WO1991018646A1 - A device and method for laser photothermotherapy - Google Patents
A device and method for laser photothermotherapy Download PDFInfo
- Publication number
- WO1991018646A1 WO1991018646A1 PCT/GB1991/000862 GB9100862W WO9118646A1 WO 1991018646 A1 WO1991018646 A1 WO 1991018646A1 GB 9100862 W GB9100862 W GB 9100862W WO 9118646 A1 WO9118646 A1 WO 9118646A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- laser
- pulse
- tissue
- local
- heating
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/062—Photodynamic therapy, i.e. excitation of an agent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/067—Radiation therapy using light using laser light
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00137—Details of operation mode
- A61B2017/00154—Details of operation mode pulsed
- A61B2017/00194—Means for setting or varying the repetition rate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N2005/0635—Radiation therapy using light characterised by the body area to be irradiated
- A61N2005/0643—Applicators, probes irradiating specific body areas in close proximity
- A61N2005/0644—Handheld applicators
Definitions
- the present invention relates to a device for laser photothermotherapy comprising a pulsed laser constructed to operate in the ultraviolet, visible or infrared portion of the spectrum, and a system arranged to deliver pulsed irradiation generated from said laser to a targeted area of living human or animal tissue.
- All devices and methods of using laser light for therapeutic and surgical purposes can be divided into two classes, depending on whether the laser-exposed biotissue suffers thermal damage upon absorption of radiation or not.
- Such a classification embraces all types of lasers, both pulsed and continuous-wave, for which the maximum permissible heating temperature of biotissue that, still does not cause damage depends on the length of time that the biotissue stays heated.
- the non-destructive class includes devices and methods which use low-intensity laser or incoherent radiation causing biostimulation without perceptible heating and find successful application in curing many a disease (the photomedical fundamentals of the method have been described in Laser Science and Technology - An International Handbook, Vol.8 (Harwood Acad. Publ., 1989) p189 under the heading Photobiology of Low-Power Laser Therapy by T T Karu). Means for phototherapy with lowintensity light are the subject-matter of a number of inventions by Omega University Technologies Limited. This class also includes photodynamic therapy means and methods which utilize the photochemical action of sensitizers introduced in biotissue.
- the destructive class includes devices and methods which use high-intensity continuous-wave or pulsed radiation causing a substantial heating of biotissue.
- High-intensity continuous-wave laser radiation absorbed by biotissue causes its heating and destruction (coagulation, carbonization, pyrolysis, and evaporation as temperature grows higher). This is employed in the laser thermal surgery of soft biotissue.
- High-intensity pulsed laser radiation at a wavelength of strong absorption by biotissue causes its high pulsed overheating, followed by vaporizing ablation. This is used for destruction of biotissue, both soft and hard (bones, atherosolerotic plaques).
- An object of the present invention is to provide a device and method for photothermotherapy whereby high- intensity laser radiation can be absorbed by biotissue in controlled conditions without unsatisfactory heating of the entire laser-exposed volume of biotissue.
- a device for laser photothermotherapy as defined in the first paragraph of this specification is characterised in that control means are provided for controlling said laser to generate pulses of variable duration, repetition rate and pulse duration between the pulses, and that measuring means responsive to the tissue, when irradiated, are provided for operating said control means for the pulse duration and wavelength delivered by said laser to correspond to exogenous or endogenous chromophores in the tissue, said measuring means being responsive to local microheating of an absorbing said chromophore or chromophores and the surrounding local microregion, significantly higher than the average temperature of the entire targeted tissue, for actuating said control means to render the pauses between consecutive laser pulses to be sufficiently long to permit cooling of the temperature elevation in said local microregion between each pulse and the next.
- a chromophore is defined as a molecule that absorbs light at a specific wavelength.
- a method of laser photothermotherapy comprises delivering ultraviolet, visible or infrared laser pulse energy to a targeted area of living human or animal tissue by means of the device defined above.
- Figure 1 is an explanatory graph showing tissue destruction as a function of time and temperature
- Figure 2 is a graph relating laser pulse fluence or radiation energy density and laser pulse duration and showing regions of laser radiation parameters
- Figure 3(a) is a graph showing laser light intensity as a function of time
- Figure 3(b) is a graph showing bio-tissue temperature variation in relation to laser pulses.
