Temperature regime of biological tissue under photodynamic therapy

An analytical model is proposed to calculate heating of human skin cover under laser light action of photodynamic therapy. A photosensitizer of «Fotolon» is taken as an example. Temperatures of skin surface and of deep dermis regions are studied as a function of time under pulsed and stationary irradiation of skin surface at the wavelength of 665 nm corresponding to the maximum of the photosensitizer absorption band. It is shown that, under the action of a short light pulse, the photosensitizer can lead to an essential temperature rise of dermis due to a considerable increase in its absorption coefficient. However, this rise does not destruct tissue cells because of the short action. Under stationary irradiation, the photosensitizer concentration has a low effect on the temperature regime of tissue. This is related with the specific features in heating of the medium by red light, where the main thermal process in skin is heat transfer over tissue volume from epidermis having a substantially larger absorption coefficient than that of dermis in the said spectral range. The role of blood perfusion in dermis and its effect on the temperature regime of tissue are evaluated.     

激光低损伤加热疗法的理论分析

激光低损伤加热疗法将激光照射与表面冷却相结合,能实现只让病变组织细胞凝固,而体表健康组织则不受损伤,它是治疗靠近体表肿瘤的一种有希望的方法。为了进一步认识这种治疗方法,本文提出了一个适用于激光低损伤加热疗法的数值计算模型,模拟了热疗过程中的光传输和热传递,得到组织内部的瞬态温度分布。在此基础上,详细讨论了散射系数、吸收系数、各向异性系数等光学参数,激光加热功率、照射半径、表面对流换热系数等热学参数。以及血液灌注率和新陈代谢等生理参数对这种低损伤加热疗法的影响。结果发现,只要通过适当调节吸收系数、散射系数和照射功率等参数就可实现对加热区域位置和范围的控制。     

Calibration of an orientation sensor for freehand 3D ultrasound and its use in a hybrid acquisition system

Background and Objectives

Liposuction continues to be one of the most popular procedures performed in cosmetic surgery. As the public's demand for body contouring continues, laser lipolysis has been proposed to improve results, minimize risk, optimize patient comfort, and reduce the recovery period. Mathematical modeling of laser lipolysis could provide a better understanding of the laser lipolysis process and could determine the optimal dosage as a function of fat volume to be removed.

Study design/Materials and Methods

An Optical-Thermal-Damage Model was formulated using finite-element modeling software (Femlab 3.1, Comsol Inc). The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation and laser-induced injury using the Arrhenius damage model. Biological tissue was represented by two homogenous regions (dermis and fat layer) with a nonlinear air-tissue boundary condition including free convection. Video recordings were used to gain a better understanding of the back and forth movement of the cannula during laser lipolysis in order to consider them in our mathematical model. Infrared video recordings were also performed in order to compare the actual surface temperatures to our calculations. The reduction in fat volume was determined as a function of the total applied energy and subsequently compared to clinical data reported in the literature.

Results

In patients, when using cooled tumescent anesthesia, 1064 nm Nd:YAG laser or 980 nm diode laser: (6 W, back and forth motion: 100 mm/s) give similar skin surface temperature (max: 41°C). These measurements are in accordance with those obtained by mathematical modeling performed with a 1 mm cannula inserted inside the hypodermis layer at 0.8 cm below the surface. Similarly, the fat volume reduction observed in patients at 6-month follow up can be determined by mathematical modeling. This fat reduction depends on the applied energy, typically 5 cm³ for 3000 J. At last, skin retraction was observed in patients at 6-month follow up. This observation can be easily explained by mathematical modeling showing that the temperature increase inside the lower dermis is sufficient (48–50°C) to induce skin tightening

Discussion and Conclusion

Laser lipolysis can be described by a theoretical model. Fat volume reduction observed in patients is in accordance with model calculations. Due to heat diffusion, temperature elevation is also produced inside the lower reticular dermis. This interesting observation can explain remodeling of the collagenous tissue, with clinically evident skin tightening. In conclusion, while the heat generated by interstitial laser irradiation provides stimulate lipolysis of the fat cells, the collagen and elastin are also stimulated resulting in a tightening in the skin. This mathematical model should serve as a useful tool to simulate and better understand the mechanism of action of the laser lipolysis     

