Theoretical modeling of RF ablation with internally cooled electrodes: Comparative study of different thermal boundary conditions at the electrode-tissue interface

  • Received: 01 September 2008 Accepted: 29 June 2018 Published: 01 June 2009
  • MSC : Primary: 92C05, 92C10, 92C50; Secondary: 93A30.

  • Previous studies on computer modeling of RF ablation with cooled electrodes modeled the internal cooling circuit by setting surface temperature at the coolant temperature (i.e., Dirichlet condition, DC). Our objective was to compare the temperature profiles computed from different thermal boundary conditions at the electrode-tissue interface. We built an analytical one-dimensional model based on a spherical electrode. Four cases were considered: A) DC with uniform initial condition, B) DC with pre-cooling period, C) Boundary condition based on Newton's cooling law (NC) with uniform initial condition, and D) NC with a pre-cooling period. The results showed that for a long time (120 s), the profiles obtained with (Cases B and D) and without (Cases A and C) considering pre-cooling are very similar. However, for shorter times (<30 s), Cases A and C overestimated the temperature at points away from the electrode-tissue interface. In the NC cases, this overestimation was more evident for higher values of the convective heat transfer coefficient (h). Finally, with NC, when h was increased the temperature profiles became more similar to those with DC. The results suggest that theoretical modeling of RF ablation with cooled electrodes should consider: 1) the modeling of a pre-cooling period, especially if one is interested in the thermal profiles registered at the beginning of RF application; and 2) NC rather than DC, especially for low flow in the internal circuit.

    Citation: María J. Rivera, Juan A. López Molina, Macarena Trujillo, Enrique J. Berjano. Theoretical modeling of RF ablation with internally cooled electrodes:Comparative study of different thermal boundary conditions at theelectrode-tissue interface[J]. Mathematical Biosciences and Engineering, 2009, 6(3): 611-627. doi: 10.3934/mbe.2009.6.611

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  • Previous studies on computer modeling of RF ablation with cooled electrodes modeled the internal cooling circuit by setting surface temperature at the coolant temperature (i.e., Dirichlet condition, DC). Our objective was to compare the temperature profiles computed from different thermal boundary conditions at the electrode-tissue interface. We built an analytical one-dimensional model based on a spherical electrode. Four cases were considered: A) DC with uniform initial condition, B) DC with pre-cooling period, C) Boundary condition based on Newton's cooling law (NC) with uniform initial condition, and D) NC with a pre-cooling period. The results showed that for a long time (120 s), the profiles obtained with (Cases B and D) and without (Cases A and C) considering pre-cooling are very similar. However, for shorter times (<30 s), Cases A and C overestimated the temperature at points away from the electrode-tissue interface. In the NC cases, this overestimation was more evident for higher values of the convective heat transfer coefficient (h). Finally, with NC, when h was increased the temperature profiles became more similar to those with DC. The results suggest that theoretical modeling of RF ablation with cooled electrodes should consider: 1) the modeling of a pre-cooling period, especially if one is interested in the thermal profiles registered at the beginning of RF application; and 2) NC rather than DC, especially for low flow in the internal circuit.


    As most readers know, the COVID-19 pandemic began in China in December 2019, then slowly spread around the world. Among its impacts on the US are changes to the education system. After Spring Break 2020, which occurred in mid-March, many colleges sent students home and switched to remote learning. During the summer, the big question became what to do in the fall. Colleges across the US have moved classes online, restricted the number of students on campus, and have modified semester schedules to run from mid-August to Thanksgiving, which occurs on the fourth Thursday in November, with no breaks. To further control the spread of the virus on campus, they have made dining halls take-out only and reconfigured public spaces to encourage social distancing. In addition, there will be daily symptom reporting, increased testing, as well as quarantine and contact tracing for infected individuals.

    In this paper we will consider two methods to suppress the spread of the virus. In Section 2, we ask the question: How much would spread be reduced if all students in dorms have single rooms? This is a significant issue for Duke because undergraduates are required to live on campus three of their four years, so at any time more than 80% live in dorms. By using a generalization of the household model [1], we show that the reduction can be substantial. Independent of the research in this paper Duke reduced the on campus student population so that every student could have a single room.

