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Kim HI, Wilson BC. Photodynamic Diagnosis and Therapy for Peritoneal Carcinomatosis from Gastrointestinal Cancers: Status, Opportunities, and Challenges. J Gastric Cancer 2020; 20:355-375. [PMID: 33425438 PMCID: PMC7781745 DOI: 10.5230/jgc.2020.20.e39] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
Selective accumulation of a photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and therapy. The limited depth of the therapeutic effect is a positive characteristic when treating surface malignancies, such as peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of aminolevulinic acid- protoporphyrin IX-guided fluorescence imaging detects cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of photosensitizers have been examined for photodynamic therapy (PDT), and treatment protocols are heterogeneous in terms of photosensitizer type and dose, photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that PDT has favorable effects in peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and capillary leak syndrome, need to be reduced. In the long term, PDD and PDT are likely to be successful therapeutic options for patients with peritoneal carcinomatosis, with several options to optimize the photosensitizer and light delivery parameters to improve safety and efficacy.
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Affiliation(s)
- Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Gastric Cancer Center, Yonsei Cancer Center, Seoul, Korea
- Open NBI Convergence Technology Research Laboratory, Severance Hospital, Seoul, Korea
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Brian C. Wilson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Ihara D, Hazama H, Nishimura T, Morita Y, Awazu K. Fluorescence detection of deep intramucosal cancer excited by green light for photodynamic diagnosis using protoporphyrin IX induced by 5-aminolevulinic acid: an ex vivo study. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-13. [PMID: 32129029 PMCID: PMC7053433 DOI: 10.1117/1.jbo.25.6.063809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/18/2020] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE The diagnostic depth of photodynamic diagnosis (PDD) for gastric cancer with protoporphyrin IX (PpIX) is limited, which leads to missing intramucosal cancers in screening and surgery. AIM The reason is that the excitation light, whose wavelength is determined by the highest absorption peak of PpIX (∼405 nm), is strongly attenuated by mucosal tissues. We investigated an excitation wavelength that can extend the diagnostic depth of PpIX fluorescence at the mucosal subsurface. APPROACH By calculating the depth-dependent intensity of the excitation light in porcine gastric mucosa for each wavelength, relationships among the wavelength, fluorophore depth, and fluorescence intensity were assessed and fluorescence images of PpIX pellets located at different fluorophore depths were compared experimentally by changing the excitation wavelength. RESULTS The numerical calculation showed that a 505-nm excitation light provided the highest fluorescence intensities at a fluorophore depth deeper than 1.1 mm. In the fluorescence observation, the fluorescence intensities at fluorophore depths of 0 and 1.0 mm at 405 nm were 5.4 × 103 and 1.0 × 103 arb. units, whereas those at 505 nm were 5.3 × 101 and 1.9 × 102 arb. units, respectively. CONCLUSION The experimental results suggest that the diagnosis depth of PDD with PpIX for intramucosal cancer can be extended by 505-nm excitation light.
