In the experiment, the features of laser interstitial thermotherapy (LITT) with wavelengths of 0.92; 0.97; 1.06; 1.56 and 1.9 μm and the possibility of estimating photothermal interactions by means of ultrasoundwere studied. Ultrasound clearly determined the tissue coagulation zone without differentiating it from carbonation. The phenomenon of "breakdown" of tissues during LITT was revealed. Most often at 1.9 Μm-LITT there was a rapid transfer of heat by gas bubbles through the vessels. Intima of the vessels was fired. Ultrasound control of LITT in 145 of 781 children with vascular tumors increased its effectiveness, reducing the number of repeated sessions by 3.2 times.
Two families of new non-analog algorithms of the Monte Carlo method are suggested for calculation of linear characteristics of optical radiation field in turbid heterogeneous media, biological tissues, first of all. One of the families is specifically aimed at calculating the readings of small-aperture radiation detectors. The algorithms allow us with high differential accuracy simultaneously for a large set of the media with different optical parameters (including phase function ones) to calculate the readings of detectors and their derivatives with respect to the parameters. This makes the algorithms high perspective for solving inverse problems of biomedical optics, in particular, for determination of optical parameters of biological tissues from measurements of radiation characteristics. The result is obtained using a rigorous approach based on the theory of Monte Carlo method for linear integral equations. For this purpose, we wrote (in the framework of the kinetic model) the adjoint integral representations for linear radiation characteristics in a heterogeneous turbid medium, correctly considering the reflection and refraction of the light on the surfaces of refractive index discontinuity.
A new method for non-invasive determination of optical parameters (absorption and reduced scattering coefficients) of biological tissues from diffuse reflectance measurements with a multifiber probe is presented. For extraction of the parameters, we use a priori estimations not only of signals of detectors, but also their parameter derivatives that increases accuracy of the extraction. This estimation is performed using a new non-analog Monte Carlo algorithm which allows us to calculate the signals and derivatives simultaneously for a given large set of optical parameters. Experimental testing has shown the measured coefficients provide a good prediction of both light reflection and penetration. Application of the method to some biological tissues are presented.
The paper presents a new method for distant non-destructive determination of concentration of light absorbing admixtures in turbid media. In particular, it is intended for non-invasive in vivo control of accumulation in patient tissues of various biochemicals introduced to the patients for chemotherapy, photodynamic therapy or diagnostics. It is require that the admixture absorption spectrum should have a clearly marked peak in the wavelength region where the pure medium one varies regularly. Fluorescence of admixtures is not required. The method uses the local diffuse reflectance spectroscopy with optical fiber probe including one emitting and two reading There are several features in the method: the value to be determined is absolute concentration of admixtures; the method needs no calibration measurements on phantoms; it needs no reference measurements on sample with zero admixture concentration; it uses a two parametric kinetic light propagation model and original algorithms to resolve direct and inverse tasks of radiation transport theory. Experimental testing passed with tissue equivalent phantoms and different admixtures, including a chlorine photosensitizer, showed accuracy under 10% in all cases.
Two low invasive laser technologies for treatment of degenerative-dystrophic bone diseases in children are presented.
The first is the transcutaneous laser osteoperforation developed by us and initially applied for treatment of different
inflammatory and traumatic diseases (osteomyelitides, osteal and osteoarticular panaritiums, delayed unions, false joints,
and others). Now the technology was applied to treatment of aseptic osteonecrosis of different localizations in 134
children aged from 1 to 16 years, including 56 cases with necrosis of femoral head (Legg-Calve-Perthes disease), 42 with
necrosis of 2nd metatarsal bone head (Kohler II disease), and 36 with necrosis of tibial tuberosity (Osgood–Schlatter
disease). The second technology is the laser intracystic thermotherapy for treatment of bone cysts. The method was
applied to 108 children aged from 3 to 16 years with aneurismal and solitary cysts of different localizations. In both
technologies a 970 nm diode laser was used. The suggested technologies increase the efficiency of treatment, reduce its
duration, can be performed on outpatient basis, which resulted in great economical effect.
A few new low invasive fiber laser technologies for treatment of 1) capillary malformations (port-wine stains), 2) venous, arterial, and arteriovenous malformations, 3) lymphatic malformations of 3 types: micro, small and large-cystic lymphangiomas are presented in this work. There were applied 1.56 μm laser distant photocoagulation, 1.56 μm laser endovascular thermotherapy, 1.9 μm laser instant ablation, 1.9 μm laser interstitial thermotherapy, and 1.9 μm laser excision. The technologies were applied to about 300 patients. Good clinical and esthetic results have been achieved in great majority cases.
