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Tese Tony Almeida.Pdf i “tese_v1_3” — 2012/8/16 — 16:45 — page 2 — #2 i i i i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 1 — #1 i i i Universidade de Coimbra Faculdade de Ciências e Tecnologia Departamento de Engenharia Eletrotécnica e de Computadores Development of a Stent-Based Electrode for Radio Frequency Thermal Ablation Procedure Tony Richard de Oliveira de Almeida Coimbra - Portugal 2012 i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 2 — #2 i i i i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 3 — #3 i i i Universidade de Coimbra Faculdade de Ciências e Tecnologia Departamento de Engenharia Eletrotécnica e de Computadores Development of a Stent-Based Electrode for Radio Frequency Thermal Ablation Procedure Dissertação submetida para a obtenção do grau de Doutor em Engenharia Eletrotécnica, na especialidade de Materiais e Campos Eletromagnéticos Tony Richard de Oliveira de Almeida Coimbra - Portugal 2012 i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 4 — #4 i i i i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 5 — #5 i i i Tese realizada sob orientação do Professor Doutor Carlos Fernando Ramos Lemos Antunes Professor Catedrático do Departamento de Engenharia Eletrotécnica e de Computadores Faculdade de Ciências e Tecnologia Universidade de Coimbra i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page 6 — #6 i i i i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page i — #7 i i i Aos meus filhos Cármen e Elói, à minha esposa Márcia e à memória do meu pai i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page ii — #8 i i i i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page iii — #9 i i i Agradecimentos Apesar do corpo da tese estar escrito em inglês, não posso deixar de expressar, na minha língua materna, os meus mais sinceros agradecimentos a todos aqueles que, de uma forma ou de outra, foram parte importante deste trabalho. Em primeiro lugar, quero agradecer ao meu orientador, o Professor Doutor Carlos Lemos Antunes, toda a sua disponibilidade e orientação científica com que me apoiou no decurso dos trabalhos que conduziram à apresentação desta dissertação. A sua motivação e empenho foram fundamentais para, se me é permitido expressar desta forma, levar este barco a bom porto. À Nélia Raposeiro, agradeço todo o apoio prestado durante o trabalho de simulação, assim como a ajuda na revisão final do texto. Ao Nuno Gonçalves, agradeço por me ter “convertido” ao LATEX, assim como todo o apoio prestado na produção deste documento. Ao Pedro Faia, agradeço a disponibilidade do Laboratório de Tecnologia dos Materi- ais Eletrónicos e Ultrassons do DEEC/FCTUC, o que permitiu fazer a caracterização elétrica do fórceps. Ao Departamento de Engenharia Eletrotécnica e de Computadores da Faculdade de Ciências e Tecnologia da Universidade de Coimbra e à Fundação para a Ciência e a Tecnologia pelo apoio institucional à realização do meu doutoramento. iii i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page iv — #10 i i i iv Ao Dr. Nuno Pinto, diretor do Matadouro da Beira Litoral (Aveiro), agradeço a disponibilidade na obtenção das várias amostras de tecido biológico necessárias para a realização da parte experimental deste trabalho. À Covidien Portugal, agradeço a disponibilidade do equipamento que foi imprescin- dível para a realização dos testes de ablação térmica por radiofrequência. Quero também agradecer profundamente aos meus amigos, à minha família, e muito especialmente à minha mulher e aos meus filhos pelas infindáveis horas que lhes roubei e que sei nunca, de forma alguma, poderei compensar. Márcia, obrigado pela tua grande compreensão, apoio e incentivo durante todo este tempo. E muito especialmente ao meu pai, a quem devo muito do que sou hoje e a quem acho que nunca pude agradecer o suficiente tudo o que fez por mim. Onde quer que estejas, muito obrigado. i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page v — #11 i i i Contents Resumo xix Abstract xxi 1 Introduction 1 1.1 Motivation and Objectives . .1 1.2 Organization of the Thesis . .4 1.3 Contribution . .5 2 Properties of Tissue 9 2.1 Electrical Properties of Biological Tissues . 10 2.1.1 Dielectric and Electrical Conductivity in Biological Tissues . 10 2.1.2 Complex Permittivity . 11 2.1.3 Relaxation . 14 2.1.4 Dispersion in Biological Tissues . 17 2.1.5 Available Data . 19 2.1.6 Parametric Model for Describing the Dielectric Properties of Biological Tissues . 21 2.1.7 Temperature Dependence of the Electrical Properties . 