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Affiliation(s)
- Daisuke Ihara
- Osaka University, Graduate School of Engineering, Suita, Japan
- Address all correspondence to Daisuke Ihara, E-mail: ; Takahiro Nishimura, E-mail:
| | - Hisanao Hazama
- Osaka University, Graduate School of Engineering, Suita, Japan
| | - Takahiro Nishimura
- Osaka University, Graduate School of Engineering, Suita, Japan
- Address all correspondence to Daisuke Ihara, E-mail: ; Takahiro Nishimura, E-mail:
| | - Yoshinori Morita
- Kobe University Graduate School of Medicine, Department of Gastroenterology, Kobe, Japan
- Kobe University, International Clinical Cancer Research Center, Department of Gastroenterology, Kobe, Japan
| | - Kunio Awazu
- Osaka University, Graduate School of Engineering, Suita, Japan
- Osaka University, Graduate School of Frontier Biosciences, Suita, Japan
- Osaka University, Global Center for Medical Engineering and Informatics, Suita, Japan
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Haj-Hosseini N, Richter JCO, Milos P, Hallbeck M, Wårdell K. 5-ALA fluorescence and laser Doppler flowmetry for guidance in a stereotactic brain tumor biopsy. BIOMEDICAL OPTICS EXPRESS 2018; 9:2284-2296. [PMID: 29760987 PMCID: PMC5946788 DOI: 10.1364/boe.9.002284] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 05/21/2023]
Abstract
A fiber optic probe was developed for guidance during stereotactic brain biopsy procedures to target tumor tissue and reduce the risk of hemorrhage. The probe was connected to a setup for the measurement of 5-aminolevulinic acid (5-ALA) induced fluorescence and microvascular blood flow. Along three stereotactic trajectories, fluorescence (n = 109) and laser Doppler flowmetry (LDF) (n = 144) measurements were done in millimeter increments. The recorded signals were compared to histopathology and radiology images. The median ratio of protoporphyrin IX (PpIX) fluorescence and autofluorescence (AF) in the tumor was considerably higher than the marginal zone (17.3 vs 0.9). The blood flow showed two high spots (3%) in total. The proposed setup allows simultaneous and real-time detection of tumor tissue and microvascular blood flow for tracking the vessels.
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Affiliation(s)
| | - Johan C. O. Richter
- Department of Biomedical Engineering, Linköping University, Sweden
- Department of Neurosurgery, Linköping University Hospital, County Council Östergötland, Linköping, Sweden
| | - Peter Milos
- Department of Neurosurgery, Linköping University Hospital, County Council Östergötland, Linköping, Sweden
| | - Martin Hallbeck
- Department of Clinical Pathology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Sweden
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Black D, Hahn HK, Kikinis R, Wårdell K, Haj-Hosseini N. Auditory display for fluorescence-guided open brain tumor surgery. Int J Comput Assist Radiol Surg 2017; 13:25-35. [PMID: 28929305 DOI: 10.1007/s11548-017-1667-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/07/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Protoporphyrin (PpIX) fluorescence allows discrimination of tumor and normal brain tissue during neurosurgery. A handheld fluorescence (HHF) probe can be used for spectroscopic measurement of 5-ALA-induced PpIX to enable objective detection compared to visual evaluation of fluorescence. However, current technology requires that the surgeon either views the measured values on a screen or employs an assistant to verbally relay the values. An auditory feedback system was developed and evaluated for communicating measured fluorescence intensity values directly to the surgeon. METHODS The auditory display was programmed to map the values measured by the HHF probe to the playback of tones that represented three fluorescence intensity ranges and one error signal. Ten persons with no previous knowledge of the application took part in a laboratory evaluation. After a brief training period, participants performed measurements on a tray of 96 wells of liquid fluorescence phantom and verbally stated the perceived measurement values for each well. The latency and accuracy of the participants' verbal responses were recorded. The long-term memorization of sound function was evaluated in a second set of 10 participants 2-3 and 7-12 days after training. RESULTS The participants identified the played tone accurately for 98% of measurements after training. The median response time to verbally identify the played tones was 2 pulses. No correlation was found between the latency and accuracy of the responses, and no significant correlation with the musical proficiency of the participants was observed on the function responses. Responses for the memory test were 100% accurate. CONCLUSION The employed auditory display was shown to be intuitive, easy to learn and remember, fast to recognize, and accurate in providing users with measurements of fluorescence intensity or error signal. The results of this work establish a basis for implementing and further evaluating auditory displays in clinical scenarios involving fluorescence guidance and other areas for which categorized auditory display could be useful.
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Affiliation(s)
- David Black
- Medical Image Computing, University of Bremen, Bremen, Germany.
- Jacobs University, Bremen, Germany.
