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Sun H, Yang W, Ong Y, Busch TM, Zhu TC. Fractionated Photofrin-Mediated Photodynamic Therapy Significantly Improves Long-Term Survival. Cancers (Basel) 2023; 15:5682. [PMID: 38067385 PMCID: PMC10705090 DOI: 10.3390/cancers15235682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024] Open
Abstract
This study investigates the effect of fractionated (two-part) PDT on the long-term local control rate (LCR) using the concentration of reactive oxygen species ([ROS]rx) as a dosimetry quantity. Groups with different fractionation schemes are examined, including a 2 h interval between light delivery sessions to cumulative fluences of 135, 180, and 225 J/cm2. While the total treatment time remains constant within each group, the division of treatment time between the first and second fractionations are explored to assess the impact on long-term survival at 90 days. In all preclinical studies, Photofrin is intravenously administered to mice at a concentration of 5 mg/kg, with an incubation period between 18 and 24 h before the first light delivery session. Fluence rate is fixed at 75 mW/cm2. Treatment ensues via a collimated laser beam, 1 cm in diameter, emitting light at 630 nm. Dosimetric quantities are assessed for all groups along with long-term (90 days) treatment outcomes. This study demonstrated a significant improvement in long-term survival after fractionated treatment schemes compared to single-fraction treatment, with the optimal 90-day survival increasing to 63%, 86%, and 100% vs. 20%, 25%, and 50%, respectively, for the three cumulative fluences. The threshold [ROS]rx for the optimal scheme of fractionated Photofrin-mediated PDT, set at 0.78 mM, is significantly lower than that for the single-fraction PDT, at 1.08 mM.
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Affiliation(s)
- Hongjing Sun
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.S.); (W.Y.); (T.M.B.)
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Weibing Yang
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.S.); (W.Y.); (T.M.B.)
| | - Yihong Ong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.S.); (W.Y.); (T.M.B.)
| | - Theresa M. Busch
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.S.); (W.Y.); (T.M.B.)
| | - Timothy C. Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (H.S.); (W.Y.); (T.M.B.)
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Wang B, Mei X, Wang Y, Hu X, Li F. Adjuncts to pulsed dye laser for treatment of port wine stains: a literature review. J COSMET LASER THER 2022; 23:209-217. [PMID: 35422188 DOI: 10.1080/14764172.2022.2052901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bing Wang
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Xianglin Mei
- Department of Pathology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Yanlong Wang
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Xin Hu
- Department of Dermatology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, P. R. China
| | - Fuqiu Li
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
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De Silva P, Saad MA, Thomsen HC, Bano S, Ashraf S, Hasan T. Photodynamic therapy, priming and optical imaging: Potential co-conspirators in treatment design and optimization - a Thomas Dougherty Award for Excellence in PDT paper. J PORPHYR PHTHALOCYA 2020; 24:1320-1360. [PMID: 37425217 PMCID: PMC10327884 DOI: 10.1142/s1088424620300098] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Photodynamic therapy is a photochemistry-based approach, approved for the treatment of several malignant and non-malignant pathologies. It relies on the use of a non-toxic, light activatable chemical, photosensitizer, which preferentially accumulates in tissues/cells and, upon irradiation with the appropriate wavelength of light, confers cytotoxicity by generation of reactive molecular species. The preferential accumulation however is not universal and, depending on the anatomical site, the ratio of tumor to normal tissue may be reversed in favor of normal tissue. Under such circumstances, control of the volume of light illumination provides a second handle of selectivity. Singlet oxygen is the putative favorite reactive molecular species although other entities such as nitric oxide have been credibly implicated. Typically, most photosensitizers in current clinical use have a finite quantum yield of fluorescence which is exploited for surgery guidance and can also be incorporated for monitoring and treatment design. In addition, the photodynamic process alters the cellular, stromal, and/or vascular microenvironment transiently in a process termed photodynamic priming, making it more receptive to subsequent additional therapies including chemo- and immunotherapy. Thus, photodynamic priming may be considered as an enabling technology for the more commonly used frontline treatments. Recently, there has been an increase in the exploitation of the theranostic potential of photodynamic therapy in different preclinical and clinical settings with the use of new photosensitizer formulations and combinatorial therapeutic options. The emergence of nanomedicine has further added to the repertoire of photodynamic therapy's potential and the convergence and co-evolution of these two exciting tools is expected to push the barriers of smart therapies, where such optical approaches might have a special niche. This review provides a perspective on current status of photodynamic therapy in anti-cancer and anti-microbial therapies and it suggests how evolving technologies combined with photochemically-initiated molecular processes may be exploited to become co-conspirators in optimization of treatment outcomes. We also project, at least for the short term, the direction that this modality may be taking in the near future.
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Affiliation(s)
- Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mohammad A. Saad
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hanna C. Thomsen
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shazia Bano
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shoaib Ashraf
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Zhang Y, Li H, Cao T, Chen R, Qiu H, Gu Y, Li P. Automatic 3D adaptive vessel segmentation based on linear relationship between intensity and complex-decorrelation in optical coherence tomography angiography. Quant Imaging Med Surg 2020; 11:895-906. [PMID: 33654663 DOI: 10.21037/qims-20-868] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Vascular quantitative metrics have been widely used in the preclinical studies and clinical applications (e.g., the diagnosis and treatment of port wine stain, PWS), which require accurate vessel segmentation. An automatic 3D adaptive vessel segmentation is in need for a reproducible and objective quantification of the optical coherence tomography angiography (OCTA) image. Methods Human skin imaging was performed with a lab-built optical coherence tomography (OCT) system. Rather than separately applying the conventional 2-step (intensity and binarization) thresholding in the decorrelation-contrast OCTA, we proposed a 3D adaptive threshold using the linear relationship between the local intensity and complex-decorrelation which was termed as inverse SNR-decorrelation (ID) threshold. Furthermore, the ID threshold was automatically determined by defining a binary image similarity (BISIM) index as the feedback and searching the ID threshold with the minimal BISIM value. The proposed ID-BISIM threshold was applied to the acquired OCTA skin images for further vessel quantification. Results The proposed ID-BISIM threshold enabled a 3D adaptive binarization and presented superior sensitivity and specificity in vessel segmentation over conventional 2-step thresholding method in the decorrelation-contrast OCTA and a 37-65% improvement of the Youden's index in human skin experiments. The 3D binarization enabled a depth-resolved vessel skeleton and enhanced the differentiation of the overlapping vessels in the depth direction. Using ID-BISIM, the quantitative OCTA image presented a significant increase of vessel diameter index (P=0.0015) and vessel area density (VAD) (P=0.0485) as well as a significant decrease of vessel complexity index (VCI) (P=0.0094) in PWS lesion skin compared with normal skin. Conclusions The proposed ID-BISIM method enables an automatic 3D adaptive vessel segmentation with enhanced performance in quantitative OCTA. The vascular quantitative metrics would be a useful tool for improving the diagnosis and the treatment of PWS.
