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Dr. N.G.P.

INSTITUTE OF TECHNOLOGY
Coimbatore-641048

BIOMEDICAL ENGINEERING

TWO MARKS WITH ANSWER

BM 6703/MEDICAL OPTICS

REGULATION: 2013

Prepared by Reviewed by
Staff Name/Designation Staff Name/Academic Co-ordinator

Approved by

HoD/BME Principal
Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

Syllabus

BM 6703 MEDICAL OPTICS LTPC


3 0 03
OBJECTIVES:
To Study about:
 The optical properties of the tissues and the applications of laser in diagnosis and therapy.

UNIT I OPTICAL PROPERTIES OF THE TISSUES 9

Refraction, Scattering, Absorption, Light transport inside the tissue, Tissue properties, Laser
Characteristics as applied to medicine and biology-Laser tissue Interaction-Chemical-Thermal-
Electromechanical – Photoabalative processes.

UNIT II INSTRUMENTATION IN PHOTONICS 9

Instrumentation for absorption, Scattering and emission measurements, excitation light sources –
high pressure arc lamp, LEDs, Lasers, Optical filters, - optical detectors – Time resolved and phase
resolved detectors.

UNIT III SURGICAL APPLICATIONS OF LASERS 9

Lasers in ophthalmology- Dermatology –Dentistry-Urology-Otolaryngology - Tissue welding.

UNIT IV NON THERMAL DIAGNOSTIC APPLICATIONS 9

Optical coherence tomography, Elastography, Laser Induced Fluorescence (LIF)-Imaging, FLIM


Raman Spectroscopy and Imaging, FLIM – Holographic and speckle application of lasers in
biology and medicine.

UNIT V THERAPEUTIC APPLICATIONS 9

Phototherapy, Photodynamic therapy (PDT) - Principle and mechanism - Oncological and


nononcological applications of PDT - Biostimulation effect – applications-Laser Safety
Procedures.

TOTAL: 45 PERIODS

OUTCOMES:
At the end of the course, the student should be able to:
 Demonstrate knowledge of the fundamentals of optical properties of tissues
 Describe surgical applications of laser.
 Describe photonics and its therapeutic applications.

TEXT BOOKS:
1. Markolf H.Niemz, “Laser-Tissue Interaction Fundamentals and Applications”, Springer, 2007
2. Paras N. Prasad, “Introduction to Biophotonics”, A. John Wiley and Sons, Inc. Publications, 2003

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

UNIT I: OPTICAL PROPERTIES OF THE TISSUES

1. State the basic interaction of light with matter. (DEC 2006)


Light interacts with matter in four ways.
a. Emission
b. Absorption
c. Transmission
d. Reflection or Scattering

2. On factors the ability of the medium to absorb the Electromagnetic wavesdepends on.
(DEC 2006)
 Absorption is a process involving the extraction of energy from lightby a molecular
species. In biomedical photonics, absorption processesare important in diagnostic and
therapeutic applications
 Absorption occurs when the photon frequency matches the frequencyassociated with the
molecules energy transition.

3. Write down any two optical properties of tissues? (DEC 2007)


a. Index of refraction
b. Scattering cross section
c. Differential scattering cross section
d. Absorption cross section

4. If the absorption and scattering coefficient of a tissue is 10 cm-1 and 40 cm-1respectively,


compute the values of absorption length and mean free opticalpath of incident photons.
(DEC 2011)
Given:
μa= 10 cm-1
μs= 40 cm-1
Absorption length la = 1/μa = 1/ 10 =0.1 cm
Mean free optical path of incident photons =1/(μa+ μs)
= 1/(10+40)= 0.02 cm

5. Define the term, thermal relaxation time. What is its clinical significance? (DEC 2011)
Thermal relaxation time is the time taken for the target to dissipate about63% of the incident
thermal energy. It is related to size of target chromophore, e.g., few nanoseconds (tattoo particles)
to hundred milliseconds (leg venules).

6. The aortic wall has an absorption coefficient of 2.3 cm-1 and a scattering Coefficient of310 cm-
1 at 633nm. What is the optical albedo of the tissue? (DEC 2011)
Given:
μa= 2.3 cm-1
μs= 310 cm-1
optical albedo = μs/ (μa + μs)
= 310/(2.3+310)
= 0.99

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

7. What is the difference between fluorescence and phosphorescence?(DEC 2012), (MAY 2014)

8. Define refractive index of the medium? (DEC 2012)


The index of refraction of a substance is equal to the ratio of the velocity oflight in a vacuum to its
speed in that substance. Its value determines the extent to which light is refracted when entering
or leaving the substance.

9. Define the term speckles. (MAY 2014)


Speckle structures are produced as a result of interference of a large numberof elementary waves
withrandom phases that arise when coherent light isreflected from a rough surface or when
coherent light passes through a scattering medium.

10. Explain the term time dependent thermal penetration depth. (MAY 2014)
The spatial extent of heat transfer is described by the time-dependent thermal penetration depth
𝑍𝑡ℎ𝑒𝑟𝑚(𝑡 ) = √4𝑘𝑡

11. State the factors that constitute the therapeutic window with reference to light? (NOV 2015)
Three (factors) types of sources are commonly employed in diffusive light measurements. The
simplest and easiest method to use is the continuous-wave (CW) device. In this case the source
amplitude is constant, and the transmitted amplitude is measured as a function of source-detector
separation or wavelength. The second method is the pulsed-time or time-resolved technique. In
this scheme a short, usually sub nanosecond light pulse is launched into the medium, and the
temporal point spread function of the transmitted pulse is measured. The third method is the
intensity modulated or frequency-domain technique. In this case the amplitude of the input source
is sinusoid ally modulated, producing a diffusive wave within the medium. The amplitude and
phase of the transmitted diffuse light wave are then measured.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

12. Enlist the optical parameters of a tissue. (NOV 2015)


Optical parameters of a tissue, in particular refractive index, are known to depend on water content.
The refractive index of water over a broad wavelength range of 0.2 to 200 µm.

