Pulsed laser ablation of soft tissues, gels, and aqueous solutions at temperatures below 100 degrees C

Machine Learning-Based Optoacoustic Tissue Classification Method for Laser Osteotomes Using an Air-Coupled Transducer

BACKGROUND AND OBJECTIVES

Using lasers instead of mechanical tools for bone cutting holds many advantages, including functional cuts, contactless interaction, and faster wound healing. To fully exploit the benefits of lasers over conventional mechanical tools, a real-time feedback to classify tissue is proposed.

STUDY DESIGN/MATERIALS AND METHODS

In this paper, we simultaneously classified five tissue types-hard and soft bone, muscle, fat, and skin from five proximal and distal fresh porcine femurs-based on the laser-induced acoustic shock waves (ASWs) generated. For laser ablation, a nanosecond frequency-doubled Nd:YAG laser source at 532 nm and a microsecond Er:YAG laser source at 2940 nm were used to create 10 craters on the surface of each proximal and distal femur. Depending on the application, the Nd:YAG or Er:YAG can be used for bone cutting. For ASW recording, an air-coupled transducer was placed 5 cm away from the ablated spot. For tissue classification, we analyzed the measured acoustics by looking at the amplitude-frequency band of 0.11-0.27 and 0.27-0.53 MHz, which provided the least average classification error for Er:YAG and Nd:YAG, respectively. For data reduction, we used the amplitude-frequency band as an input of the principal component analysis (PCA). On the basis of PCA scores, we compared the performance of the artificial neural network (ANN), the quadratic- and Gaussian-support vector machine (SVM) to classify tissue types. A set of 14,400 data points, measured from 10 craters in four proximal and distal femurs, was used as training data, while a set of 3,600 data points from 10 craters in the remaining proximal and distal femur was considered as testing data, for each laser.

RESULTS

The ANN performed best for both lasers, with an average classification error for all tissues of 5.01 ± 5.06% and 9.12 ± 3.39%, using the Nd:YAG and Er:YAG lasers, respectively. Then, the Gaussian-SVM performed better than the quadratic SVM during the cutting with both lasers. The Gaussian-SVM yielded average classification errors of 15.17 ± 13.12% and 16.85 ± 7.59%, using the Nd:YAG and Er:YAG lasers, respectively. The worst performance was achieved with the quadratic-SVM with a classification error of 50.34 ± 35.04% and 69.96 ± 25.49%, using the Nd:YAG and Er:YAG lasers.

CONCLUSION

We foresee using the ANN to differentiate tissues in real-time during laser osteotomy. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Combination laser therapy for epiretinal membrane: a physico-mathematical model

An epiretinal membrane (ERM) is a product of abnormal cell proliferation on the inner surface of the retina and at the vitreomacular interface. Laser therapy is an interesting modality for treating pathologies of the vitreomacular interface. The wise choice of laser settings (wavelength, exposure time, power) minimizes damage to the retina and ensures a good therapeutic effect. This could be a serious impetus to the development and refinement of laser technologies for treating ERM. This work investigates the biophysical response of structural retinal components, including the dynamics of temperatures and acoustic oscillations, protein denaturation, and stimulation of tissue regeneration, to a quasi-cw laser beam and a subsequent series of laser micropulses. The manuscript also analyzes the mechanisms underlying the therapeutic effect of the proposed laser therapy in patients with ERM.

Nano-Pulsed Laser Therapy Is Neuroprotective in a Rat Model of Blast-Induced Neurotrauma

We have developed a novel, non-invasive nano-pulsed laser therapy (NPLT) system that combines the benefits of near-infrared laser light (808 nm) and ultrasound (optoacoustic) waves, which are generated with each short laser pulse within the tissue. We tested NPLT in a rat model of blast-induced neurotrauma (BINT) to determine whether transcranial application of NPLT provides neuroprotective effects. The laser pulses were applied on the intact rat head 1 h after injury using a specially developed fiber-optic system. Vestibulomotor function was assessed on post-injury days (PIDs) 1–3 on the beam balance and beam walking tasks. Cognitive function was assessed on PIDs 6–10 using a working memory Morris water maze (MWM) test. BDNF and caspase-3 messenger RNA (mRNA) expression was measured by quantitative real-time PCR (qRT-PCR) in laser-captured cortical neurons. Microglia activation and neuronal injury were assessed in brain sections by immunofluorescence using specific antibodies against CD68 and active caspase-3, respectively. In the vestibulomotor and cognitive (MWM) tests, NPLT-treated animals performed significantly better than the untreated blast group and similarly to sham animals. NPLT upregulated mRNA encoding BDNF and downregulated the pro-apoptotic protein caspase-3 in cortical neurons. Immunofluorescence demonstrated that NPLT inhibited microglia activation and reduced the number of cortical neurons expressing activated caspase-3. NPLT also increased expression of BDNF in the hippocampus and the number of proliferating progenitor cells in the dentate gyrus. Our data demonstrate a neuroprotective effect of NPLT and prompt further studies aimed to develop NPLT as a therapeutic intervention after traumatic brain injury (TBI).

