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Belashov AV, Zhikhoreva AA, Salova AV, Belyaeva TN, Litvinov IK, Kornilova ES, Semenova IV, Vasyutinskii OS. Automatic segmentation of lysosomes and analysis of intracellular pH with Radachlorin photosensitizer and FLIM. Biochem Biophys Res Commun 2024; 710:149835. [PMID: 38574457 DOI: 10.1016/j.bbrc.2024.149835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/17/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
We report application of the fluorescence lifetime imaging microscopy (FLIM) for analysis of distributions of intracellular acidity using a chlorin-e6 based photosensitizer Radachlorin. An almost two-fold increase of the photosensitizer fluorescence lifetime in alkaline microenvironments as compared to acidic ones allowed for clear distinguishing between acidic and alkaline intracellular structures. Clusterization of a phasor plot calculated from fits of the FLIM raw data by two Gaussian distributions provided accurate automatic segmentation of lysosomes featuring acidic contents. The approach was validated in colocalization experiments with LysoTracker fluorescence in living cells of four established lines. The dependence of photosensitizer fluorescence lifetime on microenvironment acidity allowed for estimation of pH inside the cells, except for the nuclei, where photosensitizer does not penetrate. The developed method is promising for combined application of the photosensitizer for both photodynamic treatment and diagnostics.
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Affiliation(s)
- A V Belashov
- Ioffe Institute, Russian Academy of Sciences, 26, Polytekhnicheskaya, St.Petersburg, 194021, Russia
| | - A A Zhikhoreva
- Ioffe Institute, Russian Academy of Sciences, 26, Polytekhnicheskaya, St.Petersburg, 194021, Russia
| | - A V Salova
- Institute of Cytology, Russian Academy of Sciences, Tikhoretsky Pr., 4, St. Petersburg, 194064, Russia
| | - T N Belyaeva
- Institute of Cytology, Russian Academy of Sciences, Tikhoretsky Pr., 4, St. Petersburg, 194064, Russia
| | - I K Litvinov
- Institute of Cytology, Russian Academy of Sciences, Tikhoretsky Pr., 4, St. Petersburg, 194064, Russia
| | - E S Kornilova
- Institute of Cytology, Russian Academy of Sciences, Tikhoretsky Pr., 4, St. Petersburg, 194064, Russia
| | - I V Semenova
- Ioffe Institute, Russian Academy of Sciences, 26, Polytekhnicheskaya, St.Petersburg, 194021, Russia.
| | - O S Vasyutinskii
- Ioffe Institute, Russian Academy of Sciences, 26, Polytekhnicheskaya, St.Petersburg, 194021, Russia
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2
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Sourvanos D, Zhu TC, Dimofte A, Busch TM, Lander B, Burrell JC, Neiva R, Fiorellini JP. A novel investigational preclinical model to assess fluence rate for dental oral craniofacial tissues. Photodiagnosis Photodyn Ther 2024; 46:104015. [PMID: 38373469 PMCID: PMC11139582 DOI: 10.1016/j.pdpdt.2024.104015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE Photodynamic Therapy (PDT) and Photobiomodulation (PBM) are recognized for their potential in treating head and neck conditions. The heterogeneity of human tissue optical properties presents a challenge for effective dosimetry. The porcine mandible cadaver serves as an excellent model and has several similarities to human tissues of the dental oral craniofacial complex. This study aims to validate a novel modeling system that will help refine PDT and PBM dosimetry for the head and neck region. METHODS AND MATERIALS Light transmission was analyzed through several tissue combinations at distances of 2 mm to 10 mm. Maximum light fluence rates (mW/cm2) were compared across tissue types to reveal the effects of tissue heterogeneity. RESULTS The study revealed that light fluence is affected by tissue composition, with dentin/enamel showing reduced transmission and soft tissue regions exhibiting elevated values. The porcine model has proven to be efficient in mimicking human tissue responses to light, enabling the potential to optimize future protocols. CONCLUSION The porcine mandible cadaver is a novel model to understand the complex interactions between light and tissue. This study provides a foundation for future investigations into dosimetry optimization for PDT and PBM.
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Affiliation(s)
- Dennis Sourvanos
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA; Center for Innovation and Precision Dentistry (CiPD), School of Dental Medicine, School of Engineering, University of Pennsylvania, PA, USA.
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Andreea Dimofte
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Bradley Lander
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Justin C Burrell
- Center for Innovation and Precision Dentistry (CiPD), School of Dental Medicine, School of Engineering, University of Pennsylvania, PA, USA; Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania and University of Pennsylvania School of Dental Medicine, University of Pennsylvania, PA, USA; Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michal J. Crescenz Veterans Affairs Medical Center, PA, USA
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Joseph P Fiorellini
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
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3
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Oakley E, Parilov E, Beeson K, Potasek M, Ivanick N, Tworek L, Hutson A, Shafirstein G. Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction. Cancers (Basel) 2023; 15:cancers15092636. [PMID: 37174102 PMCID: PMC10177073 DOI: 10.3390/cancers15092636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/24/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
There are no effective treatments for patients with extrinsic malignant central airway obstruction (MCAO). In a recent clinical study, we demonstrated that interstitial photodynamic therapy (I-PDT) is a safe and potentially effective treatment for patients with extrinsic MCAO. In previous preclinical studies, we reported that a minimum light irradiance and fluence should be maintained within a significant volume of the target tumor to obtain an effective PDT response. In this paper, we present a computational approach to personalized treatment planning of light delivery in I-PDT that simultaneously optimizes the delivered irradiance and fluence using finite element method (FEM) solvers of either Comsol Multiphysics® or Dosie™ for light propagation. The FEM simulations were validated with light dosimetry measurements in a solid phantom with tissue-like optical properties. The agreement between the treatment plans generated by two FEMs was tested using typical imaging data from four patients with extrinsic MCAO treated with I-PDT. The concordance correlation coefficient (CCC) and its 95% confidence interval (95% CI) were used to test the agreement between the simulation results and measurements, and between the two FEMs treatment plans. Dosie with CCC = 0.994 (95% CI, 0.953-0.996) and Comsol with CCC = 0.999 (95% CI, 0.985-0.999) showed excellent agreement with light measurements in the phantom. The CCC analysis showed very good agreement between Comsol and Dosie treatment plans for irradiance (95% CI, CCC: 0.996-0.999) and fluence (95% CI, CCC: 0.916-0.987) in using patients' data. In previous preclinical work, we demonstrated that effective I-PDT is associated with a computed light dose of ≥45 J/cm2 when the irradiance is ≥8.6 mW/cm2 (i.e., the effective rate-based light dose). In this paper, we show how to use Comsol and Dosie packages to optimize rate-based light dose, and we present Dosie's newly developed domination sub-maps method to improve the planning of the delivery of the effective rate-based light dose. We conclude that image-based treatment planning using Comsol or Dosie FEM-solvers is a valid approach to guide the light dosimetry in I-PDT of patients with MCAO.
