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Journal of Biomedical Optics • Open Access

Photosensitizer fluorescence and singlet oxygen luminescence as dosimetric predictors of topical 5-aminolevulinic acid photodynamic therapy induced clinical erythema
Author(s): Srivalleesha Mallidi; Sriram R. Anbil; Seonkyung Lee; Dieter Manstein; Stefan A. Elrington; Garuna Kositratna; David Schoenfeld; Brian W. Pogue; Steven J. Davis; Tayyaba Hasan

Paper Abstract

The need for patient-specific photodynamic therapy (PDT) in dermatologic and oncologic applications has triggered several studies that explore the utility of surrogate parameters as predictive reporters of treatment outcome. Although photosensitizer (PS) fluorescence, a widely used parameter, can be viewed as emission from several fluorescent states of the PS (e.g., minimally aggregated and monomeric), we suggest that singlet oxygen luminescence (SOL) indicates only the active PS component responsible for the PDT. Here, the ability of discrete PS fluorescence-based metrics (absolute and percent PS photobleaching and PS re-accumulation post-PDT) to predict the clinical phototoxic response (erythema) resulting from 5-aminolevulinic acid PDT was compared with discrete SOL (DSOL)-based metrics (DSOL counts pre-PDT and change in DSOL counts pre/post-PDT) in healthy human skin. Receiver operating characteristic curve (ROC) analyses demonstrated that absolute fluorescence photobleaching metric (AFPM) exhibited the highest area under the curve (AUC) of all tested parameters, including DSOL based metrics. The combination of dose-metrics did not yield better AUC than AFPM alone. Although sophisticated real-time SOL measurements may improve the clinical utility of SOL-based dosimetry, discrete PS fluorescence-based metrics are easy to implement, and our results suggest that AFPM may sufficiently predict the PDT outcomes and identify treatment nonresponders with high specificity in clinical contexts.

Paper Details

Date Published: 6 February 2014
PDF: 13 pages
J. Biomed. Opt. 19(2) 028001 doi: 10.1117/1.JBO.19.2.028001
Published in: Journal of Biomedical Optics Volume 19, Issue 2
Show Author Affiliations
Srivalleesha Mallidi, Wellman Ctr. for Photomedicine (United States)
Sriram R. Anbil, Massachusetts General Hospital (United States)
Seonkyung Lee, Physical Sciences Inc. (United States)
Dieter Manstein, Wellman Ctr. for Photomedicine (United States)
Stefan A. Elrington, Massachusetts General Hospital (United States)
Garuna Kositratna, Massachusetts General Hospital (United States)
David Schoenfeld, Massachusetts General Hospital (United States)
Brian W. Pogue, Thayer School of Engineering at Dartmouth (United States)
Steven J. Davis, Physical Sciences Inc. (United States)
Tayyaba Hasan, Massachusetts General Hospital (United States)


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