Super Pulse Research Articles

Thulium fiber laser vs Ho:YAG in RIRS: a prospective randomized clinical trial assessing the efficacy of lasers and different fiber diameters (150 µm and 200 µm)

IntroductionThe aims of the study: (1) to compare the Super Pulse Thulium Fiber Laser (SP TFL) and the holmium: yttrium–aluminium-garnet (Ho:YAG) lasers in retrograde intrarenal surgery (RIRS); (2) to compare the efficacy of SP TFL laser fibers of different diameters (150 μm and 200 μm).MethodsA prospective randomized single-blinded trial was conducted. Patients with stones from 10 to 20 mm were randomly assigned RIRS in three groups: (1) SP TFL (NTO IRE-Polus, Russia) with fiber diameter of 150 μm; (2) SP TFL with 200-μm fiber; and (3) Ho:YAG (Lumenis, USA) with 200-μm fiber.ResultsNinety-six patients with kidney stones were randomized to undergo RIRS with SP TFL using a 150-μm fiber (34 patients) and a 200-μm fiber (32 patients) and RIRS with Ho:YAG (30 patients). The median laser on time (LOT) in the 200-μm SP TFL group was 9.2 (6.2–14.6) min, in 150-μm SP TFL—11.4 (7.7–14.9) min (p = 0.390), in Ho:YAG—14.1 (10.8–18.1) min (p = 0.021). The total energy consumed in 200-μm SP TFL was 8.4 (5.8–15.2) kJ; 150-μm SP TFL − 10.8 (7.3–13.5) kJ (p = 0.626) and in Ho:YAG—15.2 (11.1–25.3) kJ (p = 0.005).ConclusionsIrrespective of the density, RIRS with SP TFL laser has proven to be both a safe and effective procedure. Whilst the introduction of smaller fibers may have the potential to reduce the duration of surgery, SP TFL results in a reduction in the LOT and total energy for stone ablation in RIRS compared with Ho:YAG.

Study of Temperature Changes around Fibres in Super Pulse Thulium Fibre Laser in Vitro Lithotripsy.

To investigate temperature changes around the fibres of the super pulse thulium fibre laser (SP-TFL) during in vitro lithotripsy. Stones were placed in the in vitro model. The laser was continuously excited for 180 s; the probe was positioned 5 mm around the fibre; the laser power was set at 10, 15, 20, 25, and 30 W; and the irrigation rate was set at 0, 15, 25, 35 ml/min, using a domestic SP-TFL. The temperature variations around the fibre under different power settings and different irrigation rates were compared. Without irrigation, the temperature around the fibre rapidly reached the safety threshold of 43℃ at 24 s. At irrigation rate 15 ml/min and laser power <15 W, the temperature around the fibre was <43℃. Once the laser power increased to ≥20 W, the temperature around the fibre increased to >43℃ at its lowest plateau. At irrigation rate 25 ml/min and laser power ≤25 W, the temperature around the fibre was <43℃. At irrigation rate 35 ml/min and laser power <30 W, the fibre temperature was <43℃. When laser power was ≥30 W, the fibre temperature was >43℃. In extracorporeal ureteroscope SP-TFL lithotripsy, when the laser power is ≤15 W, ≤25 W, and ≤30 W, the irrigation rate should be maintained at ≥15 ml/min, ≥25 ml/min, and ≥35 ml/min, respectively.

Efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis

The objective of this study was to evaluate the efficacy and safety of super pulse CO2 laser-assisted punctoplasty with canalicular curettage in primary canaliculitis. In this retrospective serial case study, the clinical data of 26 patients who underwent super pulse CO2 laser-assisted punctoplasty for the treatment of canaliculitis were collected from January 2020 to May 2022. The clinical presentation, intraoperative and microbiologic findings, surgical pain severity, postoperative outcome, and complications were studied. Of the 26 patients, most were females (female:male 20:6), with a mean age of 60.1 ± 16.1 years (range, 19–93). Mucopurulent discharge (96.2%), eyelid redness and swelling (53.8%), and epiphora (38.5%) were the most common presentations. During the surgery, concretions were present in 73.1% (19/26) of the patients. The surgical pain severity scores ranged from 1 to 5, according to the visual analog scale, with a mean score of 3.2 ± 0.8. This procedure resulted in complete resolution in 22 (84.6%) patients and significant improvement in 2 (7.7%) patients, and 2 (7.7%) patients required additional lacrimal surgery with a mean follow-up time of 10.9 ± 3.7 months. The surgical procedure of super pulse CO2 laser-assisted punctoplasty followed by curettage appears to be a safe, effective, minimally invasive, and well-tolerated treatment for primary canaliculitis.