- Fraunhofer MEVIS, Bremen, Germany.
| | - Horst K Hahn
- Jacobs University, Bremen, Germany
- Fraunhofer MEVIS, Bremen, Germany
| | - Ron Kikinis
- Medical Image Computing, University of Bremen, Bremen, Germany
- Fraunhofer MEVIS, Bremen, Germany
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Neda Haj-Hosseini
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
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Richter JCO, Haj-Hosseini N, Hallbeck M, Wårdell K. Combination of hand-held probe and microscopy for fluorescence guided surgery in the brain tumor marginal zone. Photodiagnosis Photodyn Ther 2017; 18:185-192. [PMID: 28223144 DOI: 10.1016/j.pdpdt.2017.01.188] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/23/2016] [Accepted: 01/03/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Visualization of the tumor is crucial for differentiating malignant tissue from healthy brain during surgery, especially in the tumor marginal zone. The aim of the study was to introduce a fluorescence spectroscopy-based hand-held probe (HHF-probe) for tumor identification in combination with the fluorescence guided resection surgical microscope (FGR-microscope), and evaluate them in terms of diagnostic performance and practical aspects of fluorescence detection. MATERIAL AND METHODS Eighteen operations were performed on 16 patients with suspected high-grade glioma. The HHF-probe and the FGR-microscope were used for detection of protoporphyrin (PpIX) fluorescence induced by 5-aminolevulinic acid (5-ALA) and evaluated against histopathological analysis and visual grading done through the FGR-microscope by the surgeon. A ratio of PpIX fluorescence intensity to the autofluorescence intensity (fluorescence ratio) was used to quantify the spectra detected by the probe. RESULTS Fluorescence ratio medians (range 0 - 40) measured by the probe were related to the intensity of the fluorescence in the FGR-microscope, categorized as "none" (0.3, n=131), "weak" (1.6, n=34) and "strong" (5.4, n=28). Of 131 "none" points in the FGR-microscope, 88 (67%) exhibited fluorescence with the HHF-probe. For the tumor marginal zone, the area under the receiver operator characteristics (ROC) curve was 0.49 for the FGR-microscope and 0.65 for the HHF-probe. CONCLUSIONS The probe was integrated in the established routine of tumor resection using the FGR-microscope. The HHF-probe was superior to the FGR-microscope in sensitivity; it detected tumor remnants after debulking under the FGR-microscope. The combination of the HHF-probe and the FGR-microscope was beneficial especially in the tumor marginal zone.
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Affiliation(s)
- Johan C O Richter
- Department of Biomedical Engineering, Linköping University, Sweden; Department of Neurosurgery Linköping University Hospital, Region Östergötland, Linköping, Sweden.
| | | | - Martin Hallbeck
- Department of Clinical Pathology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Karin Wårdell
- Department of Biomedical Engineering, Linköping University, Sweden
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Hillemanns P, Wimberger P, Reif J, Stepp H, Klapdor R. Photodynamic diagnosis with 5-aminolevulinic acid for intraoperative detection of peritoneal metastases of ovarian cancer: A feasibility and dose finding study. Lasers Surg Med 2016; 49:169-176. [PMID: 27859395 DOI: 10.1002/lsm.22613] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 01/26/2023]
Abstract
OBJECTIVE With a prospective feasibility study, we aimed to analyse the effect of different time points for application and dosage of preoperative oral 5-aminolevulinic acid administration for photodynamic diagnosis of peritoneal metastases in ovarian cancer patients. MATERIALS AND METHODS In this prospective cohort study patients were randomly divided into three different groups. 