Abstract
The current study presents a computerized planning scheme for prostate cryosurgery using a variable insertion depth strategy. This study is a part of an ongoing effort to develop computerized tools for cryosurgery. Based on typical clinical practices, previous automated planning schemes have required that all cryoprobes be aligned at a single insertion depth. The current study investigates the benefit of removing this constraint, in comparison with results based on uniform insertion depth planning as well as the so-called “pullback procedure”. Planning is based on the so-called “bubble-packing method”, and its quality is evaluated with bioheat transfer simulations. This study is based on five 3D prostate models, reconstructed from ultrasound imaging, and cryoprobe active length in the range of 15–35 mm. The variable insertion depth technique is found to consistently provide superior results when compared to the other placement methods. Furthermore, it is shown that both the optimal active length and the optimal number of cryoprobes vary among prostate models, based on the size and shape of the target region. Due to its low computational cost, the new scheme can be used to determine the optimal cryoprobe layout for a given prostate model in real time.
Highlights
Cryosurgery, which is the destruction of undesired biological tissues by freezing, has been known as an invasive surgical technique since 1961, when Cooper and Lee invented the first modern, liquid nitrogen-based cryoprobe [4]
The advantages of variable insertion depth placement are discussed first in comparison with prior bubble-packing-based planning schemes; this comparison is performed on the largest reconstructed prostate model
The discussion is shifted to the unique characteristics of variable insertion depth planning, based on five prostate models
Summary
Cryosurgery, which is the destruction of undesired biological tissues by freezing, has been known as an invasive surgical technique since 1961, when Cooper and Lee invented the first modern, liquid nitrogen-based cryoprobe [4]. The pullback procedure is aimed at improving the match between the area to be treated and the developing frozen region, but again, cryoprobes cannot be further relocated once freezing begins. Computerized planning can help to alleviate these difficulties by identifying an optimal cryoprobe layout and providing close to real-time prediction of the resulting thermal field, with the match between the target region and the frozen region being one measure of the quality of planning. It is the development of planning strategies to identify the optimal cryoprobe layout which is the subject matter of the current paper
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