13. Define Scattering cross section and scattering coefficient.


The ratio of the power scattered out of a plane wave to the incident intensity is the scattering cross
section,
𝜎s(ŝ) = 𝑃𝑠𝑐𝑎𝑡𝑡/𝐼o
where is the propagation direction of the plane wave relative to the scattered.

The scattering coefficient μs[cm-1] can be expressed in terms of particle density ρ[cm-3] and
scattering cross section σs[cm2] as
𝜇 s = ρσs

14. Define absorption cross section and absorption coefficient.


For a localized absorber, the absorption cross section σacan be defined in the same manner as for
scattering:
σa =Pabs/ Io

where Pabs is the amount of power absorbed out of an initially uniform plane wave of intensity
(power per unit area) I0.

The absorption coefficient μa[cm–1] can be defined in terms of particle density ρ [cm–3] and
absorption cross section σa[cm2]
μa =ρσa

15. What do you mean by therapeutic window?


The ability of light to penetrate tissues depends on how strongly the tissues absorb light. Withinthe
spectral range known as the therapeutic window (alsocalled the diagnostic window), mosttissues
are sufficiently weak absorbers topermit significant penetration of light. This windowextends from
600 to 1300nm, from the orange region of the visible spectrum into the N/R.

16. What is scattering domination limit?


When the absorption is sufficiently low to permit significant penetrationoflight into the tissue,
scatteringis the dominant transport process. Thisscattering-dominant limit, known as the diffusion
limit, isimportant becausephotons are able to move through the tissue, although the strong
scatteringdispersesthe light in a random fashion.

17. Mention the strongly scattering and weekly scattering biological media.
Strongly scattering (opaque) like skin, brain, vessel walls, eye sclera, blood,and lymph and weakly
scattering (transparent) like cornea, crystalline lens,vitreous humor, and aqueous humor of the
front chamber of eye.

18. Write the applications of QELS spectroscopy.


QELS spectroscopy (also known as lightbeatingspectroscopy or correlationspectroscopy) is
widely used for various biomedical applications,particularlyfor blood or lymph flow measurement
and cataract diagnostics.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

19. What do you mean by optothermal effect?


The time-dependent heat generated in a tissue via interaction with pulsed orintensity-modulated
optical radiation is known as optothermal (OT) effect.

20. Why fluorescence is an appropriate parameter for detection of ischemic orneoplastic tissues?
The reduced form of coenzyme nicotinamide adenine dinucleotide (NADH) is excited selectively
in a wavelength range between 330 and 370 nm. NADHis most concentrated within mitochondria
whereit is oxidized within therespiratory chain located within the inner mitochondrial membrane
anditsfluorescence is an appropriate parameter for detection of ischemic orneoplastic tissues.

21. State subjective and objective speckles.


Subjective speckles that are produced in the image space of an opticalsystem (including an eye)
and objective speckles, formed in a free space andusually observed on a screen placed at a certain
distance from an object.

22. State the basis for optothermal radiometry.


The pulse laser heating of a tissue causes its temperature perturbations andcorresponding
modulationof its own thermal (infrared) radiation.

23. What is Diffusion wave spectroscopy?


It is a class of technique in the field of dynamic light scattering related to theinvestigation of the
dynamics of particles within very short time intervals.

24. Mention the fundamental difference between QELS from DWS.


A fundamental difference of DWS method from QELS is that it is applicableto the case of dense
media with multiple scattering.

25. Mention the exogenous fluorescing dyes applied for propping cell anatomy.
In humans, such dyes as fluorescein and indocyanine green are in use forfluorescence angiography
or blood volume determination. Fluorescencespectra often give detailed information on
fluorescent molecules, theirconformation, binding sites, and interaction within cells and tissues.

26. How scattering used both in diagnostic and therapeutic application?


Diagnostic applications: Scattering depends on the size, morphology, andstructure of the
components in tissues (e.g., lipid membranes, nuclei, collagen fibers). Variations in these
components due to disease would affect scatteringproperties, thus providing a means for diagnostic
purposes, especially inimaging applications.Therapeutic applications: Scattering signals can be
used to determine optimal light dosimeter (e.g., during laser-based treatment procedures)
andprovide useful feedback during therapy.

27. How absorption used both in diagnostic and therapeutic application?


Diagnostic applications: Transitions between two energy levels of amolecule that are well
definedat specific wavelengths could serve as aspectral fingerprint of the molecule for diagnostic
purposes.Therapeutic applications: Absorption of energy is the primary mechanismthat allows
light froma laser to produce physical effects on tissue fortreatment purposes.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

28. Define the properties reflection and refraction?


Reflection involves a change in direction of waves when they bounce off a barrier. Refraction of
waves involves a change in the direction of waves as they pass from one medium to
another. Refraction, or the bending of the path of the waves, is accompanied by a change in speed
and wavelength of the waves.

29. What are the types of optical scattering?


Light scattering is a form of scattering in which light in the form of propagating energy
is scattered. Light scattering can be thought of as the deflection of a ray from a straight path, for
example by irregularities in the propagation medium, particles, or in the interface between two
media.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

UNIT II: INSTRUMENTATION IN PHOTONICS

1. What is a Polarizer? How it helps in light detection. (DEC 2006)


A polarizer or polarizer is an optical filter that passes light of a specific polarization and blocks
waves of other polarizations. It can convert a beam of light of undefined or mixed polarization into
a beam with well-defined polarization, polarized light.

2. What are the important properties of a solid state detector? (DEC 2006)
 Low ionization energy
o Larger charge yield dq/dE
o Better energy resolution
 High field in detection volume
o Fast response better charge collection efficiency

3. What are the limitations of Deuterium arc lamp? (DEC 2007)


The operation of high-pressure arc lamps requires special care and handling, such as reduction of
the excitation stray light with a good mono chromate, use of a highly regulated DC power supply,
and removal of the heat generated by the lamp output in the IR range. A warm-up period is also
necessary to minimize arc wandering, because of a tendency for the arc to change its location
inside the lamp envelope during the first half hour of operation. This arc wandering effect may
cause sudden variations in the observed intensity, especially when the image of the arc is focused
into a small slit aperture.

