Zusammenfassung
Ziel: Gewinnung von Daten zur Systemkonstanz und zur Energiedistribution bei Laserinduzierter Thermotherapie mit handelsüblichen Komponenten. Material/Methode: Durchführung von Konstanzprüfungen optischer Kupplungen, Lasergeneratoren und Laserfasern der Firmen Dornier (Germering, Deutschland), Hüttinger (Umkirch, Deutschland) und Somatex (Berlin, Deutschland) über 60 Minuten mit 25 Watt unter sequenzieller Verwendung zweier Lasertestgeräte (MY-Test, Hüttinger). Je zwei In-vitro-Ablationen in Rinderleber mit Laserfasern Mikrodom-Applikator Typ A13-0540, Microflexx-Applikator REF A13-0561 (beide Hüttinger) Diffusor-Tip H-6111-T3, Diffusor-Tip H-6111-T4 (beide Dornier), Somaflex-Diffuser (Somatex) über 20 Minuten mit 25 Watt und Bestimmung der Koagulationsgeometrien. Ergebnisse: Die unterschiedlichen Systemkomponenten wiesen über den zeitlichen Verlauf Divergenzen auf, die 10 % nicht überschritten. Einzelne Systemkomponenten zeigten sich entgegen Herstellerempfehlungen inkompatibel. Signifikante Unterschiede wiesen die Abstrahleigenschaften der Laserfasern insbesondere in der axialen, vorwärts weisenden Ausrichtung auf. Schlussfolgerung: Die Kenntnis der Emissionsleistung des Lasersystems sowie der individuellen Abstrahlcharakteristiken der Laserfasern ist für den Ablationserfolg bei der LITT entscheidend.
Abstract
Purpose: Evaluation of the continuity and energy distribution of a laser system for laser-induced thermo therapy. Material and Methods: For evaluation of the continuity of laser optical devices, laser generating units and optical fibers of three different manufactures (Dornier, Hüttinger, Somatex), we used the equipment to generate a laser beam of 25 Watt for 60 minutes. Measurements of the applied energy were done sequentially with two MY Test (Fa. Hüttinger) units. We also performed two in vitro ablations of animal liver tissue with different fiber optics [Mikrodom A 13-0540, Microflexx REF A 13-0561 (Hüttinger), Diffusor-Tip H-6111-T 3, Diffusor H-6111-T 4 (Dornier), Somaflex-Diffusor (Somatex)] over 20 minutes at- an energy flow of 25 J per second. We then evaluated the geometry of coagulation. Results: The different equipment used for our tests showed differences of a maximum of 10 %. Some components did not work properly in certain configurations even though the manufacturer assured it would. We saw significant differences in the ablation characteristics of the different fiber optics, especially in axial and frontal directions. Conclusion: Knowledge of the different characteristics in energy distribution and ablation characteristics are an important factor in performing a successful laser-induced thermo therapy.
Schlüsselwörter
LITT - Lebermetastasen - Qualitätssicherung - Laser
Key words
LITT - Liver neoplasms - Quality - Laser
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Dr. Maciej Pech
Klinik für Strahlenheilkunde, Charité Campus Virchow-Klinikum
Augustenburger Platz 1
13353 Berlin
Email: maciej.pech@charite.de
