title: A finite element method model to simulate laser interstitial thermo therapy in anatomical inhomogeneous regions.
abstract: BACKGROUND
  Laser Interstitial ThermoTherapy (LITT) is a well established surgical method. The use of LITT is so far limited to homogeneous tissues, e.g. the liver. One of the reasons is the limited capability of existing treatment planning models to calculate accurately the damage zone. The treatment planning in inhomogeneous tissues, especially of regions near main vessels, poses still a challenge. In order to extend the application of LITT to a wider range of anatomical regions new simulation methods are needed. The model described with this article enables efficient simulation for predicting damaged tissue as a basis for a future laser-surgical planning system. Previously we described the dependency of the model on geometry. With the presented paper including two video files we focus on the methodological, physical and mathematical background of the model.
  
  
  METHODS
  In contrast to previous simulation attempts, our model is based on finite element method (FEM). We propose the use of LITT, in sensitive areas such as the neck region to treat tumours in lymph node with dimensions of 0.5 cm - 2 cm in diameter near the carotid artery. Our model is based on calculations describing the light distribution using the diffusion approximation of the transport theory; the temperature rise using the bioheat equation, including the effect of microperfusion in tissue to determine the extent of thermal damage; and the dependency of thermal and optical properties on the temperature and the injury. Injury is estimated using a damage integral. To check our model we performed a first in vitro experiment on porcine muscle tissue.
  
  
  RESULTS
  We performed the derivation of the geometry from 3D ultrasound data and show for this proposed geometry the energy distribution, the heat elevation, and the damage zone. Further on, we perform a comparison with the in-vitro experiment. The calculation shows an error of 5% in the x-axis parallel to the blood vessel.
  
  
  CONCLUSIONS
  The FEM technique proposed can overcome limitations of other methods and enables an efficient simulation for predicting the damage zone induced using LITT. Our calculations show clearly that major vessels would not be damaged. The area/volume of the damaged zone calculated from both simulation and in-vitro experiment fits well and the deviation is small. One of the main reasons for the deviation is the lack of accurate values of the tissue optical properties. In further experiments this needs to be validated.
authors.affiliation: Department of Medical Informatics, University of Goettingen, Robert-Koch-Str, 40, D-37075-Goettingen, Germany. yassene.mohammed@med.uni-goettingen.de
authors.forename: Yassene
authors.initials: Y
authors.lastname: Mohammed
authors.forename: Janko F
authors.initials: JF
authors.lastname: Verhey
mesh_terms: D000818:Animals; D016880:Anisotropy; D001831:Body Temperature / Q000502:physiology*; D003198:Computer Simulation; D006979:Hyperthermia, Induced / Q000379:methods*; D066298:In Vitro Techniques; D053685:Laser Therapy; D008954:Models, Biological; D018482:Muscle, Skeletal / Q000098:blood supply / Q000502:physiology* / Q000528:radiation effects*; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods; D013552:Swine; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013817:Thermography / Q000379:methods; D016896:Treatment Outcome