ECE2022 Poster Presentations Adrenal and Cardiovascular Endocrinology (87 abstracts)
Development of a novel treatment strategy which involves thermal ablation of adrenal adenomas using electromagnetic energy
Richard Farnan 1 , Anna Bottiglieri 2 , Laura Farina 2 , Russell Senanayake 3 , Mark Gurnell 3 , Punit Prakash 4 , Martin O’Halloran 2 , Grazia Cappiello 2 , Caoimhe Newell 2 , Muireann Keating 2 , George Rahmani 2 & Michael Conall Dennedy 2
1NUIG, Endocrinology, Galway, Ireland; 2NUIG, Galway, Ireland; 3University of Cambridge, Cambridge, United Kingdom; 4Kansas State University, Kansas, United States
Primary aldosteronism (PA) arises from one or both adrenal glands and is a common cause of secondary hypertension accounting for approximately 5-12% of all hypertension. Current therapy involves mineralocorticoid receptor antagonists for bilateral disease (60%) or adrenalectomy for unilateral disease (30%). We investigate treatment planning of percutaneous adrenal ablation as an alternative definitive therapeutic modality for unilateral and bilateral disease. The main objectives of treatment planning model the following to inform optimal therapeytic approach: (i) Localisation of the aldosterone producing adenomas. (ii) Generation of optimal power input for ablation. (iii) Probe placement for precise targeting. (iv) Heat map generation to guide thermal applicator placement. Segmentation and reconstruction was performed to produce 3D models showing the adrenal glands and the surrounding vital structures using 3DSlicer® and iSeg® respectively. 11C Metomidate PET/CT images localized functioning adrenal lesions which were then rendered in a 3D virtual environment. Microwave thermal ablation transfers electromagnetic energy, targetted to the region of interest and requires temperatures >50C to ablate adrenal tissue. The necessary power to ablate was derived by applying Maxwell’s equations. These involve a system of four partial differential equations and their utility in developing the power needed to ablate biological tissue. Models of specific adrenal glands are created using dielectric and thermal properties used to determine delivery of effective thermal energy. These parameters were used to inform power settings and probe placement necessary to safely ablate adrenal nodules.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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