Abstract
The purpose of this project was to develop a delivery system optimized for laser interstitial thermotherapy of small tumors of the breast. The proposed approach is to combine laser interstitial thermotherapy with stereotactic imaging for fiber guidance and treatment monitoring. The goals of the dissertation were to design a fiber insertion system for cylindrical diffusing tip optical fibers and to derive optimal laser parameters for coagulation of 1 cm tumor plus a surrounding 1 cm thick rim of healthy tissue. A fiber insertion system compatible with a high resolution stereotactic digital X-ray biopsy system was designed to guide the fiber into the tumor site in similar fashion to the insertion of the biopsy needle. An optical-thermal model consisting of a radiation model, a thermal model, and a coagulation model was developed and validated using ex-vivo porcine tissue. A single integrating sphere optical property measurement system and an inverse Monte Carlo algorithm were developed to measure the optical properties of ex-vivo porcine tissue at 830, 940, and 980 nm. An experimental method was developed to determine the parameters of the Arrhenius model (frequency factor (A) and activation energy (Ea)). The optical-thermal model was validated by comparing the predicted temperature and coagulation to results of laser irradiation experiments at 830, 940, and 980 nm. Using published values of the optical properties of the breast, the model predicts that a 3 cm coagulation size can be produced without vaporization in 10 min with 10.4 W at 980 and 940 nm and 13.2 W at 830 nm. The same outcome can be achieved in 20 min with 4.5 W at 980 and 940 nm and 6.1 W at 830 nm.