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Affiliation(s)
- Emily Oakley
- Department of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | | | - Karl Beeson
- Simphotek, Inc., 211 Warren St., Newark, NJ 07103, USA
| | - Mary Potasek
- Simphotek, Inc., 211 Warren St., Newark, NJ 07103, USA
| | - Nathaniel Ivanick
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Lawrence Tworek
- Department of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Alan Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Gal Shafirstein
- Department of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
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4
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Kailass K, Sadovski O, Zipfel WR, Beharry AA. Two-Photon Photodynamic Therapy Targeting Cancers with Low Carboxylesterase 2 Activity Guided by Ratiometric Fluorescence. J Med Chem 2022; 65:8855-8868. [PMID: 35700557 DOI: 10.1021/acs.jmedchem.1c01965] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Human carboxylesterase 2 (hCES2) converts anticancer prodrugs, such as irinotecan, into their active metabolites via phase I drug metabolism. Owing to interindividual variability, hCES2 serves as a predictive marker of patient response to hCES2-activated prodrug-based therapy, whereby a low intratumoral hCES2 activity leads to therapeutic resistance. Despite the ability to identify nonresponders, effective treatments for resistant patients are needed. Clinically approved photodynamic therapy is an attractive alternative for irinotecan-resistant patients. Here, we describe the application of our hCES2-selective small-molecule ratiometric fluorescent chemosensor, Benz-AP, as a single theranostic agent given its discovered functionality as a photosensitizer. Benz-AP produces singlet oxygen and induces photocytotoxicity in cancer cells in a strong negative correlation with hCES2 activity. Two-photon excitation of Benz-AP produces fluorescence, singlet oxygen, and photocytotoxicity in tumor spheroids. Overall, Benz-AP serves as a novel theranostic agent with selective photocytotoxicity in hCES2-prodrug resistant cancer cells, making Benz-AP a promising agent for in vivo applications.
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Affiliation(s)
- Karishma Kailass
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada
| | - Oleg Sadovski
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada
| | - Warren R Zipfel
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Andrew A Beharry
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada
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5
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Alanazi RS, Laref A. Monte Carlo simulations of photodynamic therapy in human blood model. Lasers Med Sci 2021; 37:1515-1529. [PMID: 34453656 DOI: 10.1007/s10103-021-03383-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
This study aims to simulate a therapeutic plan for a normal human blood model under various patho-physiological conditions, such as the development of leukemia/blood diseases, by means of Monte Carlo multilayered simulation. The photosensitizing compound selectively accumulates in the target cells. A superficial treatment of a blood sample was performed at different ratios of oxygen saturation ([Formula: see text]) under the concentration ([Formula: see text] = 30 µM) effect of merocyanine 540 (MC540) in the blood irradiation. This was done under the application of visible light of wavelength ~ [Formula: see text] at an exposure time ~ 60 s. The dose of photodynamic therapy (PDT) was evaluated for the biological damage, leading to necrosis and blood damage during the treatment. In addition, the effect of PDT treatment response in the blood is related to hemoglobin oxygen saturation, resulting in an excellent relationship between the changes caused by the treatment in the blood at a peculiar oxygen saturation rate (for the highest response: [Formula: see text] 50%) and a light dose (LD) of 3.83 [Formula: see text] above the minimal toxicity of normal tissues. The photodynamic dose is related to the depth of necrosis and the time of treatment for the achievement of the LD delivery at the PDT of blood.
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Affiliation(s)
- R S Alanazi
- Department of Physics and Astronomy, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, Saudi Arabia
| | - A Laref
- Department of Physics and Astronomy, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
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6
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Gao R, Xu H, Liu L, Zhang Y, Yin T, Zhou H, Sun M, Chen N, Ren Y, Chen T, Pan Y, Zheng M, Ohulchanskyy TY, Zheng R, Cai L, Song L, Qu J, Liu C. Photoacoustic visualization of the fluence rate dependence of photodynamic therapy. BIOMEDICAL OPTICS EXPRESS 2020; 11:4203-4223. [PMID: 32923037 PMCID: PMC7449708 DOI: 10.1364/boe.395562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/27/2020] [Accepted: 06/18/2020] [Indexed: 05/18/2023]
Abstract
This study investigates the fluence rate effect, an essential modulating mechanism of photodynamic therapy (PDT), by using photoacoustic imaging method. To the best of our knowledge, this is the first time that the fluence rate dependence is investigated at a microscopic scale, as opposed to previous studies that are based on tumor growth/necrosis or animal surviving rate. This micro-scale examination enables subtle biological responses, including the vascular damage and the self-healing response, to be studied. Our results reveal the correlations between fluence rate and PDT efficacy/self-healing magnitude, indicating that vascular injuries induced by high fluence rates are more likely to recover and by low fluence rates (≤126 mW/cm2) are more likely to be permanent. There exists a turning point of fluence rate (314 mW/cm2), above which PDT practically produces no permanent therapeutic effect and damaged vessels can fully recover. These findings have practical significance in clinical setting. For cancer-related diseases, the 'effective fluence rate' is useful to provoke permanent destruction of tumor vasculature. Likewise, the 'non effective range' can be applied when PDT is used in applications such as opening the blood brain barrier to avoid permanent brain damage.
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Affiliation(s)
- Rongkang Gao
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- These authors contributed equally to this work
| | - Hao Xu
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
- These authors contributed equally to this work
| | - Liangjian Liu
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- These authors contributed equally to this work
| | - Ying Zhang
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Ting Yin
- Guangdong Key Laboratory of Nanomedicine, CAS Key Lab for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Huichao Zhou
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Mingjian Sun
- Harbin Institute of Technology, Department of Control Science and Engineering, Weihai 264209, Shandong, China
| | - Ningbo Chen
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yaguang Ren
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Tao Chen
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yinhao Pan
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Mingbin Zheng
- Guangdong Key Laboratory of Nanomedicine, CAS Key Lab for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Tymish Y Ohulchanskyy
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
| | - Rongqin Zheng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Lintao Cai
- Guangdong Key Laboratory of Nanomedicine, CAS Key Lab for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Liang Song
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Junle Qu
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China
| | - Chengbo Liu
- Research Laboratory for Biomedical Optics and Molecular Imaging, CAS Key Laboratory of Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
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7
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Oakley E, Bellnier D, Hutson A, Cooper H, Habitzruther M, Sexton S, Curtin L, Tworek L, Mallory M, Henderson B, Shafirstein G. Irradiance, Photofrin ® Dose and Initial Tumor Volume are Key Predictors of Response to Interstitial Photodynamic Therapy of Locally Advanced Cancers in Translational Models. Photochem Photobiol 2020; 96:397-404. [PMID: 31887227 PMCID: PMC7138700 DOI: 10.1111/php.13207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/27/2019] [Indexed: 12/14/2022]
Abstract
The objective of the present study was to develop a predictive model for Photofrin® -mediated interstitial photodynamic therapy (I-PDT) of locally advanced tumors. Our finite element method was used to simulate 630-nm intratumoral irradiance and fluence for C3H mice and New Zealand White rabbits bearing large squamous cell carcinomas. Animals were treated with light only or I-PDT using the same light settings. I-PDT was administered with Photofrin® at 5.0 or 6.6 mg kg-1 , 24 h drug-light interval. The simulated threshold fluence was fixed at 45 J cm-2 while the simulated threshold irradiance varied, intratumorally. No cures were obtained in the mice treated with a threshold irradiance of 5.4 mW cm-2 . However, 20-90% of the mice were cured when the threshold irradiances were ≥8.6 mW cm-2 . In the rabbits treated with I-PDT, 13 of the 14 VX2 tumors showed either local control or were cured when threshold irradiances were ≥15.3 mW cm-2 and fluence was 45 J cm-2 . No tumor growth delay was observed in VX2 treated with light only (n = 3). In the mouse studies, there was a high probability (92.7%) of predicting cure when the initial tumor volume was below the median (493.9 mm3 ) and I-PDT was administered with a threshold intratumoral irradiance ≥8.6 mW cm-2 .
