Simulations of thermal tissue coagulation and their value for the planning and monitoring of laser-induced interstitial thermotherapy (LITT).

Abstract

MRI information is widely used for the monitoring of thermal therapies, such as laser-induced interstitial thermotherapy (LITT). However, a detailed knowledge about the relationship between time/temperature exposure and resulting tissue thermal damage is needed to estimate the lesion extent. The aims of this work were to model the thermal response of laser-irradiated tissue and to assess the value of Monte Carlo simulation (MCS) for tumor therapy planning and monitoring. MCS yielded true 3D distributions of laser-induced temperature and thermal damage. These results were compared with 2D MR thermometry data from in vitro experiments performed on animal liver tissue over an ordinary range of laser powers (10-25 W) and irradiation times (5-25 min). Clinical reference data were available from MR-guided liver LITT procedures. MCS correctly predicted the shape of temperature and damage distributions. The quantitative agreement between simulated and measured lesion diameters was within 10% and 15% for the in vitro and in vivo cases, respectively. The simulated 53 degrees C isotherm best estimated the boundary of the final thermal damage (6% variance). This study shows that MCS of interstitial laser coagulation provides unique information that can be of use in the empirical correlation of temperature with thermal damage, and can assist greatly in thermal treatment planning and monitoring.