a Division of Neurosurgery , Rutgers University, Robert Wood Johnson Medical School , New Brunswick , NJ , USA.
Int J Hyperthermia. 2018 Sep;34(6):764-772. doi: 10.1080/02656736.2017.1376355. Epub 2017 Sep 18.
Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) is a minimally invasive procedure used to treat various intracranial pathologies. This study investigated the effects of variable power on maximal estimated thermal damage during ablation and duration required to reach maximal ablation.
MATERIALS/METHODS: All ablations were performed using the Visualase Thermal Therapy System (Medtronic Inc., Minneapolis, Minnesota), which uses a 980 nm diffusing tip diode laser. Cases were stratified into low, medium and high power. Maximal thermal damage estimate (TDE) achieved in a single plane and time to reach maximal damage (t) were measured and compared between groups using a 2×3 Fixed Factor Analysis of Covariance. Ablation area change for cases in which an initial thermal dose was followed by a subsequent dose, with increased power, was also assessed.
We used real-time ablation data from 93 patients across various intracranial pathologies. t (mean ± SEM) decreased linearly as power increased (low: 139.2 ± 10.4 s, medium: 127.5 ± 4.3 s, high: 103.7 ± 5.8 s). In cases where a second thermal dose was delivered at higher power, the TDE expanded an average of 51.4 mm beyond the initial TDE generated by the first ablation, with the second ablation approaching TDE at a higher rate than the initial ablation.
Increased power results in a larger TDE and an increased ablation rate. In cases where an initial thermal dose does not fully ablate the target lesion, a second ablation at higher power can increase the area of ablation with an increased ablation rate.
磁共振引导激光诱导热疗（MRgLITT）是一种用于治疗各种颅内病变的微创程序。本研究探讨了在消融过程中可变功率对最大估计热损伤的影响，以及达到最大消融所需的时间。
材料/方法：所有消融均使用 Visualase 热疗系统（美敦力公司，明尼苏达州明尼阿波利斯市）进行，该系统使用 980nm 扩散尖端二极管激光。病例分为低、中、高功率。在单一层面测量并比较各组之间达到的最大热损伤估计值（TDE）和达到最大损伤的时间（t），并使用 2×3 固定因子协方差分析进行比较。对于初始热剂量后再增加剂量且增加功率的病例，还评估了初始消融的初始热剂量后再增加剂量且增加功率的病例的消融面积变化。
我们使用了来自各种颅内病变的 93 名患者的实时消融数据。t（平均值±SEM）随着功率的增加呈线性下降（低：139.2±10.4s，中：127.5±4.3s，高：103.7±5.8s）。在第二次以更高功率施加热剂量的情况下，TDE 比第一次消融产生的初始 TDE 平均扩大了 51.4mm，第二次消融比第一次消融更快地达到 TDE。
增加功率会导致更大的 TDE 和更高的消融率。在初始热剂量不能完全消融目标病变的情况下，第二次以更高功率进行消融可以增加消融面积，同时提高消融率。