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Affiliation(s)
- Emily Oakley
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - David Bellnier
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Alan Hutson
- Department of Biostatistics and BioinformaticsRoswell ParkBuffaloNY
| | - Hannah Cooper
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Michael Habitzruther
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Sandra Sexton
- Laboratory Animals Shared ResourcesRoswell ParkBuffaloNY
| | - Leslie Curtin
- Laboratory Animals Shared ResourcesRoswell ParkBuffaloNY
| | - Lawrence Tworek
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Matthew Mallory
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Barbara Henderson
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
| | - Gal Shafirstein
- Photodynamic Therapy CenterRoswell Park Comprehensive Cancer Center (Roswell Park)BuffaloNY
- Department of Cell Stress BiologyRoswell ParkBuffaloNY
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8
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Wilson BC, Weersink RA. The Yin and Yang of PDT and PTT. Photochem Photobiol 2019; 96:219-231. [PMID: 31769516 DOI: 10.1111/php.13184] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/24/2019] [Indexed: 12/16/2022]
Abstract
In Chinese philosophy, yin and yang ("dark-bright," "negative-positive") describe how seemingly opposite or contrary forces may actually be complementary, interconnected and interdependent. This paper provides this perspective on photodynamic and photothermal therapies, with a focus on the treatment of solid tumors. The relative strengths and weaknesses of each modality, both current and emerging, are considered with respect to the underlying biophysics, the required technologies, the biological effects, their translation into clinical practice and the realized or potential clinical outcomes. For each specific clinical application, one or the other modality may be clearly preferred, or both are effectively equivalent in terms of the various scientific/technological/practical/clinical trade-offs involved. Alternatively, a combination may the best approach. Such combined approaches may be facilitated by the use of multifunctional nanoparticles. It is important to understand the many factors that go into the selection of the optimal approach and the objective of this paper is to provide guidance on this.
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Affiliation(s)
- Brian C Wilson
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Robert A Weersink
- University Health Network/University of Toronto, Toronto, ON, M5G 1L7, Canada
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9
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Photodynamic therapy of deep tissue abscess cavities: Retrospective image‐based feasibility study using Monte Carlo simulation. Med Phys 2019; 46:3259-3267. [DOI: 10.1002/mp.13557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/11/2019] [Accepted: 04/17/2019] [Indexed: 01/11/2023] Open
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10
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Shafirstein G, Bellnier DA, Oakley E, Hamilton S, Habitzruther M, Tworek L, Hutson A, Spernyak JA, Sexton S, Curtin L, Turowski SG, Arshad H, Henderson B. Irradiance controls photodynamic efficacy and tissue heating in experimental tumours: implication for interstitial PDT of locally advanced cancer. Br J Cancer 2018; 119:1191-1199. [PMID: 30353043 PMCID: PMC6251027 DOI: 10.1038/s41416-018-0210-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/29/2018] [Accepted: 07/05/2018] [Indexed: 01/11/2023] Open
Abstract
Background Currently delivered light dose (J/cm2) is the principal parameter guiding interstitial photodynamic therapy (I-PDT) of refractory locally advanced cancer. The aim of this study was to investigate the impact of light dose rate (irradiance, mW/cm2) and associated heating on tumour response and cure. Methods Finite-element modeling was used to compute intratumoural irradiance and dose to guide Photofrin® I-PDT in locally advanced SCCVII in C3H mice and large VX2 neck tumours in New Zealand White rabbits. Light-induced tissue heating in mice was studied with real-time magnetic resonance thermometry. Results In the mouse model, cure rates of 70–90% were obtained with I-PDT using 8.4–245 mW/cm2 and ≥45 J/cm2 in 100% of the SCCVII tumour. Increasing irradiance was associated with increase in tissue heating. I-PDT with Photofrin® resulted in significantly (p < 0.05) higher cure rate compared to light delivery alone at same irradiance and light dose. Local control and/or cures of VX2 were obtained using I-PDT with 16.5–398 mW/cm2 and ≥45 J/cm2 in 100% of the tumour. Conclusion In Photofrin®-mediated I-PDT, a selected range of irradiance prompts effective photoreaction with tissue heating in the treatment of locally advanced mouse tumour. These irradiances were translated for effective local control of large VX2 tumours.
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Affiliation(s)
- Gal Shafirstein
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA. .,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA.
| | - David A Bellnier
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
| | - Emily Oakley
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
| | - Sasheen Hamilton
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
| | - Michael Habitzruther
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
| | - Lawrence Tworek
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
| | - Alan Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park, Buffalo, NY, USA
| | - Joseph A Spernyak
- Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA.,Translational Imaging Shared Resource, Roswell Park, Buffalo, NY, USA
| | - Sandra Sexton
- Laboratory Animals Shared Resources, Roswell Park, Buffalo, NY, USA
| | - Leslie Curtin
- Laboratory Animals Shared Resources, Roswell Park, Buffalo, NY, USA
| | - Steven G Turowski
- Translational Imaging Shared Resource, Roswell Park, Buffalo, NY, USA
| | - Hassan Arshad
- Department of Head and Neck Surgery, Roswell Park, Buffalo, NY, USA
| | - Barbara Henderson
- Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center (Roswell Park), Buffalo, NY, USA.,Department of Cell Stress Biology, Roswell Park, Buffalo, NY, USA
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11
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Ong YH, Kim MM, Finlay JC, Dimofte A, Singhal S, Glatstein E, Cengel KA, Zhu TC. PDT dose dosimetry for Photofrin-mediated pleural photodynamic therapy (pPDT). Phys Med Biol 2017; 63:015031. [PMID: 29106380 DOI: 10.1088/1361-6560/aa9874] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Photosensitizer fluorescence excited by photodynamic therapy (PDT) treatment light can be used to monitor the in vivo concentration of the photosensitizer and its photobleaching. The temporal integral of the product of in vivo photosensitizer concentration and light fluence is called PDT dose, which is an important dosimetry quantity for PDT. However, the detected photosensitizer fluorescence may be distorted by variations in the absorption and scattering of both excitation and fluorescence light in tissue. Therefore, correction of the measured fluorescence for distortion due to variable optical properties is required for absolute quantification of photosensitizer concentration. In this study, we have developed a four-channel PDT dose dosimetry system to simultaneously acquire light dosimetry and photosensitizer fluorescence data. We measured PDT dose at four sites in the pleural cavity during pleural PDT. We have determined an empirical optical property correction function using Monte Carlo simulations of fluorescence for a range of physiologically relevant tissue optical properties. Parameters of the optical property correction function for Photofrin fluorescence were determined experimentally using tissue-simulating phantoms. In vivo measurements of photosensitizer fluorescence showed negligible photobleaching of Photofrin during the PDT treatment, but large intra- and inter-patient heterogeneities of in vivo Photofrin concentration are observed. PDT doses delivered to 22 sites in the pleural cavity of 8 patients were different by 2.9 times intra-patient and 8.3 times inter-patient.
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Affiliation(s)
- Yi Hong Ong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, United States of America. Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104, United States of America
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12
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Mohapatra PP, Chiemezie CO, Kligman A, Kim MM, Busch TM, Zhu TC, Greer A. 31 P NMR Evidence for Peroxide Intermediates in Lipid Emulsion Photooxidations: Phosphine Substituent Effects in Trapping. Photochem Photobiol 2017; 93:1430-1438. [PMID: 28722754 DOI: 10.1111/php.12810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 06/26/2017] [Indexed: 01/05/2023]
Abstract
Intralipid is a lipid emulsion used in photodynamic therapy (PDT) for its light scattering and tissue-simulating properties. The purpose of this study is to determine whether or not Intralipid undergoes photooxidation, and we have carried out an Intralipid peroxide trapping study using a series of phosphines [2'-dicyclohexylphosphino-2,6-dimethoxy-1,1'-biphenyl-3-sulfonate, 3-(diphenylphosphino)benzenesulfonate, triphenylphosphine-3,3',3''-trisulfonate and triphenylphosphine]. Our new findings are as follows: (1) An oxygen atom is transferred from Intralipid peroxide to the phosphine traps in the dark, after the photooxidation of Intralipid. 3-(Diphenylphosphino)benzenesulfonate is the most suitable trap in the series owing to a balance of nucleophilicity and water solubility. (2) Phosphine trapping and monitoring by 31 P NMR are effective in quantifying the peroxides in H2 O. An advantage of the technique is that peroxides are detected in H2 O; deuterated NMR solvents are not required. (3) The percent yield of the peroxides increased linearly with the increase in fluence from 45 to 180 J cm-2 based on our trapping experiments. (4) The photooxidation yields quantitated by the phosphines and 31 P NMR are supported by the direct 1 H NMR detection using deuterated NMR solvents. These data provide the first steps in the development of Intralipid peroxide quantitation after PDT using phosphine trapping and 31 P NMR spectroscopy.
