Feasibility and relevance of discrete vasculature modeling in routine hyperthermia treatment planning

Kemal Sumser (Corresponding author), Esra Neufeld, René F. Verhaart, Valerio Fortunati, Gerda M. Verduijn, Tomas Drizdal, Theo van Walsum, Jifke F. Veenland, Margarethus M. Paulides

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Purpose: To investigate the effect of patient specific vessel cooling on head and neck hyperthermia treatment planning (HTP). Methods and materials: Twelve patients undergoing radiotherapy were scanned using computed tomography (CT), magnetic resonance imaging (MRI) and contrast enhanced MR angiography (CEMRA). 3D patient models were constructed using the CT and MRI data. The arterial vessel tree was constructed from the MRA images using the ‘graph-cut’ method, combining information from Frangi vesselness filtering and region growing, and the results were validated against manually placed markers in/outside the vessels. Patient specific HTP was performed and the change in thermal distribution prediction caused by arterial cooling was evaluated by adding discrete vasculature (DIVA) modeling to the Pennes bioheat equation (PBHE). Results: Inclusion of arterial cooling showed a relevant impact, i.e., DIVA modeling predicts a decreased treatment quality by on average 0.19 °C (T90), 0.32 °C (T50) and 0.35 °C (T20) that is robust against variations in the inflow blood rate (|ΔT| < 0.01 °C). In three cases, where the major vessels transverse target volume, notable drops (|ΔT| > 0.5 °C) were observed. Conclusion: Addition of patient-specific DIVA into the thermal modeling can significantly change predicted treatment quality. In cases where clinically detectable vessels pass the heated region, we advise to perform DIVA modeling.

Original languageEnglish
Pages (from-to)801-811
Number of pages11
JournalInternational Journal of Hyperthermia
Volume36
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • discrete vasculature
  • head and neck
  • Hyperthermia
  • hyperthermia treatment planning
  • thermal modelling

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