Blood flow dynamics after laser therapy of port wine stain birthmarks

Huang, Yu-Chih; Tran, Nadia; Ross, E. Victor; Shumaker, Peter R.; Nelson, J. Stuart; Kelly, Kristen M.; Choi, Bernard

doi:10.1117/12.811061

Cited by 12 publications

(19 citation statements)

References 15 publications

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“…Several optical instruments have been investigated as quantitative measures of PWS laser treatment efficacy. Methods such as optical Doppler tomography (ODT) 4, laser Doppler flowmetry imaging (LDFI) 5, and laser speckle imaging (LSI) measure tissue perfusion 6. Other methods such as reflectance spectroscopy 7 and cross‐polarized diffuse reflectance imaging 8 measure intrinsic absorption in tissue.…”

Section: Introductionmentioning

confidence: 99%

Spatial frequency domain imaging of port wine stain biochemical composition in response to laser therapy: A pilot study

et al. 2012

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Background and Objective Objective methods to assess port wine stain (PWS) response to laser treatment have been the subject of various research efforts for several years. Herein, we present a pilot study using a newly developed, light emitting diode (LED) based spatial frequency domain imaging (SFDI) device to record quantitatively biochemical compositional changes in PWS after laser therapy. Study Design/Patients and Methods A SFDI system was used to image before, and after, five PWS treatment sessions [n = 4 subjects (one subject was imaged before and after two consecutive laser treatments)]. SFDI derived wide-field optical properties (absorption and scattering) and tissue chromophore concentrations including oxy-hemoglobin (ctO2Hb), deoxy-hemoglobin (ctHHb), total hemoglobin (ctTHb), and tissue oxygen saturation (stO2) are presented for skin imaged prior to and immediately after laser treatment. The SFDI derived images were analyzed by comparing the above measurements in PWS to those of normal skin and tracking changes immediately after laser exposure. Results Elevated oxy-hemoglobin (>20%) and tissue oxygen saturation (>5%) were measured in all PWS lesions and compared to values for normal skin prior to treatment. Laser treatment resulted in an increase in deoxy-hemoglobin (>100%), decrease in tissue oxygen saturation (>10%), and reduced scattering (>15%) in all PWS lesions. One subject was followed before and after two consecutive laser treatments and the overall improvement in PWS lesion blanching was quantitatively assessed by measuring a 45% decrease in dermal blood volume. Conclusion SFDI is a rapid non-contact wide-field optical technique that shows potential as an imaging device that can be used to quantify biochemical compositional changes in PWS after laser therapy. Future work will investigate the potential of SFDI to provide intra-operative guidance for laser therapy of PWS lesions on an individual patient basis.

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Section: Introductionmentioning

confidence: 99%

Spatial frequency domain imaging of port wine stain biochemical composition in response to laser therapy: A pilot study

et al. 2012

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“…Thus, we focused specifically on developing and employing a method designed to assess blood flow changes associated with laser surgery. We previously studied the use of LSI to image subjects undergoing laser treatment of PWS birthmarks, with image collection performed before and approximately 40 minutes after treatment and identified the common presence of a heterogeneous blood‐flow pattern after treatment. Ren et al used LSI to measure blood flow of PWS and normal surrounding skin before Photodynamic Therapy (PDT) and at a follow‐up visit scheduled three to six months after PDT.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, with Doppler optical coherence tomography evaluation of PWS skin, Nelson et al acknowledge the potential of blood flow characterization as a means to monitor PWS skin during laser therapy and retreat if photocoagulation of targeted vessels has not occurred. To address the need for noninvasive blood flow characterization to provide surgical guidance to the treating clinician, we selected the method of Laser Speckle Imaging (LSI), which we have used in a number of preclinical and clinical studies involving monitoring of the microvascular response to targeted laser therapy. The purpose of this study was to determine the degree of correlation between intraoperative measurements of blood‐flow dynamics and the treatment response assessed several weeks post treatment.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative, real‐time monitoring of blood flow dynamics associated with laser surgery of port wine stain birthmarks

