Interstitial Optical Monitoring of Focal Laser Ablation.
Interstitial Optical Monitoring of Focal Laser Ablation.
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DOI：
10.1109/tbme.2022.3150279
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发表时间：
2022-08
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聚焦激光消融术是一种治疗前列腺、肝脏和大脑等器官癌性病变的微创方法。肿瘤控制是通过在整个目标诱导高温，同时最大限度地减少对周围组织的损伤。因此，成功的临床结果取决于实现所需的消融体积。磁共振测温法经常用于监测诱导热损伤区的形成，并告知终止能量输送的决定。然而，由于相关的成本和复杂性，人们对开发替代方法的兴趣越来越大。在这里，我们调查的实用程序的实时间质询问激光组织相互作用作为一种廉价的替代监测方式，提供直接评估组织凝固，而不需要器官特异性校准。光学对比度的机制，确定使用Monte Carlo模型。随后，制造了四种组织间探针设计，并在同步磁共振成像下在组织模拟体模中进行评估。最后，在离体牛肌肉中评估最佳探针设计。发现其能够提供足够的反馈，以实现4- 7 mm范围内的预定义消融半径，平均绝对误差为0.3 mm。这种方法提供了一种廉价的监测模式，可以促进广泛采用聚焦激光消融。
Focal laser ablation is a minimally invasive method of treating cancerous lesions in organs such as prostate, liver and brain. Oncologic control is achieved by inducing hyperthermia throughout the target while minimizing damage to surrounding tissue. Consequently, successful clinical outcomes are contingent upon achieving desired ablation volumes. Magnetic resonance thermometry is frequently used to monitor the formation of the induced thermal damage zone and inform the decision to terminate energy delivery. However, due to the associated cost and complexity there is growing interest in the development of alternative approaches. Here we investigate the utility of real-time interstitial interrogation of laser-tissue interaction as an inexpensive alternative monitoring modality that provides direct assessment of tissue coagulation without the need for organ specific calibration. The optical contrast mechanism was determined using a Monte Carlo model. Subsequently, four interstitial probe designs were manufactured and assessed in a tissue mimicking phantom under simultaneous magnetic resonance imaging. Finally, the optimal probe design was evaluated in ex vivo bovine muscle. It was found to be capable of providing sufficient feedback to achieve pre-defined ablation radii in the range 4–7mm with a mean absolute error of 0.3mm. This approach provides an inexpensive monitoring modality that may facilitate widespread adoption of focal laser ablation.