肿瘤激光诱导间质治疗litt实时疗效评估因子分析-real - time evaluation factor analysis of litt in tumor laser-induced interstitial therapy.docxVIP

南京航空航天大学硕士学位论文 摘 要 激光诱导间质热疗法是利用激光产生局部组织凝固坏死的肿瘤热疗技术，临床应用上存在 术中无法实时评估疗效和控制剂量问题。本文利用近红外光谱技术研究激光诱导间质热疗的实 时疗效，为临床手术精确监控提供理论基础。 论文主要工作：1、基于生物组织热传导和热损伤的基础理论，对激光治疗过程进行了模拟 仿真研究，主要有：热损伤过程中组织参数(主要研究光学参数)动态模型，并利用动态模型仿 真治疗过程的靶点温度的变化情况，通过动态模型与静态模型的分析比较，证明了热疗过程中 组织参数的动态特性对温度的影响非常大；2、通过激光诱导间质热疗离体和在体实验获得疗效 评估参数。实验采用离体猪肝和在体小鼠皮下移植肝肿瘤，获取了手术治疗靶点的近红外光学 参数(约化散射系数 μ 、吸收系数 μ )及血氧参数(血氧饱和度 SO2)；3、通过大量实验数据分析 s a 获得了较可靠的手术实时监控因子( μ 、μ )、建立了激光治疗参数(功率 P、治疗时间 t)和疗效 s a 因子的关联模型，通过数学模型来反映术中疗效，得到了较理想的治疗评估效果。 论文主要创新点：1、提出了一种基于近红外光谱的肿瘤激光诱导间质手术实时疗效评估技 术；2、构建了有限元热疗仿真参数动态模型，模拟仿真了激光热疗中的温度场分布；3、通过 离体猪肝和在体小鼠皮下移植肝肿瘤实验建立了疗效评估数学模型，初步实现了近红外光谱技 术实时疗效评估。 关键词：激光诱导间质热疗，近红外光谱，光学参数，温度场分布 i 肿瘤激光诱导间质治疗(LITT)实时疗效评估因子研究 ABSTRACT Laser-induced interstitial thermotherapy (LITT) is a new technology for tumor treatment. It causes the tissue necrosis through the interaction of light and heat effects. But during clinical application it cannot achieve real-time efficacy evaluation and control of dosage. The present study mainly makes use of Near Infrared Spectroscopy (NIRS) technique to explore real-time efficacy evaluation during LITT, and provide theoretical evidence for accurate monitoring of clinical surgery. The main work of this study is as follows: 1. Base on principle of biological tissue heat conduction and heat damage, this paper carried on analog simulation research during laser treatment. We developed a dynamic theoretical model of biological tissue (principal focus on optics parameters) and utilized dynamic theoretical model to simulate temperature field distribution of target tissue. The result proved that dynamic characteristics of tissue parameters are highly affected during LITT by comparing the dynamic model analysis with the static model. 2. We can obtain parameters of efficacy evaluation by vitro and vivo experiments with LITT. We have gained near-infrared optics parameters (reduced scattering coefficient: μ , absorption coefficient: μ ) and hemoglobin oxygen parameter s a (hemoglobin oxygen satura