Real-time feedback control of laser ablation therapies using volumetric optoacoustic imaging

使用激光消融作为治疗或切除方法的治疗方法比基于手术刀和其他机械手术方法有许多优点。这些包括手术器械与清洁的治疗区域缺乏接触，具有无与伦比的精度和选择性的潜力，最小的热和机械副作用，以及同时切割和/或凝固组织的可能性。这些优点推动了激光消融在众多医学专业的临床应用，包括肿瘤学、眼科、皮肤科、牙科、整形外科、耳鼻喉科-头颈外科。尽管取得了这些进展，但大多数手术并没有适当的反馈控制，导致在消融过程中难以识别所形成病变的关键参数。当前项目的主要目标是通过应用多光谱光声学原理来开发临床实用能力，以实时监测病变轮廓、热损伤程度、温升图、局部组织分布和其他关键参数，解决激光消融过程中对可靠反馈传感器的需求。这些方法的成功实施将使工具能够为外科医生提供足够的知识，以尽量减少或避免对功能组织和关键结构的不必要损害。由于生物组织中控制消融过程的类似物理机制，许多发现预计不仅会影响激光消融程序，还会影响其他类型的热治疗，如射频导管消融或高强度聚焦超声（HIFU）治疗。在整个项目中，我们将考虑确保开发的方法最终适用于临床环境。其中最主要的考虑因素包括，这些方法只需要小型、紧凑、低成本的设备，并且可以支持轻松集成到手持临床级设备中。

Treatments applying laser ablation as a therapeutic or resection method have many advantages over scalpel-based and other mechanistic surgical methods. These include lack of contact of surgical instruments with clean treated areas, the potential for unrivaled precision and selectivity, minimal thermal and mechanical side effects, and the possibility of simultaneous cutting and/or coagulation of tissue. These advantages have consequently motivated the clinical application of laser ablation in a myriad of medical specialties, including oncology, ophthalmology, dermatology, dentistry, plastic surgery, otolaryngology - head and neck surgery. Despite these advances, most procedures are not done with an appropriate feedback control, resulting in difficulties discerning the critical parameters of the created lesion during the ablation process. The principle aim of the current project is to address the need for reliable feedback sensor in laser ablation procedures by applying the principles of multi-spectral optoacoustics to develop clinically-practical capabilities to monitor the lesion profile, extent of thermal damage, maps of temperature rise, local tissue distribution and other key parameters in real time. The successful implementation of these methods will enable tools to provide a surgeon with sufficient knowledge to minimize or avoid undesired damage to functional tissues and critical structures. Because of similar physical mechanisms governing ablation processes in biological tissue, many of the findings are expected to impact not only the laser ablation procedures but also other types of thermal treatments, such as radiofrequency catheter ablation or high intensity focused ultrasound (HIFU) treatments. Throughout our project, we will take into account considerations for ensuring that the developed methods are appropriate for eventual use in a clinical setting. Chief among these considerations include that the methods require only equipment that is small, compact, low cost, and can support easy integration into handheld clinical-grade devices.