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| 2. |
- Andersson-Engels, Stefan, et al.
(author)
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Integrated system for interstitial photodynamic therapy
- 2003
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In: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 5142, s. 42-49
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Conference paper (peer-reviewed)abstract
- A novel photodynamic therapy system based on interstitial illumination using multiple fibres is under development. The aim with this system is to enable treatment of large tumour volumes and also to utilise real-time measurements to allow on-line dosimetry. Important dosimetric parameters to measure are light fluence rate, sensitizer fluorescence intensity and local blood oxygenation. A construction which allows all functions to be readily performed with a single system is presented. We believe that interstitial PDT utilising this technique may be attractive in many clinical situations.
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| 3. |
- Andersson-Engels, Stefan, et al.
(author)
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Integrated system for interstitial photodynamic therapy
- 2002
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In: Advanced Optical Devices, Technologies, and Medical Applications. - : SPIE. - 0277-786X .- 1996-756X. ; 5123, s. 293-302
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Conference paper (peer-reviewed)abstract
- To develop PDT beyond treatment of thin superficial tumours, to also be an efficient treatment alternative for deeply located and/or thick tumours, a system based on interstitial illumination using multiple fibres has been developed. Conditions that could benefit from such a treatment modality are for instance malignant brain tumours and tumours in the oral cavity. In interstitial PDT one needs to use multiple fibres for light delivery in order to allow treatments of tumours larger than a few millimetres in diameter. Our system consists of a laser light source, a beam-splitting system dividing the light into three or six output fibres and a custom-made dosimetry programme. The concept is then to use these fibres not only for delivering the treatment light but also to measure parameters of interest for the treatment outcome. The fluence rate of the light emitted by each fibre is measured at the positions of the other fibre tips. From these results the light dose at all positions could be recalculated. Changes in optical properties as well as bleaching and concentration of the photosensitizer during the treatment could be monitored and compensated for in the dosimetry. Tumours have been treated both in experimental studies and in patients with thick superficial Basal Cell Carcinomas. Almost all treated skin lesions responded with complete response.
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| 4. |
- Brydegaard, Mikkel, et al.
(author)
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Complete parameterization of temporally and spectrally resolved laser induced fluorescence data with applications in bio-photonics
- 2015
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In: Chemometrics and Intelligent Laboratory Systems. - : Elsevier BV. - 0169-7439. ; 142, s. 95-106
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Journal article (peer-reviewed)abstract
- We present a set of spectrally and temporally resolved clinical fluorescence data-with two separate excitation wavelengths-that was recorded in vivo. We demonstrate that data in the spectral and temporal domains are in certain ways coupled and provide a method for integrated and effective parameterization of spectrally and temporally resolved fluorescence (i.e., time-resolved emission spectra). This parameterization is based on linear algebra, matrix formulation and system identification. We demonstrate how to empirically extract single exponentially decaying components and provide rectified emission spectra without prior knowledge. We investigate the potential for improved cancer diagnostics according to the reduced parameters along the various domains. In this case, in terms of cancer diagnostics, we were unable to identify any benefits of simultaneously measuring both the temporal and spectral properties of the observed fluorescence. However, we note that this may be explained by an important experimental bias present in many studies of optical cancer diagnostics, namely, that, in general, suspected lesions always differ visually from the neighboring healthy tissue. (C) 2015 Elsevier B.V. All rights reserved.
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| 5. |
- Enejder, Annika M K, et al.
(author)
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Blood perfusion studies on basal cell carcinomas in conjunction with photodynamic- and cryo therapy employing laser-Doppler imaging
- 2000
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 80:1, s. 19-23
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Journal article (peer-reviewed)abstract
- Superficial blood perfusion mas monitored using laser-Doppler perfusion imaging in connection with a phase LII clinical trial comparing photodynamic therapy, utilizing topically applied aminoleuvlinic acid, with cryotherapy of basal cell, carcinomas. A total of 526 images mere recorded before and immediately after the treatment and during the follow-up period. Before treatment, the lesions exhibited a blood perfusion 3+/-2 times that in normal tissue. Both treatment modalities induced an increased blood perfusion inside the lesions, which slowly approached normal values in conjunction with successful treatments. The blood perfusion in successfully treated lesions approached normal values 2 months after photodynamic therapy, and about 1 year after cryotherapy, The tissue perfusion in recurrent lesions did not decrease to normal values after the treatment, suggesting that the laser-Doppler perfusion imaging technique can be used to follow the healing process and discover possible persistent tumour growth.
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| 6. |
- Jensen, LK, et al.
(author)
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Optical coherence tomography in clinical examination of non-pigmented skin malignancies
- 2003
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In: OPTICAL COHERENCE TOMOGRAPHY AND COHERENCE TECHNIQUES. - : SPIE. - 0277-786X .- 1996-756X. - 0819450103 ; 5140, s. 160-160
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Conference paper (peer-reviewed)abstract
- Optical coherence tomography (OCT) images of basal cell carcinomas (BCCs) have been acquired using a compact handheld probe with an integrated video camera allowing the OCT images to be correlated to a skin surface image. In general the healthy tissue of the skin has an obvious stratified structure, whereas the cancerous tissue shows a more homogenous structure. Thus it was demonstrated that it is possible to distinguish BCCs from healthy tissue by means of OCT. Furthermore different histological types of BCC were identified. Comparison of OCT images taken prior to and immediately after photodynamic therapy clearly shows the tissue response to the treatment, and indicates local oedema in the treated area.
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| 7. |
- Johansson, Ann, et al.
