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Biomedical subjects

D R Wyman

Publications and source records attributed to D R Wyman.

At least 19 recordsLinked to original sources
PubMed1999

Dynamic modeling of interstitial laser photocoagulation: implications for lesion formation in liver in vivo.

BACKGROUND AND OBJECTIVE: Interstitial Laser Photocoagulation (ILP) is a minimally invasive cancer treatment technique, whereby optical energy from implanted optical fibers is used to therapeutically heat small, solid tumors. In this work, the potential of ILP without tissue charring is investigated. STUDY DESIGN/MATERIALS AND METHODS: Optical diffusion and bio-heat transfer equations were used to develop dynamic models of interstitial laser heating in liver in vivo. Modifications in the optical properties due to tissue coagulation (T > or = 60 degrees C) were incorporated into the physical description. In addition, the effect of three different blood perfusion patterns on temperature distributions was explored. Model-predicted temperatures were used as an index for thermal damage based on an accumulated temperature injury (Arrhenius) model. Thermal damage dimensions were determined with tissue temperatures constrained to remain below 100 degrees C, so as to minimize the potential for tissue charring and smoke production. RESULTS: The model predicts that increases in scattering due to coagulation and choice of perfusion pattern affect substantially thermal damage dimensions. The results indicate that, for single fiber ILP at 2.55 W for 600 s, the maximum achievable thermal damage diameter in liver, without charring, is 9.6 mm. In addition, ILP performed with high-low power ramping may have an advantage over constant power treatments, in that, larger volumes of thermal damage can be realized earlier in an irradiation. CONCLUSIONS: For ILP performed with a single spherical emitting fiber, optimal irradiation parameters exist such that thermal lesions in liver up to approximately 10 mm in diameter can be induced while the maximum tissue temperature remains below 100 degrees C, avoiding tissue charring.

Body Temperature↗
PubMed1997

Comparison of 810 nm and 1064 nm wavelengths for interstitial laser photocoagulation in rabbit brain.

BACKGROUND AND OBJECTIVE: This laboratory animal study is a comparison of Nd:YAG 1064 nm and diode 810 nm laser wavelengths in brain interstitial laser photocoagulation (ILP). Specific goals were to identify potential complications and physical characteristics of the thermal damage at both wavelengths prior to undertaking a clinical trial in humans. STUDY DESIGN/MATERIALS AND METHODS: A total of 41 ILP illuminations were performed in vivo in the brains of 33 anesthetized rabbits using plane-cut fiber tips implanted directly or through catheters, and diffusing fiber tips. Delivered powers ranged from 1.1 to 4.2 W. Exposures ranged from 300 to 900 s. Survival ranged from 0 to 48 h. Experiments were performed in animals with and without VX-2 brain tumors. RESULTS: Thermal damage from 1.1 W at 810 nm was similar to that from 1.6 W at 1064 nm, but more pronounced. With plane-cut fiber tips, there was a greater propensity for severe physical effects (smoke, charring, bubbling, surface damage) at 810 nm than at 1064 nm, yet hemorrhage, thrombosis and vapor dissemination were observed at both wavelengths, in both normal brain and tumor. CONCLUSIONS: For ILP in brain, 1064 nm may be better suited than 810 nm, although both are questionable with plane-cut-fiber tips. Compactness and portability may be the only valid reasons for using laser diodes operating around 810 nm. At 1064 nm, the power delivered from plane-cut fiber tips should be less than 1.5 W, necessitating long exposures, or else an open catheter should be used. Fiber tips with distributed emission may be preferred, provided structural integrity can be maintained.

Animals↗
PubMed1997

A source localization principle for linear shift-invariant systems with application to point optical and radioactive sources.

The source localization principle is an inequality between the means of scalar fields produced by different sources in any linear shift-invariant system. This principle is presented here as a pair of conditions (spatial and temporal) under which a point source produces a greater mean field over finite source-centered regions than all other sources. Biomedical applications involving point optical sources and radioactive sources are discussed.

Hot Temperature↗
PubMed1995

Investigations of large vessel cooling during interstitial laser heating.

Interstitial laser heating of tissues is influenced by blood flow in the treatment region. Temperature gradients around large blood vessels may result in local underheating of tissues. A three-dimensional, time-dependent finite difference model of interstitial laser heating around large vessels is presented. A thermal conduction model was developed using a transport theory approximation for the energy distribution from an optical line source. Calculated transient temperature profiles and temperature reductions around 0.144 and 0.400 cm diam vessels show qualitative agreement with those measured in a series of tissue phantom studies. Experiments and calculations for a large vessel located approximately 1.0 cm from the optical source indicate that temperature reductions are less than 1 degree C at distances greater than approximately 1.0 cm from the vessel surface. The model also indicates that significant reductions in the extent of a thermal coagulation boundary can occur if a large vessel is situated inside the normal coagulation zone.