5-Aminolevulinic acid was orally administered 3-14 hours before surgery using a dosage of 1 mg/kg, 4-9 hours using 10 mg/kg, and 9-16 hours using 10 mg/kg, respectively. Fluorescence was recorded intraoperatively using endoscopic equipment. The number and localization, of fluorescing nodules were documented. To analyze sensitivity and specificity samples from fluorescent and non-fluorescent tissues were evaluated histologically. Plasma protoporphyrin concentrations as well as any adverse events were assessed perioperatively. RESULTS In total, 26 patients suspected for ovarian cancer underwent intraoperative photodynamic diagnosis with 5-aminolevulinic acid. Most of them suffered from advanced cancer, 72% from FIGO-Stage IIIc. No severe adverse events were observed. Orally applied 5-aminolevulinic acid with a dosage of 1 mg/kg revealed no detectable fluorescence. However, at a dosage of 10 mg/kg fluorescence of metastatic tissue was significantly stronger than of non-affected tissue. If administered 4-9 hours preoperatively best detection rates for peritoneal metastases were obtained resulting in a sensitivity of 75% and a specificity of 100%. CONCLUSIONS Photodynamic diagnosis with 5-aminolevulinic acid leads to safe and specific fluorescence detection of peritoneal metastases. 5-Aminolevulinic acid should be used at a dosage of at least 10 mg/kg 4-9 hours preoperatively. Further phase I-II studies are recommended. Lasers Surg. Med. 49:169-176, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Peter Hillemanns
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Jessica Reif
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Munich, Germany.,Department of Obstetrics and Gynecology, Klinikum Starnberg, Starnberg, Germany
| | - Herbert Stepp
- LIFE-Center, Hospital of the University of Munich, Munich, Germany
| | - Rüdiger Klapdor
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
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Low dose 5-aminolevulinic acid: Implications in spectroscopic measurements during brain tumor surgery. Photodiagnosis Photodyn Ther 2015; 12:209-14. [DOI: 10.1016/j.pdpdt.2015.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/14/2015] [Accepted: 03/18/2015] [Indexed: 11/17/2022]
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Almerie MQ, Gossedge G, Wright KE, Jayne DG. Photodynamic diagnosis for detection of peritoneal carcinomatosis. J Surg Res 2015; 195:175-87. [PMID: 25682189 DOI: 10.1016/j.jss.2015.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/11/2014] [Accepted: 01/08/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Peritoneal carcinomatosis is the dissemination of cancer in the peritoneal cavity secondary to abdominal or extra-abdominal malignancies. Accurate assessment of the disease's burden is a challenge because of the complexity of the peritoneal cavity and the small size of the metastatic nodules. Photodynamic diagnosis (PDD) is an emerging technology in tumor diagnosis. A photosensitizer is administered, which is preferentially taken up by cancer cells. The photosensitizer emits fluorescence when exposed to a light of a specific wavelength. This helps distinguish cancer from normal tissues. METHODS We systematically reviewed the evidence for using PDD in detecting peritoneal carcinomatosis in both animal and human literature. Both Medline and EMBASE databases were searched (November 2014). The titles and the abstracts of all retrieved citations were inspected, and the full articles of the relevant articles were obtained. RESULTS A total of 12 human and 18 animal studies were included. Clinical studies have shown PDD to be a safe modality with no significant adverse effects. It increases the detection of malignant peritoneal nodules by 21%-34% in comparison with white light alone. The sensitivity and specificity of PDD were reported at 83%-100% and 95%-100%, respectively. These findings were supported by multiple animal studies, which have shown an increase in the sensitivity of tumor detection when using PDD (72%-91%) in comparison with white light alone (39%). CONCLUSIONS PDD is a promising modality, which improves the detection of peritoneal carcinomatosis lesions. Further research, however, should investigate the impact of PDD on the patients' therapeutic management and final outcomes.
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Affiliation(s)
- Muhammad Qutayba Almerie
- Section of Translational Anaesthesia and Surgical Sciences, Leeds Institute of Biomedical & Clinical Sciences (LIBACS), St James's University Hospital, Leeds, United Kingdom.