Photobiomodulation surgery of the soft palate

The purpose of the work: To familiarize specialist in the field of laser ENT surgery with the stages of the historical development of surgical care for patients with ronchopathy and obstructive sleep apnea syndrome, to evaluate the effectiveness of traditional uvulopalatoplasty metods and to justify the introduction info practice of the use of laser radiation for uvulopalatoplasty and its modifications. To increase the effectiveness of laser uvulopalatoplasty and its application in patients with ronchopathy and obstructive sleep apnea syndrome of any severity, a method of laser sculptural uvulopalatoplasty based on the use of carbon dioxide laser radiation in the "Super pulse" mode with a scanning device is proposed.

Upper tract urothelial carcinoma: can the tumor be removed en bloc?

Diagnosis and treatment of upper tract urothelial carcinoma (UTUC) remain important problems of clinical urology. UTUC en bloc i.e. in one-piece removal during organ-sparing surgery is still hardly possible. The most typical endourological operations are either electrosurgery, holmium or thulium YAG laser tumor vaporization.We present a clinical case of ureteroscopic en bloc UTUC removal using a new super pulse thulium fiber laser (SPTFL, FiberLase U3). Recent innovations and trends in this field are also discussed. The technical steps of en bloc ureteroscopic tumor removal allowing for diagnosis verification, identification of pT stage and surgical margin are described. The further innovations in laser UTUC removal include modulation of laser pulse length and development of the correlation between preoperative tumor characteristics and possibility of en bloc removal.

Lasers for benign prostatic hyperplasia (hybrid, blue diode, TFL, Moses). Which one to choose?

To present the evidence of latest developments of lasers for the surgical treatment of benign prostatic hyperplasia (BPH). We focused on recent advancements in Ho:YAG laser such as Moses technology, the Thulium Fiber Laser (TFL), the blue diode laser, and hybrid laser. Laser enucleation of prostate techniques using either Ho:YAG laser with the Moses technology and Moses 2.0, or TFL seem efficient and safe compared with the standard enucleation using Ho:YAG laser. Only in vitro studies evaluated the blue diode laser and hybrid laser (combination of a continuous wave TFL and blue diode laser). Blue diode laser showed intermediate incision depth and minimal coagulation depth compared with Ho:YAG laser and Super Pulse TFL. Hybrid laser showed deep incision depth and small coagulation area compared with Ho:YAG laser and continuous wave TFL. Surgical treatment of BPH using Moses technology, Moses 2.0, and TFL shows encouraging results comparable to the standard enucleation using Ho:YAG laser. Only in vitro data are currently available for blue diode laser and hybrid laser. Future well-designed studies comparing these technologies and evaluating them on specific risk groups of patients as well as the long-term durability of outcomes are needed.

Evaluation of Meibomian Gland Function after Therapy of Eyelid Tumors at Palpebral Margin with Super Pulse CO2 Laser.

Purpose To investigate the effect on meibomian gland function of super pulse carbon dioxide (CO2) laser excision in the treatment of eyelid tumors at palpebral margin. Methods 36 patients with 36 eyelid tumor size ≤ 1 cm and within 1 mm to palpebral margin were recruited in this study. Of which, 16 cases with tumors in the upper eyelid and 20 cases in the lower eyelid were involved. The eyelid tumors of all the patients were treated by super pulse CO2 laser with its power density varied between 0.6 and 21.1 W/mm2 and in repeat mode. The laser spot size ranged from 120 to 200 μm. Ocular surface parameters including tear film break-up time (BUT) and meibograde, meibum expressibility, and meibum quality were evaluated at pretherapy, 1 week, 1 month, and 3 months posttherapy in all 36 patients. Result All the patients were satisfied with the therapy. No infective complications and recurrence occurred in any of the 36 patients at the following period. The eyelid wound recovered well with nearly normal appearing after 2 to 3 weeks. The morphology of limbi palpebralis, BUT, meibograde, meibum expressibility, and meibum quality of all the 36 patients showed no significant difference before and after the therapy. Conclusions Super pulse CO2 laser had no effect on meibomian gland function and morphology in the excision of tumors at palpebral margins, which was an efficacy and well-tolerated therapy with lower complications and recurrence.

