Dual-channel red/blue fluorescence dosimetry with broadband reflectance spectroscopic correction measures protoporphyrin IX production during photodynamic therapy of actinic keratosis
Dual-channel red/blue fluorescence dosimetry with broadband reflectance spectroscopic correction measures protoporphyrin IX production during photodynamic therapy of actinic keratosis
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DOI：
10.1117/1.jbo.19.7.075002
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发表时间：
2014-07-01
影响因子：
3.5
通讯作者：
Chapman, M. Shane
中科院分区：
文献类型：
--
作者：
Kanick, Stephen Chad;Davis, Scott C.;Chapman, M. Shane
用优化的荧光剂量计检测氨基乙酰丙酸（ALA）诱导的原卟啉IX（PpIX）光动力治疗光化性角化病的剂量学。虽然PpIX产生不足可能是不完全反应的指标，但不存在标准化方法来定量临床治疗期间皮肤深处的PpIX产生。在这项研究中，基于光谱仪的点探针剂量计系统被用来采样PpIX荧光从浅表（蓝色波长激发）和更深（红色波长激发）的组织层。宽带白色光谱（WLS）用于监测血管生理学方面，并告知背景光学特性的荧光校正。在组织幻影中的测量显示准确的恢复血液体积分数和减少散射系数从WLS，和线性响应的PpIX荧光与浓度下降到1.95和250 nM的蓝色和红色激发，分别。在治疗前接受1小时ALA孵育的19名患者的初步临床研究显示PpIX荧光的高内在方差，标准偏差/平均值比> 0.9。在视觉模拟量表上报告疼痛水平较高的患者中，PpIX荧光显著较高。这些初步数据表明，患者特异性PpIX定量可以预测结果反应。(C)作者。由SPIE在知识共享署名3.0未移植许可下发布。
Dosimetry for aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) photodynamic therapy of actinic keratosis was examined with an optimized fluorescence dosimeter to measure PpIX during treatment. While insufficient PpIX generation may be an indicator of incomplete response, there exists no standardized method to quantitate PpIX production at depths in the skin during clinical treatments. In this study, a spectrometer-based point probe dosimeter system was used to sample PpIX fluorescence from superficial (blue wavelength excitation) and deeper (red wavelength excitation) tissue layers. Broadband white light spectroscopy (WLS) was used to monitor aspects of vascular physiology and inform a correction of fluorescence for the background optical properties. Measurements in tissue phantoms showed accurate recovery of blood volume fraction and reduced scattering coefficient from WLS, and a linear response of PpIX fluorescence versus concentration down to 1.95 and 250 nM for blue and red excitations, respectively. A pilot clinical study of 19 patients receiving 1-h ALA incubation before treatment showed high intrinsic variance in PpIX fluorescence with a standard deviation/mean ratio of > 0.9. PpIX fluorescence was significantly higher in patients reporting higher pain levels on a visual analog scale. These pilot data suggest that patient-specific PpIX quantitation may predict outcome response. (C) The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License.