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Affiliation(s)
| | - Callistus O Chiemezie
- Department of Chemistry, Brooklyn College, Brooklyn, NY
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, New York, NY
| | - Arina Kligman
- Department of Chemistry, Brooklyn College, Brooklyn, NY
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, New York, NY
| | - Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, PA
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, PA
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, PA
| | - Alexander Greer
- Department of Chemistry, Brooklyn College, Brooklyn, NY
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, New York, NY
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Dupont C, Mordon S, Deleporte P, Reyns N, Vermandel M. A novel device for intraoperative photodynamic therapy dedicated to glioblastoma treatment. Future Oncol 2017; 13:2441-2454. [PMID: 28942677 DOI: 10.2217/fon-2017-0261] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Photodynamic therapy (PDT) appears to be a valuable new treatment modality for cancer therapy. Studies have reported successful application of PDT for glioblastoma. Here, we introduce a new device dedicated to intraoperative PDT delivered early after fluoro-guided resection combined with a transfer function that determines the treatment time based on the size of the surgical resection cavity. MATERIALS & METHODS First, we describe the device, which is composed of a trocar, a balloon filled with a diffusing solution, and a fiber guide in which a cylindrical light diffuser is inserted. Ex vivo experiments were performed to measure the fluence rate inside biological tissues. A calibration factor was defined to convert power measurements into fluence rate values. Calf brains were used to simulate light propagation in human brain tissue, and the photosensitizer administration effect on optical properties was discussed. The temperature elevation during illumination was evaluated. RESULTS Light power was measured in tissues surrounding the device during ex vivo experiments. Using the previously characterized calibration factor, power measurements were converted to fluence rate values to obtain the transfer function. No thermal elevation was observed during a 2-h temperature test, and the impact of protoporphyrin IX on brain optical properties was considered negligible. CONCLUSION A discussion of experimental precision is presented. The light duration determined by the abacus had a standard deviation of <1 min. This value is weak compared with the total illumination time necessary to treat one patient. The main advantage of our device lies in its straightforward implementation of intraoperative PDT for neurosurgery with acceptable dosimetry and easy treatment time.
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Affiliation(s)
- Clément Dupont
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
| | - Serge Mordon
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
| | - Pascal Deleporte
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
| | - Nicolas Reyns
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
| | - Maximilien Vermandel
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000 Lille, France
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Protti S, Albini A, Viswanathan R, Greer A. Targeting Photochemical Scalpels or Lancets in the Photodynamic Therapy Field—The Photochemist's Role. Photochem Photobiol 2017; 93:1139-1153. [DOI: 10.1111/php.12766] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/20/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Stefano Protti
- PhotoGreen Lab Department of Chemistry University of Pavia Pavia Italy
| | - Angelo Albini
- PhotoGreen Lab Department of Chemistry University of Pavia Pavia Italy
| | | | - Alexander Greer
- Department of Chemistry Brooklyn College Brooklyn NY
- Ph.D. Program in Chemistry The Graduate Center of the City University of New York New York City NY
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Gemmell NR, McCarthy A, Kim MM, Veilleux I, Zhu TC, Buller GS, Wilson BC, Hadfield RH. A compact fiber-optic probe-based singlet oxygen luminescence detection system. JOURNAL OF BIOPHOTONICS 2017; 10:320-326. [PMID: 27455426 PMCID: PMC5266677 DOI: 10.1002/jbio.201600078] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/02/2016] [Accepted: 07/03/2016] [Indexed: 05/26/2023]
Abstract
This paper presents a novel compact fiberoptic based singlet oxygen near-infrared luminescence probe coupled to an InGaAs/InP single photon avalanche diode (SPAD) detector. Patterned time gating of the single-photon detector is used to limit unwanted dark counts and eliminate the strong photosensitizer luminescence background. Singlet oxygen luminescence detection at 1270 nm is confirmed through spectral filtering and lifetime fitting for Rose Bengal in water, and Photofrin in methanol as model photosensitizers. The overall performance, measured by the signal-to-noise ratio, improves by a factor of 50 over a previous system that used a fiberoptic-coupled superconducting nanowire single-photon detector. The effect of adding light scattering to the photosensitizer is also examined as a first step towards applications in tissue in vivo.
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Affiliation(s)
- Nathan R. Gemmell
- Division of Electronic and Nanoscale EngineeringUniversity of GlasgowUK
| | - Aongus McCarthy
- Institute of Photonics and Quantum SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
| | - Michele M. Kim
- Department of Radiation OncologyUniversity of PennsylvaniaUSA
| | | | - Timothy C. Zhu
- Department of Radiation OncologyUniversity of PennsylvaniaUSA
| | - Gerald S. Buller
- Institute of Photonics and Quantum SciencesHeriot‐Watt UniversityEdinburghEH14 4ASUK
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Shafirstein G, Bellnier D, Oakley E, Hamilton S, Potasek M, Beeson K, Parilov E. Interstitial Photodynamic Therapy-A Focused Review. Cancers (Basel) 2017; 9:cancers9020012. [PMID: 28125024 PMCID: PMC5332935 DOI: 10.3390/cancers9020012] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/13/2017] [Accepted: 01/20/2017] [Indexed: 01/07/2023] Open
Abstract
Multiple clinical studies have shown that interstitial photodynamic therapy (I-PDT) is a promising modality in the treatment of locally-advanced cancerous tumors. However, the utilization of I-PDT has been limited to several centers. The objective of this focused review is to highlight the different approaches employed to administer I-PDT with photosensitizers that are either approved or in clinical studies for the treatment of prostate cancer, pancreatic cancer, head and neck cancer, and brain cancer. Our review suggests that I-PDT is a promising treatment in patients with large-volume or thick tumors. Image-based treatment planning and real-time dosimetry are required to optimize and further advance the utilization of I-PDT. In addition, pre- and post-imaging using computed tomography (CT) with contrast may be utilized to assess the response.
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Affiliation(s)
- Gal Shafirstein
- Photodynamic Therapy Center, Department of Cell Stress Biology, Roswell Park Cancer Institute (RPCI), Elm & Carlton Streets, Buffalo, NY 14263, USA.
| | - David Bellnier
- Photodynamic Therapy Center, Department of Cell Stress Biology, Roswell Park Cancer Institute (RPCI), Elm & Carlton Streets, Buffalo, NY 14263, USA.
| | - Emily Oakley
- Photodynamic Therapy Center, Department of Cell Stress Biology, Roswell Park Cancer Institute (RPCI), Elm & Carlton Streets, Buffalo, NY 14263, USA.
| | - Sasheen Hamilton
- Photodynamic Therapy Center, Department of Cell Stress Biology, Roswell Park Cancer Institute (RPCI), Elm & Carlton Streets, Buffalo, NY 14263, USA.
| | - Mary Potasek
- Simphotek, Inc., 211 Warren St, Newark, NJ 07103, USA.
| | - Karl Beeson
- Simphotek, Inc., 211 Warren St, Newark, NJ 07103, USA.