Thermal effects of a short light pulse on biological tissues. II. Light and heat fields

A set of heat conduction equations for a two-component medium simulating biological tissues were formulated. Their solutions were obtained, and the spatial distribution of light and temperature over tissue depth at different times after irradiation by a short light pulse was studied. The local absorption of light by blood vessels and the influence of this effect on the optical parameters of the medium, a more intense heating of blood as compared with its surrounding tissue, heat exchange between them, and heat transfer at the interface with different environments were accounted for. The solutions are expressed via characteristic times of the respective thermal processes to enable one to easily and vividly analyze the features of tissue heating and the influence of optical and thermal parameters on the temperature distributions of the components. The calculations are illustrated by examples.     

Experimental study of photodynamic effect on bacterial wound microflora

The in vitro study of the influence of photodynamic action (with the use of photosensitizer "Photosens", laser and non-laser irradiation) on the strains of the main representatives purulent wound microflora was carried out. Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis cultures have been isolated from wound secretions and identified. The photosensitizer was shown to produce no bactericidal effect by itself. Irradiation with laser and non-laser light sources induced a sharp decrease in the number of viable cells in the cultures under study. The irradiation of the photosensitizer led to its activation, manifested in bactericidal action. The results thus obtained confirm good prospect of using photodynamic therapy for the treatment of purulent wounds.     

Temperature evolution in tissues embedded with large blood vessels during photo-thermal heating

During laser-assisted photo-thermal therapy, the temperature of the heated tissue region must rise to the therapeutic value (e.g., 43 °C) for complete ablation of the target cells. Large blood vessels (larger than 500 micron in diameter) at or near the irradiated tissues have a considerable impact on the transient temperature distribution in the tissue. In this study, the cooling effects of large blood vessels on temperature distribution in tissues during laser irradiation are predicted using finite element based simulation. A uniform flow is assumed at the entrance and three-dimensional conjugate heat transfer equations in the tissue region and the blood region are simultaneously solved for different vascular models. A volumetric heat source term based on Beer–Lambert law is introduced into the energy equation to account for laser heating. The heating pattern is taken to depend on the absorption and scattering coefficients of the tissue medium. Experiments are also conducted on tissue mimics in the presence and absence of simulated blood vessels to validate the numerical model. The coupled heat transfer between thermally significant blood vessels and their surrounding tissue for three different tissue-vascular networks are analyzed keeping the laser irradiation constant. A surface temperature map is obtained for different vascular models and for the bare tissue (without blood vessels). The transient temperature distribution is seen to differ according to the nature of the vascular network, blood vessel size, flow rate, laser spot size, laser power and tissue blood perfusion rate. The simulations suggest that the blood flow through large blood vessels in the vicinity of the photothermally heated tissue can lead to inefficient heating of the target.     

Influence of blood flow and millimeter wave exposure on skin temperature in different thermal models

Recently we showed that the Pennes bioheat transfer equation was not adequate to quantify mm wave heating of the skin at high blood flow rates. To do so, it is necessary to incorporate an "effective" thermal conductivity to obtain a hybrid bioheat equation (HBHE). The main aim of this study was to determine the relationship between non-specific tissue blood flow in a homogeneous unilayer model and dermal blood flow in multilayer models providing that the skin surface temperatures before and following mm wave exposure were the same. This knowledge could be used to develop multilayer models based on the fitting parameters obtained with the homogeneous tissue models. We tested four tissue models consisting of 1-4 layers and applied the one-dimensional steady-state HBHE. To understand the role of the epidermis in skin models we added to the one- and three-layer models an external thin epidermal layer with no blood flow. Only the combination of models containing the epidermal layer was appropriate for determination of the relationship between non-specific tissue and dermal blood flows giving the same skin surface temperatures. In this case we obtained a linear relationship between non-specific tissue and dermal blood flows. The presence of the fat layer resulted in the appearance of a significant temperature gradient between the dermis and muscle layer which increased with the fat layer thickness.     