4. What are the advantages of absorption spectroscopy methods? (DEC 2007)


It is an analytical technique that measures the concentration of an element by measuring the
amount of light (intensity of light) that is absorbed - at a characteristic wavelength - when it passes
through a matter. The main advantages are given below:
 High sample throughput
 Easy to use
 High precision
 Inexpensive technique

5. Why carbon dioxide laser is extensively used for surgical applications? (DEC 2007)
CO2 laser is useful in surgical procedures, because water (which makes up most biological tissue)
absorbs this frequency of light very well. Medical uses are laser surgery and skin resurfacing
("laser facelifts", which essentially consist of vaporizing the skin to promote collagen formation).

6. What is meant by neutral density optical filter? (DEC 2011)


A neutral density filter or ND filter is a filter that reduces or modifies the intensity of all
wavelengths or colors of light equally, giving no changes in hue of color rendition. It can be a
colorless (clear) or grey filter. The purpose of a standard photographic neutral-density filter is to
reduce the amount of light entering the lens.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

7. What are optical filters? (DEC 2012),(MAY 2014)


Optical filters are devices that selectively transmit light of different wavelengths, usually
implemented as plane glass or plastic devices in the optical path which are either dyed in the bulk
or have interference coatings.Opticalfilters are completely described by their frequency response,
which specifies how the magnitude and phase of each frequency component of an incoming signal
is modified by the filter.

8. Define Raman spectroscopy? (DEC 2012)


Raman spectroscopy is the measurement of the wavelength and intensity of in elastically scattered
light from molecules. The Raman scattered light occurs at wavelengths that are shifted from the
incident light by the energies of molecular vibrations. The mechanism of Raman scattering is
different from that of infrared absorption, and Raman and IR spectra provide complementary
information. Typical applications are in structure determination, multicomponent qualitative
analysis, and quantitative analysis.

9. Describe about polarizers? (MAY 2014)


 A polarizer or polarizer is an optical filter that passes light of a specific polarization and
blocks waves of other polarizations.
 It can convert a beam of light of undefined or mixed polarization into a beam with well-
defined polarization, polarized light. The common types of polarizers are linear polarizers
and circular polarizers.
 Polarizers are used in many optical techniques and instruments, and polarizing filters find
applications in photography and liquid crystal display technology.
 Polarizers can also be made for other types of electromagnetic waves besides light, such as
radio waves, microwaves, and X-rays.

10. Outline the principle behind the link between a spectroscopic instrument and a remotely located
samples. (NOV 2015)
Optical fibers can be used to transmit the excitation light to a sample and transmit the signal
(reflected or scattered light) from the sample to the detector. Several possible optical fiber
configurations can perform these measurements: single-fiber system, bifurcated fiber system, and
dual-fiber system

11. Distinguish “Turners method from heating and pulling method in preparation of near filed
optical probes”. (NOV 2015)
The most frequently used technique is the melt-drawn, or “heating and pulling,” method. Glass
fiber is heated locally using a laser or a filament and the fiber is then pulled apart. The resulting
tip shapes depend largely on the temperature and the timing of the procedure.
The second method, based on chemical etching of glass fibers, is often called “Turner’s method.”
The tip formation occurs at the meniscus between hydrofluoric acid and an organic over layer.
Tips generated in this way generally show considerably larger angles and therefore the
transmission is higher than for melt-drawn tips. The parameters are difficult to control and the
quality is less reproducible.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

12. List the detectors for electromagnetic radiation.


 Photo emissive
 Semiconductor
 Thermal detector

13. Write short notes on CIDs and APS solid state detectors?
CIDs have pixels composed of two metal-oxide semiconductor gates that overlap and share the
same row and column electrodes. The APS consists of a photodiode, a reset transistor, and arrow-
select transistor.

14. List out the components of basic spectrophotometer.


 An excitation light source
 Dispersive devices (optical filters, monochromators, or polychromators)
 A sample (usually in a compartment with a sample holder)
 A photometric detector (equipped with a read-out device)

15. Write short notes on LEDs.


Light-emitting diodes (LEDs) are solid-state light sources that provide output over a wide range
ofwavelengths. These devices require little power and generate little heat. One can use a few LEDs
to covera spectral range from 400 to 700 nm. LEDs are practical light sources for many low-power
photonicapplications and can be amplitude-modulated up to hundreds of
megahertz.

16. Mention the three basic classes of spectrophotometers.


There are three basic classes of spectrophotometers: filter instruments, monochromatic
instruments, and multichannel devices. The first type of device uses optical filters, whereas the
latter two systems use prisms or gratings as dispersive elements.

17. Draw the schematic arrangement of a typical spectrometer for absorption.

18. Write short notes on excitation light source.


UV light is generally used for excitation in many spectroscopic measurements. These UV sources
may be classified into two categories, namely, line or continuum type, and can be used in a
continuous wave (CW) mode or in a pulsed mode. The line sources provide sharp spectral lines,
whereas continuum sources exhibit a broadband emission.

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Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

19. Draw the schematic arrangement of a typical spectrometer for emission.

20. Draw the schematic arrangement of a typical spectrometer for elastic scattering.

21. Draw the schematic arrangement of a typical spectrometer for inelastic scattering.

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Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

22. Discuss about widely used laser.


A very practical and widely used laser is the nitrogen laser. It operates only in the pulsed mode.
This laser produces sub nanosecond to tens-of-nanosecond pulses in the near-UV region (337 nm).
The energy per pulse ranges from a few micro joules to a few joules.

23. What is neutral filter?


Neutral density filters, which have a nearly constant transmission over a wide spectral range, are
generally used to attenuate the light equally at all wavelengths. For example, one can use neutral
density filters to strongly decrease luminescence signals and intense excitation light, or to adjust
or match the intensity of two signals.