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Affiliation(s)
- Yiming Zhang
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International research center for advanced photonics, Zhejiang University, Hangzhou, China
| | - Huakun Li
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International research center for advanced photonics, Zhejiang University, Hangzhou, China
| | - Tongtong Cao
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International research center for advanced photonics, Zhejiang University, Hangzhou, China
| | - Ruixiang Chen
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International research center for advanced photonics, Zhejiang University, Hangzhou, China
| | - Haixia Qiu
- Department of Laser Medicine, First Medical Center of PLA General Hospital, Beijing, China
| | - Ying Gu
- Department of Laser Medicine, First Medical Center of PLA General Hospital, Beijing, China
| | - Peng Li
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International research center for advanced photonics, Zhejiang University, Hangzhou, China
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Theoretical Study on Pressure Damage Based on Clinical Purpura during the Laser Irradiation of Port Wine Stains with Real Complex Vessels. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9245478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Port wine stains (PWSs) are congenital dermal vascular lesions composed of a hyperdilated vasculature. Purpura represented by local hemorrhage from water vaporization in blood during laser therapy of PWS is typically considered a clinical feedback, but with a low cure rate. In this study, light propagation and heat deposition in skin and PWSs is simulated by a tetrahedron-based Monte Carlo method fitted to curved bio-tissues. A curvature-corrected pressure damage model was established to accurately evaluate the relationship between purpura-bleeding area (rate) and laser therapy strategy for real complex vessels. Results showed that the standard deviation of Gaussian curvature of the vessel wall has negative relation with the fluence threshold of vessel rupture, but has positive relation with the effective laser fluence of vessel damage. This finding indicated the probable reason for the poor treatment of PWS, that is, considering purpura formation as a treatment end point (TEP) only leads to partial removal of vascular lesions. Instead, appropriate purpura area ratio with marked effects or rehabilitation should be adopted as TEP. The quantitative correlation between the fluence of a pulsed dye laser and the characteristics of vascular lesions can provide personalized and precise guidance for clinical treatments.
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Bergqvist E, Bergqvist G. The long-term effect of pulsed dye laser on Necrobiosis Lipoidica: A case study. J COSMET LASER THER 2018; 21:17-18. [PMID: 29461125 DOI: 10.1080/14764172.2018.1439966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A 57-year-old female was presented with an irrepressible case of Necrobiosis Lipoidica considering the possibility of a surgical skin graft. Instead, a pulsed dye laser treatment was used as an alternate treatment. Previous case studies have been found in the literature on the effect of pulsed dye laser on Necrobiosis Lipoidica. The use of a pulsed dye laser in this case resulted in rendering the lesions asymptomatic for pain and a reduction in volume. Prolonged control was exhibited. From this case, we conclude that pulsed dye laser therapy is effective when increasing the number of treatments of laser therapy, and can be used as a treatment for Necrobiosis Lipoidica.
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Affiliation(s)
- Emma Bergqvist
- a Plastic Surgery Center of Pennsylvania , Erie , PA , USA
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Moy WJ, Ma G, Kelly KM, Choi B. Hemoporfin-mediated photodynamic therapy on normal vasculature: implications for phototherapy of port-wine stain birthmarks. J Clin Transl Res 2016; 2:107-111. [PMID: 29226252 PMCID: PMC5722630 DOI: 10.18053/jctres.02.201603.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Port-wine stain (PWS) birthmarks currently are treated using a pulsed dye laser (PDL) combined with transient cooling of the epidermis. PDL treatment protocols utilize short pulses of light (585 or 595 nm wavelength) to heat selectively the microvasculature due to absorption by intravascular hemoglobin. Although most patients respond to PDL therapy, few experience complete removal of the PWS. An alternate treatment option to PDL therapy of PWS is photodynamic therapy (PDT). Research groups have reported on various photosensitizers for PDT of PWS, including Hemoporfin, Benzoporphyrin Derivative monoacid ring A, and talaporfin sodium. Aim Our aim was to evaluate, with an established preclinical in-vivo model, the efficacy of photodynamic therapy (PDT) with Hemoporfin to achieve persistent vascular shutdown. Methods To monitor the microvasculature, a dorsal window chamber was surgically installed on 24 adult mice. The PDT excitation source emitted 150mW of 532nm light, with an irradiance of 100mW/cm2. A retroorbital injection of Hemoporfin (2 mg/kg) was performed to deliver the drug into the bloodstream. Laser irradiation was initiated immediately after injection. To monitor blood-flow dynamics in response to PDT, we used laser speckle imaging. We employed a dose-response experimental design to study the efficacy of Hemoporfin-mediated PDT to achieve persistent vascular shutdown observed on Day 7 after PDT. Results We observed four general hemodynamic responses to PDT: (1) At low radiant exposures, we did not observe any persistent vascular shutdown; (2) at intermediate radiant exposures, we observed delayed vascular shutdown effect with significant change to the vascular structure; (3) at intermediate radiant exposures, we observed an acute vascular shutdown effect with gradual restoration of blood flow and no significant changes to the vascular structure; and (4) at high radiant exposures, we observed acute vascular shutdown that persisted during the entire 7-day monitoring period, with no change in vascular structure. With light dose-response analysis, we estimated a characteristic radiant exposure of 359 J/cm2 that was required to achieve persistent vascular shutdown observed on Day 7 after PDT. Conclusions The experimental data collectively suggest that Hemoporfin-mediated PDT can achieve persistent vascular shutdown of normal microvasculature. However, compared with our previous data using Talaporfin Sodium as photosensitizer, Hemoporfin-mediated PDT is less efficient and requires a considerably longer (~four times) irradiation time. Relevance for patients Patients with PWS lesions may benefit from the advantages that PDT potentially offers over conventional PDL therapy. PDT potentially is safer for patients of all skin types and more effective at treatment of recalcitrant lesions. Although clinical data suggest that Hemoporfin-mediated PDT is a promising alternative to PDL therapy, our results suggest that additional study of other photosensitizers is warranted.