The effect of heating by microwave irradiation and by conventional heating on the aldehyde concentration in aqueous glutaraldehyde solutions

Summary The effect of short time heating of aqueous solutions of glutaraldehyde (GA) on relative aldehyde concentration was determined using spectrophotometric analysis. Because free monomeric GA absorbs U. V. light at 280 nm, whereas the alpha, beta polymeric forms absorb at 235 nm, the purity of GA solutions can be expressed as the ratio: A 235 nm/A 280 nm (purification index, P.I.).Heating of 4 ml aliquots of 0.85% distilled aqueous GA solution resulted in an increase of the absorption at 280 nm which is correlated positively with temperature. No increase of absorption at 235 nm was found when solutions were kept at 40°C for several hours. The increase of absorption at 280 nm is caused by a rapid decyclization of hemiacetals producing an increase in free aldehyde concentration.No major differences in absorption were found between the solutions heated by microwave and by conventional heating. However, because microwave irradiation is known to produce an homogeneous rise in temperature, especially in bulky samples, it is expected that the results of fixation procedures will improve by the combined effect of higher temperature and enhanced diffusion rates of the fixating species.     

Photodynamic therapy: an update

Photodynamic therapy (PDT) is a promising local treatment modality based on the selective accumulation of a photosensitizer in malignant tissues and the subsequent irradiation with laser light. Photodynamic therapy of malignant tumors includes biological, photochemical and photophysical processes. These processes involve: (a) absorption of photosensitizing agent; (b) selective retention of the photosensitizer in tumors and (c) irradiation of sensitized tumor by laser radiation. This report provides a review of photosensitizers, photochemistry, subcellular targets, side effects and laser involved in photodynamic therapy. In addition, gradual increase in knowledge related to in vitro and in vivo mechanisms of action of PDT, as well as some clinical applications of photodynamic therapy are presented.     

Optical and Thermal Enhancement of Plasmonic Nanofluid Based on Core/Shell Nanoparticles

The plasmonic effect is introduced in solar thermal areas to enhance light harvest and absorption. The optical properties of plasmonic nanofluid are simulated by finite difference time domain (FDTD) method. Due to the excitation of localized surface plasmon resonance (LSPR) effect, an intensive absorption peak is observed at 0.5 μm. The absorption characteristics are sensitive to particle size and concentration. As the particle size increases, the absorption peak is broadened and shifted to longer wavelength. The absorption of SiO₂/Ag plasmonic nanofluid is improved gradually as the volume concentration increases, especially in the UV region. The absorption edge is shifted from 0.6 to 1.0 μm as the volume concentration increases from 0.001 to 0.01. The thermal simulation of suspended SiO₂/Ag nanoparticle shows a uniform temperature rise of 17.91 K under solar irradiation (AM 1.5), while under the same condition, the temperature rises in Ag nanoparticle and Al nanoparticle are 11.12 and 5.39 K, respectively. The core/shell plasmonic nanofluid exhibits a higher photothermal performance, which has a potential application in photothermal areas. A higher temperature rise can be obtained by improving the incident light intensity or optical absorption properties of nanoparticles.     

Thermodynamic response of soft biological tissues to pulsed infrared-laser irradiation.

The physical mechanisms that achieve tissue removal through the delivery of short pulses of high-intensity infrared laser radiation, in a process known as laser ablation, remain obscure. The thermodynamic response of biological tissue to pulsed infrared laser irradiation was investigated by measuring and analyzing the stress transients generated by Q-sw Er:YSGG (lambda = 2.79 microns) and TEA CO2 (lambda = 10.6 microns) laser irradiation of porcine dermis using thin-film piezoelectric transducers. For radiant exposures that do not produce material removal, the stress transients are consistent with thermal expansion of the tissue samples. The temporal structure of the stress transients generated at the threshold radiant exposure for ablation indicates that the onset of material removal is delayed with respect to irradiation. Once material removal is achieved, the magnitude of the peak compressive stress and its variation with radiant exposure are consistent with a model that considers this process as an explosive event occurring after the laser pulse. This mechanism is different from ArF- and KrF-excimer laser ablation where absorption of ultraviolet radiation by the collagenous tissue matrix leads to tissue decomposition during irradiation and results in material removal via rapid surface vaporization. It appears that under the conditions examined in this study, explosive boiling of tissue water is the process that mediates the ablation event. This study provides evidence that the dynamics and mechanism of tissue ablation processes can be altered by targeting tissue water rather than the tissue structural matrix.     