Blood Vessels↗
PubMed1994

Hepatic interstitial laser photocoagulation. An investigation of the relationship between acute thermal lesions and their sonographic images.

OBJECTIVES: The relationship between hepatic interstitial laser photocoagulation (ILP) lesions and their acute ultrasound images was evaluated. In addition, the natural history of ILP lesions in normal pig liver was documented. METHODS: Eighteen pigs underwent laparotomy and ultrasound-monitored ILP. In part 1 of the study, 12 pigs each had four separate exposures (1.50 W for 60, 100, 300, and 500 seconds) and were divided into four groups according to when they were killed (0, 3, 7, and 21 days). In part 2 of the study, six pigs each had two sequential exposures (1.60 W for 1,000 and then 500 seconds) at separate hepatic sites. Survival time was 3 days. Necropsy and histologic examination were performed in all animals. In 0- and 3-day survivors, actual thermal lesions were compared with "early" (immediately after ILP) and "late" (1 hour after ILP) ultrasound images. RESULTS: In the 300-, 500-, and 1,000-second exposures of parts 1 and 2, thermal lesions were overestimated or approximated by early ultrasound and were underestimated or approximated by late ultrasound. Analysis of variance showed statistically significant differences between thermal lesions and their early and late ultrasound images (F = 18.6, P < .001, no interactions). Time-growth characteristics of ILP lesions were reasonably consistent on ultrasound; exceptions were identifiable 200 seconds into the exposure. In part 2, ultrasound changes were minimal in five of six 500-second (second sequential) technically satisfactory exposures. Thermal lesions were seen at necropsy. All lesions healed by formation of granulation tissue and collagen. CONCLUSIONS: During ILP, early ultrasound images frequently overestimate actual thermal lesions. Ultrasound-monitored ILP of tumors may be most effective if, on early ultrasound, echogenic changes extend beyond the tumor margins. Late ultrasound images underestimate or approximate thermal lesions. Their value in clinical ILP should be investigated. It is unclear why ultrasound images of proven thermal lesions were not seen during 5 of 6 otherwise satisfactory 500-second ILP exposures performed immediately after 1,000-second exposures.

Animals↗
PubMed1994

Basic optothermal diffusion theory for interstitial laser photocoagulation.

A theoretical basis for interstitial laser photocoagulation (ILP) practiced with point-emitting fiber tips has been established by solving the bioheat transfer equation, using basic Green's function methods, for steady and instantaneous point sources of both optical energy and direct heat. Three combination optical and thermal parameters have been identified that strongly influence temperature distributions during ILP. These are defined here as optothermal heat capacities and an optothermal diffusion length, all of which characterize how a thermal diffusion temperature profile is flattened and reduced when optical diffusion is added. Relevance and limitations of this theory for practical ILP are discussed. A useful result is a mathematical verification of previous empirical observations that point optical sources heat tissues less than point heat sources of the same power. A comparison of normalized theoretical temperature transients with published measurements suggests that in normal liver, blood perfusion cooling may exceed thermal conduction by a factor of 5.6 +/- 1.7.

Biophysical Phenomena↗
PubMed1994

Hepatic interstitial laser photocoagulation: demonstration and possible clinical importance of intravascular gas.

PURPOSE: To investigate gas formation during hepatic interstitial laser photocoagulation (ILP). MATERIALS AND METHODS: In vitro, ILP was performed with a neodymium yttrium aluminum garnet laser on a piece of liver in a water bath. In vivo, nine pigs underwent 24 ultrasound (US)-monitored ILP procedures. Fiber tips were more than 1 cm from (n = 16) or adjacent to (n = 8) intrahepatic veins. The gas production seen on US images was graded on a scale of 0 to 4. Precordial Doppler US was performed in all cases. RESULTS: In vitro, smoke bubbles emanated from the vessels during ILP. In vivo, US showed intravascular gas production during nine of 15 exposures of at least 500 seconds duration. Gas production scores of 2 or more were recorded for nine exposures. Intracardiac gas was identified on eight precordial Doppler US recordings. All animals survived. CONCLUSION: Gas was detected in the heart during some ILP exposures. Patients with a probe-patent foramen ovale (24% prevalence) could be at risk for paradoxic air embolus during ILP.