24. What are cutoff and neutral filters?


Cutoff filters, which have a sharp transmission cutoff, are generally used to remove undesired
radiation, such as stray light or second-order diffraction light. Long pass (or high pass) filters are
often used to rejects catered light from the excitation and to transmit the emission of interest (e.g.,
fluorescence).

25. Write short notes on Photomultiplier.


The PM is a vacuum tube containing a highly sensitive surface, the photocathode, generally made
of a metal oxide. The PM tube operates as a current source. The intensity of the current output is
proportional to the intensity of the light striking the photocathode, which is a thin film of metal on
the inside of the PM window.

26. Mention the life time of absorption, scattering, fluorescence and phosphorescence.
 Absorption: instantaneous with excitation
 Fluorescence: 10-10 to 10-8 s
 Phosphorescence: 10-6 to 10-3s
 Scattering: almost instantaneous with excitation

27. Draw the schematic diagram of photomultiplier tube.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

28. What are the types of lasers?

 CO2 lasers, used cut, vaporize, ablate and photo-coagulate soft tissue.
 Diode lasers.
 Dye lasers.
 Excimer lasers.
 Fiber lasers.
 Gas lasers.
 Free electron lasers.
 Semiconductor diode lasers.

29. What is the function of optical filters?


The simplest, physically, is the absorptive filter; then there are interference or
dichroic filters. Optical filters selectively transmit light in a particular range of wavelengths, that
is, colors, while blocking the remainder.
30. Draw and explain LED.
LED will pass current in its forward direction but block the flow of current in the reverse direction.
Light emitting diodes are made from a very thin layer of fairly heavily doped semiconductor
material and depending on the semiconductor material used and the amount of doping, when
forward biased an LED will emit a colored light at a particular spectral wavelength. When the
diode is forward biased, electrons from the semiconductors conduction band recombine with holes
from the valence band releasing sufficient energy to produce photons which emit a monochromatic
(single color) of light. Because of this thin layer a reasonable number of these photons can leave
the junction and radiate away producing a colored light output.

31. List the instruments used for measure absorption.


 Spectrophotometer
 UV – Visible spectrophotometer
 IR spectrophotometer
 Spectroradiometer

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

32. Enumerate the features of solid state LEDs


 Rugged design Impact-resistant polycarbonate optic and anodized aluminum construction
ensures product longevity, LED technology eliminates the need for fragile incandescent
and fluorescent products.
 Solid state electronics No electro-magnetic interference (EMI) associated with fluorescent
products compatible with high-performance electronic equipment.
 Energy efficient Consumes less power per lumen than comparable incandescent or
fluorescent products.

Question Bank- Two Marks With Answer BM6703/Medical Optics


Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

UNIT III: SURGICAL APPLICATIONS OF LASERS

1. State the unique properties of Laser. (DEC 2006)


 Monochromatic
 Directional
 Coherent

2. Optical fibers play what role in endoscopy. (DEC 2007)


Optical fibers are narrow tubes of glass fibers with a plastic coating that carry light from one end
to the other. The light bounces off the walls of the fiber and can even bounce around corners. The
properties of optical fibers make them useful for a wide range of applications including:
 Medical - to transmit pictures of organs and arteries
 Industrial - to transmit pictures of the inside of complex machinery
 Communications - to transmit data over long distances without transmission loss

3. In the treatment of retinal detachment what type of laser is used and why? (DEC 2007)
The argon ion laser was used in ophthalmology for the treatment of retinal detachment. Because
its water transmissibility, good hemostatic ability, and small size made it ideal for ophthalmologic
procedures.

4. What are the various applications of lasers in tissue engineering? (DEC 2011)
a. Writing of 3D scaffolds for neural tissue engineering applications
b. Bio printing by laser-induced forward transfer for tissue engineering applications
c. Layer by layer tissue micro fabrication by selective Laser sintering
5. What are the applications of laser in medicine? (DEC 2012)
The following are various application of Laser in Medicine
 Cosmetic surgery (removing tattoos, scars, stretch marks, sunspots, wrinkles, birthmarks,
and hairs): see laser hair removal. Laser types used in dermatology include ruby (694 nm),
alexandrite (755 nm), pulsed diode array (810 nm), Nd:YAG (1064 nm), Ho:YAG (2090
nm), and Er:YAG (2940 nm).
 Eye surgery and refractive surgery
 Soft tissue surgery: CO2, Er:YAG laser
 Laser scalpel (General surgery, gynecological, urology, laparoscopic)
 Photo bio modulation (i.e. laser therapy)
 "No-Touch" removal of tumors, especially of the brain and spinal cord.
 Intelligent laser speckle classification for skin health assessments (especially
regarding damage caused through ageing)
 In dentistry for caries removal, endodontic/periodontic procedures, tooth
 whitening, and oral surgery

6. What are various advantages of Laser induced fluorescence? (DEC 2012, MAY 2014)
An advantage over absorption spectroscopy is that it is possible to get two and three-dimensional
images since fluorescence takes place in all directions (i.e. the fluorescence signal is usually
isotropic). The signal-to-noise ratio of the fluorescence signal is very high, providing a good
sensitivity to the process. It is also possible to distinguish between more species, since the lasing

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Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

wavelength can be tuned to a particular excitation of a given species which is not shared by other
species.

7. What are laser induced thermal effect on tissues? (DEC 2012)


Use of lasers in dermatology is for precise tissue ablation, called laser resurfacing. Two main
factors influence laser vaporization or ablation of tissue. The first is the penetration depth for the
laser radiation, which depends on wavelength. The second is the rate of tissue vaporization, which
depends on the amount and rate of laser energy absorption.

8. Write down the three steps involved in LASIK refractive corneal surgery. (MAY 2014)
In the LASIK procedure, a thin layer of the cornea is gently lifted to reveal the stroma of the cornea
(step 1). The laser is then applied to the stroma (step 2). The thin layer of the cornea is returned to
its original place (step 3). Because the epithelium of the cornea is not disturbed during this
procedure, healing is much faster, usually within 24 hours.