Particle size measurement from infrared laser ablation of tissue

The concentration and size distribution were measured for particles ablated from tissue sections using an infrared optical parametric oscillator laser system. A scanning mobility particle sizer and light scattering particle sizer were used in parallel to realize a particle sizing range from 10 nm to 20 μm. Tissue sections from rat brain and lung ranging in thickness between 10 and 50 μm were mounted on microscope slides and irradiated with nanosecond laser pulses at 3 μm wavelength and fluences between 7 and 21 kJ m(-2) in reflection geometry. The particle size distributions were characterized by a bimodal distribution with a large number of particles 100 nm in diameter and below and a large mass contribution from particles greater than 1 μm in diameter. The large particle contribution dominated the ablated particle mass at high laser fluence. The tissue type, thickness, and water content did not have a significant effect on the particle size distributions. The implications of these results for laser ablation sampling and mass spectrometry imaging under ambient conditions are discussed.

Time-resolved study of the mechanical response of tissue phantoms to nanosecond laser pulses

We present a time-resolved study of the interaction of nanosecond laser pulses with tissue phantoms. When a laser pulse interacts with a material, optical energy is absorbed by a combination of linear (heat generation and thermoelastic expansion) and nonlinear absorption (expanding plasma), according to both the laser light irradiance and material properties. The objective is to elucidate the contribution of linear and nonlinear optical absorption to bubble formation. Depending on the local temperatures and pressures reached, both interactions may lead to the formation of bubbles. We discuss three experimental approaches: piezoelectric sensors, time-resolved shadowgraphy, and time-resolved interferometry, to follow the formation of bubbles and measure the pressure originated by 6 ns laser pulses interacting with tissue phantoms. We studied the bubble formation and pressure transients for varying linear optical absorption and for radiant exposures above and below threshold for bubble formation. We report a rapid decay (of 2 orders of magnitude) of the laser-induced mechanical pressure measured (by time-resolved shadowgraphy) very close to the irradiation spot and beyond 1 mm from the irradiation site (by the piezoelectric sensor). Through time-resolved interferometry measurements, we determined that bubble formation can occur at marginal temperature increments as low as 3°C.

Plasma membrane integrity and survival of melanoma cells after nanosecond laser pulses

Circulating tumor cells (CTCs) photoacoustic detection systems can aid clinical decision-making in the treatment of cancer. Interaction of melanin within melanoma cells with nanosecond laser pulses generates photoacoustic waves that make its detection possible. This study aims at: (1) determining melanoma cell survival after laser pulses of 6 ns at λ = 355 and 532 nm; (2) comparing the potential enhancement in the photoacoustic signal using λ = 355 nm in contrast with λ = 532 nm; (3) determining the critical laser fluence at which melanin begins to leak out from melanoma cells; and (4) developing a time-resolved imaging (TRI) system to study the intracellular interactions and their effect on the plasma membrane integrity. Monolayers of melanoma cells were grown on tissue culture-treated clusters and irradiated with up to 1.0 J/cm². Surviving cells were stained with trypan blue and counted using a hemacytometer. The phosphate buffered saline absorbance was measured with a nanodrop spectrophotometer to detect melanin leakage from the melanoma cells post-laser irradiation. Photoacoustic signal magnitude was studied at both wavelengths using piezoelectric sensors. TRI with 6 ns resolution was used to image plasma membrane damage. Cell survival decreased proportionally with increasing laser fluence for both wavelengths, although the decrease is more pronounced for 355 nm radiation than for 532 nm. It was found that melanin leaks from cells equally for both wavelengths. No significant difference in photoacoustic signal was found between wavelengths. TRI showed clear damage to plasma membrane due to laser-induced bubble formation.

