Shimojo Y, Nishimura T, Hazama H, Ito N, Awazu K
Graduate School of Engineering, Osaka University, Suita, Japan.
Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan.
Laser Ther. 2020 Jul 17;29(1):61-72. doi: 10.5978/islsm.20-OR-08.
Computational clinical trial (CCT) in the field of laser medicine promotes clinical application of novel laser devices, because this trial carried out based on numerical modeling of laser-tissue interactions and simulation of a series of treatment process. To confirm the feasibility of the computational clinical trial of skin treatment with a novel picosecond laser, this paper presents an evaluation method of the safety.
STUDY DESIGN/MATERIALS AND METHODS: In this method, the light propagation and thermal diffusion process after ultrashort light pulse irradiation to a numerical skin model is calculated and the safety based on the photothermal damage is evaluated by computational modeling and simulation. As an example, the safety of a novel picosecond laser device was examined by comparing with several laser devices approved for clinical use.
The ratio of the maximum thermal damage induced by picosecond laser irradiation was 1.2 × 10 % at the epidermis, while that caused by approved laser irradiation was 99 % at the capillary vessels. The numerical simulation demonstrated that less thermal damage was observed compared with the approved devices. The results show the safety simulated by photothermal damage calculation was consistent with the reported clinical trials.
This computational clinical trial shows the feasibility of applying computational clinical trials for the safety evaluation of novel medical laser devices. In contrast to preclinical and clinical tests, the proposed computational method offers regulatory science for appropriately and quickly predicting and evaluating the safety of a novel laser device.
激光医学领域的计算临床试验推动了新型激光设备的临床应用,因为该试验基于激光与组织相互作用的数值模型以及一系列治疗过程的模拟进行。为了证实使用新型皮秒激光进行皮肤治疗的计算临床试验的可行性,本文提出了一种安全性评估方法。
研究设计/材料与方法:在该方法中,计算超短光脉冲照射数值皮肤模型后的光传播和热扩散过程,并通过计算建模与模拟评估基于光热损伤的安全性。作为示例,通过与几种已批准临床使用的激光设备进行比较,检验了一种新型皮秒激光设备的安全性。
皮秒激光照射在表皮引起的最大热损伤比例为1.2×10%,而批准使用的激光照射在毛细血管处引起的热损伤比例为99%。数值模拟表明,与已批准的设备相比,观察到的热损伤更少。结果表明,通过光热损伤计算模拟的安全性与报道的临床试验结果一致。
该计算临床试验表明了将计算临床试验应用于新型医用激光设备安全性评估的可行性。与临床前和临床试验相比,所提出的计算方法为合理、快速地预测和评估新型激光设备的安全性提供了监管科学依据。