Robotic Assisted Flexible Ureteroscopy in Covid-19 Positive Patient Using Thulium Fiber Laser: Case Report and Literature Review

Flexible Ureteroscopy (FURS) has become an integral aspect of the surgical armamentarium to treat intra-renal stones that are less than 2 cm in diameter. Despite the progress made with regards to the design of the flexible ureteroscopes, surgeons still need to work with suboptimal ergonomics, which may result in orthopedic complaints, which as a result lead to imperfect performance. Robotic- Assisted FURS with Avicenna Roboflex has provided significant improvement of ergonomics. The Super Pulse Thulium Fiber Laser (SPTFL) may be considered as a viable alternative to holmium laser in stone management. Coronavirus Disease- 19 (Covid-19) has been declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. As a result, many hospitals have been converted to dedicated facilities to manage the Covid-19 patients. Urinary stone disease represents a benign condition, but in non-negligible number of cases, it can lead to potential severe septic complications that could increase the burden on emergency services. Many surgical specialties including urology has made short pathways for patient flow to decrease the contact with the patients which in turn will decrease the possibility of transmission of Covid-19. The use of new technologies such as Avicenna Roboflex and thulium fiber laser in Covid-19 positive patients when performing flexible ureteroscopy can minimize direct contact with the patient, expedite the procedure, while protecting the staff from getting Covid-19 infection.

Case Series of Laser Therapy of Eyelid Peripunctal Benign Tumor.

Objective: This study is the first time to explore the feasibility of CO2 laser treating some eyelid lacrimal puncta benign tumor. Background: Eyelid lacrimal papillae is special anatomy region. Treatment of eyelid peripunctal tumor is relatively intractable and needs reconstruction of the lacrimal passage in most of the time. We use super pulse CO2 laser to treat peripunctal benign tumor and appears to be effective. Materials and methods: It contained 12 participants treated with super pulse CO2 laser photocoagulation without lacrimal duct silicone tube placement. The areas of lesions were as follows: eight cases were located in the upper eyelid lacrimal puncta, four cases in the lower lacrimal puncta. Super pulse CO2 laser was used to treat it. The follow-up period was 4 weeks, 24 weeks, and 3 years after treatment. Histological diagnoses were obtained in all patients. Results: All patients were satisfactory after treatment with their cosmetic outcomes, and the wounds are dry, with no infections. No patient has functional damage, secondary epiphora, and lacrimal drainage system obstruction. Complete epithelialization occurs 2-4 weeks after treatment and forms normal epithelium. It showed no obvious scars or notches after treatment, and only temporarily less hyperpigmentation is in the treated area than the circumambient normal skin. During the follow-up period, there were no complications and no relapses were observed. Conclusions: Super pulse CO2 laser therapy for eyelid peripunctal benign tumors without lacrimal duct silicone tube placement sometime appears to be available, effective, and well-tolerated alternative to traditional surgery in the clinic, especially for selected disease. The IRB proved number is 2016034.

PD26-07 IMAGE DISTORTION DURING FLEXIBLE URETEROSCOPY: A LABORATORY MODEL COMPARING SUPER PULSE THULIUM FIBER (SPTF) LASER VS HIGH POWER HO:YAG LASER

