The Role of Laser Speckle Imaging in Port-Wine Stain Research: Recent Advances and Opportunities

Choi, Bernard; Tan, Wenbin; Jia, Wangcun; White, Sean; Moy, Wesley J.; Yang, Bíngen; Zhu, Jiang; Chen, Zhongping; Kelly, Kristen M.; Nelson, J. Stuart

doi:10.1109/jstqe.2015.2493961

Cited by 22 publications

(16 citation statements)

References 145 publications

(138 reference statements)

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“…23,24 So far, the preferable mode of the SHVM laser treatment should provide laser irradiation with both light wavelengths mostly absorbed by target blood chromophore and pulse pattern as a train of micropulses with exposure duration set according to the diameter and location features of dysplastic vessels with the use of modern imaging technologies. 25 The results of our simulations for CVL were compared with the histochemical study by Neumann et al 26 Our model is in excellent agreement with the experimental data and predicts the selective vascular heating with slight perivascular collagen damage. According to classification of port-wine stains (https:// birthmark.org/node/100), we are able to predict the optimal exposure time and laser type for different 4 grades of PWS by their degree of vascular ectasia (Table 4).…”

Section: Discussionsupporting

confidence: 75%

“…However, the SHVM therapeutic recalcitrance was reported to be registered with half of such patients. 16 The most promising strategy to overcome the SHVM therapeutic recalcitrance is believed to be introduction of the optimal models to ensure the highest efficiency and safety of the SHVM patients' laser treatment. 17 Histochemical studies of the post laser treatment skin vascular bed in cases with various outcomes of the laser treatment proved the complete obstruction of the dysplastic vessels to be the most necessary for the satisfactory results of the SHVM patients' laser therapy.…”

Section: Discussionmentioning

confidence: 99%

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Numerical Modeling and Clinical Evaluation of Pulsed Dye Laser and Copper Vapor Laser in Skin Vascular Lesions Treatment

2018

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Introduction: Different yellow lasers have been successfully used for the treatment of vascular lesions. This study is aimed to ascertain the role and efficiency of copper vapor lasers (CVLs) and pulsed dye lasers (PDLs) for the treatment of vascular lesions using numerical modeling and to compare results with our clinical experience. In this study we aimed to develop criteria for the choice of more efficient laser exposure mode, investigate more relevant modes of laser irradiation to ensure selective photothermolysis of target vessels, and compare the CVL and PDL efficiency in the course of patients with skin vascular lesions (SVL) treatment. Methods: We performed numerical simulation of the processes of heating a vessel with CVL and PDL to temperatures at which its coagulation could occur. Calculated fluencies were compared with clinical results of laser therapy performed on 1242 patients with skin hemangiomas and vascular malformations (SHVM), including 635 patients treated with CVL and 607 patients treated with PDL. PDL and CVL provided excellent results in 40 and ten days after treatment. The treatment was not painful. Patients did not need anesthesia. Postoperative crusts were greater with PDL than with CVL. Results: Results of computer simulation of a selective vessel heating using PDL and CVL radiation are presented. By results obtained, depth of the location and sizes of vessels that could be selectively heated to more than 75°C are determined. Conclusion: Based on calculated and clinical data, the heating mode for dysplastic vessels using a series of CVL micropulses could be regarded to be safer and more efficient than the mode of a PDL short, powerful pulse.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Numerical Modeling and Clinical Evaluation of Pulsed Dye Laser and Copper Vapor Laser in Skin Vascular Lesions Treatment

2018

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“…This has since been reiterated several times by others [ 117 – 120 ]. Meanwhile, the objective scoring methods have been expanded and now include digital image analysis [ 90 , 118 , 121 ], reflectance confocal microscopy [ 122 ], optical coherence tomography [ 123 , 124 ], depth measurement videomicroscopy [ 125 ], laser speckle contrast imaging [ 63 , 126 ], and spatial frequency domain imaging [ 127 ]. Interestingly, these tools do not always correlate with visual assessment [ 81 , 128 ], underscoring potential flaws in subjective assessment tools.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

