...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Lasers in Medical Science >Laser-induced thermotherapy for lung tissue—evaluation of two different internally cooled application systems for clinical use
【24h】

Laser-induced thermotherapy for lung tissue—evaluation of two different internally cooled application systems for clinical use

机译：激光诱导的肺组织热疗-两种临床使用的内部冷却应用系统的评估

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Thermal ablation techniques like radiofrequency or laser-induced thermotherapy (LITT) are increasingly used to treat tumors of parenchymatous organs. Minimal access, parenchymal preservation, and a low complication rate render them suitable for pulmonary tumors as well. Their successful clinical application depends on the induction of sufficiently large lesions and a knowledge of the energy parameters required for complete thermal ablation. The aim of this study was to establish a dose–response relationship for a percutaneous and an intraoperative system for LITT of lung tissue. Thermal lesions were induced in healthy porcine lungs using an Nd:YAG laser (1,064 nm). LITT was performed with a percutaneous application system in group I (n = 18) and an intraoperative application system in group II (n = 90). Laser energy was applied for 600–1,200 s in a power range of 20–32 W (12,000–38,400 J). The lesions were longitudinally and transversally measured, and the volume was calculated after the intervention. Furthermore, an open application system was used to perform LITT under in vivo conditions during lung perfusion and ventilation in domestic pigs. Lesion volumes in both groups showed a plateau-like curve when the laser power increased from an initial level of 25 W. With the percutaneous puncture system (group I), the application of 28 W (16,800 J) for 10 min generated the largest lesions with a volume of 12.54 ± 1.33 cm3, an axial diameter of 39.33 ± 2.52 mm, and a diametrical diameter of 24.67 ± 1.15 mm. A longer application time was not possible due to thermal instability of the applicator. Moreover, group I started developing extensive carbonizations at a laser power of 22 W (13,200 J). The intraoperative application system (group II) achieved the largest lesion volumes of 11.03 ± 2.54 cm3 with diameters of 34.6 ± 4.22 mm (axial) and 25.6 ± 2.51 mm (diametrical) by an exposure time of 20 min and a power of 32 W (38,400 J). Here extensive carbonizations only started to occur at 28 W (33,600 J). Under in vivo conditions, all pigs tolerated the LITT procedure well without complications. Besides a typical cooling effect in the vicinity of blood vessels, the thermal lesions were about three times smaller than the ex vivo lesions. Both the percutaneous and the open LITT application system induced reproducible, clinically relevant lung lesions. The percutaneous puncture set generated large relevant lesions, although its usability is limited by its restricted capacity and high carbonization risk. It is suitable for powers up to 22 W. The intraoperative application system allows higher energy exposure to induce larger lesion volumes. This study elucidates the dose–effect relation of two clinically relevant puncture sets.
机译：诸如射频或激光诱导热疗（LITT）之类的热消融技术越来越多地用于治疗实质性器官的肿瘤。最少的接触，实质的保存以及低的并发症发生率也使它们也适用于肺部肿瘤。它们的成功临床应用取决于足够大的病变的诱发和完全热消融所需的能量参数知识。这项研究的目的是建立经皮和术中肺组织LITT的剂量反应关系。使用Nd：YAG激光（1,064 nm）在健康的猪肺中诱发热损伤。 LITT在第I组中使用经皮应用系统（n = 18），在第II组中使用术中应用系统（n = 90）进行。在20-32 W（12,000-38,400 J）的功率范围内，激光能量施加了600-1,200 s。纵向和横向测量病变，并在干预后计算体积。此外，在家猪的肺灌注和通气期间，在体内条件下使用开放式应用系统执行LITT。当激光功率从最初的25 W升高时，两组的病变体积均呈平台状曲线。通过经皮穿刺系统（I组），施加28 W（16,800 J）持续10分钟产生的病变最大体积为12.54±1.33 cm 3 ，轴向直径为39.33±2.52 mm，直径为24.67±1.15 mm。由于涂药器的热不稳定性，无法延长涂药时间。此外，第一组开始在22 W（13,200 J）的激光功率下进行广泛的碳化。术中应用系统（第二组）在暴露时间为20时，最大病变体积为11.03±2.54 cm 3 ，直径分别为34.6±4.22 mm（轴向）和25.6±2.51 mm（径向）分钟和32 W（38,400 J）的功率。在这里，仅在28 W（33,600 J）时才开始发生大量碳化。在体内条件下，所有猪都对LITT程序耐受良好，没有并发症。除了在血管附近具有典型的冷却效果外，热损伤比离体损伤小约三倍。经皮和开放式LITT应用系统均可诱导可再现的临床相关肺部病变。经皮穿刺装置产生了较大的相关病变，尽管其可用性受到容量受限和高碳化风险的限制。它适用于最高22 W的功率。术中应用系统允许更高的能量暴露量，从而引起更大的病变体积。这项研究阐明了两种临床相关的穿刺装置的剂量效应关系。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号