Interstitial laser-induced thermotherapy: Influence of carbonization on lesion size

BACKGROUND AND OBJECTIVE: The size of laser-induced coagulated lesions produced in porcine muscle in vitro using a cylindrical diffusing fiber tip and a conductive heat source, made by covering the diffuser with a hollow steel needle, were compared to investigate the influence of charring. MATERIALS AND METHODS: Light from a Nd:YAG laser was utilized for thermotherapy. A theoretical model for calculating tissue temperature was used to predict the experimental results and to simulate in vivo treatments. RESULTS: The metal-covered tip produced carbonization and tissue vaporization that was not found with the diffuser. After 20 min of irradiation at a laser power of 7 W, the coagulated volumes with and without carbonization were found to be 13.1 cm3 (range 12.4-14.1 cm3, n = 4) and 12.2 cm3 (range 11.5-13.4 cm3, n = 4), respectively. Mathematical simulations showed that in unperfused tissue, a diffusing laser heat source produces smaller lesions than does a conductive heat source at the same power, the difference in coagulated volume becoming smaller with increased treatment time and increased power. CONCLUSION: Using cylindrical diffusers, interstitial laser-induced thermotherapy without carbonization at the fiber tip can be as efficient as treatment with carbonization.