    In Section 3, we turn our attention to classrooms and ask a two part question inspired by Gressman and Peck [2], who analyzed a complex stochastic agent based model to determine the impact of having large classes be online-only. The first part is: How does the distribution of class sizes affect virus spread? To approach this question, we considered two scenarios for a college that has 1000 students, each taking 3 classes. In Scenario 1, all classes have size 30. In Scenario 2, 1/4 of the classes have size 60, and 3/4 have size 20. By calculating the maximum eigenvalue of the matrix that governs the spread in the second case, see [3], we show that the basic reproduction number R0 is 48% larger in scenario 2 due to increased spread in larger classes.

    Knowing that larger classes promote virus spread, it is natural to move classes above a certain threshold online. Thus, the second question we ask in Section 3 is: Where should the threshold be for moving classes online? To address this question, we consider a scenario where 2405 students take three classes each and there is one class of each size from 10 through 120. This is not a very realistic situation but it does allow us to investigate a wide range of cutoffs. We find that the threshold for moving classes online to reduce the basic reproduction number R0=1 and hence stop the spread of the epidemic depends on the basic infection probability p in the model. For the values we investigate, the threshold can be as large as 70 or as small as 30.

    Here we have examined two aspects of campus life in isolation to have models that are mathematically tractable. [4,5] have also developed models that integrate dorms and classes with dining, gyms, and socialization. The household model is appropriate for our situation since all the students are roughly the same age. If we were instead modelling the spread through Durham, we would need an age structured mode with a matrix of rates that govern the interactions between the different age classes. See [6,7,8]. For spread through a state or country, one must consider spatial aspects [9,10,11]. For more about epidemics in general see [12]. For discussions of epidemics on random graphs see [13,14,15].

    The question that motivates this section is: To what extent would the spread of COVID-19 on the Duke campus be reduced if all students had single rooms? To answer this question, we will use results that have been developed for the household model. See [1] and references therein. The household model improves on homogeneous mixing models by partitioning the population into multiple households with the probability of infecting an individual being larger for individuals in the same household.

    We will review the necessary theory on the household model in Section 2.1. In Section 2.2, we examine the case where all students have single rooms by viewing dorms as households and applying the household model. In Section 2.3, where we examine double rooms, we still view dorms as households, but generalize our approach on computing the dynamics within a household.

    Let the population of size N=mn be split into m households of size n. For simplicity, we consider the case of fixed infection time. Let pH be the probability an individual i infects individual j who is another member of the same house. Let pG be the probability of infecting individual j who is not in the same house as individual i. H is used to denote household, and G is used to denote global.

    Step 1: Connect each pair of individuals in the same house with probability pH.

    Let πk be the probability an individual belongs to a cluster of size k. Let μ=kkπk be the mean cluster size, and let GH(z)=k=1πkzk be the generating function of the cluster size. In our analyses, we suppose that the epidemic is subcritical in each dorm. Results in [1] can be used to analyze the case in which the epidemic in a single dorm is supercritical. There are >40 dorms on the Duke campus, so in this case there would be no hope of controlling the spread on campus. Fortunately, the single dorm supercritical scenario is not consistent with estimates of R0 for COVID-19.

    Step 2: Make long distance connections between individuals in different households with probability pG.

    The number of long distance infections caused by one person is Y1 Poisson(NpG) if N is large. The generating function of Y1 is Gν(z)=exp(NpG(z1)).

    From steps 1 and 2, we see that

    R0=μNpG.

    To compute the generating function, we recall that if X,Y0 are independent with generating functions ϕX and ϕY, then X+Y has generating function ϕXϕY. This implies that the generating function of the number of individuals infected by a cluster of size k is exp(NpG(z1))k and hence that the generating function for the number of individuals infected by the cluster of a randomly chosen individual is

    k=0πkexp(NpG(z1))k=GH(Gν(z)).

