Investigation of factors affecting hypothermic pelvic tissue cooling using bio-heat simulation based on MRI-segmented anatomic models

Highlights • This study investigated the influence of different pelvic tissue types as well as the choice of thermal property parameters on the efficacy of endorectal cooling balloon (ECB). • Prostate size and periprostatic venous plexus were two major factors affecting ECB cooling efficiency. • Large prostate made the cooling difficult to propagate through the prostate. • Patients with abundant periprostatic venous plexus required a longer time for neurovascular bundle (NVB) cooling. • This feasibility study demonstrated that the simulation tool could potentially be used for adjusting the setting of ECB for hypothermic radical prostatectomy.