You have accessJournal of UrologyStone Disease: Surgical Therapy III (PD26)1 Sep 2021PD26-07 IMAGE DISTORTION DURING FLEXIBLE URETEROSCOPY: A LABORATORY MODEL COMPARING SUPER PULSE THULIUM FIBER (SPTF) LASER VS HIGH POWER HO:YAG LASER Caleb S Miller, Bristol B Whiles, David A Duchene, Donald A Neff, and Wilson R Molina Caleb S MillerCaleb S Miller More articles by this author , Bristol B WhilesBristol B Whiles More articles by this author , David A DucheneDavid A Duchene More articles by this author , Donald A NeffDonald A Neff More articles by this author , and Wilson R MolinaWilson R Molina More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002019.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Digital ureteroscopes employ “chip on the tip” technology which allows significant improvement in image resolution. However, image distortion often occurs during laser lithotripsy due to acoustic wave production. We sought to compare the Super Pulse Thulium Fiber (SPTF) laser with the high power Holmium (Ho:YAG) laser in terms of image distortion using variable laser power settings and laser fiber tip distance from the scope’s tip. METHODS: Utilizing a silicone renal model fitted with a 12/14F access sheath, we developed a laboratory model to simulate ureteroscopy. The LithoVue (Boston Scientific), disposable digital flexible ureteroscope was used with 200 micron laser fibers for both the SPTF (Soltive-Olympus) and High power Ho:YAG laser (P120-Lumenis). At defined laser parameters (10, 20, 30, and 40W; short pulse) the laser fiber was slowly retracted toward the tip of the scope during laser activation. Image distortion was identified, and distance from the laser tip to the scope tip was determined. Data from the two lasers were compared utilizing a paired t-test. RESULTS: Image distortion occurred at greater distance with the Ho:YAG compared to SPTF at all laser settings (Table 1). Additionally, higher power (W) was associated with image distortion occurring further from the tip of the scope (p<0.01 for Ho:YAG; p=0.02 for SPFT). At the same power (W) with either 1J or 0.5J, there was no difference in distance for image distortion for the Ho:YAG, but distortion occurred differently with the SPTF (20 and 40W; p<0.01 and p=0.02, respectively). CONCLUSIONS: Increased total power as well as decreased distance between the scope and laser fiber tip results in image distortion during flexible ureteroscopy. Image distortion occurs at a greater distance with the Ho:YAG laser than with SPTF fibers at the same laser settings. SPTF seems to have a better safety profile in terms image distortion and potential scope damage. Further evaluation utilizing Ho:YAG on modulated pulse mode is warranted. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e440-e440 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Caleb S Miller More articles by this author Bristol B Whiles More articles by this author David A Duchene More articles by this author Donald A Neff More articles by this author Wilson R Molina More articles by this author Expand All Advertisement Loading ...

Radiation mode and tissue thickness impact on singlet oxygen dosimetry methods for antimicrobial photodynamic therapy

The target of the presented study is to evaluate the performances of illumination modes on Photodynamic therapy (PDT) for different tissue depths. For this purpose, radiation-based super pulse and pulse illumination modes were investigated for antimicrobial PDT (AmPDT). Singlet oxygen luminescence level was measured from two different points. The first one was to appraise the light penetration depth effect on singlet oxygen luminescence level for various radiation modes. The second one explored the singlet oxygen luminescence dosimetry (SOLD) method from deeper photosensitizer accumulated tissue levels. Two main experiments were performed in this study. The singlet oxygen concentration was calculated with singlet oxygen explicit dosimetry (SOED) and SOLD methods for various tissue depths in these experiments.According to the results of the experiments, super pulse mode (SPM) provided relatively high Staphylococcus Aureus (S. aureus) cell death by 5–12%. The penetration depth was increased between 0.2 mm and 0.7 mm during the experiments. SOLD-based singlet oxygen detection system was utilized to detect singlet oxygen production levels from various tissue thicknesses to evaluate the system's usefulness for deeper infected tissues. It was observed that SPM was more effective than pulse mode radiation after a certain tissue depth (≤ 2 mm).

Effect of Er:YAG laser pulse duration on repair bond strength of resin-based and hybrid CAD/CAM restorative materials

