Clinical evaluation of a mobile, low-cost system for fluorescence guided photodynamic therapy of early oral cancer in India

Siddiqui, Shahid Ali; Siddiqui, Shaista; Hussain, Mushraf; Khan, Shakir; Liu, Hui; Akhtar, Kafil; Hasan, Shirin; Ahmed, Ibne; Mallidi, Srivalleesha; Khan, Amjad P.; Cuckov, Filip; Hopper, Colin; Bown, Stephen G.; Hasan, Tayyaba

doi:10.1016/j.pdpdt.2022.102843

Cited by 25 publications

(9 citation statements)

References 33 publications

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“…In post-PDT images, the PpIX bleached area confirmed the area of therapeutic (∼635 nm) light delivery. The histopathological findings from PDT-treated tissues confirmed that the necrosis had reached a depth of 5 mm, which is reasonably consistent with expectations for light penetration at this wavelength 23 , 60 , 61 . The 14 treated lesions showed a post-ALA R-value range of 1.65 to 3.11, whereas only one lesion with a low R-value of 1.75 showed post-PDT recurrence during follow-up (see Table S1 in the Supplementary Material).…”

Section: Discussionsupporting

confidence: 87%

Clinical assessment of a low-cost, hand-held, smartphone-attached intraoral imaging probe for 5-aminolevulinic acid photodynamic therapy monitoring and guidance

et al. 2023

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India has one of the highest rates of oral squamous cell carcinoma (OSCC) in the world, with an incidence of 15 per 100,000 and more than 70,000 deaths per year. The problem is exacerbated by a lack of medical infrastructure and routine screening, especially in rural areas. New technologies for oral cancer detection and timely treatment at the point of care are urgently needed.Aim: Our study aimed to use a hand-held smartphone-coupled intraoral imaging device, previously investigated for autofluorescence (auto-FL) diagnostics adapted here for treatment guidance and monitoring photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) fluorescence (FL).Approach: A total of 12 patients with 14 buccal mucosal lesions having moderately/ well-differentiated micro-invasive OSCC lesions (<2 cm diameter and <5 mm depth) were systemically (in oral solution) administered three doses of 20 mg∕kg ALA (total 60 mg∕kg). Lesion site PpIX and auto-FL were imaged using the multichannel FL and polarized white-light oral cancer imaging probe before/after ALA administration and after light delivery (fractionated, total 100 J∕cm 2 of 635 nm red LED light).Results: The handheld device was conducive for access to lesion site images in the oral cavity. Segmentation of ratiometric images in which PpIX FL is mapped relative to auto-FL enabled improved demarcation of lesion boundaries relative to PpIX alone. A relative FL (R-value) threshold of 1.4 was found to segment lesion site PpIX production among the patients with mild to severe dysplasia malignancy. The segmented lesion size is well correlated with ultrasound findings. Lesions for which R-value was >1.65 at the time of treatment were associated with successful outcomes. Conclusion:These results indicate the utility of a low-cost, handheld intraoral imaging probe for image-guided PDT and treatment monitoring while also laying the

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Section: Discussionsupporting

confidence: 87%

Clinical assessment of a low-cost, hand-held, smartphone-attached intraoral imaging probe for 5-aminolevulinic acid photodynamic therapy monitoring and guidance

et al. 2023

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“…An additional method for early diagnosis and treatment of malignant and potentially malignant lesions of the oral cavity involves the use of photosensitizing substances, irradiated by light through laser and nonlaser devices; the most commonly used device is the diode laser because it is small and inexpensive [ 138 , 139 ]. Siddiqui et al recently proposed a portable and easy-to-use fiber-coupled LED system that uses a smartphone fluorescence imaging device [ 140 ]. Regarding photosensitizing agents, the use of Photofrin ® , administered intravenously, has been suggested for the treatment of oral cancer at any stage [ 141 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

