Laser thermal therapy: utility of interstitial fluence monitoring for locating optical sensors.

Multipoint optical fluence measurements can potentially be used to detect coagulation-induced changes in optical propagation during interstitial laser thermal therapy. Estimating the dimensions of coagulation using on-line optical monitoring, which is applicable to treatments where the tip of the source fibre is not precharred, may be limited by the accuracy of the placement of optical sensors with respect to source fibres. A strategy has been developed to determine accurately the position of a four-sensor linear array, prior to treatment, using optical fluence data obtained from the sensors for low-power (< or = 0.5 W) irradiation. A minimum of four sensors in an array was required in order to develop a mathematical formulation for position determination that did not require tissue optical properties or laser power as input. Optical propagation was based on diffusion theory for homogeneous tissues in spherical geometry. Low input laser power is needed to ensure that there are no thermally induced changes in tissue optical properties not accounted for in the mathematical description. Experimental evaluation was performed in a tissue-equivalent liquid phantom using 0.5 W of 805 nm optical energy and a translatable isotropic optical sensor. For sensor locations with 2 mm spacing, placement accuracy of 0.67 mm was achieved. The accuracy improved to 0.13 mm as the sensor spacing increased to 5 mm.