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Proceedings Paper

Laser-induced thermotherapy of benign and malignant tumors controlled by color-coded duplex sonography
Author(s): Carsten M. Philipp; Ewa Rohde; Juergen Waldschmidt; Hans-Peter Berlien
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Paper Abstract

Since 1984 we use the interstitial application of laser induced thermotherapy (LITT) for the treatment of congenital vascular disorders (CVD) such as hemangiomas and vascular malformations. In most of the procedures a 600 micron core bare fiber is used to deliver the radiation of a cw Nd:YAG laser emitting at 1064 nm into the diseased tissue. As most of the CVD treated this way are located subcutaneously, the localization of the fiber and the interstitial laser coagulation (ILC) is controlled by transillumination and palpitation of the heat expansion of the skin surface, this way a crepitation can also be detected during the ILC. As the ILC in deeper body structures cannot be controlled directly we use color coded duplex sonography (CCDS), both for diagnostic and treatment control. In the procedures where we use the B-scan image for puncture control, a color signal is displayed representing tissue movements. These movements caused by degasification and vapor are those detectable as crepitations when using direct control. The color signal starts, changes, and moves in a reproducible pattern following the heat distribution and the subsequently occurring degasification in the tissue. Also the changes in perfusion are detectable by the means of CCDS. The precise extent of the coagulation is visible in the B-scan several minutes after laser exposure. The clinical experience and an extensive experimental evaluation has proven that CCDS is a valuable real time method to monitor the tissue reaction in ILC-procedures. For two years we have performed ILC-procedures with CCDS control in patients with CVD (n equals 65) successfully. Because of its reliable imaging and the clinical advantages recently we applied this type of ILC-control to the palliative treatment of nonresectable primary and secondary liver tumors (n equals 3) and subcutaneous metastases of mamma carcinoma. (n equals 6).

Paper Details

Date Published: 23 December 1994
PDF: 7 pages
Proc. SPIE 2327, Medical Applications of Lasers II, (23 December 1994); doi: 10.1117/12.197571
Show Author Affiliations
Carsten M. Philipp, Freie Univ. Berlin (Germany)
Ewa Rohde, Freie Univ. Berlin (Germany)
Juergen Waldschmidt, Freie Univ. Berlin (Germany)
Hans-Peter Berlien, Freie Univ. Berlin (Germany)

Published in SPIE Proceedings Vol. 2327:
Medical Applications of Lasers II
Stephen G. Bown; J. Escourrou; Frank Frank; Herbert J. Geschwind M.D.; Guilhem Godlewski M.D.; Frederic Laffitte; Hans H. Scherer M.D., Editor(s)

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