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Affiliation(s)
- Wesley J Moy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, CA, Unites States
| | - Gang Ma
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, United States.,Department of Surgery, Shanghai Ninth People's Hospital, Shanghai, China
| | - Kristen M Kelly
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, United States.,Department of Dermatology, University of California, Irvine, CA, United States.,Department of Surgery, University of California, Irvine, CA, United States
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, CA, Unites States.,Department of Surgery, University of California, Irvine, CA, United States.,Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, CA, United States
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8
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Xing L, Li D, Chen B, Dai Y, Wu W, Wang G. Enhancement of light absorption by blood to Nd:YAG laser using PEG-modified gold nanorods. Lasers Surg Med 2016; 48:790-803. [DOI: 10.1002/lsm.22557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Linzhuang Xing
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
| | - Dong Li
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
| | - Bin Chen
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
| | - Yuze Dai
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
| | - Wenjuan Wu
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
| | - Guoxiang Wang
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an Shaanxi 710049 China
- Department of Mechanical Engineering; University of Akron; Akron Ohio 44325-3903
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9
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Assessment of Efficacy of the 595-nm Pulsed Dye Laser in the Treatment of Facial Port-Wine Stains in Indian Patients. Dermatol Surg 2016; 42:717-26. [DOI: 10.1097/dss.0000000000000723] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Choi B, Tan W, Jia W, White SM, Moy WJ, Yang BY, Zhu J, Chen Z, Kelly KM, Nelson JS. The Role of Laser Speckle Imaging in Port-Wine Stain Research: Recent Advances and Opportunities. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS : A PUBLICATION OF THE IEEE LASERS AND ELECTRO-OPTICS SOCIETY 2016; 2016:6800812. [PMID: 27013846 PMCID: PMC4800318 DOI: 10.1109/jstqe.2015.2493961] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Here, we review our current knowledge on the etiology and treatment of port-wine stain (PWS) birthmarks. Current treatment options have significant limitations in terms of efficacy. With the combination of 1) a suitable preclinical microvascular model, 2) laser speckle imaging (LSI) to evaluate blood-flow dynamics, and 3) a longitudinal experimental design, rapid preclinical assessment of new phototherapies can be translated from the lab to the clinic. The combination of photodynamic therapy (PDT) and pulsed-dye laser (PDL) irradiation achieves a synergistic effect that reduces the required radiant exposures of the individual phototherapies to achieve persistent vascular shutdown. PDL combined with anti-angiogenic agents is a promising strategy to achieve persistent vascular shutdown by preventing reformation and reperfusion of photocoagulated blood vessels. Integration of LSI into the clinical workflow may lead to surgical image guidance that maximizes acute photocoagulation, is expected to improve PWS therapeutic outcome. Continued integration of noninvasive optical imaging technologies and biochemical analysis collectively are expected to lead to more robust treatment strategies.
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Affiliation(s)
- Bernard Choi
- Departments of Biomedical Engineering and Surgery, the Beckman Laser Institute and Medical Clinic, and the Edwards Lifesciences Center for Advanced Cardiovascular Technology, all at University of California, Irvine 92612 USA
| | - Wenbin Tan
- Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612 USA
| | - Wangcun Jia
- Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612 USA
| | - Sean M. White
- Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612 USA
| | - Wesley J. Moy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612 USA
| | - Bruce Y. Yang
- Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612 USA
| | | | | | - Kristen M. Kelly
- Department of Dermatology and the Beckman Laser Institute and Medical Clinic, all at University of California, Irvine 92612 USA
| | - J. Stuart Nelson
- Departments of Biomedical Engineering and Surgery and the Beckman Laser Institute and Medical Clinic, all at University of California, Irvine 92612 USA
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11
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Chen D, Ren J, Wang Y, Li B, Gu Y. Intraoperative monitoring of blood perfusion in port wine stains by laser Doppler imaging during vascular targeted photodynamic therapy: A preliminary study. Photodiagnosis Photodyn Ther 2016; 14:142-51. [PMID: 27068654 DOI: 10.1016/j.pdpdt.2016.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/11/2016] [Accepted: 04/05/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The objective of this study was to monitor blood perfusion dynamics of port wine stains (PWS) during vascular targeted photodynamic therapy (V-PDT) with laser Doppler imaging (LDI). METHODS The PWS lesions of 30 facial PWS patients received V-PDT, while the normal skins on the forearm of 5 healthy subjects were treated as light-only controls for comparison. Furthermore, two different PWS lesions in the same individual from each of 3 PWS patients successively received laser irradiation only and V-PDT, respectively. LDI was used to monitor intraoperative blood perfusion dynamics. RESULTS During V-PDT, the blood perfusion (278±96 PU) in PWS lesions for 31 of 33 PWS patients significantly increased after the initiation of V-PDT treatment, then reached a peak (638±105 PU) within 10min, followed by a slow decrease to a relatively lower level (515±100 PU). Furthermore, the time for reaching peak and the subsequent magnitude of decrease in blood perfusion varied with different patients. For light-only controls, an initial perfusion peak at 3min followed by a nadir and a secondary increase were found not only in normal skin, but also in PWS lesions. CONCLUSION The preliminary results showed that the LDI permits non-invasive monitoring blood perfusion changes of PWS lesions during V-PDT. There was a clear trend in blood perfusion responses during V-PDT and laser irradiation. The blood perfusion changes during treatment were due to V-PDT effects as well as local temperature increase induced by laser irradiation.