23 2.1.8 In Vivo and Ex Vivo Properties . 25 2.1.9 Tumorous Tissues . 26 2.2 Magnetic Properties of Biological Tissues . 27 v i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page vi — #12 i i i vi 2.3 Thermal Properties of Biological Tissues . 28 2.3.1 Thermal Conductivity and Heat Diffusion . 28 2.3.2 Bioheat Equation . 29 2.3.3 Available Data on Thermal Properties of Biological Tissues . 30 2.3.4 Factors Affecting Thermal Conductivity . 31 3 Radio Frequency Ablation 35 3.1 Historical Introduction . 35 3.2 Radio Frequency Ablation . 44 3.2.1 Mechanism of Radio Frequency Ablation . 44 3.2.2 Thermal Necrosis . 46 3.3 RF Ablation Electrodes . 48 3.3.1 Monopolar Electrodes . 48 3.3.2 Bipolar Electrodes . 55 3.3.3 Combination of Electrode Designs . 57 3.3.4 Multiple Electrode Systems . 59 3.3.5 Saline-Enhanced RF Ablation . 60 3.3.6 Size and Geometry of RF Lesions . 61 3.4 Commercial RF Ablation Systems . 64 3.4.1 Covidien – Cool-tipTM RF Ablation System . 66 3.4.2 AngioDynamics – StarBurst Radiofrequency Ablation System 67 3.4.3 Boston Scientific – RF 3000 Radiofrequency Ablation System 68 3.4.4 Olympus – CelonPOWER System . 69 4 Preliminary Experimental Tests 73 4.1 Introduction . 73 4.2 Preliminary Set-up . 74 4.2.1 Description . 74 4.2.2 Results . 76 4.3 Numerical Simulation . 82 4.3.1 Theoretical Model . 82 4.3.2 Description of the Model . 83 4.3.3 Physical Properties and Boundary Conditions . 84 4.3.4 Numerical Results . 85 4.4 Connecting the Electrode to the RF Generator Through a Forceps . 88 4.5 Conclusions . 92 i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page vii — #13 i i i vii 5 Characterization of the Induced Lesion 95 5.1 Objectives . 95 5.2 Ex Vivo Experimentation . 96 5.2.1 Experimental Set-up . 96 5.2.2 Measurement of the Electrical Conductivity . 97 5.2.3 Methodology . 102 5.2.4 Results . 102 5.3 Numerical Simulation . 109 5.3.1 Description of the Model . 109 5.3.2 Physical Properties and Boundary Conditions . 110 5.3.3 Determination of the Lesion Volumefrom the Numerical Solu- tions . 111 5.3.4 Numerical Results . 112 5.4 Conclusions . 114 6 Effects of the Geometry of the Electrode on the Temperature Distribution115 6.1 Objective . 115 6.2 Numerical Model . 116 6.2.1 Theoretical Model . 116 6.2.2 Description of the Model . 116 6.2.3 Physical Properties and Boundary Conditions . 117 6.3 Determination of the Lesion Size . 118 6.4 Results and Discussion . 118 6.5 Conclusions . 126 7 RF Ablation of a Cholangiocarcinoma: Numerical Simulation 129 7.1 Introduction . 129 7.2 RF Ablation Without Saline Solution . 130 7.2.1 Theoretical Model . 130 7.2.2 Description of the Model . 131 7.2.3 Determination of the Volume Size . 134 7.2.4 Results . 134 7.3 Saline-Enhanced RF Ablation: First Approach . 138 7.3.1 Modelling the Saline Solution in the Tissue . 138 7.3.2 Results and Discussion . 139 7.4 Saline-Enhanced RF Ablation: Second Approach . 148 i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page viii — #14 i i i viii 7.4.1 Conductivity of the Tumorous Tissue . 148 7.4.2 Results and Discussion . 150 7.5 Conclusions . 155 8 Conclusion 161 8.1 Summary of the Research . 161 8.2 Future Work . 163 Bibliography 165 Errata 195 i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page ix — #15 i i i List of Tables 2.1 Mechanisms present in the dielectric response of different biological systems. 19 2.2 Parameters of Equation (2.26) for predicting the dielectric properties of liver tissue (from [GLG96b]). 22 3.1 Technical specifications of commercial RF ablation generators . 65 4.1 Material properties used in the numerical simulation of the prelimin- ary stent-based electrode (from [HST+01]). 84 5.1 Material properties (from [HST+01], except electrical conductivity of liver tissue). 110 7.1 Blood vessels properties used in the numerical simulation of the cholan- giocarcinoma RF ablation. 133 7.2 Material properties used in the numerical simulation of the cholan- giocarcinoma RF ablation. 133 ix i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page x — #16 i i i x i i i i i “tese_v1_3” — 2012/8/16 — 16:45 — page xi — #17 i i i List of Figures 2.1 Equivalent circuit of a parallel plate capacitor filled with a non-ideal dielectric . 12 2.2 Example of the polarization decay after removing an applied electric field. 12 2.3 Step electric field applied to a dielectric medium and its relaxed response 15 0 2.4 Conductivity, normalized permittivity (e − e¥)=(es − e¥), and loss 00 factor we0e =(es − e¥) vs.
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