A method for non-destructive determination of absorption and transport (reduced) scattering coefficients of turbid media
(biological tissue, first of all) is presented. It refers to the spatially resolved diffuse reflectance techniques with optical
fiber probe. The method is based on a more accurate (in comparison with diffusion) two parameters kinetic light
propagation model and a special two step non-analog Monte Carlo technique, it involves no additional parameters and
uses no assumptions about spectral dependencies of the coefficients, allows application of monochrome sources and
probes with minimally possible number of reading fibers (only 2), goes without calibration phantoms and measurements.
Numerical and experimental testing have showed the measured coefficients provide a good prediction of both light
reflection and penetration fields in semi-infinite homogeneous media with low-mid absorption.
Results of application of low invasive laser technology (developed by authors: Proc. SPIE 5863, 107-115 (2005),
Russian Federation patent No.2290228 of.27.12.06) to treatment of hemangiomas in children are presented and analyzed
in this work. From 2001 the technology was applied to about 1500 children with more than 2000 hemangiomas. Majority
of them were complicated ones: belong to cavernous or combined types or (and) were localized on problem places: on
face near eyes, nose, and lips, on auricles, on perineum near anus and genitals, in respiratory and gastrointestinal tracts.
Diode laser with wavelength 920, 970, and 1060 nm at distant and interstitial irradiation were applied. In case of need
there applied endoscopes. Excellent and good results have been achieved in 94% cases; there was a significant
improvement in the rest cases.
A photodynamic therapy experiment on 118 inbred white mice with transplanted Ehrlich's tumor (mouse
mammary gland adenocarcinoma) is performed to reveal mechanisms of necrosis formation. In 7-10 days the tumor of
1-1.5 cm diameter is formed under skin at the injection point, and PDT procedure is applied. There were used a chlorine
type photosensitizer RadachlorineTM and 662 nm wavelength diode laser. The drug is injected by intravenously at the
dose of 40 mg/kg; the irradiation is executed in 2-2.5 hours at the surface dose of about 200 J/cm2. Each of the mice had
a photochemical reaction in form of destructive changes at the irradiation region with subsequent development of dry
coagulation necrosis. After rejection of the necrosis there occurred epithelization of defect tissues in a tumor place.
Histological investigations were conducted in different follow-up periods, in 5 and 30 min, 1, 3, 6, and 12 hours, 1, 3, 7
and 28 days after irradiation. They included optical microscopy, immune marker analysis, morphometry with
measurements of volume density of epithelium, tumor stroma and necroses, vascular bed. The investigations showed that
an important role in damaging mechanisms of photodynamic action belongs to hypoxic injuries of tumor mediated by
micro vascular disorders and blood circulatory disturbances. The injuries are formed in a few stages: microcirculation
angiospasm causing vessel paresis, irreversible stases in capillaries, diapedetic hemorrhages, thromboses, and
thrombovasculitis. It is marked mucoid swelling and fibrinoid necrosis of vascular tissue. Progressive vasculitises result
in total vessel obliteration and tumor necrosis.
The method of laser osteoperforation was developed in experiment and then applied for treatment of 508 patients with
osteomyelitis, 51 patients with nonunion and pseudo-joint and 34 patients with different forms of osteochondropathy.
The clinical trial proved the efficiency of laser osteoperforation for treatment of both inflammatory and destructive bone
diseases. This method is minimally invasive, promotes rapid reduction of bone and soft tissue inflammation, and
apparently stimulates bone reparation.
Clinical results of photodynamic therapy (PDT) with a novel natural second generation chlorin-type photosensitizer "Radachlorin", mainly consisting of sodium chlorine e6, are presented. This sensitizer possesses a number of advantages over sensitizers of hematoporphyrin and phthalocyanine types. In particular, Radachlorin is excreted from organism much faster (in 1-2 days), as a result the problem of patient light hypersensitivity for a few months is non-actual for
Radachlorin. As light source there was used a 662 nm diode laser specially designed for PDT with Radachlorin. The 5 year clinical results of PDT application to 89 patients with different malignant tumors are summarized and analysed. It is shown in particular that PDT with Radachlorin is a radical high efficient method for treatment of basal cell carcinoma of skin. At intravenous introduction in drug dose 0.5 mg/kg with light fluence 300-350 J/cm2 or in dose 1 mg/kg with fluence 200-250 J/cm2 the method gives full recovery in almost 100% cases with excellent cosmetic effect. The method was successfully combined with surgical operations, laser ablations, radio- and chemotherapy. Preoperative and intraoperative PDT favors improvement of results in complex treatment of malignant tumors. The method has a potential as palliative measure; in a number of incurable cases it allowed us to achieve recanalization of obturated hollow organs, eliminate the inflammatory complications, and as a result to improve life quality.
