Simulation of Image-Guided Microwave Ablation Therapy Using a Digital Twin Computational Model

Abstract

Emerging computational tools such as healthcare digital twin modeling are enabling the creation of patient-specific surgical planning for interventional procedures, including microwave ablation to treat primary and secondary liver cancers. Healthcare digital twins (DTs) are anatomically one-to-one biophysical models constructed from structural, functional, and biomarker-based imaging data to accurately simulate patientspecific therapies and guide clinical decision-making. In microwave ablation (MWA), tissue-specific factors including tissue perfusion, hepatic steatosis, and fibrosis affect therapeutic extent, but current thermal dosing guidelines do not account for these parameters. This study establishes an MR imaging framework to construct digital twins to predict ablation delivery in livers with varying fat content in the presence of a tumor. Patient anatomic scans were segmented to develop customized three-dimensional computational biophysical digital twins. Fatquantification images were used as a surrogate to spatially enrich biophysical material properties within patient-specific models of MWA. Four microwave antenna placement strategies were considered, and simulated microwave ablations were then performed using 915 MHz and 2450 MHz antennae in <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Tumor Naïve DTs</i> (control), and <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Tumor Informed DTs</i> at five grades of steatosis. Across the range of fatty liver steatosis grades, fat content was found to significantly increase ablation volumes by approximately 29-42% in the Tumor Naïve and 55-60% in the <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Tumor Informed DTs</i> in 915 MHz and 2450 MHz antenna simulations. The presence of tumor did not significantly affect ablation volumes within the same steatosis grade in 915 MHz simulations, but did significantly increase ablation volumes within mild-, moderate-, and high-fat steatosis grades in 2450 MHz simulations. An analysis of signed distance to agreement for placement strategies suggests that accounting for patient-specific tumor tissue properties significantly impacts ablation forecasting for the preoperative evaluation of ablation zone coverage

Topics & Concepts