Novel laser system and laser irradiation method reduced the risk of carbonization during laser interstitial thermotherapy: assessed by MR temperature measurement

Background and objective: To establish laser interstitial thermotherapy (LITT) for intracranial tumors, the authors investigated a method to regulate localized temperature generated by interstitial laser irradiation using magnetic resonance (MR) temperature mapping.

Study design/materials and methods: A diode laser system and six different types of optical-fiber system were developed for LITT. The characteristics of temperature profiles produced by each laser-fiber system were investigated with MR temperature measurement (the water proton chemical technique), and differences in the temperature profile induced by two laser-irradiation methods (continuous and intermittent) were observed.

Results: All fiber systems with the exception of the diffuse-projection fiber system, created a spherical temperature profile. Carbonization sometimes occurred around the bare-end fiber tip upon high power laser irradiation. The diffuse-projection fiber system produced a cylindrical temperature distribution, and the temperature profile showed a more gradual temperature elevation than the bare-end fiber. No carbonization occurred at the tip of the diffuse-projection fiber system. In addition, the utilization of the intermittent irradiation method also increased temperature gradually. Fiber-system modification and intermittent irradiation reduced laser-beam intensity and the risk of carbonization.

Conclusion: The use of a diffuse-projection fiber system which intermittently transmits a reduced intensity laser beam is an effective tool to regulate temperature during LITT using MR temperature measurement.