Department of Biomedical Engineering, School of Medicine, Tsinghua University, Qinghuayuan Street, Haidian District, 100084, Beijing, China.
Int J Comput Assist Radiol Surg. 2018 Mar;13(3):411-423. doi: 10.1007/s11548-017-1664-8. Epub 2017 Sep 9.
Complete resection of diseased lesions reduces the recurrence of cancer, making it critical for surgical treatment. However, precisely resecting residual tumors is a challenge during operation. A novel integrated spectral-domain optical-coherence-tomography (SD-OCT) and laser-ablation therapy system for soft-biological-tissue resection is proposed. This is a prototype optical integrated diagnosis and therapeutic system as well as an optical theranostics system.
We develop an optical theranostics system, which integrates SD-OCT, a laser-ablation unit, and an automatic scanning platform. The SD-OCT image of biological tissue provides an intuitive and clear view for intraoperative diagnosis and monitoring in real time. The effect of laser ablation is analyzed using a quantitative mathematical model. The automatic endoscopic scanning platform combines an endoscopic probe and an SD-OCT sample arm to provide optical theranostic scanning motion. An optical fiber and a charge-coupled device camera are integrated into the endoscopic probe, allowing detection and coupling of the OCT-aiming beam and laser spots.
The integrated diagnostic and therapeutic system combines SD-OCT imaging and laser-ablation modules with an automatic scanning platform. OCT imaging, laser-ablation treatment, and the integration and control of diagnostic and therapeutic procedures were evaluated by performing phantom experiments. Furthermore, SD-OCT-guided laser ablation provided precision laser ablation and resection for the malignant lesions in soft-biological-tissue-lesion surgery. The results demonstrated that the appropriate laser-radiation power and duration time were 10 W and 10 s, respectively. In the laser-ablation evaluation experiment, the error reached approximately 0.1 mm. Another validation experiment was performed to obtain OCT images of the pre- and post-ablated craters of ex vivo porcine brainstem.
We propose an optical integrated diagnosis and therapeutic system. The primary experimental results show the high efficiency and feasibility of our theranostics system, which is promising for realizing accurate resection of tumors in vivo and in situ in the future.
彻底切除病变部位可降低癌症复发的风险，因此对手术治疗至关重要。然而，在手术过程中精确切除残留肿瘤是一个挑战。本文提出了一种用于软生物组织切除的新型集成光谱域光相干断层扫描（SD-OCT）和激光烧蚀治疗系统。这是一种集成的光学诊断和治疗系统，也是一种光治疗系统。
我们开发了一种光学治疗系统，它集成了 SD-OCT、激光烧蚀单元和自动扫描平台。生物组织的 SD-OCT 图像为术中诊断和实时监测提供了直观、清晰的视图。激光烧蚀效果通过定量数学模型进行分析。自动内窥镜扫描平台将内窥镜探头和 SD-OCT 采样臂结合在一起，提供光学治疗扫描运动。光纤和电荷耦合器件相机被集成到内窥镜探头中，实现了 OCT 瞄准光束和激光点的检测和耦合。
集成诊断和治疗系统将 SD-OCT 成像和激光烧蚀模块与自动扫描平台相结合。通过对体模实验进行评估，实现了 OCT 成像、激光治疗、诊断和治疗程序的集成和控制。此外，SD-OCT 引导的激光烧蚀为软生物组织病变手术中的恶性病变提供了精确的激光烧蚀和切除。结果表明，适当的激光辐射功率和持续时间分别为 10 W 和 10 s。在激光烧蚀评估实验中，误差约为 0.1 毫米。还进行了另一个验证实验，以获得离体猪脑干烧蚀前后的 OCT 图像。
我们提出了一种光学集成诊断和治疗系统。初步实验结果表明，我们的治疗系统具有高效率和可行性，有望在未来实现体内和原位肿瘤的精确切除。
