Implementation of a practical model for light and heat distribution using laser-induced thermotherapy near to a large vessel

Uncertainty analysis and optimization of laser thermal pain treatment

Uncertainty in operating parameters during laser thermal pain treatment can yield unreliable results. To ensure reliability and effectiveness, we performed uncertainty analysis and optimization on these parameters. Firstly, we conducted univariate analysis to identify significant operational parameters. Next, an agent model using RBNN regression determined the relationship between these parameters, the constraint function, and the target function. Using interval uncertainty analysis, we obtained confidence distributions and established a nonlinear interval optimization model. Introducing RPDI transformed the model into a deterministic optimization approach. Solving this with a genetic algorithm yielded an optimal solution. The results demonstrate that this solution significantly enhances treatment efficacy while ensuring temperature control stability and reliability. Accounting for parameter uncertainties is crucial for achieving dependable and effective laser thermal pain treatment. These findings have important implications for advancing the clinical application of this treatment and enhancing patient outcomes.

Fiber Optic Sensors-Based Thermal Analysis of Perfusion-Mediated Tissue Cooling in Liver Undergoing Laser Ablation

The current challenge in the field of thermo-ablative treatments of tumors is to achieve a balance between complete destruction of malignant cells and safeguarding of the surrounding healthy tissue. Blood perfusion plays a key role for thermal ablation success, especially in the case of highly vascularized organs like liver. This work aims at monitoring the temperature within perfused swine liver undergoing laser ablation (LA). Temperature was measured through seven arrays of Fiber Bragg Grating sensors (FBGs) around the laser applicator. To mimic reality, blood perfusion within the ex-vivo liver was simulated using artificial vessels. The influence of blood perfusion on LA was carried out by comparing the temperature profiles in two different spatial configurations of vessels and fibers. The proposed setup permitted to accurately measure the heat propagation in real-time with a temperature resolution of 0.1 °C and to observe a relevant tissue cooling near to the vessel up to 65%.

The effect of laser power, blood perfusion, thermal and optical properties of human liver tissue on thermal damage in LITT

In this work, the finite-element method (FEM) was used to predict the temperature distribution, and the thermal damage volume in human liver tissue subjected to laser in laser-induced interstitial thermotherapy (LITT). The effect of laser power, blood perfusion, and thermal and optical properties on maximum temperature and thermal damage volume were predicted using the finite-element method. A computer program was written in visual basic language, which was verified by comparing its result with data published elsewhere. The bio-heat equation together with the effect of linear laser source were used to simulate heat transfer through tissue from which the temperature distributions, and the subsequent thermal damage, were obtained based on Arrhenius equation. In this mathematical model for LITT, it was found that increasing laser power, absorption, and scattering coefficient increased the damage zone while increasing tissue water content, perfusion rate, and tissue anisotropy factor decreased the damage zone. These findings are important aspects for doctors in the pre-estimation of the damage zone before starting the therapy so as to kill only the desired zone.

Effects of low-level laser therapy on wound healing

OBJECTIVE: To gather and clarify the actual effects of low-level laser therapy on wound healing and its most effective ways of application in human and veterinary medicine.METHODS: We searched original articles published in journals between the years 2000 and 2011, in Spanish, English, French and Portuguese languages, belonging to the following databases: Lilacs, Medline, PubMed and Bireme; Tey should contain the methodological description of the experimental design and parameters used.RESULTS: doses ranging from 3 to 6 J/cm2 appear to be more effective and doses 10 above J/cm2 are associated with deleterious effects. The wavelengths ranging from 632.8 to 1000 nm remain as those that provide more satisfactory results in the wound healing process.CONCLUSION: Low-level laser can be safely applied to accelerate the resolution of cutaneous wounds, although this fact is closely related to the election of parameters such as dose, time of exposure and wavelength.

In vivo validation of a therapy planning system for laser-induced thermotherapy (LITT) of liver malignancies

PURPOSE

In situ ablation is increasingly being used for the treatment of liver malignancies. The application of these techniques is limited by the lack of a precise prediction of the destruction volume. This holds especially true in anatomically difficult situations, such as metastases in the vicinity of larger liver vessels. We developed a three-dimensional (3D) planning system for laser-induced thermotherapy (LITT) of liver tumors. The aim of the study was to validate the system for calculation of the destruction volume.

METHODS

LITT (28 W, 20 min) was performed in close contact to major hepatic vessels in six pigs. After explantation of the liver, the coagulation area was documented. The liver and its vascular structures were segmented from a pre-interventional CT scan. Therapy planning was carried out including the cooling effect of adjacent liver vessels. The lesions in vivo and the simulated lesions were compared with a morphometric analysis.

RESULTS

The volume of lesions in vivo was 6,568.3 ± 3,245.9 mm(3), which was not different to the simulation result of 6,935.2 ± 2,538.5 mm(3) (P = 0.937). The morphometric analysis showed a sensitivity of the system of 0.896 ± 0.093 (correct prediction of destructed tissue). The specificity was 0.858 ± 0.090 (correct prediction of vital tissue).