    A well-known result for branching processes implies that the probability ρ=1ζ that the process dies out is the fixed point <1 of the generating unction of the offspring distribution:

    1ζ=GH(Gν(1ζ)). (2.1)

    Our epidemic is essentailly percolation on the graph of connections in the household model, so the solution ζ of Eq (2.1) is an excellent approximation of the probability of a large epidemic when n and N are large. The size of a large epidemic is the same as the size of the giant component in percolation, which is the same in our homogeneous graph to the probability of a large epidemic.

    When we apply the household model to our dorm models by viewing a dorm as a household, GH will vary between models since the choice of single or double rooms results in a slightly altered local spread within a dorm. On the other hand, since the global spread of the infection is unaffected by room size, Gν will be the same for the two dorm scenarios.

    In adapting the household model to the spread of infection in a college dorm, pH will instead be written as pD, since we are concerned with a dorm rather than a household. Similarly, GH will instead be written as G1D, with the superscript 1 indicating single rooms.

    We first compute R0. Consider m dorms with n single rooms, where population size N=mn. If n is large, e.g., 120 is the size of a typical freshman dorm at Duke, then the total number of individuals infected in one dorm as a result of one infected is the total progeny of a branching process. The branching process will have the offspring distribution Poisson(λ1), where λ1=npD. Here n should be n1 but we will ignore these small imprecisions in what follows. We assume npD<1 so that the mean of the total progeny is

    μ1=1+λ1+λ21+=11λ1, (2.2)

    Each individual infected in the dorm infects an average of NpG individuals outside the dorm so the basic reproduction number is

    R0=μ1NpG=NpG1npD. (2.3)

    Now, we solve for G1D. Breaking things down according to the number of individuals directly infected by the first individual, the generating function of the size of the epidemic within the dorm caused by one infected is

    G1D(z)=zk=0eλ1λk1k!G1D(z)k=zexp(λ1(G1D(z)1))=zG1b(G1D(z)), (2.4)

    where G1b(z)=exp(npD(z1)), the generating function of the spread of the infection within the dorm. One method for solving Eq (2.4) is through iteration. We start with h0(z)=z, which corresponds to 1 individual in generation 0, and then iterate

    h(z)=zexp(λ1(h1(z)1)). (2.5)

    h(z) is the generating function of the number of individuals infected in the first generations of the process, so h(z)h(z), a solution of the recursion.

    In the case of single rooms, an explicit solution for G1D can be found by taking the derivative of equation Eq (2.4) to get the differential equation

    G1D(z)=G1D(z)/z+λ1zG1D(z)G1D(z),

    with the boundary condition G1D(1)=1. It is well known that the solution to the differential equation is

    G1D(z)=W(zW1(λ1))/λ1, (2.6)

    where W is the Lambert W function which is defined by W1(z)=zez.

    By Eq (2.1), the probability of a large epidemic is the largest solution of

    1ζ=G1D(exp(NpGζ)). (2.7)
    Figure 1.  Generating function G1D(z) for npD=.1,.3,.5,.7,.9. Solved by iteration with Eq (2.6). z represents the initial proportion of students within the dorm that were infected.

    This can be further simplified. Plugging in G1D yields

    1ζ=W(eNpGζ(λ1eλ1))/λ1=W(e(NpG+λ1)ζeλ1(ζ1)(λ1))/λ1.

    Multiplying through by λ1, then applying W1 to both sides gives

    λ1(ζ1)eλ1(ζ1)=e(NpG+λ1)ζeλ1(ζ1)(λ1).

    Recalling that λ1=npD and simplifying, we obtain

    (1ζ)=e(NpG+npD)ζ,

    which is the survival probability for a branching process with a Poisson(NpG+npD) distribution.

    Suppose now that we have m1 dorms with n1 double rooms, so that N=2m1n1. For the sake of comparison, we let the number of people in a dorm be the same, regardless of whether they have only single rooms or only double rooms, i.e., n=2n1. Let pL be the probability of infecting your roommate, and pD be the probability of infecting an individual within your dorm. To find the analogue of G1b in this scenario, we think of a generation as having a first step where the ancestor splits into two with probability pL, stays 1 with probability 1pL and then a second step in which long range connections are formed within the dorm. The offspring distribution is now a mixture of two Poissons:

    pLPoisson(22n1pD)+(1pL)Poisson(2n1pD).