Animals↗
PubMed1993

Comparison of magnetic resonance images and the histopathological findings of lesions induced by interstitial laser photocoagulation in the brain.

Interest has developed in using magnetic resonance (MR) imaging to monitor the volume of tissue destroyed by interstitial laser photocoagulation (ILP). In these experiments, ILP was induced in the normal brains of 9 anesthetized cats by delivering 1.5 W of continuous-wave Nd:YAG laser energy (1,064 nm) from a single 400-microns core optical fiber for 1,000 s. The irradiations were monitored using proton spin-echo MR imaging during and immediately after ILP and at postirradiation survival times of 2, 5, and 14 days. At 2 days postirradiation, the necrotic thermal lesion consisted of a central cavity surrounded by 2 concentric zones of coagulative necrosis, one dense and the other dispersed. The lesion shrank and the zonal appearance became less obvious over the 14 day survival period. An enhancing halo on contrast-enhanced T1-weighted images acquired immediately postirradiation best approximated the total lesion diameter at 2 days. These images also indicated that the volume of tissue destroyed during ILP corresponded better to the necrotic volume determined at 2 days than at 5 days and 14 days postirradiation. T2-weighted images acquired during and immediately after ILP consistently underestimated the total lesion diameter at 2 days.

Animals↗
PubMed1993

Selecting source locations in multifiber interstitial laser photocoagulation.

A theoretical basis and practical algorithm are described for selecting optimal fiber source locations in multifiber interstitial laser photocoagulation (ILP). By analyzing the shape of overlapping coagulation patterns, the optimal separation of adjacent point heat sources inside a flat target volume boundary is shown to be d* = 2 square root of 2rc, where rc is the coagulation radius of a single source. Against a curved boundary, the algorithm specifies how d* should be altered. To assess the validity of the theory, ILP was conducted in bovine muscle by delivering 1064 nm laser energy through two or four plane-cut optical fibers simultaneously. Delivered power, exposure duration, and source separation were varied. The observed coagulation patterns matched the theory-predicted patterns at delivered powers of 1.60W and 1.85W, but not at 2.40W. Also, the experiments indicate that reciprocity of delivered power and exposure duration is invalid for ILP.

Animals↗
PubMed1992

Magnetic resonance imaging of interstitial laser photocoagulation in brain.

Magnetic resonance (MR) imaging can be used to monitor the development of thermal lesions induced in tissue using interstitial laser photocoagulation (ILP). A potential application for ILP is the treatment of surgically inaccessible brain tumors. For the successful clinical application of MR-monitored ILP, it is necessary to relate MR images of ILP lesions to the actual induced lesions. In this preliminary study we performed ILP in the normal brains of anesthetized cats by delivering interstitially 1.0, 1.5, and 2.0 W of continuous-wave Nd:YAG laser energy (1,064 nm) for 1,000 s via a plane-cut 400 microns core optical fiber. At 48 h post-irradiation the lesions consisted of four sharply demarcated concentric zones of thermal damage. Lesion diameter increased linearly with delivered power. T2-weighted proton spin-echo images acquired during ILP showed a region of complete or near signal loss that underestimated the actual lesion at 48 h. Gadolinium-enhanced T1-weighted spin-echo images acquired immediately post-irradiation showed the actual lesion precisely.

Animals↗
PubMed1992

Interstitial laser photocoagulation: Nd:YAG 1064 nm optical fiber source compared to point heat source.

Interstitial laser photocoagulation (ILP) was performed in vitro in lean bovine and chicken muscle by delivering 1.6 W of continuous-wave Nd:YAG laser energy (1064 nm) from a 400-microns core optical fiber for 300s. The resulting thermal coagulation lesion was consistently larger when the delivered energy was deposited into a small steel sphere than when it was delivered freely into the tissue. Mathematical modelling confirms this result. This preliminary study suggests that a point heat source produces a larger volume of thermal coagulation than a point optical source (1064 nm) delivering the same power.

Animals↗
PubMed1992

Sonographic changes during hepatic interstitial laser photocoagulation. An investigation of three optical fiber tips.

