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TECHNICAL PAPERS: Fluids/Heat/Transport

Numerical Simulation of a BPH Thermal Therapy—A Case Study Involving TUMT

[+] Author and Article Information
John P. Abraham1

School of Engineering, University of St. Thomas, St. Paul, MN 55105-1079; and  Laboratory for Heat Transfer and Fluid Flow Practice, St. Paul, MN 55108-1314jpabraham@stthomas.edu

Ephraim M. Sparrow

Mechanical Engineering Department, University of Minnesota, Minneapolis, MN 55455-0111; and  Laboratory for Heat Transfer and Fluid Flow Practice, St. Paul, MN 55108-1314

Satish Ramadhyani

 Laboratory for Heat Transfer and Fluid Flow Practice, St. Paul, MN 55108-1314

1

Corresponding author.

J Biomech Eng 129(4), 548-557 (Dec 06, 2006) (10 pages) doi:10.1115/1.2746377 History: Received January 14, 2006; Revised December 06, 2006

The use of numerical simulation as a means to predict the outcome of transurethral microwave thermotherapy (TUMT) is set forth in detail. The simulation was carried out as a case study of a specific TUMT procedure. The selection of the case study was based on the availability of extensive medical records which documented an extraordinary application of TUMT. Predictions were made of the time-varying temperature patterns within the prostate, the bladder, the sphincter, the pelvic floor, and the fat and connective tissue which envelop these organs. These temperature patterns provided the basis of maps which highlighted those locations where necrosis occurred. An injury integral was used to predict the extent of the necrotic tissue produced by the therapy. It was found that, for the specific case being considered, necrosis occurred not only within the prostate but also extended to the neck of the bladder and to the fatty tissue. A special feature of the simulation was the accounting of the liquid-to-vapor phase change of the interstitial water. The vapor generated by the phase change is believed to significantly enlarge the region of necrosis. By the same token, the vapor pressure is expected to cause motion of the high-temperature liquid to deep-tissue regions. The damage predicted by the numerical simulation was compared, in detail, with post-operative medical examinations and found to be corroborated.

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Copyright © 2007 by American Society of Mechanical Engineers
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Figures

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Figure 6

(a) Temperature distributions at 2400s in the prostate and adjacent anatomical structures. At left, the lateral view; at right, the anterior-posterior view. (b) Temperature distributions at 3500s in the prostate and adjacent anatomical structures. At left, the lateral view; at right, the anterior-posterior view. (c) Temperature distributions at 4800s in the prostate and adjacent anatomical structures. At left, the lateral view; at right, the anterior-posterior view. (d) Temperature distributions at 6700s in the prostate and adjacent anatomical structures. At left, the lateral view; at right, the anterior-posterior view.

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Figure 5

Comparison of measured and predicted catheter temperatures used for the determination of blood perfusion rate

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Figure 4

Schematic diagrams of the solution spaces: (a) lateral view; and (b) anterior-posterior view

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Figure 3

Microwave power levels used during the TUMT therapy

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Figure 2

Illustration of catheter and locating balloon inserted through the urethra and into the bladder cavity (courtesy of Robert J. Cornell, MD, Houston, TX)

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Figure 1

Diagram of the microwave delivery catheter passing through prostate tissue; the coolant flow is intended to spare the urethral mucosa from the microwave heating

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