Comparison of 980-and 1064-nm wavelengths for interstitial laser thermotherapy of the liver
Comparison of 980-and 1064-nm wavelengths for interstitial laser thermotherapy of the liver
复制标题
DOI：
10.1089/pho.2005.23.284
复制
发表时间：
2005-06-01
影响因子：
--
通讯作者：
Christophi, C
中科院分区：
文献类型：
--
作者：
Nikfarjam, M;Malcontenti-Wilson, C;Christophi, C
目的：间质激光热疗（ILT）的肝脏肿瘤通常使用钕钇铝石榴石（Nd-YAG）激光器。主要为其他临床应用开发的更通用的二极管单元可能同样适用于ILT。本研究比较了二极管和Nd-YAG激光器在低功率下在小鼠模型中实现最大组织坏死的疗效。研究方法：使用直径为400 μ m的裸光纤，通过二极管（980 nm波长）和Nd-YAG（1064 nm波长）激光在CBA品系小鼠的肝脏中诱导热消融。在2 W的功率输出下，确定两种激光器在组织炭化之前的治疗时间。治疗完成后，在距离光纤插入部位3 mm处记录组织温度。通过烟酰胺腺嘌呤二核苷酸（NADH）黄递酶组织染色准确评估坏死的最大直径。结果如下：炭化前组织坏死的最大直径发生在20秒（40 J）与二极管激光相比，50秒（100 J）与Nd-YAG激光。二极管激光产生的坏死最大直径（平均值[SEM]）为5.9 mm（0.14），与Nd-YAG激光诱导的坏死5.9 mm（0.14）相当（p = 0.963）。半导体激光组ILT后即刻距离光纤应用部位3 mm处的组织温度为40.8 ℃（0.93），与Nd-YAG激光组的39.0 ℃（0.86）无统计学差异（p = 0.452）。组织炭化始终阻止二极管激光器在2 W下治疗超过20 s。结论：当通过裸光纤应用于肝脏时，使用二极管和Nd-YAG激光的低功率ILT实现了等效的最大坏死。然而，二极管激光产生最大坏死的治疗时间明显更短。
Objective: Interstitial laser thermotherapy (ILT) of liver tumors is generally performed using neodyium yttrium-aluminium-garnet (Nd-YAG) lasers. More versatile diode units, developed predominantly for other clinical applications, may be equally suitable for ILT. This study compares the efficacy of diode and Nd-YAG lasers in achieving maximum tissue necrosis, at low power, in a murine model. Methods: Thermal ablation was induced in the liver of CBA strain mice by diode (980-nm wavelength) and Nd-YAG (1064-nm wavelength) lasers using 400-mu m diameter bare fibers. Treatment time prior to tissue charring was determined for both lasers at a power output of 2 W. Tissue temperature was recorded upon completion of therapy 3 mm from the fiber insertion site. The maximum diameter of necrosis was accurately assessed by nicotinamide adenine dinucleotide (NADH) diaphorase tissue staining. Results: Maximum diameter of tissue necrosis prior to charring occurred at 20 s (40 J) with the diode laser compared to 50 s (100 J) with the Nd-YAG laser. The maximum diameter of necrosis (mean [SEM]) produced by the diode laser, 5.9 mm (0.14), was equivalent to the necrosis induced by the Nd-YAG laser, 5.9 mm (0.14) (p = 0.963). Tissue temperature 3 mm from the fiber application site immediately following ILT in the diode laser group, 40.8 degrees C (0.93), was not statistically different than that of the Nd-YAG laser group, 39.0 degrees C (0.86) (p = 0.452). Tissue charring consistently prevented treatment beyond 20 s at 2W by the diode laser. Conclusion: Low power ILT with diode and Nd-YAG lasers achieves equivalent maximal necrosis when applied to the liver by a bare fiber. Treatment time to produce maximal necrosis is however significantly shorter with the diode laser.