| | - Gemma Gossedge
- Section of Translational Anaesthesia and Surgical Sciences, Leeds Institute of Biomedical & Clinical Sciences (LIBACS), St James's University Hospital, Leeds, United Kingdom
| | - Kathleen E Wright
- Section of Translational Anaesthesia and Surgical Sciences, Leeds Institute of Biomedical & Clinical Sciences (LIBACS), St James's University Hospital, Leeds, United Kingdom
| | - David G Jayne
- Section of Translational Anaesthesia and Surgical Sciences, Leeds Institute of Biomedical & Clinical Sciences (LIBACS), St James's University Hospital, Leeds, United Kingdom
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Baraghis E, Devor A, Fang Q, Srinivasan VJ, Wu W, Lesage F, Ayata C, Kasischke KA, Boas DA, Sakadzić S. Two-photon microscopy of cortical NADH fluorescence intensity changes: correcting contamination from the hemodynamic response. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:106003. [PMID: 22029350 PMCID: PMC3206923 DOI: 10.1117/1.3633339] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 07/20/2011] [Accepted: 08/12/2011] [Indexed: 05/21/2023]
Abstract
Quantification of nicotinamide adenine dinucleotide (NADH) changes during functional brain activation and pathological conditions provides critical insight into brain metabolism. Of the different imaging modalities, two-photon laser scanning microscopy (TPLSM) is becoming an important tool for cellular-resolution measurements of NADH changes associated with cellular metabolic changes. However, NADH fluorescence emission is strongly absorbed by hemoglobin. As a result, in vivo measurements are significantly affected by the hemodynamics associated with physiological and pathophysiological manipulations. We model NADH fluorescence excitation and emission in TPLSM imaging based on precise maps of cerebral microvasculature. The effects of hemoglobin optical absorption and optical scattering from red blood cells, changes in blood volume and hemoglobin oxygen saturation, vessel size, and location with respect to imaging location are explored. A simple technique for correcting the measured NADH fluorescence intensity changes is provided, with the utilization of a parallel measurement of a physiologically inert fluorophore. The model is applied to TPLSM measurements of NADH fluorescence intensity changes in rat somatosensory cortex during mild hypoxia and hyperoxia. The general approach of the correction algorithm can be extended to other TPLSM measurements, where changes in the optical properties of the tissue confound physiological measurements, such as the detection of calcium dynamics.
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Affiliation(s)
- Edward Baraghis
- Harvard Medical School, Massachusetts General Hospital, Department of Radiology, 149 13th Street, Charlestown, Massachusetts 02129, USA
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Naghavi N, Baygi MHM, Sazgarnia A. Determination of time-dependent protoporphyrin IX concentration for photodynamic therapy dosimetry in a mice colon tumor model using fluorescence spectroscopy. APPLIED SPECTROSCOPY 2010; 64:1350-1354. [PMID: 21144152 DOI: 10.1366/000370210793561682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Photodynamic therapy (PDT) is an effective treatment method for various types of invasive tumors. The efficiency of PDT treatment depends, to a great extent, on optimal dosimetry of light, the photosensitizer used, and on tissue oxygenation. Fluorescence spectroscopy can be employed for measurement of drug concentration in target tissue and can provide a basis for in vivo evaluation of treatment efficiency. We have developed an integrated system that can be used to determine photosensitizer concentration in vivo based on fluorescence measurements. In our study, we performed fluorescence measurements on colon tumors of Balb/c mice in which CT26 cells were injected subcutaneously in the right flank. 5-Aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) was used as the photosensitizer. ALA was administered intraperitoneally at a dose of 200 mg/kg and PpIX fluorescence profiles were followed up to 34 h after ALA administration. Maximum fluorescence intensity was found 8 h after ALA administration. Also, we determined the relationship between PpIX concentration in colon tumor tissue of Balb/c mice and its fluorescence intensity at the peak of the spectrum (635 nm). This was used to determine the PpIX content in the target tissue as a function of time after ALA administration.
