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Physical Principles of Laser Ablation

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Image-guided Laser Ablation

Abstract

Laser ablation (LA) is a percutaneous tumor ablation technique that utilizes laser light delivered interstitially into the biological tissue to provoke a local hyperthermia according to a planned action. The laser light is coherent and monochromatic, it can be very collimated and focused and delivered though optical fibers with little loss of energy from the source to the target. The nature of the effects of the interaction of the laser light with the tissues depends on many factors, among which the most relevant are the laser wavelength, laser power, exposure time, pulse duration and repetition frequency in case of pulsed emission, the beam characteristics, the optical characteristics of the applicator, and physical properties of the tissue. Inside the biological tissue, light can be reflected, transmitted, scattered and absorbed. Only absorbed energy can produce biological effects while the other above-mentioned phenomena could affect the shape, the extension and the position of the warmed up volume. During the ablation process, coagulation becomes appreciable in the range of temperatures between 54 and 60 °C, depending on the heating rate. Above 60 °C, both the denaturation of larger structural proteins and cellular components accelerate, leading to widespread coagulation and rapid cell death in a duration of less than one second. Currently, most LA procedures use Nd:YAG (λ = 1064 nm) or semiconductor diode lasers (λ = 800–980 nm) operating in the range of 2–40 W. Laser fibers can be multiple and placed into the tissue and can be activated simultaneously to rapidly treat a large volume of tissue if the laser equipment has several laser sources inside. The cooled catheters are now a new technology, a progress for ablative techniques. These cooled systems allow avoiding a too rapid dehydration, reducing carbonization and then sublimation of the tissue which is a limiting factor in the efficiency of the ablation process in terms of the transfer of energy to the tissue itself. The most used guidance systems for positioning the applicator in the portion of tissue to be ablated is ultrasonic imaging; the least used is the systems using CT imaging, while the systems using Magnetic Resonance imaging are very interesting, but also they are very expensive, cumbersome and not so comfortable for the patient. They, however, allow to control in real-time of all the ablation phases from planning to final assessment of the ablative process.

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Notes

  1. 1.

    The Pennes equation was developed around 1948 [11] and, in the years to follow, it has been deeply analyzed and reinterpreted also at the mathematical level. Pennes conducted a study on a mathematical model based on the energy balance of an arbitrary volume of tissue. In this model the energy transfer is due to the phenomenon of conduction, metabolism and movement of blood or convection. In more detail, it takes into account many parameters including the thermal conductivity of the tissue—the capacity of the tissue to conduct heat, the rate of perfusion and the specific heat capacity of the blood, the specific heat and the mass density of the tissue, the density of the absorbed power—the external heat input to the tissue or the energy released from the outside, and again the heat generated by tissue metabolism (generally negligible compared to other heat inputs), the tissue and arterial blood temperatures over time—the kinetics of heat transfer caused, respectively, by thermal conduction (fats and proteins) and convection (blood flow). Alternative theoretical models have been studied to describe the characteristics of heat transfer of tumors more accurately, considering the “thermally significant” blood vessels, but the bioheat transfer (BHTE) serves as a good starting point. The balance equations are linear and, therefore, the tissue studies can be solved by various methods. For this last reason, the Pennes equation is universally recognized as the equation of human warmth (“bioheat equation”).

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Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging and Interventional Radiology, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy

    Claudio Maurizio Pacella

  2. Elesta Srl, Florence, Italy

    Luca Breschi & Daria Bottacci

  3. Scientific Committee, El.En. S.p.A., Florence, Italy

    Leonardo Masotti

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  1. Claudio Maurizio Pacella
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  2. Luca Breschi
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  3. Daria Bottacci
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  4. Leonardo Masotti
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Editors and Affiliations

  1. Department of Interventional Radiology, Ospedale Regina Apostolorum, Albano Laziale, Rome, Italy

    Claudio Maurizio Pacella

  2. Department of Ultrasound, Zhejiang University, Hangzhou, China

    Tian'an Jiang

  3. Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy

    Giovanni Mauri

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Pacella, C.M., Breschi, L., Bottacci, D., Masotti, L. (2020). Physical Principles of Laser Ablation. In: Pacella, C., Jiang, T., Mauri, G. (eds) Image-guided Laser Ablation. Springer, Cham. https://doi.org/10.1007/978-3-030-21748-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-21748-8_2

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