Yang

Guzman

et al. 2015

Lasers Surg Med

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Background and Objective Port-wine stain (PWS) birthmarks affect ~22 million people worldwide. After several treatment sessions, complete disappearance of the PWS occurs in only ~10% of treated patients. There is a need to develop a new strategy to improve the efficacy of each treatment session and the overall treatment outcome. The study objective was to determine how intraoperative measurements of blood flow correlate with treatment response assessed several weeks post treatment. Study Design/Materials and Methods We employed Laser Speckle Imaging (LSI) to measure intraoperative blood-flow dynamics. We collected data from 24 subjects undergoing laser therapy for facial PWS birthmarks. Photographs were taken before treatment and at a follow-up visit, and analyzed by two expert observers. Results Intraoperative LSI enables real-time monitoring of blood-flow dynamics in response to laser treatment and can inform clinicians on the need for focused re-treatment. The degree of PWS blanching achieved is positively correlated with the log-transformed acute blood-flow reduction (P =0.022). Conclusion LSI is a simple, intraoperative monitoring tool during laser therapy of PWS birthmarks. LSI provides a single value for blood flow that correlates well with the degree of blanching achieved with laser therapy. Lasers Surg. Med.

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“…The LSI instrument consisted of a laser source, a CCD camera, and a macro lens. It is similar to the instrument described in previous publications 13, 14. Briefly, a 12‐bit thermoelectrically cooled CCD camera (1,600 × 1,200 pixel resolution, Model 2000R, QImaging, Surrey, Canada) was used to image the raw speckle image remitted from the tooth.…”

Section: Methodsmentioning

confidence: 99%

“…For widespread clinical acceptance, this method ideally involves rapid data collection and does not require use of a dental splint. Based on our laboratory's prior experience with laser speckle imaging (LSI) to study blood‐flow dynamics in preclinical animal models 11, 12 and human subjects 13, 14, we investigated its efficacy in assessing fluid flow in an in vitro tooth model. We hypothesized that the existence of blood perfusion within the pulp can be determined with analysis of laser speckle patterns generated by transillumination of the tooth.…”

Section: Introductionmentioning

confidence: 99%

Assessment of pulpal vitality using laser speckle imaging

2011

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Background and Objective The pulpal chamber of each tooth contains the vasculature necessary to maintain a viable tooth. A critical need exists to develop an objective, repeatable method to assess pulpal viability. We hypothesized that the existence of blood perfusion within the pulp can be determined with analysis of laser speckle imaging (LSI) patterns generated by transillumination of the tooth. Study Design/Materials and Methods We used nine extracted human cuspids and incisors. A Tygon tube was inserted into a channel created within each tooth and Intralipid pumped through the tube in a controlled manner with a syringe infusion pump. We evaluated the feasibility of LSI for flow assessment using both transillumination and epiillumination imaging configurations. With the transillumination geometry, we also assessed the effect of the angle of incidence of the probe laser light on the speckle flow index (SFI) values extracted from the collected speckle images. Results Transillumination LSI, and not epiillumination LSI, enables differentiation between the absence and presence of perfusion in an in vitro tooth model. SFI values are insensitive to the relative angle of incidence of the laser light, over a wide range of angles. Conclusions Our preliminary in vitro data suggest that transillumination LSI is a promising method to identify the presence of blood flow in the pulpal chamber. Future in vivo evaluation is warranted.

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Blood flow dynamics after laser therapy of port wine stain birthmarks

Cited by 12 publications

References 15 publications

Spatial frequency domain imaging of port wine stain biochemical composition in response to laser therapy: A pilot study

Spatial frequency domain imaging of port wine stain biochemical composition in response to laser therapy: A pilot study

Intraoperative, real‐time monitoring of blood flow dynamics associated with laser surgery of port wine stain birthmarks

Assessment of pulpal vitality using laser speckle imaging

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