Noninvasive blood flow imaging for real-time feedback during laser therapy of port wine stain birthmarks
Noninvasive blood flow imaging for real-time feedback during laser therapy of port wine stain birthmarks
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DOI：
10.1002/lsm.20619
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发表时间：
2008-03-01
影响因子：
2.4
通讯作者：
Choi, Bernard
中科院分区：
文献类型：
--
作者：
Huang, Yu-Chih;Ringold, Tyson L.;Choi, Bernard
背景和目的：在激光治疗鲜红斑痣（PWS）胎记的过程中，可能存在持续灌注的区域。这些区域的立即再治疗可以改善PWS激光治疗结果。为了满足这一需求，我们建议使用激光散斑成像（LSI）在激光手术过程中提供实时、定量的反馈。在此，我们提出了在体外和体内收集的数据与临床为基础的LSI instrument.Study设计/材料和方法：在临床实施之前，我们首先调查了LSI的三个方面被认为是重要的临床成像：（1）仪器景深（DOF）;（2）激光辐照度对散斑流动指数（SFI）值的影响;和（3）测量的可重复性。结果：我们的临床前数据表明：（1）仪器的DOF近似于1cm，（2）LSI的定量流动特性在标准化辐照度值为0.06 ~ 0.5时几乎不受影响，（3）仪器的测量结果与实验结果一致。（3）我们的LSI仪器能够高度再现SFI值。从我们的临床测量中，我们发现PWS病变和邻近正常皮肤的血液灌注之间的相对差异是高度可变的。基于SFI图像，PWS皮肤的灌注有时与相邻正常皮肤的灌注难以区分。与激光治疗，我们测量了一个全球性的血液灌注减少，我们经常观察到不同的区域持续perfusion.Conclusions：我们的研究结果表明，图像引导的激光治疗PWS胎记的潜在作用。LSI是一个有前途的工具，在激光治疗过程中，由于其相对简单和低成本的无创血流表征。
Background and Objectives: During laser therapy of port wine stain (PWS) birthmarks, regions of persistent perfusion may exist. Immediate retreatment of such regions may improve PWS laser therapeutic outcome. To address this need, we propose use of laser speckle imaging (LSI) to provide real-time, quantitative feedback during laser surgery. Herein, we present in vitro and in vivo data collected with a clinic-based LSI instrument.Study Design/Materials and Methods: Prior to clinical implementation, we first investigated three aspects of LSI deemed important for clinical imaging: (1) instrument depth of field (DOF); (2) effects of laser irradiance on speckle flow index (SFI) values; and (3) measurement repeatability. Clinical measurements were acquired from the lesions of PWS patients immediately prior to and after laser therapy at the Beckman Laser Institute.Results: Our preclinical data suggest the following: (1) instrument DOF was similar to 1 cm; (2) quantitative flow characterization with LSI was practically unaffected at normalized irradiance values between 0.06 and 0.5; and (3) our LSI instrument was capable of highly reproducible SFI values. From our clinical measurements, we found that the relative difference between blood perfusion in PWS lesions and adjacent normal skin was highly variable. Based on SFI images, the perfusion of PWS skin is sometimes indistinguishable from that of adjacent normal skin. With laser therapy, we measured a global decrease in blood perfusion, and we frequently observed distinct regions of persistent perfusion.Conclusions: Our results demonstrate the potential role of image-guided laser therapy of PWS birthmarks. LSI is a promising tool for noninvasive blood flow characterization during laser therapy due to its relative simplicity and low cost.