CONCLUSIONS

A 3D computer planning system for the prediction of thermal lesions in LITT was developed. The calculation of the directional cooling effect of intrahepatic vessels is possible for the first time. The morphometric analysis showed a good correlation under clinical conditions. The pre-therapeutic calculation of the ablation zone might be a valuable tool for procedure planning.

Spatial temperature distribution in human hairy and glabrous skin after infrared CO2 laser radiation

BACKGROUND

CO2 lasers have been used for several decades as an experimental non-touching pain stimulator. The laser energy is absorbed by the water content in the most superficial layers of the skin. The deeper located nociceptors are activated by passive conduction of heat from superficial to deeper skin layers.

METHODS

In the current study, a 2D axial finite element model was developed and validated to describe the spatial temperature distribution in the skin after infrared CO2 laser stimulation. The geometry of the model was based on high resolution ultrasound scans. The simulations were compared to the subjective pain intensity ratings from 16 subjects and to the surface skin temperature distributions measured by an infrared camera.

RESULTS

The stimulations were sensed significantly slower and less intense in glabrous skin than they were in hairy skin (MANOVA, p < 0.001). The model simulations of superficial temperature correlated with the measured skin surface temperature (r > 0.90, p < 0.001). Of the 16 subjects tested; eight subjects reported pricking pain in the hairy skin following a stimulus of 0.6 J/cm2 (5 W, 0.12 s, d1/e2 = 11.4 mm) only two reported pain to glabrous skin stimulation using the same stimulus intensity. The temperature at the epidermal-dermal junction (depth 50 μm in hairy and depth 133 μm in glabrous skin) was estimated to 46°C for hairy skin stimulation and 39°C for glabrous skin stimulation.

CONCLUSIONS

As compared to previous one dimensional heat distribution models, the current two dimensional model provides new possibilities for detailed studies regarding CO2 laser stimulation intensity, temperature levels and nociceptor activation.

Simulation of laser-induced thermotherapy using a dual-reciprocity boundary element model with dynamic tissue properties

This paper presents a nonlinear dual-reciprocity boundary element method (DRBEM) for bioheat transfer in laser-induced thermotherapy. The nonlinearity stems from the dynamic changes of tissue thermophysical and optical properties and the blood perfusion rate during laser heating. The proposed DRBEM is coupled with a modified Monte Carlo method and the Arrhenius rate equation to investigate laser light propagation, bioheat transfer, and irreversible thermal damage in tumors. The computer code is justified by comparing the DRBEM results with the finite-difference results. The photothermal processes in interstitial laser thermotherapy with single or double laser fiber scattering applicators are chosen as the demonstrative examples. The dynamic nature, together with the unique advantages of "boundary-only" and excellent adaptability to complex anatomical geometries that the DRBEM method offers, makes the present nonlinear DRBEM a powerful tool for analysis and optimization of the parameters in laser surgical procedure.

Effects of variation in perfusion rates and of perfusion models in computational models of radio frequency tumor ablation

PURPOSE

Finite element method (FEM) models are commonly used to simulate radio frequency (RF) tumor ablation. Prior FEM models of RF ablation have either ignored the temperature dependent effect of microvascular perfusion, or implemented the effect using simplified algorithms to reduce computational complexity. In this FEM modeling study, the authors compared the effect of different microvascular perfusion algorithms on ablation zone dimensions with two commercial RF electrodes in hepatic tissue. They also examine the effect of tissue type and inter-patient variation of perfusion on ablation zone dimensions.

METHODS AND MATERIALS

The authors created FEM models of an internally cooled and multi-tined expandable electrode. RF voltage was applied to both electrodes (for 12 or 15 min, respectively) such that the maximum temperature in the model was 105 degrees C. Temperature dependent microvascular perfusion was implemented using three previously reported methodologies: cessation above 60 degrees C, a standard first-order Arrhenius model with decreasing perfusion with increasing degree of vascular stasis, and an Arrhenius model that included the effects of increasing perfusion at the ablation zone boundary due to hyperemia. To examine the effects of interpatient variation, simulations were performed with base line and +/-1 standard deviation values of perfusion. The base line perfusion was also varied to simulate the difference between normal and cirrhotic liver tissue.

RESULTS

The ablation zone volumes with the cessation above 60 degrees C perfusion algorithm and with the more complex Arrhenius model were up to 70% and 25% smaller, respectively, compared to the standard Arrhenius model. Ablation zone volumes were up to 175% and approximately 100% different between the simulations where -1 and +1 standard deviation values of perfusion were used in normal and cirrhotic liver tissue, respectively.

CONCLUSIONS

The choice of microvascular perfusion algorithm has significant effects on final ablation zone dimensions in FEM models of RF ablation. The authors also found that both interpatient variation in base line tissue perfusion and the reduction in perfusion due to cirrhosis have considerable effect on ablation zone dimensions.