RATIONALE AND OBJECTIVES: Interstitial laser photocoagulation (ILP) destroys tumors thermally, using laser energy delivered from implanted optical fibers. The objectives of the study are to identify a fiber tip/delivered energy combination which produces lesions of useful size, visible on ultrasound (US) during ILP, and to compare ILP lesions and their US images. METHODS: Hepatic ILP was performed at laparotomy in six pigs, using three different fiber tips (cylindrical diffusing, spherical diffusing, plane-cut). US images were obtained during ILP, immediately after ("early" images), and before the animals were killed (2-2.5 hours, "late" images). Actual lesions were assessed histopathologically. RESULTS: Few US changes were seen around cylindrical diffusing and spherical diffusing tips until tip destruction. Plane-cut tips, at 1.5 to 2.0 W, produced prominent US images of the 1- to 2-cm thermal lesions. Early images tended to overestimate necrosis. Late images approximated necrosis. CONCLUSION: For US-controlled ILP, plane-cut tips are better than currently available cylindrical diffusing or spherical diffusing tips. Lesion image growth periods might enable control of lesion size. Further studies are needed to determine the consistency of the described relationship between lesion images and actual lesions.

Animals↗
PubMed1991

A control method for a nonlinear multivariable system: application to interstitial laser hyperthermia.

An original adaptive control method is presented for controlling a nonlinear multivariable system. The method, which could be described as a modified quasi-linear approach, involves dividing the source excitation into a series of pulsing rounds and is implemented as a control algorithm on a computer. The theory underlying the method is developed with reference to an application involving temperature control in interstitial laser hyperthermia. In this application, the method is both successful and necessary to achieve optimally uniform elevated temperatures in a ground beef phantom. Apart from variable and parameter definitions, the method is otherwise general and might be useful for controlling a nonlinear system in which no prior exact characterization of the system is possible. Simulations were conducted to assess the effectiveness of the method in systems for which the unit excitation response changes by factors ranging from zero to three over the total period of excitation. In each case the method has proven stable.

Algorithms↗
PubMed1990

Optical properties of normal and diseased human breast tissues in the visible and near infrared.

The optical absorption and scattering coefficients have been determined for specimens of normal and diseased human breast tissues over the range of wavelengths from 500 to 1100 nm. Total attenuation coefficients were measured for thin slices of tissue cut on a microtome. The diffuse reflectance and transmittance were measured for 1.0 mm thick samples of these tissues, using standard integrating sphere techniques. Monte Carlo simulations were performed to derive the scattering and absorption coefficients, as well as the mean cosine of the scattering angle. The results indicate that scatter exceeds absorption by at least two orders of magnitude. Absorption is most significant at wavelengths below 600 nm. The scattering coefficients lie in the range 30-90 mm-1 at 500 nm, and fall smoothly with increasing wavelength to between 10 and 50 mm-1 at 1100 nm. The scattering coefficient for adipose tissue differs, in that it is invariant with wavelength over this spectral range. For all tissues examined, the scattered light is highly forward peaked, with the mean cosine of the scattering angle in the range 0.945-0.985. Systematic differences between the optical properties of some tissue types are demonstrated.

Breast↗
PubMed1989

Monte Carlo modeling of light propagation in highly scattering tissue--I: Model predictions and comparison with diffusion theory.

Using optical interaction coefficients typical of mammalian soft tissues in the red and near infrared regions of the spectrum, calculations of fluence-depth distributions, effective penetration depths and diffuse reflectance from two models of radiative transfer, diffusion theory, and Monte Carlo simulation are compared for a semi-infinite medium. The predictions from diffusion theory are shown to be increasingly inaccurate as the albedo tends to zero and/or the average cosine of scatter tends to unity.

Light↗
PubMed1987

Assessment of a procedure for left ventricle volumetry.

A three-step radiographic procedure is described for the determination of left ventricle volumes, based on one lateral and two angled single plane images. The first angled image is taken to yield a minimally foreshortened LV image and the second image, at the same angle, is taken of a calibration sphere. Five sources of operator-related, or 'input', error are analysed, two of which are normally removable. The remaining three input errors are assessed using a commercial digital subtraction angiography system and comparisons with the analysis are given. A summary result is that relative errors in end-systolic and end-diastolic LV volumes, as well as cardiac output, should normally be less than 13% under reasonable operator care. The input errors should not contribute to errors in calculated ejection fractions.

Heart↗
PubMed1985

The reduction of renogram deconvolution to a direct method of transit time determination.

It is known that the intrarenal mean transit time (MTT) can be determined using renography by first deconvoluing the kidney retention function from the obtained time-activity curve and then integrating the retention function. A direct and approximate calculational method, based on an integral mathematical model, has also been employed to estimate the MTT. In this work it is shown that the direct approximate method is equivalent to the standard deconvolution method applied with the assumption of a time independent retention function. Potential errors incurred using the direct method are thus quantified and assessed over a range of representative decay parameters.

Humans↗