(author)
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In vivo measurement of parameters of dosimetric importance during interstitial photodynamic therapy of thick skin tumors
- 2006
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In: Journal of Biomedical Optics. - : SPIE-Intl Soc Optical Eng. - 1083-3668. ; 11
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Journal article (peer-reviewed)abstract
- A system for interstitial photodynamic therapy is used in the treatment of thick skin tumors. The system allows simultaneous measurements of light fluence rate, sensitizer fluorescence, and tissue oxygen saturation by using the same fibers as for therapeutic light delivery. Results from ten tumor treatments using delta-aminolevulinic acid (ALA)-induced protoporphyrin IX show a significant, treatment-induced increase in tissue absorption at the therapeutic wavelength, and rapid sensitizer photobleaching. The changes in oxy- and deoxyhemoglobin content are monitored by means of near-infrared spectroscopy, revealing a varying tissue oxygenation and significant changes in blood volume during treatment. These changes are consistent with the temporal profiles of the light fluence rate at the therapeutic wavelength actually measured. We therefore propose the observed absorption increase to be due to treatment-induced deoxygenation in combination with changes in blood concentration within the treated volume. A higher rate of initial photobleaching is found to correlate with a less pronounced increase in tissue absorption. Based on the measured signals, we propose how real-time treatment supervision and feedback can be implemented. Simultaneous study of the fluence rate, sensitizer fluorescence, and local tissue oxygen saturation level may contribute to the understanding of the threshold dose for photodynamic therapy. (c) 2006 Society of Photo-Optical Instrumentation Engineers.
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| 8. |
- Johansson, Ann, et al.
(author)
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Influence of treatment-induced changes in tussue absorption on treatment volume during interstitial photodynamic therapy
- 2006
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In: Medical Laser Application. - : Elsevier BV. - 1615-1615. ; 21, s. 261-261
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Journal article (peer-reviewed)abstract
- Interstitial photodynamic therapy on thick skin lesions has been shown to induce changes in tissue light transmission as a direct consequence of variations in total blood volume and oxygen saturation. A finite element method was used in order to simulate the fluence rate distribution and total light dose throughout the target tissue for two cases. The first case constitutes a pre-treatment model where the tissue optical properties are assumed constant during the entire treatment. The second situation takes into account observed changes in tissue light transmission, small deviations in fiber insertion depth and a few cases of almost complete loss of source fiber output power possibly as a result of blood accumulation in front of the fiber tip. The pre- and post-treatment models from six clinical treatments are compared in terms of simulated treatment volumes. We conclude that real-time monitoring of the delivered fluence is necessary in order to ascertain a pre-determined light dose to the target tissue. Finally, we speculate on how to also include the sensitizer fluorescence level and tissue oxygenation in the real-time treatment feedback.
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| 9. |
- Johansson, Ann, et al.
(author)
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Interstitial photodynamic therapy for primary prostate cancer incorporating realtime treatment dosimetry
- 2007
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In: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422 .- 1042-4687. ; 6427, s. 4270-4270
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Conference paper (peer-reviewed)abstract
- Photodynamic therapy (PDT) for the treatment of prostate cancer has been demonstrated to be a safe treatment option capable of inducing tissue necrosis and decrease in prostate specific antigen (PSA). Research groups report on large variations in treatment response, possibly due to biological variations in tissue composition and shortterm response to the therapeutic irradiation. Within our group, an instrument for interstitial PDT on prostate tissue that incorporates realtime treatment feedback is being developed. The treatment protocol consists of two parts. The first part incorporates the pre-treatment plan with ultrasound investigations, providing the geometry for the prostate gland and surrounding risk organs, an iterative random-search algorithm to determine near-optimal fiber positions within the reconstructed geometry and a Block-Cimmino optimization algorithm for predicting individual fiber irradiation times. During the second part, the therapeutic light delivery is combined with measurements of the light transmission signals between the optical fibers, thus monitoring the tissue effective attenuation coefficient by means of spatially resolved spectroscopy. These data are then used as input for repeated runs of the Block-Cimmino optimization algorithm. Thus, the irradiation times for individual fibers are updated throughout the treatment in order to compensate for the influence of changes in tissue composition on the light distribution at the therapeutic wavelength.
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| 10. |
- Johansson, Ann, et al.
(author)
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System for integrated interstitial photodynamic therapy and dosimetric monitoring
- 2005
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In: Proceedings of the SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 5689:1, s. 130-140
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Conference paper (peer-reviewed)abstract
- Photodynamic therapy for the treatment of cancer relies on the presence of light, sensitizer and oxygen. By monitoring these three parameters during the treatment a better understanding and treatment control could possibly be achieved. Here we present data from in vivo treatments of solid skin tumors using an instrument for interstitial photodynamic therapy with integrated dosimetric monitoring. By using intra-tumoral ALA-administration and interstitial light delivery solid tumors are targeted. The same fibers are used for measuring the fluence rate at the treatment wavelength, the sensitizer fluorescence and the local blood oxygen saturation during the treatment. The data presented is based on 10 treatments in 8 patients with thick basal cell carcinomas. The fluence rate measurements at 635 nm indicate a major treatment induced absorption increase, leading to a limited light penetration at the treatment wavelength. This leads to a far from optimal treatment since the absorption increase prevents peripheral tumor regions from being fully treated. An interactive treatment has been implemented assisting the physician in delivering the correct light dose. The absorption increase can be compensated for by either prolonging the treatment time or increasing the output power of each individual treatment fiber. The other parameters of importance, i.e. the sensitizer fluorescence at 705 nm and the local blood oxygen saturation, are monitored in order to get an estimate of the amount of photobleaching and oxygen consumption. Based on the oxygen saturation signal, a fractionized irradiation can be introduced in order to allow for a re-oxygenation of the tissue
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