Laser-induced thermal response and characterization of nanoparticles for cancer treatment using magnetic resonance thermal imaging

Spherical nanoparticles with a gold outer shell and silica core can be tuned to absorb near-infrared light of a specific wavelength. These nanoparticles have the potential to enhance the treatment efficacy of laser-induced thermal therapy (LITT). In order to enhance both the potential efficacy and safety of such procedures, accurate methods of treatment planning are needed to predict the temperature distribution associated with treatment application. In this work, the standard diffusion approximation was used to model the laser fluence in phantoms containing different concentrations of nanoparticles, and the temperature distribution within the phantom was simulated in three-dimensions using the finite element technique. Magnetic resonance temperature imaging was used to visualize the spatiotemporal distribution of the temperature in the phantoms. In most cases, excellent correlation is demonstrated between the simulations and the experiment (<3.0% mean error observed). This has significant implications for the treatment planning of LITT treatments using gold-silica nanoshells.

Perturbative diffusion theory formalism for interpreting temporal light intensity changes during laser interstitial thermal therapy

In an effort to understand dynamic optical changes during laser interstitial thermal therapy (LITT), we utilize the perturbative solution of the diffusion equation in heterogeneous media to formulate scattering weight functions for cylindrical line sources. The analysis explicitly shows how changes in detected interstitial light intensity are associated with the extent and location of the volume of thermal coagulation during treatment. Explanations for previously reported increases in optical intensity observed early during laser heating are clarified using the model and demonstrated with experimental measurements in ex vivo bovine liver tissue. This work provides an improved understanding of interstitial optical signal changes during LITT and indicates the sensitivity and potential of interstitial optical monitoring of thermal damage.

Comparison of diffusion approximation and Monte Carlo based finite element models for simulating thermal responses to laser irradiation in discrete vessels

Both diffusion approximation (DA) and Monte Carlo (MC) models have been used to simulate light distribution in multilayered human skin with or without discrete blood vessels. However, no detailed comparison of the light distribution, heat generation and induced thermal damage between these two models has been done for discrete vessels. Three models were constructed: (1) MC-based finite element method (FEM) model, referred to as MC-FEM; (2) DA-based FEM with simple scaling factors according to chromophore concentrations (SFCC) in the epidermis and vessels, referred to as DA-FEM-SFCC; and (3) DA-FEM with improved scaling factors (ISF) obtained by equalizing the total light energy depositions that are solved from the DA and MC models in the epidermis and vessels, respectively, referred to as DA-FEM-ISF. The results show that DA-FEM-SFCC underestimates the light energy deposition in the epidermis and vessels when compared to MC-FEM. The difference is nonlinearly dependent on wavelength, dermal blood volume fraction, vessel size and depth, etc. Thus, the temperature and damage profiles are also dramatically different. DA-FEM-ISF achieves much better results in calculating heat generation and induced thermal damage when compared to MC-FEM, and has the advantages of both calculation speed and accuracy. The disadvantage is that a multidimensional ISF table is needed for DA-FEM-ISF to be a practical modelling tool.

A finite element method model to simulate laser interstitial thermo therapy in anatomical inhomogeneous regions

BACKGROUND

Laser Interstitial ThermoTherapy (LITT) is a well established surgical method. The use of LITT is so far limited to homogeneous tissues, e.g. the liver. One of the reasons is the limited capability of existing treatment planning models to calculate accurately the damage zone. The treatment planning in inhomogeneous tissues, especially of regions near main vessels, poses still a challenge. In order to extend the application of LITT to a wider range of anatomical regions new simulation methods are needed. The model described with this article enables efficient simulation for predicting damaged tissue as a basis for a future laser-surgical planning system. Previously we described the dependency of the model on geometry. With the presented paper including two video files we focus on the methodological, physical and mathematical background of the model.

METHODS

In contrast to previous simulation attempts, our model is based on finite element method (FEM). We propose the use of LITT, in sensitive areas such as the neck region to treat tumours in lymph node with dimensions of 0.5 cm - 2 cm in diameter near the carotid artery. Our model is based on calculations describing the light distribution using the diffusion approximation of the transport theory; the temperature rise using the bioheat equation, including the effect of microperfusion in tissue to determine the extent of thermal damage; and the dependency of thermal and optical properties on the temperature and the injury. Injury is estimated using a damage integral. To check our model we performed a first in vitro experiment on porcine muscle tissue.

RESULTS

We performed the derivation of the geometry from 3D ultrasound data and show for this proposed geometry the energy distribution, the heat elevation, and the damage zone. Further on, we perform a comparison with the in-vitro experiment. The calculation shows an error of 5% in the x-axis parallel to the blood vessel.

CONCLUSIONS

The FEM technique proposed can overcome limitations of other methods and enables an efficient simulation for predicting the damage zone induced using LITT. Our calculations show clearly that major vessels would not be damaged. The area/volume of the damaged zone calculated from both simulation and in-vitro experiment fits well and the deviation is small. One of the main reasons for the deviation is the lack of accurate values of the tissue optical properties. In further experiments this needs to be validated.