3D-Bestrahlungsplanung für die laserinduzierte Thermotherapie (LITT)

Zusammenfassung Es wurde ein Dosimetriemodell fur die thermische Therapie von biologischem Gewebe mittels Laserstrahlung erarbeitet und auf die interstitielle laserinduzierte Thermotherapie von Organtumoren angewendet. Das Modell kombiniert eine Monte-Carlo-Simulation zur Berechnung der Photonenverteilung im Zielvolumen, ein Finite-Differenzen-Verfahren zur Berucksichtigung von Warmetransportprozessen und den Arrhenius-Formalismus zur Bestimmung der Proteindenaturierung und finalen Gewebedestruktion. Die Implementierung der Algorithmen erfolgte auf einer Windows™-basierten Plattform und ermoglicht die dreidimensionale Kontrolle des Zielvolumens. Die In-vitro-Evaluierung in Schweineleber zeigte eine Ubereinstimmung von besser 7 % bezuglich des Destruktionsvolumens. Die Anwendung des Modells fur eine klinisch relevante Situation machte deutlich, dass Masnahmen zur Perfusionsminderung die Effizienz der LITT um ein Vielfaches steigern konnen.

[1]  P. Rougier,et al.  Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial. , 1992, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  L. C. Henyey,et al.  Diffuse radiation in the Galaxy , 1940 .

[3]  H.J.C.M. Sterenborg,et al.  Skin optics , 1989, IEEE Transactions on Biomedical Engineering.

[4]  Martin G Mack,et al.  Percutaneous MRI-guided laser-induced thermotherapy for hepatic metastases for colorectal cancer , 1997, The Lancet.

[5]  Gerhard Müller,et al.  Optical properties of native and coagulated human liver tissue and liver metastases in the near infrared range , 1998, Lasers in surgery and medicine.

[6]  F Fobbe,et al.  Magnetic Resonance Imaging—Controlled Laser–Induced Interstitial Thermotherapy , 1994, Investigative radiology.

[7]  M Deimling,et al.  Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. , 1995, Radiology.

[8]  F. Wacker,et al.  Vascular lesions in children: percutaneous MR imaging-guided interstitial Nd:YAG laser therapy--preliminary experience. , 1998, Radiology.

[9]  A. Roggan,et al.  [Laser-induced thermotherapy. Technical prerequisites for treatment of malignant liver tumors]. , 1998, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[10]  A Roggan,et al.  Internally cooled power laser for MR-guided interstitial laser-induced thermotherapy of liver lesions: initial clinical results. , 1998, Radiology.

[11]  B. Wilson,et al.  A Monte Carlo model for the absorption and flux distributions of light in tissue. , 1983, Medical physics.

[12]  I. Yaroslavsky,et al.  Treatment planning for MRI‐guided laser‐induced interstitial thermotherapy of brain tumors—The role of blood perfusion , 1998, Journal of magnetic resonance imaging : JMRI.

[13]  A. Roggan,et al.  The effect of preparation technique on the optical parameters of biological tissue , 1999 .

[14]  W R Lees,et al.  Ultrasound features of low power interstitial laser hyperthermia. , 1992, Clinical Radiology.

[15]  S. Thomsen PATHOLOGIC ANALYSIS OF PHOTOTHERMAL AND PHOTOMECHANICAL EFFECTS OF LASER–TISSUE INTERACTIONS , 1991, Photochemistry and photobiology.

[16]  S L Jacques,et al.  Laser-tissue interaction modeling with LATIS. , 1997, Applied optics.

[17]  A Roggan,et al.  Experimental study of laparoscopic laser‐induced thermotherapy for liver tumours , 1997, The British journal of surgery.

[18]  A Roggan,et al.  Laser-induced thermotherapy combined with hepatic arterial embolization in the treatment of liver tumors in a rat tumor model. , 1999, Annals of surgery.

[19]  N. Petrelli,et al.  A prospective evaluation of hepatic resection for colorectal carcinoma metastases to the liver: Gastrointestinal Tumor Study Group Protocol 6584. , 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  A. Welch,et al.  The thermal response of laser irradiated tissue , 1984, IEEE Journal of Quantum Electronics.

[21]  Johan Olsrud,et al.  Feedback interstitial diode laser (805 nm) thermotherapy system: Ex vivo evaluation and mathematical modeling with one and four‐fibers , 1998, Lasers in surgery and medicine.

[22]  S. Arrhenius Über die Reaktionsgeschwindigkeit bei der Inversion von Rohrzucker durch Säuren , 1889 .

[23]  J. Aldrete,et al.  Hepatic Resection of Metastasis from Colorectal Carcinoma: Morbidity, Mortality, and Pattern of Recurrence , 1989, Annals of surgery.

[24]  H. J. Buhr,et al.  Laserinduzierte Thermotherapie Technische Voraussetzungen zur Behandlung maligner Lebertumoren , 1998, Der Chirurg.

[25]  W R Lees,et al.  Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. , 1993, Radiology.

[26]  D. M. Sherman,et al.  Palliation of hepatic metastasis , 1978, Cancer.