Besides the output power and pulse frequency, the pulse duration of Er:YAG laser is an important parameter for conditioning the restorative material surface. This study aimed to investigate the effect of six different pulse modes of Er:YAG laser on the repair bond strength of a hybrid ceramic and two resin-based CAD/CAM restorative materials. Twenty-eight specimens (5 × 5 × 4 mm) were prepared for each CAD/CAM block (Lava Ultimate-(LU), Vita Enamic-(VE), and GC Cerasmart-(GCC)) and randomly divided into seven groups. The specimens except the control group were irradiated using Er:YAG laser at 3 W and 20 Hz using quantum square pulse (QSP), super short pulse (SSP), short pulse (SP), medium short pulse (MSP), long pulse (LP), and a very long pulse (VLP). A micro-hybrid resin composite (Filtek Z250, 3 M ESPE, USA) was placed up to 4 mm on each CAD/CAM specimen in two increments. Bar specimens (1 × 1 × 8 mm) were obtained using a cutting device and thermocycled 10,000 times at 5–55 °C. Microtensile bond strength (µTBS) test was performed at a 1 mm/min crosshead speed. Data were statistically analyzed using two-way ANOVA and Tukey’s HSD tests (p < 0.05). µTBS was significantly affected by both pulse duration and material type (p < 0.001). Pulse duration and material type showed a statistically significant interaction (p < 0.001). Except for QSP, shorter pulse modes resulted in a higher repair bond strength. VLP mode is not recommended to be used in repair procedures with the materials tested.

Ureteroscopic Performance of High Power Super Pulse Thulium Fiber Laser for the Treatment of Urolithiasis: Results of the First Case Series in North America

To report the first case series of ureterorenoscopy in North America using the High Power Super Pulse Thulium Fiber Laser for the treatment of upper urinary tract stones. After Institutional Review Board approval, a multicentric retrospective chart review of patients treated with the High Power Super Pulse Thulium Fiber Laser from October 2019 to March 2020 was conducted. Basic demographic information, pre-operative, and peri-operative data were recorded. Seventy-six patients were included with a mean age of 60.9 ± 13.3 years. 118 stones were treated including 32 within the ureter, 49 in the lower pole, 37 in mid or upper poles. Dusting technique was commonly used (67.1%) with pulse frequencies up to 2400 Hz. Mean operative time was 59.4 ± 31.5 minutes. Mean laser time and total laser energy were 10.8 ± 14.1 minutes and 12.5 ±19.1 KJ, respectively. Intraoperative complications were limited to 7 grade 1, 3 grade 2, and 1 grade 3 ureteral injuries and one case of renal collecting system bleeding that was adequately managed with laser coagulation settings (1J-20Hz). This initial case series in North America of the High Power Super Pulse Thulium Fiber Laser is promising for the treatment of urolithiasis. Sub-200 μm fibers and dusting settings up to 2400 Hz were utilized successfully. No specific complications related to use of the laser were seen.

Super Single Pulse Charge Pumping Technique for Profiling Interfacial Defects

Traditional charge pumping (CP) technique relies on trap-assisted recombination from the source/drain to the body contact to characterize interface trap density ( ${N}_{\text {it}}$ ) of classical bulk MOSFETs. A variant of the technique called single pulse CP (SPCP) allows interface trap characterization even if the bulk contact is absent, as in silicon-on-insulator (SOI) MOSFET. Unfortunately, neither technique is useful for devices with source-body-tied (SBT) and inhomogeneous channel doping profile, as in lateral diffused MOS (LDMOS) power transistors. Here, we propose a generalization of the CP/SPCP techniques, called Super SPCP ( $\text{S}^{{2}}$ PCP), to extract position-resolved localized degradations ( ${\Delta {N}}_{\text {it}}$ ) in an SBT LDMOS. Careful TCAD modeling and experimental characterizations demonstrate the effectiveness of the proposed approach. Our analysis provides deep insights into the physics of the SPCP technique, demonstrating that the approach can be used to characterize a variety of transistors with nontraditional doping profiles and contact configurations.

Clinical Comparison of Super Pulse Thulium Fiber Laser and High-Power Holmium Laser for Ureteral Stone Management.