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Tylcz JB, Bastogne T, Bourguignon A, Frochot C, Barberi-Heyob M. Realtime Tracking of the Photobleaching Trajectory During Photodynamic Therapy. IEEE Trans Biomed Eng 2017; 64:1742-1749. [PMID: 28113251 DOI: 10.1109/tbme.2016.2620239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Photodynamic therapy (PDT) is an alternative treatment for cancer, which involves the administration of a photosensitizing agent that is activated by light at a specific wavelength. This illumination causes after a sequence of photoreactions, the production of reactive oxygen species responsible for the death of the tumor cells but also the degradation of the photosensitizing agent, which then loose the fluorescence properties. The phenomenon is commonly known as the photobleaching process and can be considered as a therapy efficiency indicator. METHODS This paper presents the design and validation of a real-time controller able to track a preset photobleaching trajectory by modulating the light impulses width during the treatment sessions. RESULTS This innovative solution was validated by in vivo experiments that have shown a significantly improvement of reproducibility of the interindividual photobleaching kinetic. CONCLUSION We believe that this approach could lead to personalized PDT modalities. SIGNIFICANCE This work may open new perspectives in the control and optimization of photodynamic treatments.
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Lymperopoulos G, Lymperopoulos P, Alikari V, Dafogianni C, Zyga S, Margari N. Application of Theranostics in Oncology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 989:119-128. [DOI: 10.1007/978-3-319-57348-9_10] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Penjweini R, Kim MM, Liu B, Zhu TC. Evaluation of the 2-(1-Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH) mediated photodynamic therapy by macroscopic singlet oxygen modeling. JOURNAL OF BIOPHOTONICS 2016; 9:1344-1354. [PMID: 27653233 PMCID: PMC5159301 DOI: 10.1002/jbio.201600121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/12/2016] [Accepted: 08/21/2016] [Indexed: 05/02/2023]
Abstract
Photodynamic therapy (PDT) is known as a non-invasive treatment modality that is based on photochemical reactions between oxygen, photosensitizer, and a special wavelength of light. However, a dosimetric predictor for PDT outcome is still elusive because current dosimetric quantities do not account for the differences in the PDT oxygen consumption rate for different fluence rates. In this study, we evaluate several dose metrics, total fluence, photobleaching ratio, PDT dose, and mean reacted singlet oxygen (mean [1 O2 ]rx ) for predicting the PDT outcome and a clinically relevant tumor re-growth endpoint. For this reason, radiation-induced fibrosarcoma (RIF) mice tumors are treated with 2-(1-Hexyloxyethyl)-2-devinyl pyropheophorbide (HPPH) and different in-air fluences (30 J/cm2 , 50 J/cm2 , 135 J/cm2 , 250 J/cm2 , and 350 J/cm2 ) and in-air fluence rates (20, 50, 75, 150 mW/cm2 ). Explicit measurements of HPPH and oxygen concentration as well as tissue optical properties are performed pre- and post-treatment. Then, this information is incorporated into a macroscopic model to calculate the photobleaching, PDT dose, and mean [1 O2 ]rx . Changes in tumor volume are tracked following the treatment and compared with the dose metrics. The correlation demonstrates that mean [1 O2 ]rx serves as a better dosimetric quantity for predicting treatment outcome and a clinically relevant tumor re-growth endpoint.
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Affiliation(s)
| | | | - Baochang Liu
- University of Pennsylvania, School of Medicine, Department of Radiation Oncology, 3400 Civic Center Boulevard TRC 4W, hiladelphia, Pennsylvania 19104, USA
| | - Timothy C. Zhu
- University of Pennsylvania, School of Medicine, Department of Radiation Oncology, 3400 Civic Center Boulevard TRC 4W, hiladelphia, Pennsylvania 19104, USA
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de Faria CMG, Inada NM, Kurachi C, Bagnato VS. Determination of the threshold dose distribution in photodynamic action from in vitro experiments. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 162:168-175. [DOI: 10.1016/j.jphotobiol.2016.06.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/28/2022]
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21
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Pogue BW, Elliott JT, Kanick SC, Davis SC, Samkoe KS, Maytin EV, Pereira SP, Hasan T. Revisiting photodynamic therapy dosimetry: reductionist & surrogate approaches to facilitate clinical success. Phys Med Biol 2016; 61:R57-89. [PMID: 26961864 DOI: 10.1088/0031-9155/61/7/r57] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Photodynamic therapy (PDT) can be a highly complex treatment, with many parameters influencing treatment efficacy. The extent to which dosimetry is used to monitor and standardize treatment delivery varies widely, ranging from measurement of a single surrogate marker to comprehensive approaches that aim to measure or estimate as many relevant parameters as possible. Today, most clinical PDT treatments are still administered with little more than application of a prescribed drug dose and timed light delivery, and thus the role of patient-specific dosimetry has not reached widespread clinical adoption. This disconnect is at least partly due to the inherent conflict between the need to measure and understand multiple parameters in vivo in order to optimize treatment, and the need for expedience in the clinic and in the regulatory and commercialization process. Thus, a methodical approach to selecting primary dosimetry metrics is required at each stage of translation of a treatment procedure, moving from complex measurements to understand PDT mechanisms in pre-clinical and early phase I trials, towards the identification and application of essential dose-limiting and/or surrogate measurements in phase II/III trials. If successful, identifying the essential and/or reliable surrogate dosimetry measurements should help facilitate increased adoption of clinical PDT. In this paper, examples of essential dosimetry points and surrogate dosimetry tools that may be implemented in phase II/III trials are discussed. For example, the treatment efficacy as limited by light penetration in interstitial PDT may be predicted by the amount of contrast uptake in CT, and so this could be utilized as a surrogate dosimetry measurement to prescribe light doses based upon pre-treatment contrast. Success of clinical ALA-based skin lesion treatment is predicted almost uniquely by the explicit or implicit measurements of photosensitizer and photobleaching, yet the individualization of treatment based upon each patients measured bleaching needs to be attempted. In the case of ALA, lack of PpIX is more likely an indicator that alternative PpIX production methods must be implemented. Parsimonious dosimetry, using surrogate measurements that are clinically acceptable, might strategically help to advance PDT in a medical world that is increasingly cost and time sensitive. Careful attention to methodologies that can identify and advance the most critical dosimetric measurements, either direct or surrogate, are needed to ensure successful incorporation of PDT into niche clinical procedures.
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Affiliation(s)
- Brian W Pogue
- Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA. Department of Surgery, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
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Zhu TC, Kim MM, Liang X, Finlay JC, Busch TM. In-vivo singlet oxygen threshold doses for PDT. ACTA ACUST UNITED AC 2015; 4:59-71. [PMID: 25927018 DOI: 10.1515/plm-2014-0037] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Dosimetry of singlet oxygen (1O2) is of particular interest because it is the major cytotoxic agent causing biological effects for type-II photosensitizers during photodynamic therapy (PDT). An in-vivo model to determine the singlet oxygen threshold dose, [1O2]rx,sh, for PDT was developed. MATERIAL AND METHODS An in-vivo radiation-induced fibrosarcoma (RIF) tumor mouse model was used to correlate the radius of necrosis to the calculation based on explicit PDT dosimetry of light fluence distribution, tissue optical properties, and photosensitizer concentrations. Inputs to the model include five photosensitizer-specific photochemical parameters along with [1O2]rx,sh. Photosensitizer-specific model parameters were determined for benzoporphyrin derivative monoacid ring A (BPD) and compared with two other type-II photosensitizers, Photofrin® and m-tetrahydroxyphenylchlorin (mTHPC) from the literature. RESULTS The mean values (standard deviation) of the in-vivo [1O2]rx,sh are approximately 0.56 (0.26) and 0.72 (0.21) mM (or 3.6×107 and 4.6×107 singlet oxygen per cell to reduce the cell survival to 1/e) for Photofrin® and BPD, respectively, assuming that the fraction of generated singlet oxygen that interacts with the cell is 1. While the values for the photochemical parameters (ξ, σ, g, β) used for BPD were preliminary and may need further refinement, there is reasonable confidence for the values of the singlet oxygen threshold doses. DISCUSSION In comparison, the [1O2]rx,sh value derived from in-vivo mouse study was reported to be 0.4 mM for mTHPC-PDT. However, the singlet oxygen required per cell is reported to be 9×108 per cell per 1/e fractional kill in an in-vitro mTHPC-PDT study on a rat prostate cancer cell line (MLL cells) and is reported to be 7.9 mM for a multicell in-vitro EMT6/Ro spheroid model for mTHPC-PDT. A theoretical analysis is provided to relate the number of in-vitro singlet oxygen required per cell to reach cell killing of 1/e to in-vivo singlet oxygen threshold dose (in mM). The sensitivity of threshold singlet oxygen dose for our experiment is examined. The possible influence of vascular vs. apoptotic cell killing mechanisms on the singlet oxygen threshold dose is discussed by comparing [1O2]rx,sh for BPD with 3 hr and 15 min drug-light-intervals, with the later being known to have a dominantly vascular effect. CONCLUSIONS The experimental results of threshold singlet oxygen concentration in an in-vivo RIF tumor model for Photofrin®, BPD, and mTHPC are about 20 times smaller than those observed in vitro. These results are consistent with knowledge that factors other than singlet oxygen-mediated tumor cell killing can contribute to PDT damage in-vivo.
