Neodymium:yttrium aluminum garnet (Nd:YAG) lasers exhibit considerable potential for treating deeply buried port-wine stains. However, the application of Nd:YAG laser is limited by its weak absorption to blood. This in vivo study tested the efficacy and safety of utilizing thiol-terminated methoxypolyethylene glycol-modified gold nanorods (PEG-GNRs) to enhance the absorption of Nd:YAG laser to blood. Mouse mesentery and dorsal skinfold chamber (DSC) model were prepared to analyze the thermal responses of a single venule without anatomic structures, as well as blood vessels in the complex structure of the skin, to laser light. After the injection of 0.44 mg of PEG-GNRs, the required threshold density of laser energy for blood coagulation and complete vasoconstriction decreased from 24 to 18 J/cm2 in the mesentery model and from 36 to 31 J/cm2 in the DSC model. The laser pulse required for blood coagulation and complete vasoconstriction decreased by 67.75% and 62.25% on average in the mesentery model and by 67.55% and 54.45% on average in the DSC model. Histological and histochemical results confirmed that PEG-GNRs are nontoxic in the entire mouse life span. Therefore, combining PEG-GNRs with Nd:YAG laser may be effective and safe for inducing an obvious thermal response of blood vessels under low energy density and minimal pulse conditions.
The voxel-based Monte Carlo method (VMC) is now a gold standard in the simulation of light propagation in turbid media. For complex tissue structures, however, the computational cost will be higher when small voxels are used to improve smoothness of tissue interface and a large number of photons are used to obtain accurate results. To reduce computational cost, criteria were proposed to determine the voxel size and photon number in 3-dimensional VMC simulations with acceptable accuracy and computation time. The selection of the voxel size can be expressed as a function of tissue geometry and optical properties. The photon number should be at least 5 times the total voxel number. These criteria are further applied in developing a photon ray splitting scheme of local grid refinement technique to reduce computational cost of a nonuniform tissue structure with significantly varying optical properties. In the proposed technique, a nonuniform refined grid system is used, where fine grids are used for the tissue with high absorption and complex geometry, and coarse grids are used for the other part. In this technique, the total photon number is selected based on the voxel size of the coarse grid. Furthermore, the photon-splitting scheme is developed to satisfy the statistical accuracy requirement for the dense grid area. Result shows that local grid refinement technique photon ray splitting scheme can accelerate the computation by 7.6 times (reduce time consumption from 17.5 to 2.3 h) in the simulation of laser light energy deposition in skin tissue that contains port wine stain lesions.
To adapt the complex tissue structure, laser propagation in a two-layered skin model is simulated to compare voxel-based Monte Carlo (VMC) and tetrahedron-based MC (TMC) methods with a geometry-based MC (GMC) method. In GMC, the interface is mathematically defined without any discretization. GMC is the most accurate but is not applicable to complicated domains. The implementation of VMC is simple because of its structured voxels. However, unavoidable errors are expected because of the zigzag polygonal interface. Compared with GMC and VMC, TMC provides a balance between accuracy and flexibility by the tetrahedron cells. In the present TMC, the body-fitted tetrahedra are generated in different tissues. No interface tetrahedral cells exist, thereby avoiding the photon reflection error in the interface cells in VMC. By introducing a distance threshold, the error caused by confused optical parameters between neighboring cells when photons are incident along the cell boundary can be avoided. The results show that the energy deposition error by TMC in the interfacial region is one-tenth to one-fourth of that by VMC, yielding more accurate computations of photon reflection, refraction, and energy deposition. The results of multilayered and n-shaped vessels indicate that a laser with a 1064-nm wavelength should be introduced to clean deep-buried vessels.
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