- Figure 4 is a schematic diagram of a device for photothermotherapy.
- the area beneath the curve covers the range of relationships between temperature and duration whereby permissible heating temperture of biotissue can be effected without causing damage to the tissue.
- the region I covering laser photochemical reactions that are non-destructive (as well as photodynamical therapy and biostimulation) is related to the curve of Figure 1.
- the parameter range of radiation of laser surgery is denoted by region II in Figure 2 where high-intensity continuous-wave laser radiation absorbed by bio-tissue causes its heating and destruction as by vaporization and coagulation.
- the parameter region of laser radiation for ablation surgery is denoted by symbol III in Figure 2. Both regions II and III constitutute the destructive class of laser photochemical reactions.
- Biotissue is characterised by its volume-averaged absorption per unit length, ⁇ o , and attenuation per unit length. A, which somewhat exceeds ⁇ o because of scattering. As a result, laser radiation penetrates biotissue to a depth of z o ⁇ 1/A. Owing to absorption of radiation, biotissue gets heated by an amount of ⁇ T, and then cools by diffusion during the time
- Biotissue has local absorption inhomogeneities of varying size: of the order of a few nanometers (biomolecules), a few tens of nanometers (biomolecular aggregation, membrane thickness), a few microns (cells and subcellular units), and more (microcapillaries). If a local absorption microregion has an absorptivity of ⁇ loc exceeding the volume-averaged absorptivity ⁇ o ' it can be heated with a laser pulse by an amount of ⁇ T1oc exceeding the volume-averaged heating ⁇ T.
- the cooling time T1 oc of the local overheating microregion is determined by its size 1: T1oc ⁇ I 2 /4x ( 3 )
- the duration T p of the laser pulse used must be shorter than 2 ns. If the laser pulse fluence permissible from the standpoint of the volume- averaged non-destructive heating is, according to the above numerical example, ⁇ ma ⁇ ⁇ 4 J/cm 2 , the peak intensity of the ultrashort laser pulse is 1 p ⁇ ⁇ max /T ⁇ ⁇ 2 x 10 9 W/CM 2 . This intensity value is quite permissible, but it is fairly close to the threshold marking the onset of multiple-photon absorption effects.
- the laser pulse duration must be shorter, in accordance with equation (3), and to prevent multiple-photon effects in the bulk of biotissue, the laser energy must be distributed among several pulses within the time interval T cool' so as to ensure that the peak intensity does not perceptibly exceed the value of 1 P ⁇ 2x10 9 W/cm 2 .
- the laser energy must be distributed among several pulses within the time interval T cool' so as to ensure that the peak intensity does not perceptibly exceed the value of 1 P ⁇ 2x10 9 W/cm 2 .
- the peak laser intensity will be lower than 10 9 W/cm 2 , radiation energy can be deposited in biotissue with single pulses. The interval between them in this case must not exceed Tcool in order to avoid destructive volume-averaged heating of biotissue.
- Figure 3a shows the laser pulse sequence and Figure 3b, the temporal variation of the temperature of the exposed medium, caused by both the local heating ⁇ T 1oc of the microregions of increased absoption and the volume- averaged heating ⁇ T of the tissue.
- the volume-averaged laser heating can accumulate during a long period of Tcool , if the cooling time is much longer than the interval T rep between the pulses.
- the local heating of the microregions of increased absorption rapidly vanishes within the time T1oc ⁇ T rep .
- ⁇ he average heating ⁇ T of the exposed region during the timeTcool must not exceed a maxium value of ⁇ T max .
