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首页> 外文会议>International Symposium on Therapeutic Ultrasound >Thermal Dosimetry Analysis Combined with Patient-specific Thermal Modeling of Clinical Interstitial Ultrasound Hyperthermia Integrated within HDR Brachytherapy for Treatment of Locally Advanced Prostate Cancer
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Thermal Dosimetry Analysis Combined with Patient-specific Thermal Modeling of Clinical Interstitial Ultrasound Hyperthermia Integrated within HDR Brachytherapy for Treatment of Locally Advanced Prostate Cancer

机译：热量剂量分析结合患者特异性热建模临床间质超热疗，整合在HDR近距离放射治疗中治疗局部晚期前列腺癌

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This study presents thermal dosimetry analysis from clinical treatments where ultrasound hyperthermia (HT) was administered following high-dose rate (HDR) brachytherapy treatment for locally advanced prostate cancer as part of a clinical pilot study. HT was administered using ultrasound applicators from within multiple 13-g brachytherapy catheters implanted along the posterior periphery of the prostate. The heating applicators were linear arrays of sectored tubular transducers (～7 MHz), with independently powered array elements enabling energy deposition with 3D spatial control. Typical heat treatments employed time-averaged peak acoustic intensities of 1 - 3 W/cm~2 and lasted for 60 - 70 minutes. Throughout the treatments, temperatures at multiple points were monitored using multi-junction thermocouples, placed within available brachytherapy catheters throughout mid-gland prostate and identified as the hyperthermia target volume (HTV). Clinical constraints allowed placement of 8 - 12 thermocouple sensors in the HTV and patient-specific 3D thermal modeling based on finite element methods (FEM) was used to supplement limited thermometry. Patient anatomy, heating device positions, orientations, and thermometry junction locations were obtained from patient CT scans and HDR and hyperthermia planning software. The numerical models utilized the applied power levels recorded during the treatments. Tissue properties such as perfusion and acoustic absorption were varied within physiological ranges such that squared-errors between measured and simulated temperatures were minimized. This data-fitting was utilized for 6 HT treatments to estimate volumetric temperature distributions achieved in the HTV and surrounding anatomy devoid of thermocouples. For these treatments, the measured and simulated T_(50) values in the hyperthermia target volume (HTV) were between 40.1 - 43.9°C and 40.3 - 44.9°C, respectively. Maximum temperatures between 46.8 - 49.8 °C were measured during these treatments and the corresponding range obtained from simulation was 47.3 - 51.1°C. Based on the simulations, the maximum temperatures in the bladder and the rectum were below 41.7°C and 41.1°C, respectively.
机译：从临床治疗本研究提出的热放射量测定分析，其中超声热疗（HT）施用以下高剂量率（HDR）近距离放射治疗治疗局部晚期前列腺癌的临床试验研究的一部分。 HT使用超声波涂敷器沿着前列腺的后部周缘的多个植入13-G短程治疗导管内施用。加热施用器是管状扇形换能器（〜7兆赫）的线性阵列，具有独立供电阵列元件使能量沉积与3D空间控制。典型的热处理采用1的时间平均峰值声强度 - 3瓦/平方厘米〜2，历时60 - 70分钟。在整个处理中，温度在多个点处使用多结热电偶监控置于可用短程治疗导管内整个前列腺中期腺和鉴定为热疗目标体积（HTV）。临床约束所允许的放置8 - 在HTV和基于有限元方法（FEM）患者特异性三维热建模12个热电偶传感器被用来补充限制测温。患者解剖，加热装置的位置，方向和测温结的位置从病人CT扫描和HDR和热疗计划软件获得。所述数值模型所使用的处理过程中记录的应用的功率电平。组织性质如灌注和吸音物生理范围，使得最小化被测量和模拟的温度之间的平方-误差范围内变化。这个数据拟合用于6个HT处理，以估计在HTV实现体积的温度分布和周围解剖结构没有热电偶。分别44.9℃， - 43.9℃，40.3 - 对于这些处理，所测量的和模拟的T_（50）在高温目标体积值（HTV）40.1之间者。 46.8之间的最大温度 - Visual C 49.8°在这些处理期间进行测量和从模拟获得的对应的范围为47.3 - 51.1℃。基于该模拟中，最高温度在膀胱和直肠低于，41.7℃，41.1℃，分别。

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