以多探針進行前列腺癌冷凍手術之最佳化排列的數值模擬

冷凍手術已經成功的應用於前列腺癌、腎腫瘤、和肺癌等。做冷凍手術時，醫生必須把冷凍探針插入組織的最佳位置，因為前列腺的腫瘤較大，所以必需同時使用多探針進行冷凍手術，並用超音波、CT或MRI來監測因為低溫所形成冰球的大小，冰球體積要大於腫瘤體積才會使靶區的冷凍傷害達到最大，同時對周圍健康組織或血管的冷凍傷害降到最小。因此在本研究中使用數值方法模擬前列腺癌的冷凍手術治療，使用生物熱傳方程式去預測溫度分佈，並提出一個最佳化方法去找出最理想的冷凍探針位置。研究範圍適用於平面的分析，結合生物熱傳方程式和數值最佳化技術之後，會找出不同的2-D幾何外型的冷凍探針最理想的位置。相變化發生的溫度範圍及溶化的潛熱，也結合在這生物熱傳方程式中。另外，此研究將提供-20℃的等溫線給真實冷凍手術參考，此等溫線將組織的區域劃分成靶區和周圍健康組織。此研究是希望能完全的凍結和破壞病變細胞，且同時對健康細胞的傷害降到最小，以供實際冷凍手術時的參考。

關鍵字

前列線；癌症；生物熱傳方程式；冷凍手術

並列摘要

Cryosurgery has been found in several areas of application, including treatment of cancerous prostate growth, kidney cancer, and lung cancer etc. Because the size of the prostate tumor is usually greater than the diameter of cryoprobe, it must use multiprobe to perform a cryosurgery at the same time. The doctor uses ultrasound, CT, or MRI to guide the cryoprobe and monitor the size of the ice ball. The present study is to exactly split the target region and the surrounding healthy tissue in the detective area. Also, the target region can be maintained below -20 ℃.Hence, in this research, an optimization method is introduced to find the optimal location of multi-cryoprobes, while a bioheat transfer simulation is used to predict the temperature distribution that would result from the current configuration of the cryoprobes during iteration. The 2-D numerical method combine optimization techniques with bioheat transfer simulation will be used to determine the best location of cryoprobes. After combining bioheat transfer simulation with numerical optimization technique in this research, the optimal location of cryoprobes will be found on different 2-D geometries. The latent heat of fusion should be incorporated into bioheat transfer model during the occurrence of the phase change in tissue. In addition, the -20 ℃ isotherm has been distinguished in the present study to supply for the reference of a real cryosurgery. It is believed that the results from this research can supply valuable data to the clinician for the reference of a real cryosurgery in the future.

並列關鍵字

prostate ； tumor ； bioheat equation ； cryosurgeryr

參考文獻

1. J. Arnott, Practical Illustrations of the Remedial Efficacy of a Very Low or Anaesthetic Temperature, The Lancet, Vol. 2, pp. 257-259, 1850.

3. A. C. White, Possibilities of Liquid Air to the Physician, The Journal of the American Medical Association, Vol. 36, pp. 426-428, 1901.

4. I. S. Cooper, Cryogenic Surgery of the Basal Ganglia, The Journal of the American Medical Association, Vol. 181, pp. 600-604, 1962.

5. S. A. Zacarianb, D. Stoneb, and M. Claterb, Effects of Cryogenic Temperatures on Microcirculation in the Golden Hamster Cheek Pouch, Cryobiology, Vol. 7, pp. 27-39, 1970.

6. R. G. Keanini, B. Rubinsky, Optimization of Multiprobe Cryosurgery, ASME Journal of Heat Transfer, Vol. 114, pp. 796-802, 1992.

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以多探針進行前列腺癌冷凍手術之最佳化排列的數值模擬

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