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Affiliation(s)
- Defu Chen
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Jie Ren
- Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ying Wang
- Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Buhong Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory for Photonics Technology, Fujian Normal University, Fujian 350007, China
| | - Ying Gu
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China; Department of Laser Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
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Mallidi S, Spring BQ, Hasan T. Optical Imaging, Photodynamic Therapy and Optically Triggered Combination Treatments. Cancer J 2015; 21:194-205. [PMID: 26049699 PMCID: PMC4459538 DOI: 10.1097/ppo.0000000000000117] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Optical imaging is becoming increasingly promising for real-time image-guided resections, and combined with photodynamic therapy (PDT), a photochemistry-based treatment modality, optical approaches can be intrinsically "theranostic." Challenges in PDT include precise light delivery, dosimetry, and photosensitizer tumor localization to establish tumor selectivity, and like all other modalities, incomplete treatment and subsequent activation of molecular escape pathways are often attributable to tumor heterogeneity. Key advances in molecular imaging, target-activatable photosensitizers, and optically active nanoparticles that provide both cytotoxicity and a drug release mechanism have opened exciting avenues to meet these challenges. The focus of the review is optical imaging in the context of PDT, but the general principles presented are applicable to many of the conventional approaches to cancer management. We highlight the role of optical imaging in providing structural, functional, and molecular information regarding photodynamic mechanisms of action, thereby advancing PDT and PDT-based combination therapies of cancer. These advances represent a PDT renaissance with increasing applications of clinical PDT as a frontline cancer therapy working in concert with fluorescence-guided surgery, chemotherapy, and radiation.
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Affiliation(s)
- Srivalleesha Mallidi
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114
| | - Bryan Q. Spring
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114
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13
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Kelly KM, Moy WJ, Moy AJ, Lertsakdadet BS, Moy JJ, Nguyen E, Nguyen A, Osann KE, Choi B. Talaporfin sodium-mediated photodynamic therapy alone and in combination with pulsed dye laser on cutaneous vasculature. J Invest Dermatol 2014; 135:302-304. [PMID: 25036051 PMCID: PMC4268332 DOI: 10.1038/jid.2014.304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kristen M Kelly
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Department of Dermatology, University of California, Irvine, Irvine, California, USA; Department of Surgery, University of California, Irvine, Irvine, California, USA
| | - Wesley J Moy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA
| | - Austin J Moy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA
| | - Ben S Lertsakdadet
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | - Justin J Moy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | - Elaine Nguyen
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ashley Nguyen
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA
| | - Kathryn E Osann
- Department of Medicine, University of California, Irvine, Irvine, California, USA
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California, USA; Department of Surgery, University of California, Irvine, Irvine, California, USA; Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA; Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, Irvine, California, USA.
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Thompson KE, Zeng K, Wilson CM, Gaber MW, Miller DD, Yates CR. Quinic acid derivative KZ-41 exhibits radiomitigating activity in preclinical models of radiation injury. Drug Dev Res 2013; 75:29-36. [PMID: 24648047 DOI: 10.1002/ddr.21164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Acute radiation syndrome is induced when a significant portion of the body receives high-dose, as well as high-dose rate, radiation. We have previously identified a quinic acid-based derivative, KZ-41, that protects from radiation injury. Further preclinical efficacy studies were conducted to determine the radiomitigating activity of KZ-41. C57BL/6 mice received total body irradiation (TBI-LD₈₀/₃₀, ¹³⁷Cs; ∼2 min) followed by either normal saline or KZ-41 (100 mg/kg sc ∼26 h post-TBI). KZ-41 increased 30-day survival by approximately 45% compared with vehicle controls (P < 0.05). To further investigate the potential radiomodulating mechanisms of KZ-41, we developed a combined radiation and vascular injury model. C57BL/6 mice surgically fixed with dorsal windows for dermal vasculature imaging received either sham or TBI (¹³⁷Cs; 6 Gray). Postcapillary venule injury was induced (24, 48, 72, and 96 h post-TBI) followed by imaging at 5 min and 24 h to assess clot formation and blood flow. Impairment in flow (P < 0.05) and clot formation (P < 0.05) were observed as early as 48 and 72 h, respectively. Thus, vascular injury 72 h post-TBI was used to evaluate intervention (KZ-41; 100 mg/kg i.p. at 12, 36, and 60 h post-TBI) on radiation-induced changes in both flow and clot formation. KZ-41, although not improving flow, increased clot formation (P < 0.05). Platelet counts were lower in both irradiated groups compared with sham controls (P < 0.05). In summary, KZ-41 exerts radiomitigating activity in lethally irradiated mice. Imaging results suggest KZ-41 exerts radiomitigating activity through mechanisms involving promotion of initial clot formation and vascular flow restoration. The imaging model described herein is useful for further examination of radiation-induced vascular injury repair mechanisms.
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Affiliation(s)
- Karin E Thompson
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, Tennessee, 38163
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Assessment of tissue perfusion changes in port wine stains after vascular targeted photodynamic therapy: a short-term follow-up study. Lasers Med Sci 2013; 29:781-8. [PMID: 23975603 DOI: 10.1007/s10103-013-1420-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/07/2013] [Indexed: 12/17/2022]
Abstract
The occlusion effect of vascular targeted photodynamic therapy (V-PDT) for malformed vessels in port wine stains (PWS) often last for some time after the treatment. A relatively longer period after V-PDT is needed to accurately assess the final response of PWS microcirculation to the treatment. In this study, we intended to use laser speckle imaging (LSI) to assess the tissue perfusion changes of PWS at follow-up after V-PDT and preliminarily analyze the relationship between perfusion change and color bleaching. Seventeen patients with 40 PWS lesions were scanned by LSI before and 3-6 months after they received V-PDT. The speckle flow indices of PWS lesions and normal skin before and at follow-up after V-PDT were recorded. We also performed analyses on the correlation between perfusion changes and color bleaching. Before V-PDT, the 40 PWS lesions showed higher perfusion than the normal skin (1,421 ± 463 and 1,115 ± 386 perfusion unit (PU), respectively, P < 0.01). The PWS lesions scanned at follow-up showed decreased perfusion level compared to the preoperative values (1,282 ± 460 and 1,421 ± 463 PU, respectively, P < 0.01). After V-PDT, the perfusion change rates coincide well with the color bleaching rates (correlation coefficient, 0.73). In conclusion, the LSI system is capable of imaging PWS perfusion precisely, and it has shown promising results in assessing the changes of tissue perfusion of V-PDT for PWS, with objective and quantitative data, real-time images, and a shorter detection time. It may also provide an effectiveness assessment method for the treatment of PWS.