9. Why Argon ion laser photocoagulation is found more suitable for treatment of retina?
(NOV 2015)
The initial use of the argon ion laser was in ophthalmology for the treatment of retinal detachment.
Its water transmissibility, good hemostatic ability, and small size made it ideal for ophthalmologic
procedures.

10. CO2 laser has been extensively used for surgical applications. Point out the reason.
(NOV 2015)
The CO2 laser was superior at vaporization, cutting, hemostasis, and sterilization, and its tissue-
damage characteristics were more predictable.

11. What are the benefits of laser tissue welding?


While laser tissue welding is unlikely to replace sutures in all applications, it has been shown to
achieve functionality comparable to that of conventional suturing techniques, with the added
advantage of moderately reduced operation times, reduced skill requirements, reduced suture and
needle trauma, reduced foreign-body reaction, and reduced bleeding Repairs formed using laser
tissue welding tend to heal faster, have the ability to grow, and exhibit better cosmetic appearances.
Welding also has the potential to form complete closures, enabling an immediate watertight
anastomosis intra operatively in the case of vascular, genitourinary-tract, and gastrointestinal
repairs.

12. What are the limitations of tissue welding?


Low strength of the resulting anastomosis, especially in the acute-healing phase up to 5 d
postoperative; the second is thermal damage of tissue by direct laser heating and heat transfer.
Technical difficulties with the ambiguity of the endpoint for the procedure, tissue apposition, and
poor reproducibility.

13. Write short notes on photochemical welding.


Photochemical welding of tissue has been investigated as an alternative method for tissue repair
without the use of heat and its associated tissue damage.The technique utilizes chemical cross-
linking agents that, when light activated, produce covalent cross-links between the collagen fibers
contained within the tissue. In theory, this technique should produce stronger bonds than the non-

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Dr.N.G.P. Institute of Technology Department of Biomedical Engineering

covalent bonds produced by photo thermal welding. Agents used for photochemical welding
include 1,8-naphthalimide, rose Bengal (RB),riboflavin-5-phosphate (R-5-P),fluorescein (Fl),
methylene blue (MB), and N-hydroxypyridine-2-(1H)-thione (N-HPT).

14. What is laser tissue welding?


Laser tissue welding is a technological advance for tissue closure that offers many beneficial
features over conventional closure techniques including reduced suture and needle trauma, reduced
foreign-body reaction, better cosmetic appearance, reduced bleeding, the potential to form an
immediate watertight anastomosis intraoperatively, and shorter operating times.

15. List out the applications of laser tissue welding.


 Cardiothoracic and Vascular Surgery
 Dermatology
 General Surgery
 Gynecology and Obstetrics
 Laparoscopic and Endoscopic Surgery
 Neurosurgery
 Ophthalmology
 Orthopedic Surgery
 Otolaryngology
 Urology

16. Define the term selective photothermolysis.


The term “selective photothermolysis” was coined to describe site-specific, thermally mediated
injury of pigmented tissue targets by pulses of radiation. This technique relies on selective
absorption of a brief optical pulse to generate and confine heat at certain pigmented targets.

17. What are three basic requirements in Selective photothermolysis?


 The wavelength used must be preferentially absorbed by the targeted structure. This can
be achieved by choosing a wavelength within absorption bands for a chromophore
associated with the target, e.g., melanin in a pigmented hair follicle or hemoglobin’s in a
blood vessel.
 A sufficient fluence (fluence = energy/area) is required to achieve a damaging temperature
in the targets.
 The pulse duration or exposure time must be about equal to or less than the time needed
for the targets to cool.

18. What are the two procedures performing in laser vision correction?
 Photorefractive keratectomy (PRK) and
 Laser-Assisted in situ Keratomileusis (LASIK).

19. Sate the goals in Laser surgery of Iris.


Several laser surgical procedures are performed on the iris. There are three main goals with this
type of surgery: (1) create a bypass between the space behind the iris and the AC to reduce eye
pressure, (2) enlarge the approach to the ACA, and (3) enlarge pupil size. The argon laser described
above and Nd:YAG lasers can be used.

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20. Write about laser iridotomy


This procedure is designed to create a bypassing hole in the iris to allow fluid trapped behind it to
flow to the AC. Fluid blockage occurs due to closure of the ACA or to pupillary block. Both
argon12 and Nd:YAG 13 lasers can be used — separately or in combination. Laser parameters for
the argon laser are energy = 800 to 1000 mW, diameter = 50 μm, and exposure time = 0.1 sec. A
total of 40 to 80 applications are used. For the Nd:YAG laser, energy = 3 to 7 mJ, and four to ten
applications are used.

21. What is thermotherapy?


Thermotherapy is the treatment of tissue disorders by causing a rise in tissue temperature, is
another novel medical approach. Retinal temperature rise in laser therapy is proportional to retinal
irradiance (laser power/area) for a particular spot size, exposure duration, and wavelength.
22. Write short notes on Transpupillary thermotherapy (TTT).
Transpupillary thermotherapy (TTT) is a low-irradiance, large-spot-size, and prolonged-exposure
(long-pulse) laser treatment using infrared diode-laser energy. TTT has been successfully used to
treat intraocular tumors such as choroidal melanoma and choroidal hemangioma.

23. Which laser is commonly used in otolaryngology?


The most common application of the medical laser in otolaryngology is for tissue ablation. It is
therefore not surprising that the most commonly used laser in otolaryngology is the CO2 laser.

24. What is LAUP?


Laser-assisted uvulo-palatoplasty (LAUP) is a technique that was developed by Dr. Yves-Victor
Kamami in Paris, France in the late 1980s. The procedure is designed to correct snoring caused by
airway obstruction and soft-tissue vibration at the level of the soft palate by reducing the amount
of tissue in the velum and uvula. The procedure can be performed in an ambulatory setting under
local anesthesia and is performed over several stages.

25. List out the sensitizers that are currently in use.


Newer sensitizers currently in clinical development include benzo porphyrin derivative (BPD), tin
ethyl etiopurpurin (SnET2), 5- animolevulinic acid (ALA), meso-tetra (hydroxyphenyl) chlorin
(mTHPC), and lutetium texaphyrin (Lutex).