et al. 2020

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Background Valid and reliable outcome measures are needed to determine and compare treatment results of port wine stain (PWS) studies. Besides, uniformity in outcome measures is crucial to enable inter-study comparisons and meta-analyses. This study aimed to assess the heterogeneity in reported PWS outcome measures by mapping the (clinical) outcome measures currently used in prospective PWS studies. Methods OVID MEDLINE, OVID Embase, and CENTRAL were searched for prospective PWS studies published from 2005 to May 2020. Interventional studies with a clinical efficacy assessment were included. Two reviewers independently evaluated methodological quality using a modified Downs and Black checklist. Results In total, 85 studies comprising 3,310 patients were included in which 94 clinician/observerreported clinical efficacy assessments had been performed using 46 different scoring systems. Eighty-one-studies employed a global assessment of PWS appearance/improvement, of which-82% was expressed as percentage improvement and categorized in 26 different scoring systems. A wide variety of other global and multi-item scoring systems was identified. As a result of outcome heterogeneity and insufficient data reporting, only 44% of studies could be directly compared. A minority of studies included patient-reported or objective outcomes. Thirteen studies of good quality were found.

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“…Second, no information was available on TA release at T > T m . It is clinically difficult to achieve an equal temperature distribution across a tissue volume where the target vessels are situated up to a depth of 0.9 mm from the skin surface [ 90 , 91 ] and where semi-occluded blood vessels arguably account for temperature gyrations due to convection [ 13 , 92 , 93 ]. Accordingly, unhampered TA release from liposomes in the L α phase is a desirable endpoint to make the second phase of SSPLT (heat-induced TA release, Figure 1 ) practically feasible in that heating would not have to occur in a narrow temperature range.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Assessment of Thermosensitive Liposomes for the Treatment of Port Wine Stains by Antifibrinolytic Site-Specific Pharmaco-Laser Therapy

Raath

Khakpour

et al. 2020

Pharmaceutics

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Antifibrinolytic site-specific pharmaco-laser therapy (SSPLT) is an experimental treatment modality for refractory port wine stains (PWS). Conceptually, antifibrinolytic drugs encapsulated in thermosensitive liposomes are delivered to thrombi that form in semi-photocoagulated PWS blood vessels after conventional laser treatment. Local release of antifibrinolytics is induced by mild hyperthermia, resulting in hyperthrombosis and complete occlusion of the target blood vessel (clinical endpoint). In this study, 20 thermosensitive liposomal formulations containing tranexamic acid (TA) were assayed for physicochemical properties, TA:lipid ratio, encapsulation efficiency, and endovesicular TA concentration. Two candidate formulations (DPPC:DSPE-PEG, DPPC:MPPC:DSPE-PEG) were selected based on optimal properties and analyzed for heat-induced TA release at body temperature (T), phase transition temperature (Tm), and at T > Tm. The effect of plasma on liposomal stability at 37 °C was determined, and the association of liposomes with platelets was examined by flow cytometry. The accumulation of PEGylated phosphocholine liposomes in laser-induced thrombi was investigated in a hamster dorsal skinfold model and intravital fluorescence microscopy. Both formulations did not release TA at 37 °C. Near-complete TA release was achieved at Tm within 2.0–2.5 min of heating, which was accelerated at T > Tm. Plasma exerted a stabilizing effect on both formulations. Liposomes showed mild association with platelets. Despite positive in vitro results, fluorescently labeled liposomes did not sufficiently accumulate in laser-induced thrombi in hamsters to warrant their use in antifibrinolytic SSPLT, which can be solved by coupling thrombus-targeting ligands to the liposomes.

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The Role of Laser Speckle Imaging in Port-Wine Stain Research: Recent Advances and Opportunities

Cited by 22 publications

References 145 publications

Numerical Modeling and Clinical Evaluation of Pulsed Dye Laser and Copper Vapor Laser in Skin Vascular Lesions Treatment

Numerical Modeling and Clinical Evaluation of Pulsed Dye Laser and Copper Vapor Laser in Skin Vascular Lesions Treatment

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

In Vivo Assessment of Thermosensitive Liposomes for the Treatment of Port Wine Stains by Antifibrinolytic Site-Specific Pharmaco-Laser Therapy

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