论文标题

用体外γ闪烁体的验证鼻窦药物输送计算流体动力学(CFD)建模

Validation of Sinus Drug Delivery Computational Fluid Dynamics (CFD) Modeling with In Vitro Gamma Scintigraphy

论文作者

Kudlaty, K., Bennett, W., Holbrook, L., Burke, A., Wu, J., Langworthy, B., Fine, J. P., Ebert Jr., C. S., Kimple, A. J., Thorp, B. D., Zanation, A. M., Senior, B. A., Kimbell, J. S.

论文摘要

背景:慢性鼻炎(CRS)是一种普遍且破坏性的疾病。包括鼻类固醇喷雾在内的医疗管理是主要治疗方式。计算流体动力学(CFD)已用于表征鼻纳纳斯气流和鼻内药物递送。但是,仿真方法的变化表明需要大规模CFD模型验证。 方法:在模拟物(TM)中创建了3个功能性内窥镜鼻窦手术患者的术前和后CT扫描的解剖重建。在18例中使用Fluent(TM)的CFD方法进行了流体分析和药物颗粒沉积模型。模型是3D打印的,并使用TC99标记的Nasacort(TM)进行体外研究。在叠加的网格中对伽马闪光灯信号和CFD模型的喷雾质量进行了后处理,并进行了比较。使用重叠系数(OC)的统计分析评估了计算和实验分布之间的相似性,而Kendall的TAU等级相关系数用于测试独立性。 结果:OCS揭示了CFD模型之间的沉积百分比和网格曲线的强烈一致性和实验结果(矢状,轴向和冠状电网的平均[范围]分别为0.69 [0.57],0.61 [0.49]和0.78和0.78 [0.78 [0.44])。肯德尔(Kendall)的tau值在一个模型中具有统计学意义(p <0.05),在一个模型中表现出很大的一致性(平均0.73),除了一个模型和两个矢状网格外,它们具有统计学意义(p <0.05)。 结论:CFD建模证明了与体外实验结果的统计一致。这项验证研究是同类研究中最大的研究之一,并支持CFD在准确建模鼻喷雾剂输送和使用计算方法来研究改善临床药物输送的手段方面的适用性。

Background: Chronic rhinosinusitis (CRS) is a prevalent and disruptive disease. Medical management including nasal steroid sprays is the primary treatment modality. Computational fluid dynamics (CFD) has been used to characterize sinonasal airflow and intranasal drug delivery; however, variation in simulation methods indicates a need for large scale CFD model validation. Methods: Anatomic reconstructions of pre and post-operative CT scans of 3 functional endoscopic sinus surgery patients were created in Mimics(TM). Fluid analysis and drug particle deposition modeling were conducted using CFD methods with Fluent(TM) in 18 cases. Models were 3D printed and in vitro studies were performed using Tc99-labeled Nasacort(TM). Gamma scintigraphy signals and CFD-modeled spray mass were post-processed in a superimposed grid and compared. Statistical analysis using overlap coefficients (OCs) evaluated similarities between computational and experimental distributions and Kendall's tau rank correlation coefficient was employed to test independence. Results: OCs revealed strong agreement in percent deposition and grid profiles between CFD models and experimental results (mean [range] for sagittal, axial, and coronal grids were 0.69 [0.57], 0.61 [0.49], and 0.78 [0.44], respectively). Kendall's tau values showed strong agreement (average 0.73) between distributions, which were statistically significant (p < 0.05) apart from a single coronal grid in one model and two sagittal grids of another. Conclusions: CFD modeling demonstrates statistical agreement with in vitro experimental results. This validation study is one of the largest of its kind and supports the applicability of CFD in accurately modeling nasal spray drug delivery and using computational methods to investigate means of improving clinical drug delivery.

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