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While prostate cryosurgery represents only one application of minimally invasive cryosurgery, it is arguably one of the most challenging applications of its kind, due to the large number of simultaneously operating cryoprobes and difficulties with TRUST imaging. The current study uses prostate cryosurgery as a developmental model and TRUST imaging as a choice of practice.
The minimally invasive nature of the clinical procedure poses many technical difficulties, some of which can be alleviated by means of computational tools.
Those difficulties can be conveniently classified as being related to either surgical planning [ 22 , 26 ] or real-time monitoring [ 6 , 7,12,21 ]. With these technical difficulties in mind, cryosurgery success is highly dependent on the skill and personal experience of the clinician.
The current study addresses difficulties in cryosurgery monitoring by developing a computational approach to improve the reconstruction of the frozen-region shape in real time.
The primary challenge with ultrasound imaging for cryosurgery is its wave reflection from solid surfaces, such as the cryoprobe shell and the freezing front. As a consequence, the frozen region appears opaque on the ultrasound monitor, while acoustic shadowing is formed behind the frozen region [ 12 ].
Using TRUST, the freezing front next to the rectal wall can be clearly observed during prostate cryosurgery, but no imaging information may be obtained about the remaining portion of the freezing front. This lack of information may affect the quality of the medical treatment and lead to post-operational complications. The current study aims at that portion of the frozen region hidden from the ultrasound transducer. Since temperature measurements during prostate cryosurgery are rarely done at one or a couple of locations, if at all , the location of the lethal temperature during clinical practice represents a speculation at best.
The current study is further aimed at improving the prediction of the location of the lethal-temperature isotherm.
The current study presents a proof-of-concept for temperature-field reconstruction during minimally invasive cryosurgery, using a potential-field analogy method PFAM. The current study aims at ultrasound-monitored prostate cryosurgery, and builds upon a recently developed temperature-field reconstruction method TFRM [ 27 ].
The current study presents: i a numerical technique to estimate the location of the freezing front in the acoustic shadowed region, ii an integrated approach to reconstruct the temperature field, and iii validation of the integrated method with published experimental data [ 18 ]. Mathematical Formulation 2. The proposed method is based on following principles: The temperature field within the simulated cryosurgery domain is analogous to an electric-potential field, where isotherms are analogous to isoelectric lines.
Cryoprobes are analogous to static electric charges.