- a device for laser photothermotherapy includes a pulsed laser 1 whose wavelength ⁇ corresponds to that of local absorption by microregions of average size 1 ( ⁇ ) in biotissue, a laser pulse duration control unit 2 providing for the generation of laser pulses with a duration of T P satisfying the condition
- T P ⁇ T 1oc /2( ⁇ )/4X (6) and a repetition period of T rep meeting the requirement for the absence of any noticeable volume-averaged heating of biotissue:
- T rep ⁇ Tcool ( ⁇ )/4X ⁇ 1/[4 ⁇ ( ⁇ ) ]X (7) a delivery system 3 to deliver radiation to a biotissue treatment region that ensures the necessary laser pulse fluence ⁇ p ⁇ ⁇ T max Pc/ ⁇ o ( 8 ) with which the volume-averaged heating of biotissue falls within permissible limits, ⁇ T max ' while the pulsed local heating of the microregions in the tissue reaches therapeutic levels ( ⁇ T1oc > 15-50°C), and a rise and fall measurement unit 4 for measuring the local heating by a single laser pulse and the average heating ⁇ T by a train of laser pulses, which controls, by way of feedback to the control unit 2, the pulse energy and repetition period and the total exposure dose in order to provide for therapeutic effect without running the risk of thermal damage to the exposed tissue region.
- the laser pulse repetition period is determined by the cooling time Tcool' whereas for 1 ⁇ 30 n, the pulse repetition period is selected to be shorter in order to limit the peak pulse intensity to a non-destructive level of some 2x10 9 W/cm 2 . In that case, the laser pulse fluence is limited to a safe average heating level of around 4 J/cm 2 .
- the device can also be used in a method of laser photothermotherapy where tissue is injected by exogenak non-toxic dye or drug comprised by chromophores of suitable size to enable local micro-heating, on absorbing the effective wavelength, of the microregion where the chromophores of the dye or drug are situated and cause therapeutic or destructive effects according to the condition treated.
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB9011998.3 | 1990-05-30 | ||
GB909011998A GB9011998D0 (en) | 1990-05-30 | 1990-05-30 | A device and method for laser photothermotherapy |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1991018646A1 true WO1991018646A1 (en) | 1991-12-12 |
Family
ID=10676737
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB1991/000862 WO1991018646A1 (en) | 1990-05-30 | 1991-05-30 | A device and method for laser photothermotherapy |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP0485570A1 (en) |
GB (1) | GB9011998D0 (en) |
WO (1) | WO1991018646A1 (en) |
Cited By (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1993003793A1 (en) * | 1991-08-22 | 1993-03-04 | Roberto Enzo Di Biaggio | Medical light treatment apparatus |
WO1994028972A1 (en) * | 1993-05-14 | 1994-12-22 | Eberhard Oppold | Safety laser beam apertures (sla) for therapeutic and diagnostic medical equipment |
WO1996017656A1 (en) * | 1994-12-09 | 1996-06-13 | Cynosure, Inc. | Near-infrared selective photothermolysis for vascular targets |
WO1997046280A1 (en) * | 1996-06-07 | 1997-12-11 | Biolight Patent Holding Ab | Device for external treatment with pulsating light of high duty cycle |
WO1997046279A1 (en) * | 1996-06-07 | 1997-12-11 | Biolight Patent Holding Ab | A device for external medical treatment with monochromatic light |
WO1998003224A1 (en) * | 1996-07-19 | 1998-01-29 | Theratechnologies R & D Inc. | Irradiating apparatus using a scanning light source for photodynamic treatment |
EP0846477A1 (en) * | 1996-12-05 | 1998-06-10 | Centre International De Recherches Dermatologiques Galderma (C.I.R.D. Galderma) | Chromophor use in a composition suitable to be used on the skin in conjonction with laser treatment |
WO1998052644A1 (en) * | 1997-05-23 | 1998-11-26 | Hofmann Guenther | System for photodynamic therapy of living organisms and their organs and/or tissues |
US5843072A (en) * | 1996-11-07 | 1998-12-01 | Cynosure, Inc. | Method for treatment of unwanted veins and device therefor |