Laser osteoperforation method, initially developed for treatment of osteomyelitis, was successfully applied to 66 patients
with osteal and osteoarticular panaritium. The procedure consisted in perforation of the affected phalanx with diode laser
radiation (wavelength 970nm; average power 10-12W; pulse mode 100/50 ms), delivered through quartz monofiber.
Additional laser induced thermotherapy (power 2-3W; continuous mode) was fulfilled for persistent fistulas. In
comparison with conventional surgery, laser osteoperforation provided faster pain relieve, edema dissipation, wound and
fistula closure; good functional results; decreasing of disability cases number.
Infra-red diode laser with wavelength 1060 nm was used for combined treatment of 163 children aged from 21 days to 13 years with 221 hemangiomas. For interstitial coagulation a power of 1.8-2 W and a power density of 5-90 J/cm3 were used in continuous mode. For distant coagulation pulse mode was applied with pulse/pause duration 30-50/200-250 ms, average power 1.3-2 W, and power density 65-450 J/cm2. 197 (89.1 %) hemangiomas were capillary, 7 (3.2 %) cavernous, and 17 (7.7 %) combined (combination of capillary and cavernous hemangiomas). The area of hemangiomas ranged from 6 mm2 to 48 cm2. For the majority (193, 87.3 %) of hemangiomas one session of photocoagulation was enough to achieve a good cosmetic effect. However, 28 (12.7 %) hemangiomas were treated repeatedly, 11 (5%) of them needed 4-7 sessions. In 8 children with cavernous and combined hemangiomas both distant and interstitial laser coagulation were used. In all, good or excellent results were obtained in 96,3 % of the patients. In 6 (3.7%) patients with extensive combined hematomas the considerable improvement was achieved.
Photodynamic therapy (PDT) was performed with a new photosensitizer, a water soluble form of chlorins (Radachlorin, Russia) possessing an absorption peak around 662 nm. As light source there was used the diode laser (ML-662-SP, Russia) with 662 nm wavelength and 2.5 W optical power. The sensitizer had passed broad pre-clinical in vitro and in vivo studies, which showed safety and efficiency of it. PDT was applied to 51 patients with basal cell cancer of the skin (about 60% of all cases), breast cancer, lip cancer, melanoma, cancer of esophagus, stomach, and rectum, cancer and leucoplacia of vulva, malignant ganglioneuroma, sarcoma of soft tissue, cancer and reticular sarcoma of thyroid gland, cancer of ductus choledochus. Most of non-basalioma patients had either forth stage or recurrence of disease. The sensitizer was injected intravenously or applied externally (Radachlorin gel). There were used surface, endoscopic, and interstitial ways of irradiation. Full tumor regression with excellent cosmetic effect was reached in 100% cases of 1-3 stage basal cell cancer patients treated with intravenous Radachlorin injection. In most other (non-basalioma) cases significant regression of tumors and improvement of life quality of patients (recanalization and regain of conductivity) was obtained.
Laser osteoperforation, previously studied in experiment in rabbits at treatment for acute purulent osteomyelitis (Privalov V. et.al., SPIE Proc., v.3565., pp. 72-79), was applied in clinic to 36 patients with chronic purulent osteomyelitis and to 6 patients (children) with acute haematogenic osteomyelitis. Diode lasers of 805 and 980 nm wavelength were used. There was achieved full recovery in all acute cases, and stable remission in chronic cases during all the observation period (1 - 2.5 years).
Laser-induced interstitial thermotherapy was performed in 29 patients with recurrent nodular and multinodular goiter, and in 3 patients with recurrent inoperable thyroid cancer. There were used transcutaneous puncture under ultrasonic control, diode lasers with wavelength 805, 980, and 1060 nm, quartz monofibers, special computerized thermometer with microthermocouples. Disappearance or significant reduction of nodes in the most goiter cases, and regress of tumor in the cancer cases were marked during observation period (0.5 - 2.5 years).