Comparative analysis of different laser systems to study cellular responses to DNA damage in mammalian cells

Proper recognition and repair of DNA damage is critical for the cell to protect its genomic integrity. Laser microirradiation ranging in wavelength from ultraviolet A (UVA) to near-infrared (NIR) can be used to induce damage in a defined region in the cell nucleus, representing an innovative technology to effectively analyze the in vivo DNA double-strand break (DSB) damage recognition process in mammalian cells. However, the damage-inducing characteristics of the different laser systems have not been fully investigated. Here we compare the nanosecond nitrogen 337 nm UVA laser with and without bromodeoxyuridine (BrdU), the nanosecond and picosecond 532 nm green second-harmonic Nd:YAG, and the femtosecond NIR 800 nm Ti:sapphire laser with regard to the type(s) of damage and corresponding cellular responses. Crosslinking damage (without significant nucleotide excision repair factor recruitment) and single-strand breaks (with corresponding repair factor recruitment) were common among all three wavelengths. Interestingly, UVA without BrdU uniquely produced base damage and aberrant DSB responses. Furthermore, the total energy required for the threshold H2AX phosphorylation induction was found to vary between the individual laser systems. The results indicate the involvement of different damage mechanisms dictated by wavelength and pulse duration. The advantages and disadvantages of each system are discussed.

Low-threshold cavitation in water using IR laser pulse trains

The low-temperature cavitational disruption by trains of laser pulses was demonstrated in water. The trains used in the experiment were generated by a Raman laser at a wavelength of 1626 nm. The mean value of the fragmentation threshold energy density per pulse in a train was estimated to be equal to 7.2x10(6) J/m(3). The corresponding amplitude of the negative pressure had the order of 6-7 bars at a temperature jump of only about 2 degrees C. This result opens up prospects for developing precision nonthermal cavitational laser surgery.

Hollow fiber optics with improved durability for high-peak-power pulses of Q-switched Nd:YAG lasers

To improve the damage threshold of hollow optical waveguides for transmitting Q-switched Nd:YAG laser pulses, we optimize the metallization processes for the inner coating of fibers. For silver-coated hollow fiber as the base, second, and third Nd:YAG lasers, drying silver films at a moderate temperature and with inert gas flow is found to be effective. By using this drying process, the resistance to high-peak-power optical pulse radiation is drastically improved for fibers fabricated with and without the sensitizing process. The maximum peak power transmitted in the fiber is greater than 20 MW. To improve the energy threshold of aluminum-coated hollow fibers for the fourth and fifth harmonics of Nd:YAG lasers, a thin silver film is added between the aluminum film and the glass substrate to increase adhesion of the aluminum coating. By using this primer layer, the power threshold improves to 3 MW for the fourth harmonics of a Q-switched Nd:YAG laser light.

Laser-induced bubbles in living cells

BACKGROUND AND OBJECTIVES

Laser-activated micro- and nano-bubbles (LAB) in cells may be used as universal and sensitive non-toxic probes for measuring functional properties of individual cells.

STUDY DESIGN/MATERIALS AND METHODS

Such bubbles can be detected and imaged by microscopy and flow cytometry. LABs in living blood and tumor cells were induced by pulsed (532 nm, 10 nanoseconds) laser radiation and detected by the thermal lens optical method.

RESULTS

Registered lifetime and maximal diameter of the studied LABs varied within the ranges of 0.02-10 microseconds and 0.44-100 microm, respectively. LAB parameters, thresholds and probabilities, were found to depend upon the physiological state of cells. Specificity and sensitivity of LAB cytometry were increased due to the use of light-absorbing nanoparticles conjugated to specific monoclonal antibodies.

CONCLUSIONS

LAB were found to be the universal phenomena that can be used for sensitive and non-invasive monitoring of any individual cell, intact or nanoparticle-treated.

Photothermal responses of individual cells

Photothermal (PT) responses of individual intact cells are studied with a thermal lens dual-laser scheme. A multiparameter model for analysis of PT responses as a function of cell size, structure, and optical properties is suggested and verified experimentally for living cells, red blood cells, lymphocytes, tumor cells (K 562), hepatocytes, and miocytes, by applying pulsed laser radiation at 532 nm for 10-ns duration. PT responses for noninvasive and damaging modes of laser-cell interaction are investigated. It is shown theoretically and experimentally that specific optical and structural features of cells influence the polarity, shape, front, and tail lengths of their PT responses. Common for different cells, features of PT responses are evaluated. It is found that in cells with a highly heterogeneous light-absorbing structure, the PT response of a whole cell differs from that of the local absorbing area. The model suggested allows us to interpret PT responses from single cells and to compare cells in terms of their diameter, degree of spatial heterogeneity of light absorbance, and laser-induced damage thresholds.

Hollow-waveguide-based nanosecond, near-infrared pulsed laser ablation of tissue

BACKGROUND AND OBJECTIVE

Short-pulse solid-state lasers have recently received much attention as new coherent light sources for medical applications, but steady transmission of their high-energy output pulses through a solid quartz fiber is difficult because of the onset of laser-induced breakdown. We previously demonstrated that hollow waveguides could be used to deliver nanosecond laser pulses for tissue ablation. The aim of this study was to determine the optimum laser pulse energy and range of defocused distance for obtaining a deep and sharp ablation channel in myocardial tissue with laser pulses transmitted through a hollow waveguide.