Local heating of human skin by millimeter waves: a kinetics study

Heating rates of human skin exposed locally to 42.25 GHz mm waves, coming from a waveguide (WG) opening or a YAV device designed for therapeutic application, were studied in vivo using infrared (IR) thermography. For both radiators, the power density distribution was described by a circularly symmetrical Gaussian type function on the exposed skin surface. Insertion of a small thermocouple (d = 0.1 mm) in the exposed area did not produce any significant artifact, either in the power density distribution or kinetics measurement, providing it was perpendicular to the E vector. The heating kinetics in the skin exposed with either the WG opening or the YAV device were well fitted to solutions of the 2-D bio-heat transfer equation for homogeneous tissue. Changes in irradiating beam size (1-8 mm) had no detectable effect on the initial (0.3-3.0 s) phase of the heating kinetics. However, the amplitude of the kinetics decreased substantially with decreasing the beam size. As the temperature rise in the time interval necessary for reliable measurement of the initial temperature rise rate was very small, an accurate experimental determination of specific absorption rate (SAR) becomes practically impossible at the low intensities normally used in our experiments. The correct SAR values may be found from fitting of the model to the heating kinetics. Bioelectromagnetics 24:571-581, 2003.     

Two-photon irradiation of an intracellular singlet oxygen photosensitizer: achieving localized sub-cellular excitation in spatially-resolved experiments

The response of a given cell to spatially-resolved sub-cellular irradiation of a singlet oxygen photosensitizer (protoporphyrin IX, PpIX) using a focused laser was assessed. In these experiments, incident light was scattered over a volume greater than that defined by the dimensions of the laser beam as a consequence of the inherent inhomogeneity of the cell. Upon irradiation at a wavelength readily absorbed by PpIX in a one-photon transition, this scattering of light eliminated any advantage accrued to the use of focused irradiation. However, upon irradiation at a longer wavelength where PpIX can only absorb light under non-linear two-photon conditions, meaningful intracellular resolution was achieved in the small spatial domain where the light intensity was high enough for absorption to occur.     

The thermodynamic response of soft biological tissues to pulsed ultraviolet laser irradiation.

The physical mechanisms that enable short pulses of high-intensity ultraviolet laser radiation to remove tissue, in a process known as laser ablation, remain obscure. The thermodynamic response of biological tissue to pulsed laser irradiation was investigated by measuring and subsequently analyzing the stress transients generated by pulsed argon fluorine (ArF, lambda = 193 nm) and krypton fluorine (KrF, lambda = 248 nm) excimer laser irradiation of porcine dermis using thin-film piezoelectric transducers. For radiant exposures that do not cause material removal, the stress transients are consistent with rapid thermal expansion of the tissue. At the threshold radiant exposure for ablation, the peak stress amplitude generated by 248 nm irradiation is more than an order of magnitude larger than that produced by 193 nm irradiation. For radiant exposures where material removal is achieved, the temporal structure of the stress transient indicates that the onset of material removal occurs during irradiation. In this regime, the variation of the peak compressive stress with radiant exposure is consistent with laser-induced rapid surface vaporization. For 193 nm irradiation, ionization of the ablated material occurs at even greater radiant exposures and is accompanied by a change in the variation of peak stress with radiant exposure consistent with a plasma-mediated ablation process. These results suggest that absorption of ultraviolet laser radiation by the extracellular matrix of tissue leads to decomposition of tissue on the time scale of the laser pulse. The difference in volumetric energy density at ablation threshold between the two wavelengths indicates that the larger stresses generated by 248 nm irradiation may facilitate the onset of material removal. However, once material removal is achieved, the stress measurements demonstrate that energy not directly responsible for target decomposition contributes to increasing the specific energy of the plume (and plasma, when present), which drives the gas dynamic expansion of ablated material. This provides direct evidence that ultraviolet laser ablation of soft biological tissues is a surface-mediated process and not explosive in nature.     

