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Sun H, Rastogi V, Zhu TC. Evaluation of Fractionated Photofrin-mediated Photodynamic Therapy Using Different Light Fluences with Reactive Oxygen Species Explicit Dosimetry (ROSED). PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12359:1235906. [PMID: 37378071 PMCID: PMC10299793 DOI: 10.1117/12.2650434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Photodynamic therapy (PDT) is an established modality for cancer treatment, and reactive oxygen species explicit dosimetry (ROSED), based on direct measurements of in-vivo light fluence (rate), in-vivo photofrin concentration, and tissue oxygenation concentration, has been proved to provide the best dosimetric quantity which can be used to predict non-fractionated PDT outcome. This study performed ROSED for Photofrin-mediated PDT for mice bearing radiation-induced fibrosacorma (RIF) tumor. As demonstrated by our previous study, fractionated PDT with a 2-hour time interval can significantly improve the long-term cure rate (from 15% to 65% at 90 days), and it tends to increase as the light dose for the first light fraction gets larger. This study focused on further improving the long-term cure rate without introducing apparent toxicity using combinations of different first light fraction lengths and total light fluences. Photofrin was injected through the mouse tail vein at a concentration of 5 mg/kg. After 18~24 hours, treatment was delivered with a collimated laser beam of 1 cm diameter at 630 nm. Mice were treated using two fractions of light fluences with a 2-hour dark interval. Different dose metrics were quantified, including light fluence, PDT dose, and [ROS]rx. In addition, the total reacted [ROS]rx and treatment outcomes were evaluated and compared to identify the optimal light fraction length and total light fluence.
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Affiliation(s)
- Hongjing Sun
- Department of Radiation Oncology, Perelman Center for Advanced Medicine (PCAM), University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Vivek Rastogi
- Department of Radiation Oncology, Perelman Center for Advanced Medicine (PCAM), University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Timothy C. Zhu
- Department of Radiation Oncology, Perelman Center for Advanced Medicine (PCAM), University of Pennsylvania, Philadelphia, PA, 19104, USA
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Moritz TJ, Zhao Y, Hinds MF, Gunn JR, Shell JR, Pogue BW, Davis SJ. Multispectral singlet oxygen and photosensitizer luminescence dosimeter for continuous photodynamic therapy dose assessment during treatment. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-13. [PMID: 32170859 PMCID: PMC7068220 DOI: 10.1117/1.jbo.25.6.063810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/17/2020] [Indexed: 05/03/2023]
Abstract
SIGNIFICANCE Photodynamic therapy (PDT) involves complex light-drug-pathophysiology interactions that can be affected by multiple parameters and often leads to large variations in treatment outcome from patient to patient. Direct PDT dosimetry technologies have been sought to optimize the control variables (e.g., light dose, drug administration, tissue oxygenation, and patient conditioning) for best patient outcomes. In comparison, singlet oxygen (O21) dosimetry has been tested in various forms to provide an accurate and perhaps comprehensive prediction of the treatment efficacy. AIM We discuss an advanced version of this approach provided by a noninvasive, continuous wave dosimeter that can measure near-infrared spectrally resolved luminescence of both photosensitizer (PS) and O21 generated during PDT cancer treatment. APPROACH This dosimetry technology uses an amplified, high quantum efficiency InGaAs detector with spectroscopic decomposition during the light treatment to continuously extract the maximum signal of O21 phosphorescence while suppressing the strong PS luminescence background by spectrally fitting the data points across nine narrow band wavelengths. O21 and PS luminescence signals were measured in vivo in FaDu xenograft tumors grown in mice during PDT treatment using Verteporfin as the PS and a continuous laser treatment at 690 nm wavelength. RESULTS A cohort of 19 mice was used and observations indicate that the tumor growth rate inhibition showed a stronger correlation with O21 than with just the PS signal. CONCLUSIONS These results suggest that O21 measurement may be a more direct dosimeter of PDT damage, and it has potential value as a definitive diagnostic for PDT treatment, especially with spectral separation of the background luminescence and online estimation of the PS concentration.