US5871479A (en) * | 1996-11-07 | 1999-02-16 | Cynosure, Inc. | Alexandrite laser system for hair removal and method therefor |
DE19954710C1 (en) * | 1999-11-17 | 2001-03-15 | Pulsion Medical Sys Ag | Apparatus for treatment of blood vessels especially in eye, comprises laser to deliver structured beam and monitor system to measure concentration of chromophoric agents for system control |
US6228075B1 (en) | 1996-11-07 | 2001-05-08 | Cynosure, Inc. | Alexandrite laser system for hair removal |
WO2001047601A1 (en) * | 1999-12-28 | 2001-07-05 | Antonia Villalon Castilla | Thermostimulation apparatus for therapeutic treatments |
EP1637182A1 (en) * | 2003-06-20 | 2006-03-22 | Keio University | Photodynamic therapy apparatus, method for controlling photodynamic therapy apparatus, and photodynamic therapy method |
WO2007057017A1 (en) * | 2005-11-16 | 2007-05-24 | Aalborg Universitet | Light modulation of cell function |
WO2013169180A1 (en) * | 2012-05-07 | 2013-11-14 | Biolight Patent Holding Ab | Device for external medical treatment using light of varying pulse lengths |
US8915948B2 (en) | 2002-06-19 | 2014-12-23 | Palomar Medical Technologies, Llc | Method and apparatus for photothermal treatment of tissue at depth |
US9028536B2 (en) | 2006-08-02 | 2015-05-12 | Cynosure, Inc. | Picosecond laser apparatus and methods for its operation and use |
US9550070B2 (en) | 2012-06-15 | 2017-01-24 | Aptar France S.A.S. | Light pen dispenser |
US9780518B2 (en) | 2012-04-18 | 2017-10-03 | Cynosure, Inc. | Picosecond laser apparatus and methods for treating target tissues with same |
US10245107B2 (en) | 2013-03-15 | 2019-04-02 | Cynosure, Inc. | Picosecond optical radiation systems and methods of use |
US10434324B2 (en) | 2005-04-22 | 2019-10-08 | Cynosure, Llc | Methods and systems for laser treatment using non-uniform output beam |
US11418000B2 (en) | 2018-02-26 | 2022-08-16 | Cynosure, Llc | Q-switched cavity dumped sub-nanosecond laser |
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GB2000335A (en) * | 1977-06-20 | 1979-01-04 | Rca Corp | Apparatus for hyperthermia treatment |
DE3134953A1 (en) * | 1981-09-03 | 1983-03-10 | Schmid, geb.Bühl, Annemarie, 7914 Pfaffenhofen | Infrared irradiation device |
WO1986000515A1 (en) * | 1982-06-28 | 1986-01-30 | The Johns Hopkins University | Electro-optical device and method for monitoring singlet oxygen produced photoradiation using pulsed excitation and time domain signal processing |
US4950268A (en) * | 1987-02-27 | 1990-08-21 | Xintec Corporation | Laser driver and control circuit |
-
1990
- 1990-05-30 GB GB909011998A patent/GB9011998D0/en active Pending
-
1991
- 1991-05-30 EP EP91910683A patent/EP0485570A1/en not_active Ceased
- 1991-05-30 WO PCT/GB1991/000862 patent/WO1991018646A1/en not_active Application Discontinuation
Patent Citations (4)
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GB2000335A (en) * | 1977-06-20 | 1979-01-04 | Rca Corp | Apparatus for hyperthermia treatment |
DE3134953A1 (en) * | 1981-09-03 | 1983-03-10 | Schmid, geb.Bühl, Annemarie, 7914 Pfaffenhofen | Infrared irradiation device |
WO1986000515A1 (en) * | 1982-06-28 | 1986-01-30 | The Johns Hopkins University | Electro-optical device and method for monitoring singlet oxygen produced photoradiation using pulsed excitation and time domain signal processing |
US4950268A (en) * | 1987-02-27 | 1990-08-21 | Xintec Corporation | Laser driver and control circuit |
Cited By (49)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1993003793A1 (en) * | 1991-08-22 | 1993-03-04 | Roberto Enzo Di Biaggio | Medical light treatment apparatus |
WO1994028972A1 (en) * | 1993-05-14 | 1994-12-22 | Eberhard Oppold | Safety laser beam apertures (sla) for therapeutic and diagnostic medical equipment |
US5749868A (en) * | 1994-12-09 | 1998-05-12 | Cynosure, Inc. | Near infra-red selective photothermolysis for ectatic vessels and method therefor |
WO1996017656A1 (en) * | 1994-12-09 | 1996-06-13 | Cynosure, Inc. | Near-infrared selective photothermolysis for vascular targets |