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Affiliation(s)
| | - Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, TRC 4W, 3400 Civic Center Blvd, Philadelphia, Pennsylvania 19104, United States
| | - Xing Liang
- Department of Radiation Oncology, University of Pennsylvania, TRC 4W, 3400 Civic Center Blvd, Philadelphia, Pennsylvania 19104, United States
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, TRC 4W, 3400 Civic Center Blvd, Philadelphia, Pennsylvania 19104, United States
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, TRC 4W, 3400 Civic Center Blvd, Philadelphia, Pennsylvania 19104, United States
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Zhu TC, Liu B, Kim MM, McMillan D, Liang X, Finlay JC, Busch TM. Comparison of singlet oxygen threshold dose for PDT. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2014; 8931. [PMID: 25999651 DOI: 10.1117/12.2039719] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Macroscopic modeling of singlet oxygen (1O2) is of particular interest because it is the major cytotoxic agent causing biological effects for type II photosensitizers during PDT. We have developed a macroscopic model to calculate reacted singlet oxygen concentration ([1O2]rx for PDT. An in-vivo RIF tumor mouse model is used to correlate the necrosis depth to the calculation based on explicit PDT dosimetry of light fluence distribution, tissue optical properties, and photosensitizer concentrations. Inputs to the model include 4 photosensitizer specific photochemical parameters along with the apparent singlet oxygen threshold concentration. Photosensitizer specific model parameters are determined for several type II photosensitizers (Photofrin, BPD, and HPPH). The singlet oxygen threshold concentration is approximately 0.41 - 0.56 mM for all three photosensitizers studied, assuming that the fraction of singlet oxygen generated that interacts with the cell is (f = 1). In comparison, value derived from other in-vivo mice studies is 0.4 mM for mTHPC. However, the singlet oxygen threshold doses were reported to be 7.9 and 12.1 mM for a multicell in-vitro EMT6/Ro spheroid model for mTHPC and Photofrin PDT, respectively. The sensitivity of threshold singlet oxygen dose for our experiment is examined. The possible influence of vascular vs. apoptotic cell killing mechanism on the singlet oxygen threshold dose is discussed using the BPD with different drug-light intervals 3 hrs vs. 15 min. The observed discrepancies between different experiments warrant further investigation to explain the cause of the difference.
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Affiliation(s)
- Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Baochang Liu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Dayton McMillan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Xing Liang
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
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Mallidi S, Anbil S, Lee S, Manstein D, Elrington S, Kositratna G, Schoenfeld D, Pogue B, Davis SJ, Hasan T. Photosensitizer fluorescence and singlet oxygen luminescence as dosimetric predictors of topical 5-aminolevulinic acid photodynamic therapy induced clinical erythema. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:028001. [PMID: 24503639 PMCID: PMC3915169 DOI: 10.1117/1.jbo.19.2.028001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 05/19/2023]
Abstract
The need for patient-specific photodynamic therapy (PDT) in dermatologic and oncologic applications has triggered several studies that explore the utility of surrogate parameters as predictive reporters of treatment outcome. Although photosensitizer (PS) fluorescence, a widely used parameter, can be viewed as emission from several fluorescent states of the PS (e.g., minimally aggregated and monomeric), we suggest that singlet oxygen luminescence (SOL) indicates only the active PS component responsible for the PDT. Here, the ability of discrete PS fluorescence-based metrics (absolute and percent PS photobleaching and PS re-accumulation post-PDT) to predict the clinical phototoxic response (erythema) resulting from 5-aminolevulinic acid PDT was compared with discrete SOL (DSOL)-based metrics (DSOL counts pre-PDT and change in DSOL counts pre/post-PDT) in healthy human skin. Receiver operating characteristic curve (ROC) analyses demonstrated that absolute fluorescence photobleaching metric (AFPM) exhibited the highest area under the curve (AUC) of all tested parameters, including DSOL based metrics. The combination of dose-metrics did not yield better AUC than AFPM alone. Although sophisticated real-time SOL measurements may improve the clinical utility of SOL-based dosimetry, discrete PS fluorescence-based metrics are easy to implement, and our results suggest that AFPM may sufficiently predict the PDT outcomes and identify treatment nonresponders with high specificity in clinical contexts.
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Affiliation(s)
- Srivalleesha Mallidi
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Sriram Anbil
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Seonkyung Lee
- Physical Sciences Inc., Andover, Massachusetts 01810
| | - Dieter Manstein
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts 02114
| | - Stefan Elrington
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
| | - Garuna Kositratna
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts 02114
| | - David Schoenfeld
- Massachusetts General Hospital, Biostatistics Department, Boston, Massachusetts 02114
| | - Brian Pogue
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755
| | | | - Tayyaba Hasan
- Massachusetts General Hospital, Wellman Center for Photomedicine, Boston, Massachusetts 02114
- Address all correspondence to: Tayyaba Hasan, E-mail:
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Dimofte A, Finlay JC, Liang X, Zhu TC. Determination of optical properties in heterogeneous turbid media using a cylindrical diffusing fiber. Phys Med Biol 2012; 57:6025-46. [PMID: 22968172 DOI: 10.1088/0031-9155/57/19/6025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
For interstitial photodynamic therapy (PDT), cylindrical diffusing fibers (CDFs) are often used to deliver light. This study examines the feasibility and accuracy of using CDFs to characterize the absorption (μ(a)) and reduced scattering (μ'(s)) coefficients of heterogeneous turbid media. Measurements were performed in tissue-simulating phantoms with μ(a) between 0.1 and 1 cm(-1) and μ'(s) between 3 and 10 cm(-1) with CDFs 2 to 4 cm in length. Optical properties were determined by fitting the measured light fluence rate profiles at a fixed distance from the CDF axis using a heterogeneous kernel model in which the cylindrical diffusing fiber is treated as a series of point sources. The resulting optical properties were compared with independent measurement using a point source method. In a homogenous medium, we are able to determine the absorption coefficient μ(a) using a value of μ'(s) determined a priori (uniform fit) or μ'(s) obtained by fitting (variable fit) with standard (maximum) deviations of 6% (18%) and 18% (44%), respectively. However, the CDF method is found to be insensitive to variations in μ'(s), thus requiring a complementary method such as using a point source for determination of μ'(s). The error for determining μ(a) decreases in very heterogeneous turbid media because of the local absorption extremes. The data acquisition time for obtaining the one-dimensional optical properties distribution is less than 8 s. This method can result in dramatically improved accuracy of light fluence rate calculation for CDFs for prostate PDT in vivo when the same model and geometry is used for forward calculations using the extrapolated tissue optical properties.