STUDY DESIGN/MATERIALS AND METHODS

Cyclic-olefin-polymer-coated silver hollow waveguides of 1 mm in inner diameter and 1 m in length were used. A vacuum-cored scheme was applied to the waveguides to suppress laser-induced air breakdown. Porcine myocardial tissue was irradiated with 300 laser pulses that were delivered through the waveguide in vitro at various laser energy levels and defocused distances, and depths and diameters of channels were measured. Histological analysis of the ablated tissues was also performed.

RESULTS

At an ablation energy of approximately 60 mJ/pulse, deep (>4.5 mm) and sharp (depth-to-diameter ratio of > 6) channels were created in tissue in the range of defocused distances of -4 approximately + 0.5 mm. Under these conditions, waveguide bending did not cause a remarkable change in ablation characteristics. Histological analysis of ablated tissue showed limited thermal damage but suggested a certain extent of mechanical effects in the tissue.

CONCLUSION

With near-infrared, nanosecond laser pulses delivered through a cyclic-olefin-polymer-coated silver hollow waveguide, efficient and sharp ablation of myocardial tissue can be achieved, suggesting the usefulness of the hollow waveguide as a new flexible delivery system for high-intensity laser pulses.

Brain ablation in the rat cerebral cortex using a tunable-free electron laser

BACKGROUND AND OBJECTIVES

We used the MARK III free electron laser (FEL) tuned to molecular vibrational absorbance maxima in the infrared (IR) wavelength range of 3.0-6.45 microm to study the effect of these various wavelengths and a power level of 5 mJ/2 microseconds macropulse on photoablation of CNS tissue.

STUDY DESIGN/MATERIALS AND METHODS

Laser lesions were produced in the parietal cortex of anesthetized rats using thermal confined mid-IR (infrared) laser pulses tuned to the -OH, -CH, amide 1, and amide 2 absorbance bands. Histological assessments following recovery periods of 4 hours, 4 days, and 3 weeks were performed to determine the size, shape, and character of the photoablative lesions. Cell density studies were done in adjacent edematous tissue.

RESULTS

Significant differences in lesion size and shape were observed as a function of wavelength. Although maximum ablation and collateral damage seemed to coincide with spectral peaks in the mid-IR, area and depth/width ratios did not.

CONCLUSIONS

It was found in these experiments that wavelengths in the mid-IR could be selected for optimal ablative properties. Using tunable, high-peak-power pulsed lasers, it will be possible to produce well-defined photoablative lesions that conform to small, irregularly shaped neurosurgical targets.

Atomic force microscopic study of the human cornea following excimer laser keratectomy

The aim of this study was to examine the corneal surface structures with a new investigative method, the atomic force microscope following 193 nm excimer laser photoablation. Fresh human corneas were irradiated in vitro with an increasing number of impulses emitted by a 193 nm ArF laboratory excimer laser in order to produce either smooth flat surfaces or stair-like formations within the cornea. The corneas were investigated in a Topometrix(R) atomic force microscope in their native state. For comparison, three corneas were fixed with glutaraldehyde and processed for scanning electron microscopy. Atomic force microscopy and scanning electron microscopy revealed the same surface characteristics of photoablated corneas, though the preparation for scanning electron microscopy induced considerable shrinkage of the tissues. The layers of the cornea could be distinguished from each other and deeper ablations of the stroma produced a rougher surface. On the lateral walls of ablated stairs small droplets of ejected material could be seen with scanning electron microscope. Atomic force microscope produces three-dimensional images of the scanned native corneal surfaces and it could be a valuable tool to investigate the corneal smoothness. Our investigations have provided similar results as those obtained with scanning electron microscopy showing that the laser-ablated corneal surface remains relatively smooth. We suggest that the formation of condense droplets of ejected materials is based on hydrodynamic motions induced by boiling water solutions.

Modelling infrared temperature measurements: implications for laser irradiation and cryogen cooling studies

The use of thermographic techniques has increased as infrared detector technology has evolved and improved. For laser-tissue interactions, thermal cameras have been used to monitor the thermal response of tissue to pulsed and continuous wave irradiation. It is important to note that the temperature indicated by the thermal camera may not be equal to the actual surface temperature. It is crucial to understand the limitations of using thermal cameras to measure temperature during laser irradiation of tissue. The goal of this study was to demonstrate the potential difference between measured and actual surface temperatures in a quantitative fashion using a ID finite difference model. Three ablation models and one cryogen spray cooling simulation were adapted from the literature, and predictions of radiometric temperature measurements were calculated. In general, (a) steep superficial temperature gradients, with a surface peak, resulted in an underestimation of the actual surface temperature, (b) steep superficial temperature gradients, with a subsurface peak, resulted in an overestimation, and (c) small gradients led to a relatively accurate temperature estimate.

