Simulation study on the heating of the surrounding anatomy during transurethral ultrasound prostate therapy: a 3D theoretical analysis of patient safety

Medical Physics
Mathieu BurtnykMichael Bronskill

Abstract

MRI-guided transurethral ultrasound therapy can generate highly accurate volumes of thermal coagulation conforming to 3D human prostate geometries. This work simulated, quantified, and evaluated the thermal impact of these treatments on the rectum, pelvic bone, neurovascular bundles (NVBs), and urinary sphincters because damage to these structures can lead to complications. Twenty 3D anatomical models of prostate cancer patients were used with detailed bioacoustic simulations incorporating an active feedback algorithm which controlled a rotating, planar ultrasound transducer (17, 4 x 3 mm2 elements, 10 W(acoustic)/cm2). Heating of the adjacent surrounding anatomy was evaluated at 4.7, 9.7, and 14.2 MHz using thermal tolerances reported in literature. Heating of the rectum posed the most important safety concern, influenced largely by the water temperature of an endorectal cooling device (ECD); depending on anatomy, temperatures of 7-37 degrees C were required to limit potential damage to less than 10 mm3 on the outer 1 mm layer of the rectal wall. Heating of the pelvic bone could be important at 4.7 MHz. A smaller sized ECD or a higher ultrasound frequency in sectors where the bone was less than 10 mm from the prostate reduced ...Continue Reading

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