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Affiliation(s)
| | - Youbo Zhao
- Physical Sciences Inc., Andover, Massachusetts, United States
- Address all correspondence to Youbo Zhao, E-mail:
| | | | - Jason R. Gunn
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, United States
| | - Jennifer R. Shell
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, United States
| | - Brian W. Pogue
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, United States
| | - Steven J. Davis
- Physical Sciences Inc., Andover, Massachusetts, United States
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Sheng T, Ong Y, Guo W, Zhu TC. Reactive oxygen species explicit dosimetry to predict tumor growth for benzoporphyrin derivative-mediated vascular photodynamic therapy. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-13. [PMID: 31912689 PMCID: PMC6952881 DOI: 10.1117/1.jbo.25.6.063805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
Photodynamic therapy (PDT) is a well-established treatment modality for cancer and other malignant diseases; however, quantities such as light fluence and PDT dose do not fully account for all of the dynamic interactions between the key components involved. In particular, fluence rate (ϕ) effects, which impact the photochemical oxygen consumption rate, are not accounted for. In this preclinical study, reacted reactive oxygen species ([ROS]rx) was investigated as a dosimetric quantity for PDT outcome. The ability of [ROS]rx to predict the cure index (CI) of tumor growth, CI = 1 - k / kctr, where k and kctr are the growth rate of tumor under PDT study and the control tumor without PDT, respectively, for benzoporphyrin derivative (BPD)-mediated PDT, was examined. Mice bearing radiation-induced fibrosarcoma (RIF) tumors were treated with different in-air fluences (Φ = 22.5 to 166.7 J / cm2) and in-air fluence rates (ϕair = 75 to 250 mW / cm2) with a BPD dose of 1 mg / kg and a drug-light interval (DLI) of 15 min. Treatment was delivered with a collimated laser beam of 1-cm-diameter at 690 nm. Explicit measurements of in-air light fluence rate, tissue oxygen concentration, and BPD concentration were used to calculate for [ROS]rx. Light fluence rate at 3-mm depth (ϕ3 mm), determined based on Monte-Carlo simulations, was used in the calculation of [ROS]rx at the base of tumor. CI was used as an endpoint for three dose metrics: light fluence, PDT dose, and [ROS]rx. PDT dose was defined as the product of the time-integral of photosensitizer concentration and ϕ3 mm. Preliminary studies show that [ROS]rx best correlates with CI and is an effective dosimetric quantity that can predict treatment outcome. The threshold dose for [ROS]rx for vascular BPD-mediated PDT using DLI of 15 min is determined to be 0.26 mM and is about 3.8 times smaller than the corresponding value for conventional BPD-mediated PDT using DLI of 3 h.