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Affiliation(s)
- Nadia Naghavi
- Department of Biomedical Engineering, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran
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Zeisser-Labouèbe M, Delie F, Gurny R, Lange N. Benefits of nanoencapsulation for the hypercin-mediated photodetection of ovarian micrometastases. Eur J Pharm Biopharm 2008; 71:207-13. [PMID: 18977296 DOI: 10.1016/j.ejpb.2008.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 09/29/2008] [Accepted: 10/02/2008] [Indexed: 11/28/2022]
Abstract
The high recurrence and lethality of ovarian cancer at advanced stages is problematic, especially due to the development of numerous micrometastases scattered throughout the abdominal cavity. Fluorescence photodetection (PD) used in combination with surgical resection of malignant tissues has been suggested to improve recovery. Based on promising in vivo results for the detection of bladder cancer, hypericin (Hy), a natural photosensitizer (PS), stands as a good candidate for the photodetection of ovarian cancer. However, due to its hydrophobicity, systemic administration of Hy is problematic. Polymeric nanoparticles (NPs) help to overcome these delivery and stability problems and enable intravenous administration of Hy. In this study, Hy-loaded NPs of polylactic acid were produced with the following properties: (i) mean size of 268 nm, (ii) negative zeta potential, (iii) low residual surfactant and (iv) drug loading of 3.7 % (w/w). The potential of hypericin-loaded nanoparticles for the fluorescence photodetection of ovarian metastases in Fischer 344 rats bearing ovarian tumours was compared to free drug. The selectivity of Hy administered with both formulations was assessed first by fluorescence endoscopy, and then quantified after tissue extraction. The results showed an improved selective accumulation of Hy in ovarian micrometastases when NPs were used.
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Affiliation(s)
- Magali Zeisser-Labouèbe
- Department of Pharmaceutics and Biopharmaceutics, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
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Aalders MCG, Van Der Vange N, Star WM, Sterenborg HJCM. A Mathematical Evaluation of Dose-dependent PpIX Fluorescence Kinetics In Vivo¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2001)0740311ameodd2.0.co2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dysart JS, Patterson MS, Farrell TJ, Singh G. Relationship Between mTHPC Fluorescence Photobleaching and Cell Viability During In Vitro Photodynamic Treatment of DP16 Cells¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2002)0750289rbmfpa2.0.co2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bradley RS, Thorniley MS. A review of attenuation correction techniques for tissue fluorescence. J R Soc Interface 2006; 3:1-13. [PMID: 16849213 PMCID: PMC1618480 DOI: 10.1098/rsif.2005.0066] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Fluorescence intensity measurements have the potential to facilitate the diagnoses of many pathological conditions. However, accurate interpretation of the measurements is complicated by the distorting effects of tissue scattering and absorption. Consequently, different techniques have been developed to attempt to compensate for these effects. This paper reviews currently available correction techniques with emphasis on clinical application and consideration given to the intrinsic accuracy and limitations of each technique.
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Affiliation(s)
- Robert S Bradley
- The University of Manchester School of Chemical Engineering and Analytical Science, The University of Manchester, M60 1QD, UK.
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Dysart JS, Patterson MS, Farrell TJ, Singh G. Relationship between mTHPC fluorescence photobleaching and cell viability during in vitro photodynamic treatment of DP16 cells. Photochem Photobiol 2002; 75:289-95. [PMID: 11950095 DOI: 10.1562/0031-8655(2002)075<0289:rbmfpa>2.0.co;2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An implicit dosimetric model has been proposed in which biological damage caused by photodynamic therapy (PDT) is monitored through the decrease in sensitizer fluorescence during treatment. To investigate this, in vitro experiments were performed in which DP16 cells were incubated in meta-tetra(hydroxyphenyl)chlorin (mTHPC) and then irradiated with 514 nm light. Photosensitizer concentration, fluence rate and oxygenation were independently controlled and monitored during the treatment. Fluorescence of mTHPC was continuously monitored via a charge-coupled device-coupled spectrometer during treatment and, at selected fluence levels, cell viability was determined using a trypan blue exclusion assay. The relationship of cell viability to normalized fluorescence was obtained for the different treatment conditions. The relationship was independent of cell medium oxygenation, treatment fluence rate and sensitizer incubation concentration except at a high mTHPC concentration (4 microg/mL). This relationship suggests that fluorescence bleaching may be used to predict mTHPC PDT damage in vitro.
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