Whiteside Paul J D, Qian Chenxi, Golda Nicholas, Hunt Heather K
Department of Bioengineering, University of Missouri, Columbia, Missouri 65211.
Department of Dermatology, University of Missouri, School of Medicine, Columbia, Missouri 65212.
Lasers Surg Med. 2017 Sep;49(7):666-674. doi: 10.1002/lsm.22662. Epub 2017 Apr 18.
Applications of light-based energy devices involving optical targets within the dermis frequently experience negative side-effects resultant from surface scattering and excess optical absorption by epidermal melanin. As a broadband optical absorber, melanin decreases the efficacy of light-based treatments throughout the ultraviolet, visible, and near-infrared spectra while also generating additional heat within the surface tissue that can lead to inflammation or tissue damage. Consequently, procedures may be performed using greater energy densities to ensure that the target receives a clinically relevant dose of light; however, such practices are limited, as doing so tends to exacerbate the detrimental complications resulting from melanin absorption of treatment light. The technique presented herein represents an alternative method of operation aimed at increasing epidermal energy fluence while mitigating excess absorption by unintended chromophores. The approach involves the application of continuously pulsed ultrasound to modulate the tissue's optical properties and thereby improve light transmission through the epidermis.
To demonstrate the change in optical properties, pulsed light at a wavelength of 532 nm from a Q-switched Nd:YAG laser was transmitted into 4 mm thick samples of porcine skin, comprised of both epidermal and dermal tissue. The light was transmitted using an optical waveguide, which allowed for an ultrasonic transducer to be incorporated for simultaneous paraxial pulsation in parallel with laser operation. Light transmitted through the tissue was measured by a photodiode attached to an integrating sphere.
Increasing the driving voltage of ultrasonic pulsation resulted in an increase in mean transmitted optical power of up to a factor of 1.742 ± 0.0526 times the control, wherein no ultrasound was applied, after which the optical power increase plateaued to an average amplification factor of 1.733 ± 0.549 times the control.
The increase implies a reduction in light either back-scattered or absorbed within the tissue, which would allow for a greater proportion of incident energy to be delivered to the clinical target, thereby improving procedural efficacy and potentially reducing the severity of detrimental side-effects. Apparatus Lasers Surg. Med. 49:666-674, 2017. © 2017 Wiley Periodicals, Inc.
涉及真皮层内光学靶点的光基能量设备的应用,经常会因表面散射以及表皮黑色素过多的光吸收而产生负面副作用。作为一种宽带光吸收剂,黑色素会降低整个紫外、可见和近红外光谱范围内光基治疗的疗效,同时还会在表层组织内产生额外热量,进而导致炎症或组织损伤。因此,可能会使用更高的能量密度来进行治疗,以确保靶点接收到具有临床意义的光剂量;然而,这种做法是有限的,因为这样做往往会加剧因黑色素吸收治疗光而产生的有害并发症。本文介绍的技术代表了一种旨在增加表皮能量通量,同时减轻非预期发色团过度吸收的替代操作方法。该方法包括应用连续脉冲超声来调节组织的光学特性,从而改善光通过表皮的传输。
为了证明光学特性的变化,将调Q Nd:YAG激光发出的波长为532 nm的脉冲光传输到由表皮和真皮组织组成的4 mm厚的猪皮样本中。光通过一个光波导进行传输,该光波导允许并入一个超声换能器,以便在与激光操作并行的情况下进行同步近轴脉动。透过组织的光由连接到积分球的光电二极管进行测量。
增加超声脉动的驱动电压会导致平均透射光功率增加,最高可达未施加超声时对照值的1.742±0.0526倍,之后光功率增加趋于平稳,平均放大倍数为对照值的1.733±0.549倍。
这种增加意味着组织内背散射或吸收的光减少,这将使更大比例的入射能量能够传递到临床靶点,从而提高治疗效果,并有可能降低有害副作用的严重程度。仪器激光外科学杂志。49:666 - 674, 2017。©2017威利期刊公司。