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Affiliation(s)
- Tianqi Sheng
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, Pennsylvania, United States
| | - Yihong Ong
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, Pennsylvania, United States
| | - Wensheng Guo
- University of Pennsylvania, Department of Biostatistics and Epidemiology, Philadelphia, Pennsylvania, United States
| | - Timothy C. Zhu
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, Pennsylvania, United States
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Ong YH, Dimofte A, Kim MM, Finlay JC, Sheng T, Singhal S, Cengel KA, Yodh AG, Busch TM, Zhu TC. Reactive Oxygen Species Explicit Dosimetry for Photofrin-mediated Pleural Photodynamic Therapy. Photochem Photobiol 2019; 96:340-348. [PMID: 31729774 DOI: 10.1111/php.13176] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 10/18/2019] [Indexed: 01/10/2023]
Abstract
Explicit dosimetry of treatment light fluence and implicit dosimetry of photosensitizer photobleaching are commonly used methods to guide dose delivery during clinical PDT. Tissue oxygen, however, is not routinely monitored intraoperatively even though it is one of the three major components of treatment. Quantitative information about in vivo tissue oxygenation during PDT is desirable, because it enables reactive oxygen species explicit dosimetry (ROSED) for prediction of treatment outcome based on PDT-induced changes in tumor oxygen level. Here, we demonstrate ROSED in a clinical setting, Photofrin-mediated pleural photodynamic therapy, by utilizing tumor blood flow information measured by diffuse correlation spectroscopy (DCS). A DCS contact probe was sutured to the pleural cavity wall after surgical resection of pleural mesothelioma tumor to monitor tissue blood flow (blood flow index) during intraoperative PDT treatment. Isotropic detectors were used to measure treatment light fluence and photosensitizer concentration. Blood-flow-derived tumor oxygen concentration, estimated by applying a preclinically determined conversion factor of 1.5 × 109 μMs cm-2 to the blood flow index, was used in the ROSED model to calculate the total reacted reactive oxygen species [ROS]rx. Seven patients and 12 different pleural sites were assessed and large inter- and intrapatient heterogeneities in [ROS]rx were observed although an identical light dose of 60 J cm-2 was prescribed to all patients.
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Affiliation(s)
- Yi Hong Ong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA.,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA
| | - Andreaa Dimofte
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Tianqi Sheng
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Sunil Singhal
- Division of Thoracic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Keith A Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Arjun G Yodh
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
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Izumoto A, Nishimura T, Hazama H, Ikeda N, Kajimoto Y, Awazu K. Singlet oxygen model evaluation of interstitial photodynamic therapy with 5-aminolevulinic acid for malignant brain tumor. JOURNAL OF BIOMEDICAL OPTICS 2019; 25:1-13. [PMID: 31838789 PMCID: PMC7013325 DOI: 10.1117/1.jbo.25.6.063803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/26/2019] [Indexed: 05/09/2023]
Abstract
Interstitial photodynamic therapy (iPDT) with 5-aminolevulinic acid (ALA) is a possible alternative treatment for malignant brain tumors. Further evaluation is, however, required before it can be clinically applied. Computational simulation of the photophysical process in ALA-iPDT can offer a quantitative tool for understanding treatment outcomes, which depend on various variables related to clinical treatment conditions. We propose a clinical simulation method of ALA-iPDT for malignant brain tumors using a singlet oxygen (O12) model and O12 threshold to induce cell death. In this method, the amount of O12 generated is calculated using a photosensitizer photobleaching coefficient and O12 quantum yield, which have been measured in several previous studies. Results of the simulation using clinical magnetic resonance imaging data show the need to specify the insertion positions of cylindrical light diffusers and the level of light fluence. Detailed analysis with a numerical brain tumor model demonstrates that ALA-iPDT treatment outcomes depend on combinations of photobleaching and threshold values. These results indicate that individual medical procedures, including pretreatment planning and treatment monitoring, will greatly benefit from simulation of ALA-iPDT outcomes.
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Affiliation(s)
- Atsuki Izumoto
- Osaka University, Graduate School of Engineering, Suita, Japan
- Address all correspondence to Atsuki Izumoto, E-mail: ; Takahiro Nishimura, E-mail:
| | - Takahiro Nishimura
- Osaka University, Graduate School of Engineering, Suita, Japan
- Address all correspondence to Atsuki Izumoto, E-mail: ; Takahiro Nishimura, E-mail:
| | - Hisanao Hazama
- Osaka University, Graduate School of Engineering, Suita, Japan
| | - Naokado Ikeda
- Osaka Medical College, Department of Neurosurgery, Takatsuki, Japan
| | | | - Kunio Awazu
- Osaka University, Graduate School of Engineering, Suita, Japan
- Osaka University, Graduate School of Frontier Biosciences, Suita, Japan
- Osaka University, Global Center for Medical Engineering and Informatics, Suita, Japan
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