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Moy WJ, Patel SJ, Lertsakdadet BS, Arora RP, Nielsen KM, Kelly KM, Choi B. Preclinical in vivo evaluation of NPe6-mediated photodynamic therapy on normal vasculature. Lasers Surg Med 2012; 44:158-62. [PMID: 22334298 DOI: 10.1002/lsm.21155] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Current treatments of port-wine stain birthmarks typically involve use of a pulsed dye laser (PDL) combined with cooling of the skin. Currently, PDL therapy protocols result in varied success, as some patients experience complete blanching, while others do not. Over the past decade, we have studied the use of photodynamic therapy (PDT) as either a replacement or adjuvant treatment option to photocoagulate both small and large vasculature. The objective of the current study was to evaluate a PDT protocol that involves use of an alternate intravascular photosensitizer mono-L-aspartylchlorin-e6 (NPe6) activated by an array of low-cost light emitting diodes. STUDY DESIGN/MATERIALS AND METHODS To monitor the microvasculature, a dorsal window chamber model was installed on 22 adult male mice. The light source consisted of a custom-built LED array that emitted 10 W at a center wavelength of 664 nm (FWHM = 20 nm). The light source was positioned at a fixed distance from the window chamber to achieve a fixed irradiance of 127 mW/cm(2). A retroorbital injection of NPe6 (5 mg/kg) was performed to deliver the drug into the bloodstream. Laser irradiation was initiated immediately after injection. To monitor blood-flow dynamics in response to PDT, we used laser speckle imaging. We employed a dose-response experimental design to evaluate the efficacy of NPe6-mediated PDT. RESULTS We observed three general hemodynamic responses to PDT: (1) At low radiant exposures, we did not observe any persistent vascular shutdown; (2) at intermediate radiant exposures, we observed an acute decrease in blood flow followed by gradual restoration of blood flow over the 7-day monitoring period; and (3) at high radiant exposures, we observed acute vascular shutdown that persisted during the entire 7-day monitoring period. Dose-response analysis enabled identification of 85 J/cm(2) as a characteristic radiant exposure required to achieve persistent vascular shutdown at Day 7 following PDT. CONCLUSION The experimental data suggest that NPe6-mediated PDT can achieve persistent vascular shutdown of normal microvasculature.
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Affiliation(s)
- Wesley J Moy
- Beckman Laser Institute and Medical Clinic, Department of Surgery, University of California, Irvine, California 92612, USA
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Kawakubo M, Eguchi K, Arai T, Kobayashi K, Hamblin MR. Surface layer-preserving photodynamic therapy (SPPDT) in a subcutaneous mouse model of lung cancer. Lasers Surg Med 2012; 44:500-7. [PMID: 22752880 DOI: 10.1002/lsm.22046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Photodynamic therapy (PDT) may be a less invasive treatment for lung cancer. Our newly developed surface layer-preserving PDT (SPPDT) technique enables us to irradiate deep tumor while preserving the overlying tissue. The aim of this basic study was to verify that the SPPDT technique might be applied to lung cancer. STUDY DESIGN/MATERIALS AND METHODS PDT with talaporfin sodium was performed using a pulsed laser with different pulse dose rates (PDRs, 2.5-20.0 mJ/cm(2) /pulse) in a mouse model of subcutaneous tumor. To mimic the tracheal wall structure and a thoracic tumor in the tracheobronchus, we also made a mouse model in which a piece of swine cartilage was placed between the dermis and the tumor, and PDT was carried out 2 weeks after implantation. In both experiments, the tissue samples were collected 48 hours after PDT and evaluated microscopically. RESULTS SPPDT using a high-PDR laser damaged the underlying tissue but left the superficial tissue intact in the mouse subcutaneous tumor model. In SPPDT, a higher PDR produced a thicker layer of intact superficial tissue than a lower PDR, while a lower PDR produced a deeper layer of damaged tissue than a higher PDR. SPPDT was also able to preserve the superficial tissue and to damage the tumor tissue beneath the cartilage implant. CONCLUSION SPPDT was able to damage tumor beneath the superficial normal tissue layer, which included tracheal cartilage in the mouse model. The thickness control of SPPDT was provided by controlling laser pulse intensity. SPPDT is a new technology, whose future potential is unknown. The initial clinical application of this technology could be endoscopic treatment (e.g., palliative therapy of thoracic malignancies via bronchoscopy).
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Affiliation(s)
- Masayoshi Kawakubo
- Department of Thoracic Surgery, School of Medicine, Keio University, Tokyo, Japan.
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Qiu H, Zhou Y, Gu Y, Ang Q, Zhao S, Wang Y, Zeng J, Huang N. Monitoring Microcirculation Changes in Port Wine Stains During Vascular Targeted Photodynamic Therapy by Laser Speckle Imaging. Photochem Photobiol 2012; 88:978-84. [DOI: 10.1111/j.1751-1097.2012.01153.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Review of laser speckle-based analysis in medical imaging. Med Biol Eng Comput 2012; 50:547-58. [PMID: 22476712 DOI: 10.1007/s11517-012-0902-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
Abstract
Speckle pattern forms when a rough object is illuminated with coherent light (laser) and the backscattered radiation is imaged on a screen. The pattern changes over time due to movement in the object. Such time-integrate speckle pattern can be statistically analyzed to reveal the flow profile. For higher velocity the speckle contrast gets reduced. This theory can be utilized for tissue perfusion in capillaries of human skin tissue and cerebral blood flow mapping in rodents. Early, the technique was suffered from low resolution and computational intricacies for real-time monitoring purpose. However, modern engineering has made it feasible for real-time monitoring in microcirculation imaging with improved resolution. This review illustrates several modifications over classical technique done by many researchers. Recent advances in speckle contrast methods gain major interest, leading towards practical implementation of this technique. The review also brings out the scopes of laser speckle-based analysis in various medical applications.