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Affiliation(s)
- Andreea Dimofte
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA
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Senge MO, Brandt JC. Temoporfin (Foscan®, 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)--a second-generation photosensitizer. Photochem Photobiol 2011; 87:1240-96. [PMID: 21848905 DOI: 10.1111/j.1751-1097.2011.00986.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review traces the development and study of the second-generation photosensitizer 5,10,15,20-tetra(m-hydroxyphenyl)chlorin through to its acceptance and clinical use in modern photodynamic (cancer) therapy. The literature has been covered up to early 2011.
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Affiliation(s)
- Mathias O Senge
- Medicinal Chemistry, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland.
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Zhu TC, Altschuler MD, Hu Y, Wang K, Finlay JC, Dimofte A, Cengel K, Hahn SM. A heterogeneous optimization algorithm for reacted singlet oxygen for interstitial PDT. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2010; 7551:75510E. [PMID: 25995533 PMCID: PMC4435729 DOI: 10.1117/12.842968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Singlet oxygen (1O2) is the major cytotoxic agent for type II photodynamic therapy (PDT). The production of 1O2 involves the complex reactions among light, oxygen molecule, and photosensitizer. From universal macroscopic kinetic equations which describe the photochemical processes of PDT, the reacted 1O2 concentration, [1O2]rx, with cell target can be expressed in a form related to time integration of the product of 1O2 quantum yield and the PDT dose rate. The object of this study is to develop optimization procedures that account for the optical heterogeneity of the patient prostate, the tissue photosensitizer concentrations, and tissue oxygenation, thereby enable delivery of uniform reacted singlet oxygen to the gland. We use the heterogeneous optical properties measured for a patient prostate to calculate a light fluence kernel. Several methods are used to optimize the positions and intensities of CDFs. The Cimmino feasibility algorithm, which is fast, linear, and always converges reliably, is applied as a search tool to optimize the weights of the light sources at each step of the iterative selection. Maximum and minimum dose limits chosen for sample points in the prostate constrain the solution for the intensities of the linear light sources. The study shows that optimization of individual light source positions and intensities is feasible for the heterogeneous prostate during PDT. To study how different photosensitizer distributions as well as tissue oxygenation in the prostate affect optimization, comparisons of light fluence rate were made with measured distribution of photosensitizer in prostate under different tissue oxygenation conditions.
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Affiliation(s)
- Timothy C. Zhu
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Martin D. Altschuler
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Yida Hu
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Ken Wang
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Jarod C. Finlay
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Andreea Dimofte
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Keith Cengel
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Stephen M. Hahn
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
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Altschuler MD, Zhu TC, Hu Y, Finlay JC, Dimofte A, Wang K, Li J, Cengel K, Malkowicz SB, Hahn SM. A heterogeneous algorithm for PDT dose optimization for prostate. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2009; 7164:71640B. [PMID: 25914793 DOI: 10.1117/12.809897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The object of this study is to develop optimization procedures that account for both the optical heterogeneity as well as photosensitizer (PS) drug distribution of the patient prostate and thereby enable delivery of uniform photodynamic dose to that gland. We use the heterogeneous optical properties measured for a patient prostate to calculate a light fluence kernel (table). PS distribution is then multiplied with the light fluence kernel to form the PDT dose kernel. The Cimmino feasibility algorithm, which is fast, linear, and always converges reliably, is applied as a search tool to choose the weights of the light sources to optimize PDT dose. Maximum and minimum PDT dose limits chosen for sample points in the prostate constrain the solution for the source strengths of the cylindrical diffuser fibers (CDF). We tested the Cimmino optimization procedures using the light fluence kernel generated for heterogeneous optical properties, and compared the optimized treatment plans with those obtained using homogeneous optical properties. To study how different photosensitizer distributions in the prostate affect optimization, comparisons of light fluence rate and PDT dose distributions were made with three distributions of photosensitizer: uniform, linear spatial distribution, and the measured PS distribution. The study shows that optimization of individual light source positions and intensities are feasible for the heterogeneous prostate during PDT.
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Affiliation(s)
- Martin D Altschuler
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Yida Hu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Andreea Dimofte
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Ken Wang
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Jun Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Keith Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S B Malkowicz
- Department of Urology, University of Pennsylvania, Philadelphia, PA
| | - Stephen M Hahn
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
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Ol’shevskaya VA, Nikitina RG, Savchenko AN, Malshakova MV, Vinogradov AM, Golovina GV, Belykh DV, Kutchin AV, Kaplan MA, Kalinin VN, Kuzmin VA, Shtil AA. Novel boronated chlorin e6-based photosensitizers: Synthesis, binding to albumin and antitumour efficacy. Bioorg Med Chem 2009; 17:1297-306. [DOI: 10.1016/j.bmc.2008.12.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 12/02/2008] [Accepted: 12/08/2008] [Indexed: 11/29/2022]
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Huang Z, Xu H, Meyers AD, Musani AI, Wang L, Tagg R, Barqawi AB, Chen YK. Photodynamic therapy for treatment of solid tumors--potential and technical challenges. Technol Cancer Res Treat 2008; 7:309-20. [PMID: 18642969 DOI: 10.1177/153303460800700405] [Citation(s) in RCA: 222] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Photodynamic therapy (PDT) involves the administration of photosensitizer followed by local illumination with visible light of specific wavelength(s). In the presence of oxygen molecules, the light illumination of photosensitizer can lead to a series of photochemical reactions and consequently the generation of cytotoxic species. The quantity and location of PDT-induced cytotoxic species determine the nature and consequence of PDT. Much progress has been seen in both basic research and clinical application in recent years. Although the majority of approved PDT clinical protocols have primarily been used for the treatment of superficial lesions of both malignant and non-malignant diseases, interstitial PDT for the ablation of deep-seated solid tumors are now being investigated worldwide. The complexity of the geometry and non-homogeneity of solid tumor pose a great challenge on the implementation of minimally invasive interstitial PDT and the estimation of PDT dosimetry. This review will discuss the recent progress and technical challenges of various forms of interstitial PDT for the treatment of parenchymal and/or stromal tissues of solid tumors.
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Affiliation(s)
- Zheng Huang
- University of Colorado Denver, Aurora Campus, CO, USA.
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Abstract
Photodynamic therapy (PDT) is an emerging treatment modality that employs the photochemical interaction of three components: light, photosensitizer, and oxygen. Tremendous progress has been made in the last 2 decades in new technical development of all components as well as understanding of the biophysical mechanism of PDT. The authors will review the current state of art in PDT research, with an emphasis in PDT physics. They foresee a merge of current separate areas of research in light production and delivery, PDT dosimetry, multimodality imaging, new photosensitizer development, and PDT biology into interdisciplinary combination of two to three areas. Ultimately, they strongly believe that all these categories of research will be linked to develop an integrated model for real-time dosimetry and treatment planning based on biological response.