26. Explain eye diagram.


The human eye is an organ that reacts to light and has several purposes. Rod and cone cells in
the retina allow conscious light perception and vision including color differentiation and the
perception of depth.

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UNIT IV: NON THERMAL DIAGNOSTIC APPLICATIONS

1. What is the condition for interference to occur? State its features. (DEC 2006)
The source must be coherent, that is they must maintain a constant phase with respect to each
other. The source must be monochromatic, that is of a single wavelength.

2. What is an optical Hologram? (DEC 2006)


A hologram is a photographic recording of a light field, rather than of an image formed by a lens,
and it is used to display a fully three dimensional image of the holographed subject, which is seen
without the aid of special glasses or other intermediate optics. The hologram itself is not an image
and it is usually unintelligible when viewed by diffuse ambient light. It is an encoding of the light
field as an interference pattern of seemingly random variations in the opacity, density, or surface
profile of the photographic medium.

3. Write down the principles of an optical hologram. (DEC 2007)


Holography is based on the principle of interference. A hologram captures the interference pattern
between two or more beams of coherent light (i.e. laser light). One beam is shone directly on the
recording medium and acts as a reference to the light scattered from the illuminated scene.

4. An optical glucose sensor is built up on what principles? (DEC 2007)


Optical glucose biosensors are devices that measure the concentration of glucose in diabetic
patients by means of sensitive protein that relays the concentration by means of fluorescence an
alternative to ampere metric session of glucose.

5. Mention the three parts of biosensor.


There are three main parts of a biosensor:
(i) The biological recognition elements that differentiate the target molecules in the presence of
various chemicals
(ii) A transducer that converts the bio recognition event into a measurable signal
(iii) A signal processing system that converts the signal into a readable form

6. What is meant by Photoelastography? (DEC 2011)


Elastography is a medical imaging modality that maps the elastic properties of soft tissue. The
main idea is that whether the tissue is hard or soft will give diagnostic information about the
presence or status of disease. Forexample,cancerous tumors will often be harder than the
surrounding tissue, and diseased livers are stiffer than healthy ones. Elastography is a relatively
new technology, and entered the clinic primarily in the last decade. The most prominent techniques
use ultrasound or magnetic resonance imaging (MRI) to make both the stiffness map and an
anatomical image for comparison.

7. What is meant by photoablation? (DEC 2011)


Photoablation is the use of light or lasers to destroy tissues. The excimerlaser of deep ultra-violet
light is mainly used in Photoablation. The wavelength of laser used in photoablation is
approximately 200 nm.

8. What are the ideal properties of photosensitizer? (DEC 2012, MAY 2014)
 It should be able to produce singlet oxygen efficiently because singlet oxygen and type II
photochemical reaction is responsible for the majority of lesons generated during PDT.

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 It should have high absorption coefficient at the long wavelength region.


 It should have no dark toxicity, minimal or absent skin photosensitivity and should
selectively accumulate in tumor tissue in order to minimize skin phototoxicity.
 The distribution of PS is important in PDT processes and is influenced by its chemical
structure.
 It should be stable and easy to dissolve in the injectable solvents.

9. What are the uses of photo ablation?


Photo ablation is mainly used in corrective eye surgery procedures such as LASIK and LASEK.
In fact, all laser eye surgeries are photo ablation techniques in theory. It is mainly used to correct
the shape of cornea or front part of the eye. Excimer laser is used to destroy (photoablate) part of
the cornea, which automatically decreases refractive or optical power of the eye. The laser removes
the tissues by vaporization by transferring the energy to the target area. This procedure of photo
ablation with excimer lasers allows to correct many common eye problems. The procedure is
relatively painless. Recovery from photoablation usually occurs within weeks.

10. Write short notes on OCT? (DEC 2012)


Optical coherence tomography (OCT) is a fundamentally new type of optical imaging modality.
OCT performs high-resolution, cross-sectional tomographic imaging of the internal microstructure
in material sand biological systems by measuring backscattered or back reflected light. Image
resolutions of1 to 15 μm can be achieved — one to two orders of magnitude higher than
conventional ultrasound.Imaging can be performed in situ and nondestructively. High-speed, real-
time imaging is possible withacquisition rates of several frames per second. OCT enables “optical
biopsy,” the imaging of tissue structure or pathology on resolution scales approaching that of
histopathology, with imaging performedin situ and in real time, without the need to excise
specimens and process them as in standard excisional biopsy and histopathology.

11. Identify the limitation of optical coherence tomography. (NOV 2015)


Limitation of OCT is the poor penetration, power and inability to measure plaque burden, where
thickness exceeds 1.5 mm. in addition the severity of plaque’s located at aort0 - ostial location is
difficult to assess with the current stage of technology.
12. Can optical tomography overcome the demerits of X ray computed tomography?
(NOV 2015)
Yes optical tomography overcome the demerits of X ray computed tomography. The OCT
performs high resolution, cross section tomographic imaging of the internal microstructure in
material and biological systems by measuring the backscattering. Image resolution of 1 – 15m can
be achieved imaging can be performed in situ and nondestructively.

13. Why OCT is considered as powerful imaging technology?


OCT is a powerful imaging technology in medicine because it enables the real-time, in situ
visualizationof tissue microstructure without the need to remove and process a specimen excision
ally. The concept of non-excisional “optical biopsy” performed by OCT and the ability to visualize
tissue morphology in real time under operator guidance can be used for diagnostic imaging and to
guide intervention.

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14. What are the applications of optical coherence tomography?


 Imaging in Ophthalmology
 Optical biopsy
 Imaging Where Excisional Biopsy Is Hazardous or Impossible
 Detecting Early Neoplastic Changes

15. Why optical biopsy important in clinical scenarios?


The capability to perform “optical biopsy” — the in situ, real-time imaging of tissue morphology
—could be important in a variety of clinical scenarios, including:
 Assessing tissue pathology in situations where conventional excisional biopsy is hazardous
orimpossible
 Guiding conventional biopsy to reduce false negative rates from sampling errors
 Guiding surgical or microsurgical intervention

16. State the principle of Magnetic Resonance Elastography.


In MR elastography, a mechanical vibrator is used on the surface of the patient's body; this creates
shear waves that travel into the patient's deeper tissues. An imaging acquisition sequence that
measures the velocity of the waves is used, and this is used to infer the tissue's stiffness (the shear
modulus). The result of an MRE scan is a quantitative 3-D map of the tissuestiffness, as well as a
normal 3-D MRI image to compare it to.

