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用于恶性中央气道阻塞患者间质光动力治疗的辐照度和光通量的计算优化

Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction.

作者信息

Oakley Emily, Parilov Evgueni, Beeson Karl, Potasek Mary, Ivanick Nathaniel, Tworek Lawrence, Hutson Alan, Shafirstein Gal

机构信息

Department of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.

Simphotek, Inc., 211 Warren St., Newark, NJ 07103, USA.

出版信息

Cancers (Basel). 2023 May 6;15(9):2636. doi: 10.3390/cancers15092636.

Abstract

There are no effective treatments for patients with extrinsic malignant central airway obstruction (MCAO). In a recent clinical study, we demonstrated that interstitial photodynamic therapy (I-PDT) is a safe and potentially effective treatment for patients with extrinsic MCAO. In previous preclinical studies, we reported that a minimum light irradiance and fluence should be maintained within a significant volume of the target tumor to obtain an effective PDT response. In this paper, we present a computational approach to personalized treatment planning of light delivery in I-PDT that simultaneously optimizes the delivered irradiance and fluence using finite element method (FEM) solvers of either Comsol Multiphysics or Dosie™ for light propagation. The FEM simulations were validated with light dosimetry measurements in a solid phantom with tissue-like optical properties. The agreement between the treatment plans generated by two FEMs was tested using typical imaging data from four patients with extrinsic MCAO treated with I-PDT. The concordance correlation coefficient (CCC) and its 95% confidence interval (95% CI) were used to test the agreement between the simulation results and measurements, and between the two FEMs treatment plans. Dosie with CCC = 0.994 (95% CI, 0.953-0.996) and Comsol with CCC = 0.999 (95% CI, 0.985-0.999) showed excellent agreement with light measurements in the phantom. The CCC analysis showed very good agreement between Comsol and Dosie treatment plans for irradiance (95% CI, CCC: 0.996-0.999) and fluence (95% CI, CCC: 0.916-0.987) in using patients' data. In previous preclinical work, we demonstrated that effective I-PDT is associated with a computed light dose of ≥45 J/cm when the irradiance is ≥8.6 mW/cm (i.e., the effective rate-based light dose). In this paper, we show how to use Comsol and Dosie packages to optimize rate-based light dose, and we present Dosie's newly developed domination sub-maps method to improve the planning of the delivery of the effective rate-based light dose. We conclude that image-based treatment planning using Comsol or Dosie FEM-solvers is a valid approach to guide the light dosimetry in I-PDT of patients with MCAO.

摘要

对于外在性恶性中央气道阻塞(MCAO)患者,目前尚无有效的治疗方法。在最近的一项临床研究中,我们证明了间质光动力疗法(I-PDT)对于外在性MCAO患者是一种安全且可能有效的治疗方法。在之前的临床前研究中,我们报告称,为了获得有效的光动力疗法(PDT)反应,应在目标肿瘤的相当大体积内维持最低光辐照度和光通量。在本文中,我们提出了一种用于I-PDT中光传输个性化治疗计划的计算方法,该方法使用Comsol Multiphysics或Dosie™的有限元方法(FEM)求解器同时优化传输的辐照度和光通量,以进行光传播。通过在具有类似组织光学特性的固体模型中进行光剂量测定,对有限元方法(FEM)模拟进行了验证。使用来自4例接受I-PDT治疗的外在性MCAO患者的典型成像数据,测试了两种有限元方法(FEM)生成的治疗计划之间的一致性。一致性相关系数(CCC)及其95%置信区间(95%CI)用于测试模拟结果与测量值之间以及两种有限元方法(FEM)治疗计划之间的一致性。CCC = 0.994(95%CI,0.9"

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/290a/10177073/98fe65e0f6b8/cancers-15-02636-g001.jpg

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