    The mean number of infections in one generation, λ2, will be the sum of the means of the two Poisson distributions so λ2=(1+pL)2n1pD.

    Imitating calculations in Section 2.2, if λ2<1, the mean of the total progeny of the branching process is

    μ2=1+λ2+λ22+=11λ2, (2.8)

    and the basic reproduction number is

    R0=μ2NpG=NpG1(1+pL)2n1pD. (2.9)

    To compute G2D, the analogue of G1D for the double room scenario, we note that the generating function of the number of infections in one generation is

    G2b(z)=pLexp(2n1pD(z1))2+(1pL)exp(2n1pD(z1)),

    so G2D satisfies

    G2D(z)=zG2b(G2D(z)). (2.10)

    G2D can then be solved using the iteration method in Section 2.2.

    Figure 2.  Generating function G2D(z) for 2n1pD=.1,.3,.5,.5882 while pL=.7. Solved by iteration. When pL=.7 and λ2>.5882, there is a large epidemic within the dorm. The graph of G2D(z) increased with z, regardless of the value of 2n1pD. As 2n1pD increased, the value of G2D(z) at respective values of z slightly decreased.

    Having computed G2D we can compute the probability of a large epidemic as in the previous case by numerically solving

    1ζ=G2D(exp(NpGζ)). (2.11)

    A comparison of the epidemic probabilities ζ for double-room and single-room dorms is given in Figure 3. Note that in the double-room situation when 2n1pD=0.7 or 0.9, there is a positive probability of a large epidemic within a single dorm, so the curves are positive when NpG=0. When 2n1pD=0.3 or 0.5, pG needs to exceed a positive threshold for there to be an epidemic in a university with double-room dorms, but those thresholds are higher when there are only single-room dorm.

    Figure 3.  Size of the epidemics in the single and double room scenarios of the household model when npD=2n1pD=0.3,0.5,0.7,0.9 and NpG varies.

    This section addresses two questions. The first asks how different class size distributions affect pandemic spread. The second asks whether taking classes above a certain size online can prevent outbreaks.

    To address these questions, we consider some simplified models in which each student takes three classes. The situation can be described by a graph in which there are n students and m classes with sizes ci1im, and there is an edge from each student to the three classes they are enrolled in. Each classroom is assumed to be homogeneously mixing. To formulate the dynamics, we say that the three class members that correspond to one student are their alter egos.

    An individual that is infected in class i at time, adds his two alter egos (his presence in other classes) to the infected population at time 1/2 and then infections at time 1 are produced. None of the infecteds from time 1/2 are present at time 1.

    To show that class sizes impact spread, we compare two scenarios for a college with 1000 students that each take three classes.

    Scenario 1. 100 classes of size 30. An individual infected in class 1 at time 0 will produce a Poisson(29p) number of new infected individuals in class 1 at time 1. His two alter egos are equally likely to be in classes 2–100, and each alter ego will produce Poisson(29p) infecteds in whichever class they are in. So if mi,j is the mean number of infecteds in class j at time 1 from a single infected person in class i, then

    mi,i=29pmi,j=29929pwhen ji

    From this we see that an infected at time 0 produces an average of 329p infecteds at time 1 so

    R0=87p. (3.1)

    Scenario 2. 25 classes of size 60 (1i25) and 75 of size 20 (26i100). Let m(i,j) be the expected number of infections in class j caused by one infected student in i. ci and cj represent that sizes of class i and j respectively. In this scenario, the probability that an individual in class i has an alter ego in a different class j is 2cj/(3000ci), where ci is the size of class i. The 2 comes from 2 alter egos. Thus, we have

    ci={60i2520i26,mi,j={(ci1)pi=j2cj3000ci(cj1)pij

    Since the eigenvector x associated with the maximum eigenvalue will have xi=a for 1i25 and xi=b for 26i100, the eigenvalue problem for the 100×100 matrix can be reduced to the eigenvalue problem for the 2×2 matrix with entries

    [59+2459260/29407519220/29402559260/298019+7419220/2980]p

    Solving a quadratic shows that this matrix has eigenvalues 129.380p and 25.288p. Thus,

    R0=129.38p. (3.2)

    This value is 48% larger than the R0 for scenario 1, and suggests that larger classes increase virus transmission.