Quantitative alterations of hyaluronan and dermatan sulfate in the hairless mouse dorsal skin exposed to chronic UV irradiation.

The quantitative alterations of hyaluronan and dermatan sulfate in the upper dermis (fibrous tissue) and the lower dermis (adipose tissue) of the hairless mouse skin chronically exposed to the UV irradiation as solar-simulating irradiation (lambda(max) 352 nm, UV distribution: 300-310 nm, 0.9%; 310-320 nm, 2.0%; 320-420 nm, 97.1%) were evaluated. Hyaluronan and dermatan sulfate contents in each part of dermis were determined as follows: skin sections on a glass slide prepared by histological technique were processed into the upper dermis and the lower dermis with a small surgical knife, and treated with chondroitinase ABC and ACII in the presence of bacterial collagenase. The resulting unsaturated disaccharides were determined by HPLC method. By applying this method to the UV-irradiated hairless mouse skin, it was found that the chronic UV irradiation increased dermatan sulfate in the upper dermis, whereas an increase of hyaluronan content was not statistically significant. In the lower dermis, on the contrary, both hyaluronan and dermatan sulfate contents remarkably increased as compared with the control mice. Furthermore, the histological study showed the accumulation of the collagen fibers in the lower dermis of the UV-irradiated hairless mouse skin following the disappearance of adipocytes. These findings indicate that the increases of glycosaminoglycan contents in the UV-irradiated skin are related to the accumulation of the extracellular matrix components in the lower dermis.     

Heating of tissues by microwaves: A model analysis

We consider the thermal response times for heating of tissue subject to nonionizing (microwave or infrared) radiation. The analysis is based on a dimensionless form of the bioheat equation. The thermal response is governed by two time constants: one(τ₁) pertains to heat convection by blood flow, and is of the order of 20–30 min for physiologically normal perfusion rates; the second (τ₂) characterizes heat conduction and varies as the square of a distance that characterizes the spatial extent of the heating. Two idealized cases are examined. The first is a tissue block with an insulated surface, subject to irradiation with an exponentially decreasing specific absorption rate, which models a large surface area of tissue exposed to microwaves. The second is a hemispherical region of tissue exposed at a spatially uniform specific absorption rate, which models localized exposure. In both cases, the steady-state temperature increase can be written as the product of the incident power density and an effective time constant τ_eff, which is defined for each geometry as an appropriate function of τ₁ and τ₂. In appropriate limits of the ratio of these time constants, the local temperature rise is dominated by conductive or convective heat transport. Predictions of the block model agree well with recent data for the thresholds for perception of warmth or pain from exposure to microwave energy. Using these concepts, we developed a thermal averaging time that might be used in standards for human exposure to microwave radiation, to limit the temperature rise in tissue from radiation by pulsed sources. We compare the ANSI exposure standards for microwaves and infrared laser radiation with respect to the maximal increase in tissue temperature that would be allowed at the maximal permissible exposures. A historical appendix presents the origin of the 6-min averaging time used in the microwave standard. Bioelectromagnetics 19:420–428, 1998. © 1998 Wiley-Liss, Inc.     

Two-photon irradiation of an intracellular singlet oxygen photosensitizer: Achieving localized sub-cellular excitation in spatially-resolved experiments

Abstract

The response of a given cell to spatially-resolved sub-cellular irradiation of a singlet oxygen photosensitizer (protoporphyrin IX, PpIX) using a focused laser was assessed. In these experiments, incident light was scattered over a volume greater than that defined by the dimensions of the laser beam as a consequence of the inherent inhomogeneity of the cell. Upon irradiation at a wavelength readily absorbed by PpIX in a one-photon transition, this scattering of light eliminated any advantage accrued to the use of focused irradiation. However, upon irradiation at a longer wavelength where PpIX can only absorb light under non-linear two-photon conditions, meaningful intracellular resolution was achieved in the small spatial domain where the light intensity was high enough for absorption to occur.     