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Peters M, van Drooge A, Wolkerstorfer A, van Gemert M, van der Veen J, Bos J, Beek J. Double Pass 595 nm pulsed dye laser at a 6 minute interval for the treatment of port-wine stains is not more effective than single pass. Lasers Surg Med 2012; 44:199-204. [DOI: 10.1002/lsm.22011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2012] [Indexed: 11/09/2022]
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Jia W, Tran N, Sun V, Marinček M, Majaron B, Choi B, Nelson JS. Photocoagulation of dermal blood vessels with multiple laser pulses in an in vivo microvascular model. Lasers Surg Med 2012; 44:144-51. [PMID: 22275290 DOI: 10.1002/lsm.22000] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND/OBJECTIVES Current laser therapy of port wine stain (PWS) birthmarks with a single laser pulse (SLP) does not produce complete lesion removal in the majority of patients. To improve PWS therapeutic efficacy, we evaluated the performance of an approach based on multiple laser pulses (MLP) to enhance blood vessel photocoagulation. STUDY DESIGN The hamster dorsal window chamber model was used. Radiant exposure (RE), pulse repetition rate (f(r)), total number of pulses (n(p)), and length of vessel irradiated were varied. Blood vessels in the window were irradiated with either SLP with RE of 4-7 J/cm(2) or MLP with RE per pulse of 1.4-5.0 J/cm(2), f(r) of 0.5-26.0 Hz, and n(p) of 2-5. The laser wavelength was 532 nm and pulse duration was 1 ms. Either a 2 mm vessel segment or entire vessel branch was irradiated. Digital photographs and laser speckle images of the window were recorded before and at specific time points after laser irradiation to monitor laser-induced blood vessel structural and functional changes, respectively. RESULTS We found that: (1) for a SLP approach, the RE required to induce blood vessel photocoagulation was 7 J/cm(2) as compared to only 2 J/cm(2) per pulse for the MLP approach; (2) for MLP, two pulses at a repetition rate of 5 Hz and a RE of 3 J/cm(2) can induce photocoagulation of more than 80% of irradiated blood vessel; and (3) irradiation of a longer segment of blood vessel resulted in lower reperfusion rate. CONCLUSIONS The MLP approach can induce blood vessel photocoagulation at much lower RE per pulse as compared to SLP. The 5 Hz f(r) and the need for two pulses are achievable with modern laser technology, which makes the MLP approach practical in the clinical management of PWS birthmarks.
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Affiliation(s)
- Wangcun Jia
- Beckman Laser Institute and Medical Clinic, Department of Surgery, University of California, Irvine, California 92617-3010, USA.
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XIAO Q, LI Q, YUAN KH, CHENG B. Photodynamic therapy of port-wine stains: Long-term efficacy and complication in Chinese patients. J Dermatol 2011; 38:1146-52. [DOI: 10.1111/j.1346-8138.2011.01292.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Influence of laser wavelength on the damage of comb’s vasculature by photodynamic therapy—simulation and validation of mathematical models. Lasers Med Sci 2011; 26:665-72. [DOI: 10.1007/s10103-011-0890-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 01/18/2011] [Indexed: 10/18/2022]
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Ramírez-San-Juan JC, Huang YC, Salazar-Hermenegildo N, Ramos-García R, Muñoz-Lopez J, Choi B. Integration of image exposure time into a modified laser speckle imaging method. Phys Med Biol 2010; 55:6857-66. [PMID: 21048287 DOI: 10.1088/0031-9155/55/22/016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Speckle-based methods have been developed to characterize tissue blood flow and perfusion. One such method, called modified laser speckle imaging (mLSI), enables computation of blood flow maps with relatively high spatial resolution. Although it is known that the sensitivity and noise in LSI measurements depend on image exposure time, a fundamental disadvantage of mLSI is that it does not take into account this parameter. In this work, we integrate the exposure time into the mLSI method and provide experimental support of our approach with measurements from an in vitro flow phantom.
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Li W, Yamada I, Masumoto K, Ueda Y, Hashimoto K. Photodynamic therapy with intradermal administration of 5-aminolevulinic acid for port-wine stains. J DERMATOL TREAT 2010; 21:232-9. [DOI: 10.3109/09546630903159099] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jia W, Sun V, Tran N, Choi B, Liu SW, Mihm MC, Phung TL, Nelson JS. Long-term blood vessel removal with combined laser and topical rapamycin antiangiogenic therapy: implications for effective port wine stain treatment. Lasers Surg Med 2010; 42:105-12. [PMID: 20166161 DOI: 10.1002/lsm.20890] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Complete blanching of port wine stain (PWS) birthmarks after laser therapy is rarely achieved for most patients. We postulate that the low therapeutic efficacy or treatment failure is caused by regeneration and revascularization of photocoagulated blood vessels due to angiogenesis associated with the skin's normal wound healing response. Rapamycin (RPM), an antiangiogenic agent, has been demonstrated to inhibit growth of pathological blood vessels. Our objectives were to (1) investigate whether topical RPM can inhibit reperfusion of photocoagulated blood vessels in an animal model and (2) determine the effective RPM concentration required to achieve this objective. STUDY DESIGN/MATERIALS AND METHODS For both laser-only and combined laser and RPM treated animals, blood vessels in the dorsal window chambers implanted on golden Syrian hamsters were photocoagulated with laser pulses. Structural and flow dynamics of blood vessels were documented with color digital photography and laser speckle imaging to evaluate photocoagulation and reperfusion. For the combined treatment group, topical RPM was applied to the epidermal side of the window daily for 14 days after laser exposure. RESULTS In the laser-only group, 23 out of 24 photocoagulated blood vessels reperfused within 5-14 days. In the combined treatment group with different RPM formulae and concentrations, the overall reperfusion rate of 36% was much lower as compared to the laser-only group. We also found that the reperfusion rate was not linearly proportional to the RPM concentration. CONCLUSIONS With topical RPM application, the frequency of vessel reperfusion was considerably reduced, which implies that combined light and topical antiangiogenic therapy might be a promising approach to improve the treatment efficacy of PWS birthmarks.
