹,

Rabin²

2007

Phys. Med. Biol.

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“…Functional imaging such as the aforementioned 3DUS will be used to accurately localize the bulk of the prostatic cancer through biopsy 20 and assessment of radiological stage. [21][22][23] It will then be possible to use 3DUS to guide focal therapies such as prostate cryotherapy, [24][25][26] which will be aided by automated computerized planning 27,28 and techniques such as 3D bubble packing. 29 Furthermore, cryotechnology is likely to continue improving, with smaller needles leading to decreased morbidity.…”

Section: Dus-guided Prostate Cryotherapymentioning

confidence: 99%

Contemporary technique of intraoperative 3-dimensional ultrasonography–guided transperineal prostate cryotherapy

Chalasani

Gardi

Martínez

et al. 2013

CUAJ

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Successful cryotherapy of the prostate for neoplasms relies on imaging to achieve good oncological outcomes with minimal complications. Traditional prostatic cryotherapy relies on 2-dimensional ultrasonography (2DUS) guidance, which often makes it difficult to track the passage of needles in an oblique plane. We describe our initial 3-dimensional ultrasonography (3DUS) system, and the subsequent improvements that have been made during the last 10 years. Our imaging system uses a Philips HDI 5000 ultrasonography unit, a standard PC, a Matrox Meteor II video frame grabber and 3DUS developed at Robarts Research Institute. For the cryotherapy we use ultrathin (17-gauge) IceRod needles. After image acquisition, preplanning is performed using the 3-dimensional (3D) software, and then the IceRod needles are inserted into the prostate. As the freezing process commences, continuous 3DUS images are taken and analyzed during the double freeze-thaw cycles to monitor the progress of the ice ball formation. Real-time intraoperative 3D imaging of the prostate during cryotherapy has allowed us to accurately preplan and then monitor the progression of ice ball formation, which represents a significant advantage over conventional 2DUS. RésuméPour être efficace, la cryothérapie prostatique utilisée pour le traitement de tumeurs nécessite une technique d'imagerie en vue d'obtenir de bons résultats tout en minimisant les complications. La cryothérapie prostatique classique est guidée par échogra-phie transrectale en deux dimensions, avec laquelle il est souvent difficile de suivre le trajet des aiguilles sur un plan oblique. Nous décrivons ici notre système d'échographie en trois dimensions initial, et les améliorations ultérieures apportées au cours des 10 dernières années. Notre système d'imagerie comprend un appareil d'échographie Philips HDI 5000, un ordinateur standard, un saisisseur d'image Matrox Meteor II et un logiciel d'échogra-phie en trois dimensions élaboré au Robarts Research Institute; pour la cryothérapie, nous utilisons des aiguilles de calibre 17 de Galil Medical. Une fois l'imagerie en fonction, la planification est effectuée à l'aide du logiciel en 3D, puis les aiguilles de

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“…While the ratio of the volume below the planning isotherm to the volume of the frozen region is quite low at steady state (as also concluded in [3] for different cryoprobes), actual cryoprocedures are ordinarily terminated at the very early stage of the heat transfer process. In fact, several studies suggest that the number of cryoprobes should be increased in order to decrease the internal defect region, which can be concluded from the volume histograms in [7,9,11,12]; the termination of cryosurgery occurs earlier with the increasing number of cryoprobes. Without a target region and matching cryoprobe dimensions, termination of the freezing process remains hypothetical.…”

Section: Duration Of the Proceduresmentioning

confidence: 99%

“…the objective to provide results useful for understanding and designing the multi-cryoprobe procedure is commendable, critical evaluation of the Magalov et al [3] report must incorporate recent and relevant literature [4][5][6][7][8][9][10][11][12] not cited by these authors. (A few of the publications cited here were published only after [3] in archival journal, but are nonetheless relevant to the current discussion; those subjects have been widely presented in conferences in the past few years.)…”

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confidence: 99%

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

Rabin

2008

Cryobiology

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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

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Towards intra‐operative computerized planning of prostate cryosurgery

Abstract: Due to time constraints in a clinical setup, bubble packing alone may be considered adequate for computerized planning. Furthermore, only bubble packing is demonstrated to be adequate for intra-operative planning.

Cited by 21 publications

References 19 publications

Experimental verification of numerical simulations of cryosurgery with application to computerized planning

Experimental verification of numerical simulations of cryosurgery with application to computerized planning

Contemporary technique of intraoperative 3-dimensional ultrasonography–guided transperineal prostate cryotherapy

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

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