    For a more detailed look at the two scenarios, we turn to a stochastic model. As in the previous section the model takes place in discrete time. Each time step is roughly one class meeting, so that two time steps are roughly equivalent to a week in real time. An infected person in a class infects each other individual with probability p0.01 and has a 0.5 probability of entering quarantine. Using Eq (3.1) we see that R0=2(0.87)=1.74 in scenario 1. Eq (3.2) implies that R0=2(1.2938)=2.5876. R0=2.5 is a commonly used value for an uncontrolled COVID-19 epidemic. Figures 46 confirm that Scenario 2 is worse than Scenario 1.

    Figure 4.  A typical realization of the epidemic when all classes have size 30. The left panel gives the current number of infections. The right the cumulative number. In this situation, it takes roughly 11 weeks for the epidemic to reach its peak. By week 15, almost all individuals on campus have been infected.
    Figure 5.  Sample epidemics generated by Python. We ran the model 1000 times for each scenario. The left panel gives the result for scenario 1, the right for scenario 2. The top line is the 75th percentile, the next line is the median, the one parallel to the axis is the 25th percentile. Note that, in Scenario 1, the probability of no community infection is 0.243, and the probability of no major outbreak (no more than 20 total infected) is 0.432. For Scenario 2, the probabilities are 0.203 and 0.309 respectively.
    Figure 6.  Distributions of final epidemic size given that a large outbreak occurs. The data is the same data shown in Figure 5.

    The next figure compares the equal class size and 60–20 scenarios. In both scenarios, the outbreak generally grows out of control within a few weeks and infects the majority of students. In Scenario 2, the outbreaks tend to develop faster, have a higher peak, and vary less in size and dynamics. Scenario 2 also produces a higher probability a large outbreak will occur from one individual, and larger final epidemic sizes. Thus, it is clear that the presence of larger classes, even if average class size remains the same, increases the risks for students on campus.

    In this section, we consider the effects of moving classes above a given size online. To do so, we consider a university with 111 classes, one each of sizes ranging from 10, 11... 120. The total class size is 10+11+...+120=7215 and there are 7215/3=2405 students. To begin, we first consider when all classes are in person.

    Following the calculations for scenario 2 in Section 3.1, we see that the average number for people infected in classroom j by an infected individual in classroom i is

    mi,j={(cj1)pi=j2cj7215ci(cj1)pij,

    Similar to the previous scenarios in this section, we find the largest eigenvalue of the above matrix to determine R0. Although we were unable to find the eigenvalue analytically, we used Python to determine that

    R0=251.5p.

    When p=0.01, R0=2.515.

    We now look at the situation where the university moves all of its classes of size >k. Viruses can't spread through online classes, we have

    mi,j=0 when cj>k.

    The other values of m(i,j) remain unchanged. The change in R0 depending on k and various p can be seen in Figure 7, which makes clear that establishing a cutoff can sharply reduce virus spread through classes. Although Gressman and Peck suggested a cutoff of 30 based on their stochastic simulations for spread in universities [2], our results in Figure 7 suggest that the optimal cutoff depends largely on p. For sufficiently small p, even cutoffs as high as 70 can be effective.

    Figure 7.  Basic reproduction number of COVID-19 after moving classes of size >k online for varying values of p. Establishing a sufficiently small cutoff for moving classes online can make R01, preventing an outbreak for a large range of p. What is considered sufficiently small depends greatly on p.

    The research for this paper was supported by the summer 2020 program DOmath, sponsored by the Duke Mathematics Department with partial funding from the Rhodes Information Initiative at Duke and Duke's Trinity Research Enhancement fund. Durrett and one of the undergraduate students were supported by NSF grant DMS 1614838 from the Math Biology Program.

    The authors have no conflicts of interest to disclose.

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