17. Mention the application of OCT.


 Ophthalmology
 Diagnosing retinal diseases.
 Dermatology
 Skin diseases,early detection of skin cancers.
 Cardio-vascular diseases
 Vulnerable plaque detection.
 Endoscopy (fiber-optic devices)
 Gastroenterology
 Gynecology
 Embryology/Developmental biology

18. What are the two methods available for obtaining spectral interference in OCT?
There are two common methods of obtaining spectral interference in OCT. One involves using a
spectrometer as the detectors and is called Spectral domain OCT. Here the light is split into
different wavelengths during detection. Another method involves splitting the light into different
wavelengths at the source. This is called Swept-source OCT. Here incident light changes the
wavelength as a function of time and the temporal output of the detector is converted to spectral
interference.

19. Define Sensitivity in OCT.


Sensitivity in OCT refers to ability of the system to detect smallest amount back-reflection from
the sample under observation. Numerically it is the attenuation in the signal that results in signal
to noise ratio SNR of 1.

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20. Mention the key benefits of OCT.


 Live sub-surface images at near-microscopic resolution
 Instant, direct imaging of tissue morphology
 No preparation of the sample or subject
 No ionizing radiation

21. What are the applications of MR Elastography?


 Differentiating malignant and benign neoplasms (especially breast)Identifying early
traumatic changes in muscles and tendons
 Aiding in deciding the biopsy site more accurately, reducing negativebiopsy rates
 Assessing liver fibrosis

21. Draw the schematic of optical coherence imaging system.

Figure: The OCT system (a) includes a light


source with a broad wavelength
distribution (called a low-coherencelight
source), an interferometer (for
dividing/recombining the light), and
detection electronics. A compact, pen
sized, handheld probe was used for lateral
scanning of the articular cartilage, in
conjunction with an aiming beam. The
handheld OCT imaging probe (b) consists
of a four-lens relay and a scanning mirror.
The outer shell of the probe can be
detached for ease of sterilization. A/D,
analog-to-digital converter; VCR, video
cassette recorder.

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UNIT V: THERAPEUTIC APPLICATIONS

1. What is near field imaging? State its features. (DEC 2006)


Near Field Imaging is based on the concept of forcing a wave through an aperture smaller than a
wavelength of the radiation used. It is called near field because it resolves sub-wavelength
structures in the near field, generally within a wavelength or two of the aperture.

2. What is the principle of florescent spectroscopy? (DEC 2006)


Fluorescence spectroscopy (also known as fluorometry or spectro fluorometry) is a type of
electromagnetic spectroscopy which analyzes fluorescence from a sample. It involves using a
beam of light, usually ultraviolet light, that excites the electrons in molecules of certain compounds
and causes them to emit light; typically, but not necessarily, visible light. A complementary
technique is absorption spectroscopy.

3. Clinical laboratory instruments make use of holograms in what way? (DEC 2007)
Holograms can be used to test blood, breath, urine, saliva or tear fluid for a wide range of
compounds, such as glucose, alcohol, hormones, drugs or bacteria. When one of these compounds
is present, the hologram changes color, potentially making the monitoring of various conditions as
simple as checking the color of the hologram against a color gradient.

4. Reflection oximetry is based on what principles? (DEC 2007)


The principle of pulse oximetry is based on the red and infrared light absorption characteristics of
oxygenated and deoxygenated hemoglobin. Oxygenated hemoglobin absorbs more infrared light
and allows more red light to pass through. Deoxygenated hemoglobin absorbs more red light and
allows more infrared light to pass through.

5. Mention few applications of Near Infrared imaging techniques. (DEC 2011)


 To measure hemoglobin concentration changes
 Screening tool for intracranial bleeding
 Non invasive assessment of brain function
 Optical coherence tomography
 NIRS measure venous oxygen saturation

6. Define Lambert - Beer's law (DEC 2011)


 The Beer-Lambert law states that the quantity of light absorbed by a substance dissolved
in a fully transmitting solvent is directly proportional to the concentration of the substance
and the path length of the light through the solution.
 Absorbance [A (λ)] of a substance at a particular wavelength of electromagnetic radiation,
λ, is proportional to the concentration, c, of the absorbing substance and to the length of
the path, l, of the electromagnetic radiation through the sample containing the absorbing
substance.
 The law is written as follows:
A(λ) = e(λ) l c.
 The proportionality constant e (λ) is called the absorptivity of the substance at the
wavelength λ. e (λ) is called the molar absorptivity if the concentration is measured in
moles/liter.
 The absorbance is inversely proportional to the transmittance of the solution

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7. What is Photo Dynamic Therapy (PDT)? (DEC 2012)


Photodynamic therapy (PDT), sometimes called photo chemotherapy, is a form of phototherapy
using nontoxic light-sensitive compounds that are exposed selectively to light, whereupon they
become toxic to targeted malignant and other diseased cells (phototoxicity).

8. Explain the term photo coagulation. (MAY 2014)


The coagulation (clotting) of tissue using a laser which produces light in the visible green
wavelength that is selectively absorbed by hemoglobin, the pigment in red blood cells, in order to
seal off bleeding blood vessels. Photocoagulation has diverse uses such as, for example, in cancer
treatment to destroy blood vessels entering a tumor and deprive it of nutrients; in the treatment of
a detached retina; to destroy abnormal blood vessels in the retina; to treat tumors in the eye.