WO1997046279A1 (en) * | 1996-06-07 | 1997-12-11 | Biolight Patent Holding Ab | A device for external medical treatment with monochromatic light |
US6238424B1 (en) | 1996-06-07 | 2001-05-29 | Biolight Patent Holding Ab | Device for external treatment with pulsating light of high duty cycle |
US6238425B1 (en) | 1996-06-07 | 2001-05-29 | Biolight Patent Holding Ab | Device for external medical treatment with monochromatic light |
WO1997046280A1 (en) * | 1996-06-07 | 1997-12-11 | Biolight Patent Holding Ab | Device for external treatment with pulsating light of high duty cycle |
WO1998003224A1 (en) * | 1996-07-19 | 1998-01-29 | Theratechnologies R & D Inc. | Irradiating apparatus using a scanning light source for photodynamic treatment |
US5798523A (en) * | 1996-07-19 | 1998-08-25 | Theratechnologies Inc. | Irradiating apparatus using a scanning light source for photodynamic treatment |
AU721100B2 (en) * | 1996-07-19 | 2000-06-22 | Celmed Biosciences Inc. | Irradiating apparatus using a scanning light source for photodynamic treatment |
US6228075B1 (en) | 1996-11-07 | 2001-05-08 | Cynosure, Inc. | Alexandrite laser system for hair removal |
US6632218B1 (en) | 1996-11-07 | 2003-10-14 | Cynosure, Inc. | Alexandrite laser system for hair removal and method therefor |
US5843072A (en) * | 1996-11-07 | 1998-12-01 | Cynosure, Inc. | Method for treatment of unwanted veins and device therefor |
US5871479A (en) * | 1996-11-07 | 1999-02-16 | Cynosure, Inc. | Alexandrite laser system for hair removal and method therefor |
US6045548A (en) * | 1996-11-07 | 2000-04-04 | Cynosure, Inc. | Alexandrite laser system for hair removal and method therefor |
AU699637B2 (en) * | 1996-12-05 | 1998-12-10 | C.I.R.D. Galderma | Use of a chromophore in a composition intended to be applied to the skin before a laser treatment |
FR2756741A1 (en) * | 1996-12-05 | 1998-06-12 | Cird Galderma | USE OF A CHROMOPHORE IN A COMPOSITION INTENDED TO BE APPLIED TO THE SKIN BEFORE LASER TREATMENT |
US6086580A (en) * | 1996-12-05 | 2000-07-11 | Centre International De Recherches Dermatologiques | Laser treatment/ablation of skin tissue |
EP0846477A1 (en) * | 1996-12-05 | 1998-06-10 | Centre International De Recherches Dermatologiques Galderma (C.I.R.D. Galderma) | Chromophor use in a composition suitable to be used on the skin in conjonction with laser treatment |
WO1998052644A1 (en) * | 1997-05-23 | 1998-11-26 | Hofmann Guenther | System for photodynamic therapy of living organisms and their organs and/or tissues |
US6491715B1 (en) | 1999-11-17 | 2002-12-10 | Pulsion Medical Systems Ag | Device for treating growing, dilated or malformed blood vessels and method for treating biological material |
EP1101450A1 (en) | 1999-11-17 | 2001-05-23 | Pulsion Medical Systems AG | Device and method for treating growing, dilated or malformed blood vessels |
DE19954710C1 (en) * | 1999-11-17 | 2001-03-15 | Pulsion Medical Sys Ag | Apparatus for treatment of blood vessels especially in eye, comprises laser to deliver structured beam and monitor system to measure concentration of chromophoric agents for system control |
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US10500413B2 (en) | 2002-06-19 | 2019-12-10 | Palomar Medical Technologies, Llc | Method and apparatus for treatment of cutaneous and subcutaneous conditions |
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WO2013169180A1 (en) * | 2012-05-07 | 2013-11-14 | Biolight Patent Holding Ab | Device for external medical treatment using light of varying pulse lengths |
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US10245107B2 (en) | 2013-03-15 | 2019-04-02 | Cynosure, Inc. | Picosecond optical radiation systems and methods of use |
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Also Published As
Publication number | Publication date |
---|---|
EP0485570A1 (en) | 1992-05-20 |
GB9011998D0 (en) | 1990-07-18 |
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