Purpose: To evaluate the efficacy of new super pulse thulium fiber laser (SP TFL) and compare it with holmium laser for ureterolithotripsy. Patients and Methods: A total of 174 patients with solitary ureteral calculi were enrolled in 2016 to 2018. Stone sizes ranged between 0.6 and 2.4 cm. The SP TFL FiberLase U2 and 120H Ho:YAG laser with fibers diameters of 400 and 365 μm, respectively, were used. The laser settings were 1 J × 10 Hz = 10 W for both devices. All patients were randomized into two groups. The age, stone size, location, and density were comparable in both groups. The evaluated parameters were operation time, endoscopic view quality, retropulsion grade, stone-free rate, and complication rate. Results: The total operation time and lasering time were longer in the Ho:YAG group (24.7 ± 0.7 minutes vs 32.4 ± 0.7 minutes, p = 0.05), and postoperative stenting was necessary in one vs four cases, respectively. At 30 days of follow-up, no residual stones were observed in the SP TFL group (vs five cases of Ho:YAG). Conclusion: SP TFL technology was associated with excellent efficacy/safety ratio. The SP TFL may be considered as a viable alternative to Ho:YAG laser stone management.

Self-contrast study of pinprick therapy combined with super pulse fractional CO2 laser for the treatment of atrophic acne scars.

This study is to evaluate the clinical efficacy and safety of a "double-layer" mode of super pulse fractional CO2 laser and a combined treatment of pinprick therapy with fractional CO2 laser for the treatment of atrophic acne scars. A split-face and self-contrast method was applied. A total of 20 patients with atrophic acne scars randomly received the above mentioned therapy on the left or right side of the cheek for 3 times with an interval of 3months. ECCA scores, IVA scores, patients' satisfaction, VAS scores, and adverse reactions were evaluated. Atrophic acne scars on both sides of the cheek were improved obviously. The ECCA scores showed a significant decrease, while IVA scores significantly increased. Compared with the super pulse fractional CO2 laser group, the decrease of ECCA scores, the increase of IVA scores, and the patients' satisfaction were significantly higher and improvement on V-shaped and U-shaped acne scars was significantly better in the combined treatment group. No patients had severe adverse reactions such as blister, infection, or hypertrophic scars. Super pulse fractional CO2 laser and pinprick treatment combined with fractional CO2 laser are both safe and effective therapy for the treatment of atrophic acne scars.

New super waveforms for modified Korteweg-de-Veries-equation

The existences of new important supersolitary and periodic solutions are obtained using the expansion method of Jacobian elliptic function (EMJEF) for the MKdV equation. This equation can be describe the critical case for vanishing the nonlinearity of the well-known KdV equation. This robust method is appropriate for production of new super waves which can confirm the new super pulse observations. It is established that some new solitary waves as periodic, solitons, shock, cnoidal, soliton-shock like, supersoliton and localized soliton waves are obtained. Also, these new forms which may be applicable in fluids and physics applications dependence on the system and Jacobian parameters.

Performance of Thulium Super Pulse Laser for Endoscopic Ablation of Urothelial Cell Carcinoma: Results of the First Cases in North America

Abstract Introduction: Tumor laser ablation (LTA) is a valuable option for treatment of urothelial cell carcinoma (UCC) in patients who are not amenable to nephroureterectomy. Recent in vitro studi...

Initial Experiences Using Super Pulse Thulium Fiber Laser: Multipurpose Applications and the Assessment of Urologists' First Impression

Abstract Introduction: The super pulse thulium fiber (SPTF) laser has recently been acclaimed by more efficient lithotripsy activities, shorter laser, and treatment times demonstrated in preclinica...

Development of a new multi-mode NIR laser system for photodynamic therapy

Photodynamic Therapy (PDT) has been used in various fields especially in cancer treatment. In PDT, designing a light source has vital importance in order to achieve a successful treatment. Among the light sources, Lasers are important candidates for their precise wavelengths to activate the photosensitizers (PS), coherent nature and fiber-coupled usage. In order to achieve perfect PDT treatment, the Laser light sources needs to be embedded withhigh stability current, temperature controllers and closed loop control systems.In this study, a novel Multi-mode PDT Laser system (MPTL) was developed with four different radiation modes. Importantly, Super Pulse Mode (SPM) was implemented for the first time among the PDT Laser systems in the open literature tominimize the thermal damage to the target tissue. The proposed system achieved high optical output stability by precise current and temperature control of the Laser resonator. The MPTL achieved high optical output stability (±1mW) in the range of 0–1500 mW, high wavelength stability (±1nm) at 635 nm,and high temperature stability (±0.2 °C) in all radiation modes. The MPTL system with super pulse mode can be safely used for wide range of PDT clinical applications.