9. List down the prime requisites for photodynamic therapy. (MAY 2014)
 A drug that can be activated by light (Photosensitizer)
 Light
 Oxygen

10. Without excisional biopsy or cytology which optical method gives a better diagnosis?
(NOV 2015)
For better diagnosis without excisional biopsy or cytology, fluorescent spectroscopy is used.
11. The ability of PDT to eliminate tumor cells through direct photo damage is studied through
what methodology. (NOV 2015)
Ability of PDT eliminate tumor cells through direct damage was studied through methodology of
clinical photodynamic therapy.
12. Expand NSOM and SNOM.
 NSOM for near-field scanning optical microscopy and
 SNOM for scanning near-field microscopy

13. How near field microscopy differ from far field microscopy?
In contrast to far-field microscopy in which the light source is confined by a lens, in near-field
optical microscopy the light source is confined by a metal aperture. Within a short distance beyond
the screen, the size of the illuminated spot is limited only by the dimensions of the aperture. This
area is the so called optical near-field. If such a small light source is scanned above a surface and
the distance between aperture and sample is in this near-field region, all scattering or absorption
phenomena must originate from that small illumination spot. Consequently, aperture size and
distance determine their solution.

14. Mention the two simple methods used to prepare probe tips.
The most frequently used technique is the melt-drawn, or “heating and pulling,” method. Glass
fiber is heated locally using a laser or a filament and the fiber is then pulled apart. The resulting
tip shapes depend largely on the temperature and the timing of the procedure. The second method,
based on chemical etching of glass fibers, is often called “Turner’s method.” The tip formation
occurs at the meniscus between hydrofluoric acid and an organic over layer. Tips generated in this

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way generally show considerably larger angles and therefore the transmission is higher than for
melt-drawn tips.

15. Write short notes on Fluorescence Resonance Energy Transfer.


Fluorescence resonance energy transfer (FRET) is a method that uses the distance dependence of
nonradioactive energy transfer from an excited donor molecule to an acceptor molecule. The
transfer efficiency is given by a sixth power dependence on the intermolecular separation:
E= 1/ (1+(R/R0)6)
Where R is the distance between donor and acceptor and R0 is the distance at which 50% of the
energy is transferred.

16. What is the limitation of near field optical microscope?


The main restriction of near-field optical microscopy is the aperture. Although an aperture is
necessary to achieve the resolution, it also imposes serious limitations.

17. What is the advantage of multiphoton optical microscope?


The advantage of this approach, the high signal-to-background level, is identical to the two-photon
probe enhanced technique mentioned in the previous section. The detected signal is blue shifted
with respect to the excitation source, so that normal fluorescence is spectrally far away and can
easily be filtered. In addition, resolution enhancement occurs because the two photon energy is the
same as one single UV-photon of half the wavelength.

18. How fluorescence diagnostic methods are grouped?


Fluorescence diagnostic methods can be grouped into two main categories:
 Methods that detect endogenous fluorophores in tissues
 Methods that detect or use exogenous fluorophores or fluorophoreprecursors [such as 5-
aminolevulinic acid (ALA)]

19. What is vibrational relaxation?


In condensed media, the molecules in the Sn state deactivate rapidly, within 10–13 to 10–11 s via
VR processes, ensuring that they are in the lowest vibrational levels of Sn possible as described by
the thermal Boltzmann distribution. Because the VR process is faster than electronic transitions,
any excess vibrational energy is rapidly lost as the molecules are deactivated to lower vibronic
levels of the corresponding excited electronic state.

20. What is single vibronic level?


In the gas phase at very low pressures (<10–6 torr) emission may be observed from higher
vibrational levels of the excited state. These emission mechanisms, known as single-vibronic-level
(SVL) luminescence processes, do not generally occur in condensed media such as tissues.

21. State Kasha’s rule.


Internal conversion (IC) processes are transitions between states of the same multiplicity. The
molecule subsequently deactivates to the lowest vibronic levels of Sn–1 via a VR process. By a
succession of IC processes immediately followed by VR processes, the molecule deactivates
rapidly to S1. As a result, a molecule may be excited to S1 or higher excited states, Sn, depending
on the excitation energy used, but the emission takes place only from the lowest excited electronic
state, S1. This is known as Kasha’s rule.

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22. What do you mean by fluorescence?


Relaxation of the molecule from the S1 state may occur by one of a several different of
processes, including:
 Further deactivation to S0 in a radiation less fashion via internal conversion (IC) and VR
processes or
 Emission of a photon without a change in spin multiplicity. The latter S1 → S0 transition
is known as fluorescence.

23. What is Intersystem Crossing (ISC)?


Molecules in the Si state may relax is through a transition to some vibrational level of the triplet
manifold via a mechanism known as an intersystem crossing (ISC) process. The ISC process
involves a change in spin multiplicity. The molecule then relaxes to the lowest vibrational level of
T1 via successive IC and VR processes.

24. What is Delayed Fluorescence (DF)?


Fluorescence and phosphorescence are the two most common luminescence processes. A less
common emission process is delayed fluorescence (DF). Delayed fluorescence may occur from
the S1state, exhibiting a spectrum identical to conventional fluorescence (often called “prompt
fluorescence”) but having a longer lifetime due to the additional stay in the triplet state.

25. What are the two types of delayed fluorescence?


Two types of DF processes can be differentiated:
(1) an eosin-type (E-type) DF produced by repopulation of S1 from the triplet state by thermal
activation, and
(2) apyrene-type (P-type) DF produced when pairs of triplet state
molecules interact, providing an activation energy greater than or equal to the S1 energy.

26. How fluorescence and phosphorescence are characterized?


Several physical observables may be used to characterize fluorescence and phosphorescence.
These include the following:
 Emission, excitation, and synchronous spectra
 Quantum yields
 Lifetimes
 Polarization

27. Write short notes on photofrin.


Photofrin (polyhematoporphyrin ethers), the first and, thus far, only photosensitizer approved by
health agencies worldwide for treatment of cancer, remains the most widely used in routine clinical
practice for treatment of esophageal and lung cancers (approved), as well as in a host of off-label
indications (e.g., skin cancer, bladder cancer, brain tumors, head and neck cancer, etc.).

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