“…In 1993, as reported by Grant et al, 5-ALA is given orally for systemic use (previously used topically or by intravenous administration) for the first time in the treatment of advanced oral OSCC, inducing necrosis in three out of four patients [ 143 ]. This treatment is precise, selective, and noninvasive and can be used for potentially malignant, precancerous, and cancerous lesions even when other therapeutic strategies, such as surgery, are not applicable [ 140 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

State of the Art in the Diagnosis and Assessment of Oral Malignant and Potentially Malignant Disorders: Present Insights and Future Outlook—An Overview

Menditti,

Santagata,

Guida

et al. 2024

Bioengineering

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Oral Potentially Malignant Disorder (OPMD) is a significant concern for clinicians due to the risk of malignant transformation. Oral Squamous Cell Carcinoma (OSCC) is a common type of cancer with a low survival rate, causing over 200,000 new cases globally each year. Despite advancements in diagnosis and treatment, the five-year survival rate for OSCC patients remains under 50%. Early diagnosis can greatly improve the chances of survival. Therefore, understanding the development and transformation of OSCC and developing new diagnostic methods is crucial. The field of oral medicine has been advanced by technological and molecular innovations, leading to the integration of new medical technologies into dental practice. This study aims to outline the potential role of non-invasive imaging techniques and molecular signatures for the early detection of Oral Malignant and Potentially Malignant Disorders.

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“…Siddiqui et al [22] reported the effects of photoactivated aminolevulinic acid as an oral cancer therapy. The regimen of the photosensitizing agent is normally 60 mg/kg divided into three doses, which leads to accumulation of the photoactive product protoporphyrin IX (PpIX), followed, after 0.5-1 h, by illumination of the tumor with 100 J/cm 2 LED light at 635 nm.…”

Section: -Aminolevulinic Acidmentioning

confidence: 99%

Photodynamic Therapy of Oral Cancer and Novel Liposomal Photosensitizers

Düzgüneş

Piskorz

Skupin-Mrugalska

et al. 2023

Oral

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Photodynamic therapy facilitates the selective destruction of cancer tissue by utilizing a photosensitizer drug, the light near the absorbance wavelength of the drug, and oxygen. Methylene Blue, 5-aminolevulinic acid (the precursor of the photosensitizer, protoporphyrin IX), porphyrin, Foscan, Chlorin e6, and HPPH have been used successfully as photosensitizers in the treatment of oral verrucous hyperplasia, oral leukoplakia, oral lichen planus, and head and neck squamous cell carcinoma. “Theranostic” liposomes can deliver a contrast agent for magnetic resonance imaging and a photosensitizer for the image-guided photodynamic therapy of head and neck cancer. Liposomes incorporating photosensitizers can be targeted to cell surface markers overexpressed on cancer cells. Novel porphyrinoids have been developed in our laboratories that are highly effective as photosensitizers. Tribenzoporphyrazines encapsulated in cationic liposomes have produced IC50 values up to 50 times lower compared to the free photosensitizers. It is anticipated that targeting these drugs to cancer stem cells, using upconversion nanoparticles for the near-infrared irradiation of tumors to activate the photosensitizers, and overcoming tumor hypoxia will enhance the efficacy of photodynamic therapy of tumors accessible to light sources.

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Clinical evaluation of a mobile, low-cost system for fluorescence guided photodynamic therapy of early oral cancer in India

Cited by 25 publications

References 33 publications

Clinical assessment of a low-cost, hand-held, smartphone-attached intraoral imaging probe for 5-aminolevulinic acid photodynamic therapy monitoring and guidance

Clinical assessment of a low-cost, hand-held, smartphone-attached intraoral imaging probe for 5-aminolevulinic acid photodynamic therapy monitoring and guidance

State of the Art in the Diagnosis and Assessment of Oral Malignant and Potentially Malignant Disorders: Present Insights and Future Outlook—An Overview

Photodynamic Therapy of Oral Cancer and Novel Liposomal Photosensitizers

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