Development of stereotactically guided laser interstitial thermotherapy of breast cancer

In situ measurement and analysis of the temperature field in ex vivo and in vivo adipose tissue

Peter J. Milne, Jean-Marie A Parel, Fabrice Manns, David B. Denham, Xochitl Gonzalez-Cirre, David S. Robinson

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background and Objective: The size (0.5-1.0 cm) of early nonpalpable breast tumors currently detected by mammography and confirmed by stereotactic core biopsy is of the order of the penetration depth of near infrared photons in breast tissue. In principle, stereotactically biopsied tumors, therefore, could be safely and efficiently treated with laser thermotherapy. The aim of the current study is to confirm the controlled heating produced by clinically relevant power levels delivered with an interstitial laser fiber optic probe adapted for use with stereotactic mammography and biopsy procedures. Study Design/Materials and Methods: Temperature increases and the resultant thermal field produced by the irradiation of ex vivo (porcine and human) and in vivo (porcine) tissue models appropriate to the treatment of human breast tissue by using cw Nd:YAG laser radiation delivered with a interstitial fiber optic probe with a quartz diffusing tip, were recorded with an array of fifteen 23- gauge needle thermocouple probes connected to a laboratory computer-based data acquisition system. Results: By using a stepwise decreasing power cycle to avoid tissue charring, acceptably symmetric thermal fields of repeatable volumetric dimensions were obtained. Reproducible thermal gradients and predictable tissue necrosis without carbonization could be induced in a 3-cm- diameter region around the fiber probe during a single treatment lasting only 3 minutes. The time-dependences of the temperature rise of the thermocouples surrounding the LITT probe were quantitatively modeled with simple linear functions during the applied laser heating cycles. Conclusion: Analysis of our experimental results show that reproducible, symmetric and predictable volumetric temperature increases in time can be reliably produced by interstitial laser thermotherapy.

Original languageEnglish
Pages (from-to)67-75
Number of pages9
JournalLasers in Surgery and Medicine
Volume26
Issue number1
DOIs
StatePublished - Jan 29 2000

Fingerprint

Induced Hyperthermia
Adipose Tissue
Lasers
Breast Neoplasms
Temperature
Hot Temperature
Mammography
Heating
Breast
Swine
Biopsy
Quartz
Solid-State Lasers
Photons
Information Systems
Needles
Necrosis
Radiation
Therapeutics
Neoplasms

Keywords

  • Breast cancer
  • Hyperthermia
  • Nd:YAG laser
  • Thermal measurements
  • Thermocouples

ASJC Scopus subject areas

  • Surgery

Cite this

Development of stereotactically guided laser interstitial thermotherapy of breast cancer : In situ measurement and analysis of the temperature field in ex vivo and in vivo adipose tissue. / Milne, Peter J.; Parel, Jean-Marie A; Manns, Fabrice; Denham, David B.; Gonzalez-Cirre, Xochitl; Robinson, David S.

In: Lasers in Surgery and Medicine, Vol. 26, No. 1, 29.01.2000, p. 67-75.

Research output: Contribution to journalArticle

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abstract = "Background and Objective: The size (0.5-1.0 cm) of early nonpalpable breast tumors currently detected by mammography and confirmed by stereotactic core biopsy is of the order of the penetration depth of near infrared photons in breast tissue. In principle, stereotactically biopsied tumors, therefore, could be safely and efficiently treated with laser thermotherapy. The aim of the current study is to confirm the controlled heating produced by clinically relevant power levels delivered with an interstitial laser fiber optic probe adapted for use with stereotactic mammography and biopsy procedures. Study Design/Materials and Methods: Temperature increases and the resultant thermal field produced by the irradiation of ex vivo (porcine and human) and in vivo (porcine) tissue models appropriate to the treatment of human breast tissue by using cw Nd:YAG laser radiation delivered with a interstitial fiber optic probe with a quartz diffusing tip, were recorded with an array of fifteen 23- gauge needle thermocouple probes connected to a laboratory computer-based data acquisition system. Results: By using a stepwise decreasing power cycle to avoid tissue charring, acceptably symmetric thermal fields of repeatable volumetric dimensions were obtained. Reproducible thermal gradients and predictable tissue necrosis without carbonization could be induced in a 3-cm- diameter region around the fiber probe during a single treatment lasting only 3 minutes. The time-dependences of the temperature rise of the thermocouples surrounding the LITT probe were quantitatively modeled with simple linear functions during the applied laser heating cycles. Conclusion: Analysis of our experimental results show that reproducible, symmetric and predictable volumetric temperature increases in time can be reliably produced by interstitial laser thermotherapy.",
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AB - Background and Objective: The size (0.5-1.0 cm) of early nonpalpable breast tumors currently detected by mammography and confirmed by stereotactic core biopsy is of the order of the penetration depth of near infrared photons in breast tissue. In principle, stereotactically biopsied tumors, therefore, could be safely and efficiently treated with laser thermotherapy. The aim of the current study is to confirm the controlled heating produced by clinically relevant power levels delivered with an interstitial laser fiber optic probe adapted for use with stereotactic mammography and biopsy procedures. Study Design/Materials and Methods: Temperature increases and the resultant thermal field produced by the irradiation of ex vivo (porcine and human) and in vivo (porcine) tissue models appropriate to the treatment of human breast tissue by using cw Nd:YAG laser radiation delivered with a interstitial fiber optic probe with a quartz diffusing tip, were recorded with an array of fifteen 23- gauge needle thermocouple probes connected to a laboratory computer-based data acquisition system. Results: By using a stepwise decreasing power cycle to avoid tissue charring, acceptably symmetric thermal fields of repeatable volumetric dimensions were obtained. Reproducible thermal gradients and predictable tissue necrosis without carbonization could be induced in a 3-cm- diameter region around the fiber probe during a single treatment lasting only 3 minutes. The time-dependences of the temperature rise of the thermocouples surrounding the LITT probe were quantitatively modeled with simple linear functions during the applied laser heating cycles. Conclusion: Analysis of our experimental results show that reproducible, symmetric and predictable volumetric temperature increases in time can be reliably produced by interstitial laser thermotherapy.

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