Spatially resolved diffuse imaging for high‐speed depth estimation of jet injection

We investigate the use of spatially resolved diffuse imaging to track a fluid jet delivered at high speed into skin tissue. A jet injector with a short needle to deliver drugs beneath the dermis, is modified to incorporate a laser beam into the jet, which is ejected into ex vivo porcine tissue. The diffuse light emitted from the side and top of the tissue sample is recorded using high‐speed videography. Similar experiments, using a depth‐controlled fiber optic source, generate a reference dataset. The side light distribution is related to source depth for the controlled‐source experiments and used to track the effective source depth of the injections. Postinjection X‐ray images show agreement between the jet penetration and ultimate light source depth. The surface light intensity profile is parameterized with a single parameter and an exponential function is used to relate this parameter to source depth for the controlled‐source data. This empirical model is then used to estimate the effective source depth from the surface profile of the injection experiments. The depth estimates for injections into fat remain close to the side depth estimates, with a root‐mean‐square error of 1.1 mm, up to a source depth of 8 mm.      

光敏剂特性影响光动力治疗鲜红斑痣的数学仿真研究

目的：通过建立光动力治疗鲜红斑痣中激光、光敏剂、氧的分布及其相互作用关系的数学模型,对表皮、真皮、血管中单线态氧的产生过程进行仿真,了解光敏剂的药代动力学和扩散特性对单线态氧产生的影响,进而了解光敏剂特性在光动力治疗鲜红斑痣中的作用和意义。方法：用’Monte Carlo方法描述光在组织中的分布;用药代动力学描述光敏剂在血管中的变化规律;用Fick定律描述光敏剂和氧在组织中的扩散和分布;用与氧含量有关的二级动力学描述光敏剂的漂白;用Lambert—Beer定律和单线态氧的量子产率来计算各层组织中单线态氧的产生。结果：光敏剂药代动力学的变化,使注射光敏剂后开始照光的时间对各层组织中单线态氧产量有明显的影响。光敏剂扩散特性的改变,对真皮和表皮中单线态氧的产生有较大影响,对血管中单线态氧的产生没有影响。结论：光敏剂的特性对光动力治疗鲜红斑痣有明显的影响,数学仿真能较全面地反应这种作用的特点和意义。     

Different rates of ultraviolet-induced DNA damage in the epidermis and dermis of a platyfish model for carcinogenesis

The purpose of this study was to compare fluence-response relationships for the production of cyclobutane pyrimidine dimers in epidermal or dermal DNA of platyfishXiphophorus hybrids irradiated with UVB, and to determine photoreactivation from black light on dimers producedin situ. This was accomplished by quantitative gel electrophoresis of unlabeled DNA following extraction of the DNA and treatment with an enzyme specific for the detection of pyrimidine dimers. The dermis was the target tissue for UV-induced DNA damage inXiphophorus hybrid fish skin. Shapes of dimer-fluence response data following filtered sunlamp irradiation ( > 290 nm) or monochromatic wavelength 302 nm in the epidermis or dermis were different. In the epidermis there was an initial steep upward slope followed by a plateau, whereas in the dermis a linear relationship was observed. The final values of dimers at the high doses were, however, nearly equal in the epidermis and dermis exposed to either radiation. These differences in fluence-response relationships are probably attributable to the intertwining of the epidermis and to the shielding effect of the epidermal layer, with scales leading to a heterogenous population of cells which are exposed to different UV doses. Photoreversal of dimers was readily observed by black light irradiation in both epidermis and dermis irradiated with either > 290 nm or 302 nm.This research was supported by the Office of Health and Environmental Research of the U.S. Department of EnergyThe author is recipient of the National Academy of Sciences' Kobelt Fund Grant