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Affiliation(s)
- Wangcun Jia
- Beckman Laser Institute, University of California, Irvine, California 92617-3010, USA.
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Celli JP, Spring BQ, Rizvi I, Evans CL, Samkoe KS, Verma S, Pogue BW, Hasan T. Imaging and photodynamic therapy: mechanisms, monitoring, and optimization. Chem Rev 2010; 110:2795-838. [PMID: 20353192 PMCID: PMC2896821 DOI: 10.1021/cr900300p] [Citation(s) in RCA: 1624] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jonathan P Celli
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
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Zhao S, Gu Y, Xue P, Guo J, Shen T, Wang T, Huang N, Zhang L, Qiu H, Yu X, Wei X. Imaging port wine stains by fiber optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:036020. [PMID: 20615022 DOI: 10.1117/1.3445712] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We develop a fiber optical coherence tomography (OCT) system in the clinical utility of imaging port wine stains (PWS). We use our OCT system on 41 patients with PWS to document the difference between PWS skin and contralateral normal skin. The system, which operates at 4 frames with axial and transverse resolutions of 10 and 9 mum, respectively, in the skin tissue, can clearly distinguish the dilated dermal blood vessels from normal tissue. We present OCT images of patients with PWS and normal human skin. We obtain the structural parameters, including epidermal thickness and diameter and depth of dilated blood vessels. We demonstrate that OCT may be a useful tool for the noninvasive imaging of PWS. It may help determine the photosensitizer dose and laser parameters in photodynamic therapy for treating port wine stains.
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Affiliation(s)
- Shiyong Zhao
- Beijing Institute of Technology, Department of Optoelectronics, Beijing 100081, China
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Photodynamic therapy induces selective extravasation of macromolecules: Insights using intravital microscopy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 98:69-76. [DOI: 10.1016/j.jphotobiol.2009.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 10/07/2009] [Accepted: 11/21/2009] [Indexed: 11/19/2022]
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Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port wine stain birthmarks. Photodiagnosis Photodyn Ther 2009; 6:195-9. [PMID: 19932451 DOI: 10.1016/j.pdpdt.2009.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 10/10/2009] [Accepted: 10/12/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Pulsed dye laser (PDL) is a commonly utilized treatment for port wine stain birthmarks (PWS) in the United States; however, results are variable and few patients achieve complete removal. Photodynamic therapy (PDT) is commonly used in China, but treatment associated photosensitivity lasts several weeks and scarring may occur. We propose an alternative treatment option, combined PDT+PDL and performed a proof-of-concept preliminary clinical trial. METHODS Subjects with non-facial PWS were studied. Each subject had four test sites: control, PDL alone, PDT alone (benzoporphyrin derivative monoacid ring A photosensitizer with 576 nm light), and PDT+PDL. Radiant exposure time for PDT was increased in increments of 15 J/cm(2). Authors evaluated photographs and chromametric measurements before and 12 weeks post-treatment. RESULTS No serious adverse events were reported; epidermal changes were mild and self-limited. No clinical blanching was noted in control or PDT-alone sites. At PDT radiant exposures of 15 and 30 J/cm(2), equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30 J/cm(2), greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75 J/cm(2), improved blanching was noted at PDT+PDL sites. CONCLUSIONS Preliminary results indicate that PDT+PDL is safe and may offer improved PWS treatment efficacy. Additional studies are warranted.
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Channual J, Choi B, Osann K, Pattanachinda D, Lotfi J, Kelly KM. Vascular effects of photodynamic and pulsed dye laser therapy protocols. Lasers Surg Med 2009; 40:644-50. [PMID: 18951421 DOI: 10.1002/lsm.20673] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Pulsed dye laser (PDL) treatment of cutaneous vascular lesions is associated with variable and unpredictable efficacy. Thus, alternative treatment modalities are needed. Previous in vitro and in vivo studies have demonstrated enhanced selective vascular destruction with benzoporphyrin derivative (BPD) monoacid ring A photodynamic therapy (PDT) followed immediately by PDL irradiation (PDT+PDL). Here, we evaluate PDT alone, PDL alone, and PDT+PDL protocols using an optimized in vivo rodent dorsal window chamber model. STUDY DESIGN/MATERIALS AND METHODS A dorsal window chamber was surgically installed on male Golden Syrian hamsters. BPD solution was administered intravenously via a jugular venous catheter. Evaluated interventions included: (1) Control (no BPD, no light); (2) Control (BPD, no light); (3) PDT alone (lambda = 576 nm; 25, 50, 75, or 96 J/cm2 radiant exposure; 15 minutes post-BPD injection); (4) PDL alone at 7 J/cm2 (585 nm, 1.5 milliseconds pulse duration, 7 mm spot); and (5) PDT (25 or 75 J/cm2)+PDL (7 J/cm2). Laser speckle imaging was used to monitor blood flow dynamics before, immediately after, and 1, 3, and 5 days post-intervention. RESULTS Perfusion reduction on day 1 post-intervention was achieved with PDT>50 J/cm2, PDL alone, and PDT+PDL. However, by day 5 post-intervention, recovery of flow was observed with PDT alone at 50 J/cm2 (-15.1%) and PDL alone (+215%). PDT (75 J/cm2)+PDL resulted in the greatest prolonged reduction in vascular perfusion (-99.8%). CONCLUSIONS Our in vivo data suggest that the PDT+PDL therapeutic protocol can result in enhanced and persistent vascular shutdown compared to PDT or PDL alone. The PDT+PDL approach has potential for considerable superficial vascular destruction and should be considered as a treatment modality for cutaneous vascular lesions. Monitoring of blood flow changes for as long as possible is crucial for accurate assessment of light-based vascular interventions.
