Laser induced breakdown spectroscopy for bone and cartilage differentiation - ex vivo study as a prospect for a laser surgery feedback mechanism

Abstract

Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model. 31(2), 155-156 (1978). 12. M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, "Transoral management of localized carcinoma of the oral cavity using the CO2 laser," Laryngoscope 89(6 Pt 1), 897-905 (1979). 13. J. A. Carruth, "Resection of the tongue with the carbon dioxide laser," J. Laryngol. Otol. 96(6), 529-543 (1982). 14. L. Gáspár, "The use of high-power lasers in oral surgery," J. Clin. Laser Med. Surg. 12(5), 281-285 (1994). 15. M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman, Jr., "Laser management of oral leukoplakias: a follow-up study of 70 patients," Laryngoscope 109(6), 949-953 (1999). 16. J. A. Carruth, "Lasers in medicine and surgery," J. Med. Eng. Technol. 8(4), 161-167 (1984). 17. M. K. Basu, J. W. Frame, and P. H. Rhys Evans, "Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats," J. Laryngol. Otol. 102(4), 322-327 (1988). 18. M. Luomanen, "A comparative study of healing of laser and scalpel incision wounds in rat oral mucosa," Scand. ©2014 Optical Society of America

A critical review of recent progress in analytical laser-induced breakdown spectroscopy

“…Today, research into the development of a BLIBS-based iKnife^is becoming more and more intense. Ex-vivo surgical situations are created, and the qualitative performance of LIBS under these conditions is specifically tested [143,144]. A further boost to LIBS-guided surgery is expected with the future incorporation of fiber lasers as the ablation source, replacing the bulky and inefficient pulsed Na:YAG lasers currently used in surgical devices.…”

Investigation of the differentiation ofex vivonerve and fat tissues using laser-induced breakdown spectroscopy (LIBS): Prospects for tissue-specific laser surgery

“…Here, the identification and preservation of nerve tissue is perhaps the most critical challenge. In previous studies, our group has investigated the differentiation between several tissue types, at times specifically highlighting the nerve recognition and nerve-fat pair differentiation performance [23][24][25][26][27][28][29]. The challenge posed by this particular pair results from the peripheral nerve fiber's myelin cover.…”

“…In our previous investigations using LIBS, a very high differentiation performance among various tissue types is demonstrated. The technique is able to differentiate between cartilage and cortical bone with 100% sensitivity and specificity [29]. The investigation of soft tissue differentiation (fat, muscle, nerve and skin) also yields promising results with lower differentiation performance of the nerve-fat pair as compared to the other combinations [27,28].…”

Analysis of major elements in pigmented melanocytic chicken skin using laser‐induced breakdown spectroscopy

“…Previously, LIBS has been applied for the classification of malignant and normal tissues of a canine hemangiosarcoma and the differentiation of brain, lung, spleen, liver, kidney and skeletal muscle tissues of a chicken by multivariate analysis . A portable LIBS system for in‐situ measurement of the biochemical elements in malignant skin and recently the potential of LIBS as a surgical feedback technique for the differentiation of tissues like fat, nerve, muscle and skin of pig head were also reported .…”