A Theoretical Comparison of the Efficacy of Microwave and Ultrasound Applicators Used in Transurethral Thermal Therapy

Abstract

Microwave and ultrasound energy sources are commonly used in minimally invasive thermal therapy for benign prostatic hyperplasia. Successful management of the therapy using either of these methods requires an accurate estimation of the thermal dosage. The purpose of this study is to evaluate, theoretically, the thermal damage caused by typical transurethral microwave and ultrasound applicators for different thermal doses and compare the efficacy of the two methods. Using an Alternating-direction implicit method, the Pennes bio-heat transfer equation is solved for different levels of power and heating times. Internal and external cooling is applied to preserve the urethral and rectal lining and to control the temperatures within the tissue. The extent of thermal coagulation is determined from the resulting temperature histories, using the existing experimental thermal damage data for prostate tumor cells. The temperatures and damage contours calculated are validated using an Arrhenius analysis of the temperature and thermal-lesion data from the available experimental results. Results show that the calculated damage zones are in good agreement with those observed in the experiments. Results from calculations for different combinations of the parameters are presented in terms of the transient temperature histories and radial and axial extent of the lesion shapes. These results suggest that both methods can yield comparable thermal damage, though ultrasound appears to possess an improved control of directional heating.