Physical properties of hydrated tissue determined by surface interferometry of laser-induced thermoelastic deformation

Knee meniscus is a hydrated tissue; it is a fibrocartilage of the knee joint composed primarily of water. We present results of interferometric surface monitoring by which we measure physical properties of human knee meniscal cartilage. The physical response of biological tissue to a short laser pulse is primarily thermomechanical. When the pulse is shorter than characteristic times (thermal diffusion time and acoustic relaxation time) stresses build and propagate as acoustic waves in the tissue. The tissue responds to the laser-induced stress by thermoelastic expansion. Solving the thermoelastic wave equation numerically predicts the correct laser-induced expansion. By comparing theory with experimental data, we can obtain the longitudinal speed of sound, the effective optical penetration depth and the Grüneisen coefficient. This study yields information about the laser tissue interaction and determines properties of the meniscus samples that could be used as diagnostic parameters.

Photospallation: A New Theory and Mechanism for Mid-infrared Corneal Ablations

PURPOSE

A new mechanism for ablating corneal tissue is proposed, based on photospallation with short pulse mid-infrared (IR) laser radiation.

METHODS

By using a judicious combination of high absorption, short pulses, and low fluences, ablation with this process can potentially remove tissue in a highly localized manner with submicron collateral thermal damage characteristics similar to those achieved by excimer lasers. We provide a brief qualitative overview of aspects of the spallation process that distinguish it from the more familiar photoablation and photothermal mechanisms.

RESULTS

Results of preliminary parametric analysis based on one-dimensional models of thermoelastic expansion are summarized.

CONCLUSION

These preliminary calculations lend support to the conjecture that corneal tissue can be removed effectively with strongly absorbed nanosecond pulses from a mid-IR laser, using operational fluence levels of less than 200 mJ/cm2.

Minimizing Thermal Damage in Corneal Ablation with Short Pulse Mid-infrared Lasers

Photospallation is proposed as the primary mechanism behind our recent animal studies involving corneal ablation by nanosecond-pulse mid-IR laser beams. Following a brief summary of earlier work directed to refractive procedures in the mid-IR, a preliminary analysis is presented, based on simple one-dimensional models of thermoelastic expansion developed previously. The results of the analysis indicate that front surface spallation is consistent with the striking tissue ablation characteristics observed in our recent in vivo work with short pulse beams, including very small ablation rates and submicron thermal damage zones. This is attributed to the fact that spallation is a mechanical-rather than a thermal-mechanism, which allows tissue to be removed in small layers at fluences far lower than those used in the earlier corneal studies with mid-IR beams, typically under 200 mJ/cm2, resulting in minimal heating of tissue. Unlike prior work in the area of photospallation, we also suggest that the existing theoretical basis supports the use of nanosecond pulses as an effective approach to achieving controlled ablation in the presence of very high absorption. We further suggest that such domain of operation may be preferred over shorter pulses, both from a practical standpoint and to mitigate against potential damage from shock waves. © 1999 Society of Photo-Optical Instrumentation Engineers.

Optical phantom materials for near infrared laser photocoagulation studies

BACKGROUND AND OBJECTIVE

Phantoms were developed that simulate tissue with dynamic and static optical properties with which to study the effects of laser irradiation.

STUDY DESIGN/MATERIALS AND METHODS

Albumen, agar, and an absorbing dye (Naphthol Green) were combined to form a phantom with heat sensitive optical properties to mimic tissue response. The optical properties of this phantom were measured by using the added absorber technique. A polyacrylamide phantom with static optical properties was designed with the equivalent values of micro(a) and micro'(s) by combining appropriate concentrations of Naphthol Green and Intralipid-10%.

RESULTS

The absorption and reduced scattering coefficient of the phantoms were 0. 50 +/- 0.04 cm(-1) and 2.67 +/- 0.07 cm(-1) respectively, in the native state at 805 nm. In the coagulated state, the absorption and scattering coefficient were 0.7 +/- 0.1 cm(-1) and 13.1 +/- 0.5 cm(-1) respectively.

CONCLUSION

Two phantoms with dynamic or static optical properties were developed with properties similar to tissue. They may be used in future studies of opto-thermal effects in tissues.