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Affiliation(s)
- Jennifer Channual
- Beckman Laser Institute, University of California, Irvine, California 92612, USA
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Abstract
Lasers and optical technologies play a significant role in aesthetic and reconstructive surgery. The unique ability of optical technologies to target specific structures and layers in tissues to effect chemical, mechanical, or thermal changes makes them a powerful tool in cutaneous rejuvenation, hair removal, fat removal, and treatment of vascular lesions such as port-wine stains, among many other procedures. With the development of adjunct techniques such as epidermal cooling, lasers and optical technologies have become more versatile and safe. The constant improvement of existing applications and the emergence of novel applications such as photodynamic therapy, nanoparticles, spectroscopy, and noninvasive imaging continue to revolutionize aesthetic medicine by offering a minimally invasive alternative to traditional surgery. In the future, therapies will be based on individualized, maximum, safe radiant exposure to deliver optimal dosimetry. Lasers and optical technologies are headed toward safer, easier, more quantifiable, and more individualized therapy.
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Affiliation(s)
- Edward C Wu
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd E, Irvine, CA 92612, USA
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Draijer M, Hondebrink E, van Leeuwen T, Steenbergen W. Review of laser speckle contrast techniques for visualizing tissue perfusion. Lasers Med Sci 2008; 24:639-51. [PMID: 19050826 PMCID: PMC2701498 DOI: 10.1007/s10103-008-0626-3] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 10/14/2008] [Indexed: 11/27/2022]
Abstract
When a diffuse object is illuminated with coherent laser light, the backscattered light will form an interference pattern on the detector. This pattern of bright and dark areas is called a speckle pattern. When there is movement in the object, the speckle pattern will change over time. Laser speckle contrast techniques use this change in speckle pattern to visualize tissue perfusion. We present and review the contribution of laser speckle contrast techniques to the field of perfusion visualization and discuss the development of the techniques.
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Affiliation(s)
- Matthijs Draijer
- Biophysical Engineering Group Institute for Biomedical Technology, University of Twente, Enschede, The Netherlands.
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Chen B, Crane C, He C, Gondek D, Agharkar P, Savellano MD, Hoopes PJ, Pogue BW. Disparity between prostate tumor interior versus peripheral vasculature in response to verteporfin-mediated vascular-targeting therapy. Int J Cancer 2008; 123:695-701. [PMID: 18498134 DOI: 10.1002/ijc.23538] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Photodynamic therapy (PDT) is a light-based cancer treatment modality. Here we employed both in vivo and ex vivo fluorescence imaging to visualize vascular response and tumor cell survival after verteporfin-mediated PDT designed to target tumor vasculature. EGFP-MatLyLu prostate tumor cells, transduced with EGFP using lentivirus vectors, were implanted in athymic nude mice. Immediately after PDT with different doses of verteporfin, tumor-bearing animals were injected with a fluorochrome-labeled albumin. The extravasation of fluorescent albumin along with tumor EGFP fluorescence was monitored noninvasively with a whole-body fluorescence imaging system. Ex vivo fluorescence microscopy was performed on frozen sections of tumor tissues taken at different times after treatment. Both in vivo and ex vivo imaging demonstrated that vascular-targeting PDT with verteporfin significantly increased the extravasation of fluorochrome-labeled albumin in the tumor tissue, especially in the tumor periphery. Although PDT induced substantial vascular shutdown in interior blood vessels, some peripheral tumor vessels were able to maintain perfusion function up to 24 hr after treatment. As a result, viable tumor cells were typically detected in the tumor periphery in spite of extensive tumor cell death. Our results demonstrate that vascular-targeting PDT with verteporfin causes a dose- and time-dependent increase in vascular permeability and decrease in blood perfusion. However, compared to the interior blood vessels, peripheral tumor blood vessels were found less sensitive to PDT-induced vascular shutdown, which was associated with subsequent tumor recurrence in the tumor periphery.
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Affiliation(s)
- Bin Chen
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, Philadelphia, PA 19104, USA.
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Affiliation(s)
- Kristen Kelly
- Associate Professor of Dermatology and Surgery, Beckman Laser Institute, University of California, Irvine, , Phone 949 824-7997, Fax 949 824 2726
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37
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Choi B, Jia W, Channual J, Kelly KM, Lotfi J. The importance of long-term monitoring to evaluate the microvascular response to light-based therapies. J Invest Dermatol 2007; 128:485-8. [PMID: 17657245 PMCID: PMC3494406 DOI: 10.1038/sj.jid.5700991] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
- Department of Biomedical Engineering, University of California, Irvine, California, USA
| | - Wangcun Jia
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
| | - Jennifer Channual
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
| | - Kristen M. Kelly
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
- Department of Dermatology, University of California, Irvine, California, USA
| | - Justin Lotfi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, USA
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Choi B, Ramirez-San-Juan JC, Lotfi J, Stuart Nelson J. Linear response range characterization and in vivo application of laser speckle imaging of blood flow dynamics. JOURNAL OF BIOMEDICAL OPTICS 2006; 11:041129. [PMID: 16965157 DOI: 10.1117/1.2341196] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Noninvasive blood flow imaging can provide critical information on the state of biological tissue and the efficacy of approaches to treat disease. With laser speckle imaging (LSI), relative changes in blood flow are typically reported, with the assumption that the measured values are on a linear scale. A linear relationship between the measured and actual flow rate values has been suggested. The actual flow rate range, over which this linear relationship is valid, is unknown. Herein we report the linear response range and velocity dynamic range (VDR) of our LSI instrument at two relevant camera integration times. For integration times of 1 and 10 ms, the best case VDR was 80 and 60 dB, respectively, and the worst case VDR was 20 and 50 dB. The best case VDR values were similar to those reported in the literature for optical Doppler tomography. We also demonstrate the potential of LSI for monitoring blood flow dynamics in the rodent dorsal skinfold chamber model. These findings imply that LSI can provide accurate wide-field maps of microvascular blood flow rate dynamics and highlight heterogeneities in flow response to the application of exogenous agents.
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Affiliation(s)
- Bernard Choi
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, 1002 Health Sciences Road East, Irvine, California 92612, USA.
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