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Affiliation(s)
- Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Patel H, Mick R, Finlay J, Zhu TC, Rickter E, Cengel KA, Malkowicz SB, Hahn SM, Busch TM. Motexafin lutetium-photodynamic therapy of prostate cancer: short- and long-term effects on prostate-specific antigen. Clin Cancer Res 2008; 14:4869-76. [PMID: 18676760 DOI: 10.1158/1078-0432.ccr-08-0317] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The time course of serum prostate-specific antigen (PSA) response to photodynamic therapy (PDT) of prostate cancer was measured. EXPERIMENTAL DESIGN Seventeen patients were treated in a phase I trial of motexafin lutetium-PDT. PDT dose was calculated in each patient as the product of the ex vivo measured pre-PDT photosensitizer level and the in situ measured light dose. Serum PSA level was measured within 2 months before PDT (baseline), and at day 1; weeks 1 to 3; months 1, 2, and 3; months 4 to 6; and months 7 to 11 after PDT. RESULTS At 24 hours after PDT, serum PSA increased by 98% +/- 36% (mean +/- SE) relative to baseline levels (P = 0.007). When patients were dichotomized based on median PDT dose, those who received high PDT dose showed a 119% +/- 52% increase in PSA compared with a 54% +/- 27% increase in patients treated at low PDT dose. Patients treated with high versus low PDT dose showed a median biochemical delay of 82 versus 43 days (P = 0.024), with biochemical delay defined as the length of time between PDT and a nonreversible increase in PSA to a value greater than or equal to baseline. CONCLUSIONS Results show PDT to induce large, transient increases in serum PSA levels. Patients who experienced high PDT dose showed greater short-term increase in PSA and a significantly more durable PSA response (biochemical delay). These data strongly promote the need for individualized delivery of PDT dose and assessment of treatment effect in PDT of prostate cancer. Information gained from such patient-specific measurements could facilitate the introduction of multiple PDT sessions in patients who would benefit.
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Affiliation(s)
- Hiral Patel
- Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6072, USA
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Trachtenberg J, Weersink RA, Davidson SRH, Haider MA, Bogaards A, Gertner MR, Evans A, Scherz A, Savard J, Chin JL, Wilson BC, Elhilali M. Vascular-targeted photodynamic therapy (padoporfin, WST09) for recurrent prostate cancer after failure of external beam radiotherapy: a study of escalating light doses. BJU Int 2008; 102:556-62. [PMID: 18494829 DOI: 10.1111/j.1464-410x.2008.07753.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report on the efficacy of TOOKAD (WST 09; NegmaLerads, Magny-Les-Hameaux, France) vascular-targeted photodynamic therapy (VTP) as a method of whole-prostate ablation in patients with recurrent localized prostate cancer after the failure of external beam radiotherapy (EBRT). PATIENTS AND METHODS Patients received a fixed photosensitizer dose of 2 mg/kg and patient-specific light doses as determined by computer-aided treatment planning. Up to six cylindrical light-diffusing delivery fibres were placed transperineally in the prostate under ultrasonographic guidance. The treatment response was assessed by measuring serum prostate-specific antigen (PSA) levels, lesion formation (avascular areas of tissue) measured on 7-day gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) and a 6-month biopsy. RESULTS Treatment of the whole prostate was possible with minimal effects on surrounding organs. An increased light dose improved the tissue response, with MRI-detectable avascular lesions, encompassing up to 80% of the prostate in some patients. A complete response, as determined by the 6-month biopsy, required that patients received light doses of at least 23 J/cm(2) in 90% of the prostate volume (D(90) > 23 J/cm(2)). Of the 13 patients who received at least this light dose, eight were biopsy-negative at 6 months. In this group of eight patients, PSA levels decreased and did so to negligible levels for those patients with a baseline PSA level of <5 ng/mL. Side-effects were modest and self-limited in most patients; there were recto-urethral fistulae in two patients, one of which closed spontaneously. CONCLUSIONS TOOKAD-VTP can produce large avascular regions in the irradiated prostate, and result in a complete negative-biopsy response at high light doses. A response rate of more than half for those patients receiving the highest light doses shows the clinical potential of TOOKAD-VTP to manage recurrence of prostatic carcinoma after EBRT.
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Affiliation(s)
- John Trachtenberg
- Surgical Oncology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Canada.
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Li J, Zhu TC, Zhou X, Andreea D, Finlay JC. Integrated light dosimetry system for prostate photodynamic therapy. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2008; 6845:68450Q. [PMID: 26113761 PMCID: PMC4477956 DOI: 10.1117/12.763806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A light dosimetry system is developed for prostate PDT, which integrates four main components: a light fluence rate calculation engine, an optimization tool for treatment planning, a light delivery system, and an in vivo light fluence rate measurement system. Three-dimensional light fluence rate distribution in a prostate is calculated using a kernel algorithm, which takes into account of heterogeneous optical properties. A Cimmino optimization algorithm is used to optimize the parameters of the cylindrical diffusing fibers (CDFs) to generate uniform PDT dose (or light fluence rate under uniform drug distribution) to cover the heterogeneous prostate. The light delivery system is composed of a 12-channel beamsplitter and the intensities of each channel (i.e., source) are controlled individually by programmable motorized attenuators. Our tests show that the light fluence rate calculation is fast and the accuracy is close to that of a finite-element method model, and the approach that uses the treatment CDFs to determine optical properties, improves the accuracy of light fluence rate prediction. The light delivery system allows real time control of the light source intensities for both PDT dosimetry and PDT light delivery. Integrating the fast light fluence rate calculation, optimization, instant source intensity adjustment, and in vivo light fluence rate measurement, the dosimetry system is suitable for prostate PDT.
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Affiliation(s)
- Jun Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Xiaodong Zhou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Dimofte Andreea
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
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Zhu TC, Finlay JC, Zhou X, Li J. Macroscopic Modeling of the singlet oxygen production during PDT. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2007; 6427:642708. [PMID: 25983366 DOI: 10.1117/12.701387] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Photodynamic therapy (PDT) dose, D, is defined as the absorbed dose by the photosensitizer during photodynamic therapy. It is proportional to the product of photosensitizer concentration and the light fluence. This quantity can be directly characterized during PDT and is considered to be predictive of photodynamic efficacy under ample oxygen supply. For type-II photodynamic interaction, the cell killing is caused by the reaction of cellular acceptors with singlet oxygen. The production of singlet oxygen can be expressed as ηD, where η is the singlet oxygen quantum yield and is a constant under ample oxygen supply. For most PDT, it is desirable to also take into account the effect of tissue oxygenation. We have modeled the coupled kinetics equation of the concentrations of the singlet oxygen, the photosensitizers in ground and triplet states, the oxygen, and tissue acceptors along with the diffusion equation governing the light transport in turbid medium. We have shown that it is possible to express η as a function of local oxygen concentration during PDT and this expression is a good approximation to predict the production of singlet oxygen during PDT. Theoretical estimation of the correlation between the tissue oxygen concentration and hemoglobin concentration, oxygen saturation, and blood flow is presented.
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Affiliation(s)
- Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Xiaodong Zhou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Jun Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
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Li J, Zhu TC. Modeling light fluence rate distribution in optically heterogeneous prostate photodynamic therapy using a kernel method. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2007; 6427. [PMID: 26113759 DOI: 10.1117/12.702798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
To accurately calculate light fluence rate distribution for light dosimetry in prostate photodynamic therapy (PDT), heterogeneity of optical properties has to be taken into account. Previous study has shown that a finite-element method (FEM) can be an efficient tool to deal with the optical heterogeneity. However, the calculation speed of the FEM is not suitable for real time treatment planning. In this paper, two kernel models are developed. Because the kernels are based on analytic solutions of the diffusion equation, calculations are much faster. We derived our extensions of kernel from homogeneous medium to heterogeneous medium assuming spherically symmetrical heterogeneity of optical properties. The kernel models are first developed for a point source and then extended for a linear source, which is considered a summation of point sources uniformly spaced along a line. The kernel models are compared with the FEM calculation. In application of the two kernel models to a heterogeneous prostate PDT case, both kernel models give improved light fluence rate results compared with those derived assuming homogeneous medium. In addition, kernel model 2 predicts reasonable light fluence rates and is deemed suitable for treatment planning.
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Affiliation(s)
- Jun Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104
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