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Preclinical assessment of a mathematical model for ablation zone prediction in thyroid laser ablation

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Abstract

To develop and validate a 3D simulation model to calculate laser ablation (LA) zone size and estimate the volume of treated tissue for thyroid applications, a model was developed, taking into account dynamic optical and thermal properties of tissue change. For validation, ten Yorkshire swines were equally divided into two cohorts and underwent thyroid LA at 3 W/1,400 J and 3 W/1,800 J respectively with a 1064-nm multi-source laser (Echolaser X4 with Orblaze™ technology; ElEn SpA, Calenzano, Italy). The dataset was analyzed employing key statistical measures such as mean and standard deviation (SD). Model simulation data were compared with animal gross histology. Experimental data for longitudinal length, width (transverse length), ablation volume and sphericity were 11.0 mm, 10.0 mm, 0.6 mL and 0.91, respectively at 1,400 J and 14.6 mm, 12.4 mm, 1.12 mL and 0.83, respectively at 1,800 J. Gross histology data showed excellent reproducibility of the ablation zone among same laser settings; for both 1,400 J and 1,800 J, the SD of the in vivo parameters was ≤ 0.7 mm, except for width at 1,800 J, for which the SD was 1.1 mm. Simulated data for longitudinal length, width, ablation volume and sphericity were 11.6 mm, 10.0 mm, 0.62 mL and 0.88, respectively at 1,400 J and 14.2 mm, 12.0 mm, 1.06 mL and 0.84, respectively at 1,800 J. Experimental data for ablation volume, sphericity coefficient, and longitudinal and transverse lengths of thermal damaged area showed good agreement with the simulation data. Simulation datasets were successfully incorporated into proprietary planning software (Echolaser Smart Interface, Elesta SpA, Calenzano, Italy) to provide guidance for LA of papillary thyroid microcarcinomas. Our mathematical model showed good predictability of coagulative necrosis when compared with data from in vivo animal experiments.

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Acknowledgements

This paper is dedicated to the memory of Professor Leonardo Masotti. A visionary entrepreneur, a passionate researcher, an inspiring leader, but most of all, a gentleman. Thanks to his efforts, we all know today the huge potential of this technology in medicine. The authors gratefully acknowledge the late Claudio Maurizio Pacella, M.D. for his tireless dedication in developing LA in medicine. He saw before others the infinite potential of laser in tissue ablation and oncology and was very vocal throughout his life to educate the scientific community on technological advantages of laser over other energies currently available.

Funding

No funding was received for this study. Editorial support for the preparation of this article was provided by George Clarkson Ph.D., funded by Elesta SpA.

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Authors and Affiliations

  1. Elesta SpA, Calenzano, Florence, Italy

    Luca Breschi

  2. Interventional Radiology Service, Department of Radiology, Weill-Cornell Medical College, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, USA

    Ernesto Santos, Stephen B. Solomon & Fourat Ridouani

  3. Department of Clinical Sciences, Florida State University College of Medicine, Sarasota, Florida, USA

    Juan C. Camacho

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  1. Luca Breschi
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  2. Ernesto Santos
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  3. Juan C. Camacho
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  4. Stephen B. Solomon
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  5. Fourat Ridouani
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Luca Breschi. The first draft of the manuscript was written by Luca Breschi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Luca Breschi.

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Ethical approval

The animal study was reviewed and approved by the Institutional Animal Care and Use Committee (IACUC).

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Not applicable.

Conflict of interest

Luca Breschi is an employee of Elesta SpA and developer of the model. Juan C. Camacho and Stephen B. Solomon receive grant support from Elesta. Ernesto Santos and Fourat Ridouani have none to declare.

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Supplementary material 1

: This article is accompanied by a Supplementary Materials appendix, which describes math modeling of the optical source and development for the model for thermal damage evaluation.

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Breschi, L., Santos, E., Camacho, J.C. et al. Preclinical assessment of a mathematical model for ablation zone prediction in thyroid laser ablation. Lasers Med Sci 39, 121 (2024). https://doi.org/10.1007/s10103-024-04062-7

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