A non-stationary two-dimensional computer code for modelling of radiation and heat transport in heterogeneous biological tissues irradiated with laser is presented. Radiation transport is considered in the kinetic model, radiation transport equation is solved by the Monte Carlo method. Heat transport is considered in the heat conduction model, the heat equation is solved by a combination of Galerkin and the finite element methods. The code has passed a number of tests including comparisons with analytical solutions, numerical calculations of other authors, and with experimental results. The code can be used for working out and designing of laser surgical and therapeutic procedures. As well it can be used in inverse problem of experimental determination of optical and thermal parameters of biological tissues.
In the experiment on 41 dogs the possibilities of Nd:YAG (1064 nm) and diode lasers (805 nm) usage for thermotherapy of thyroid gland was grounded. We founded the regimes of laser irradiation causing local destruction of thyroid glands without damage of surrounding organs and tissues. An intratissue dynamic thermometry control in the thyroid and surrounding tissues and their histological analysis were used for determination of the operating mode. The thermometry was performed with the help of an original setup, specimens for the analysis were taken in the period from 1 - 3 to 130 days after the laser irradiation. The results of the experiments gave occasion to the use of intrathyroid local laser hyperthermia in the treatment of 15 patients with recurrent nodal and multinodal euthyroid goiter and 2 patients with inoperable (incurable) medullary thyroid cancer. The laser thermotherapy was fulfilled transcutaneously with ultrasonic control. No complications were registered during the irradiation and the nearest postoperative period. The dynamic ultrasonic examination of the patients carried out for 3 - 18 months showed a positive effect in all cases.
The Monte Carlo methods are widely used in biooptics to calculate different characteristics of the optical radiation fields. In the most cases the radiation characteristics including local ones (fluence, absorbed dose, etc.) are calculated with non-local Monte Carlo estimates, which give the values averaged over some region. These methods can lead to large systematical errors if the characteristics have fast space variation. At the same time there are local algorithms in the theory of the Monte Carlo methods. They are widely used in calculations of fields of ionizing radiation. In particular, the famous Kalos `local estimate' allows computations of radiation flux at a fixed point. This estimate solves the problem of the systematical error but because of infinite variance it has lower convergence and stability in comparison with non-local methods. Recently a method of acceleration of convergence of the Monte Carlo estimates possessing infinite variance was suggested. In the present work this accelerated Monte Carlo algorithm is applied to the Kalos estimate under typical conditions of biooptics (rat liver irradiated by 1.064 mkm laser). It is shown that the algorithm gives the gain in computational time up to 100 times. Obtained results allow us to recommend this algorithm for calculation of local characteristics of laser radiation fields in biological tissues.
The problems of contact measurement of temperature in the presence of intensive radiation are discussed. A new measuring-calculative method for thermometry in such conditions is presented. The method has been realized in a setup including: miniature thermodetectors, amplifiers, analog-to-digital converter and a computer with software to record thermodetector temperatures, to recalculate them to medium temperatures and to display the results. The setup and the method have passed testing in model experiments and are successfully applied to thermometry in various biological tissues irradiated by near infrared lasers.
We suggest to use laser osteoperforation as a new approach to surgical treatment of acute haemotogenic osteomyelitis. In the present work this approach is studied in experiment on 30 rabbits with an emphasis on a role of hypertermia. The osteomyelitis was produced with the help of an original technique by percutaneous introduction of microorganisms `Staph. Aureus' in medullar channel. The animals were divided into 2 group, experimental (17 rabbits) and control (13). On the 7th day of the illness all animals were subjected to the osteoperforation, with Nd:YAG laser (1064 nm) in the first group and with mechanic drill in the second. During the laser osteoperforation the dynamic control of temperature was performed simultaneously in 5 - 7 points in medullar channel. The original measuring- computational system designed for temperature measurements in the presence of intense laser radiation was used. Significant increase of temperature in medulla was fixed near laser channels, in the range up to 2 mm. In the experimental group the perforation results rapid positive clinical changes and convalescence of all animals confirmed by clinical, roentgenological, and histological tests. In the control group there was no positive dynamics, there were intermuscular phlegmon and plo-inflammatory changes in medulla, sequestra were formed. The reason of such an advantage of laser perforation consists in new factors of action in addition to decompression of medullar channel (available in both methods). The laser produces hypertermia of the medulla which kills a significant part of microorganisms, and it creates intensive radiation field which, possible, stimulates reparative processes.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.