Abstract
Among the different thermal therapies known in the clinical practice, the technique based on laser light appears to be fast and relatively tissue insensitive. Improvement of the procedure for inducing thermal damage only within the tumor volume and safety margins, while spearing the surrounding healthy tissue and structures, is still a priority for research groups and companies working in this field.
The achievement of a safe and effective procedure could be enhanced by means of some technical solutions, like the improvement of the selective absorption of the laser light by the tumor tissue, the accurate and real-time monitoring of the ablation effects, and the immediate evaluation of the outcome to visualize viability gaps at clinically relevant locations. Numerous in vitro and in vivo studies on different tissues are now demonstrating the important and sophisticated role played by nanoparticles: they favor the absorption of laser light into the target, thus inducing a significant increase in temperature in the target area compared to the surrounding tissues. We are very likely to be on the eve of a possible revolution in the ablation techniques thanks to a targeted, controlled, and customized approach of the killer temperatures of the tumor cells in the absence of damage to the adjacent healthy structures.
As largely mentioned in this book, diagnostic images are useful for therapy guidance; during the last decades, the key role of imaging also for real-time feedback of the therapy effects has emerged. The standard thermometric technique used in clinical practice relies on MRI, while a deep study on the use of computed tomography, ultrasound images, and novel approaches is under development. Beyond the images, sensors play also a relevant role in this field. Fiber optic-based temperature sensors are small, biocompatible, do not interfere with the laser radiation and provide accurate measurement of the tissue temperature evolution during the procedure. Another relevant role is played by the hyperthermal treatment planning tools, which can calculate the optimal therapy settings based on the images of the patient and mathematical models.
This chapter aims at providing an overview on the novel approaches extensively employed in the research world, and which could foster the use of laser ablation technology in clinical practice.
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Saccomandi, P., Schena, E., Pacella, C.M. (2020). New Horizons for Laser Ablation: Nanomedicine, Thermometry, and Hyperthermal Treatment Planning Tools. In: Pacella, C., Jiang, T., Mauri, G. (eds) Image-guided Laser Ablation. Springer, Cham. https://doi.org/10.1007/978-3-030-21748-8_15
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