Effects of patient-specific treatment planning on eligibility for photodynamic therapy of deep tissue abscess cavities: retrospective Monte Carlo simulation study.
Effects of patient-specific treatment planning on eligibility for photodynamic therapy of deep tissue abscess cavities: retrospective Monte Carlo simulation study.
复制标题
患者特异性治疗计划对深层组织脓肿腔光动力疗法资格的影响：回顾性蒙特卡洛模拟研究。
DOI：
10.1117/1.jbo.27.8.083007
复制
发表时间：
2022-03
影响因子：
3.5
通讯作者：
Baran TM
中科院分区：
文献类型：
--
作者：
Li Z;Nguyen L;Bass DA;Baran TM
抗菌光动力疗法（PDT）可有效杀死深部组织脓肿腔中发现的细菌菌株。PDT反应取决于多个因素，包括光剂量，这取决于患者的光学特性。对60例脓肿引流受试者的计算机断层扫描图像进行分割，并用于蒙特卡罗（MC）模拟。我们评估了光学特性和脓肿形态对PDT资格的影响并制定了治疗计划。模拟了一系列脓肿壁剥离（）和腔内Intraperoid浓度。在每种组合中，发现了能流率目标的阈值光功率和最佳Intraperoid浓度，如果用光源光可以达到目标，则受试者有资格进行PDT。在腔内吸收的情况下进行了进一步的模拟（）。患者特异性治疗计划大大增加了预期达到抗菌PDT有效光剂量的受试者数量，尤其是使用Intraperoid修饰的受试者。阈值光功率和最佳Intraluminoid浓度随着（）的增加而增加。通过患者特定治疗计划改善PDT合格性（）。合格率从42%提高到92%。增加减少PDT资格（）;在这种情况下，修改输送的光焦度影响最大。基于MC的治疗计划大大提高了脓肿腔PDT的合格性。
Antimicrobial photodynamic therapy (PDT) effectively kills bacterial strains found in deep tissue abscess cavities. PDT response hinges on multiple factors, including light dose, which depends on patient optical properties. Computed tomography images for 60 abscess drainage subjects were segmented and used for Monte Carlo (MC) simulation. We evaluated effects of optical properties and abscess morphology on PDT eligibility and generated treatment plans. A range of abscess wall absorptions () and intra-cavity Intralipid concentrations were simulated. At each combination, the threshold optical power and optimal Intralipid concentration were found for a fluence rate target, with subjects being eligible for PDT if the target was attainable with of source light. Further simulations were performed with absorption within the cavity (). Patient-specific treatment planning substantially increased the number of subjects expected to achieve an efficacious light dose for antimicrobial PDT, especially with Intralipid modification. The threshold optical power and optimal Intralipid concentration increased with increasing (). PDT eligibility improved with patient-specific treatment planning (). With , eligibility increased from 42% to 92%. Increasing reduced PDT eligibility (); modifying the delivered optical power had the greatest impact in this case. MC-based treatment planning greatly increases eligibility for PDT of abscess cavities.