Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction
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 preclinica...
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| Format: | Article |
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MDPI AG
2023-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/9/2636 |
| _version_ | 1797602811128578048 |
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| author | Emily Oakley Evgueni Parilov Karl Beeson Mary Potasek Nathaniel Ivanick Lawrence Tworek Alan Hutson Gal Shafirstein |
| author_facet | Emily Oakley Evgueni Parilov Karl Beeson Mary Potasek Nathaniel Ivanick Lawrence Tworek Alan Hutson Gal Shafirstein |
| author_sort | Emily Oakley |
| collection | DOAJ |
| description | 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<sup>®</sup> 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<sup>2</sup> when the irradiance is ≥8.6 mW/cm<sup>2</sup> (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. |
| first_indexed | 2024-03-11T04:21:47Z |
| format | Article |
| id | doaj.art-0c5d30b197fd48b4b8654d4658e9a48a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T04:21:47Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-0c5d30b197fd48b4b8654d4658e9a48a2023-11-17T22:42:29ZengMDPI AGCancers2072-66942023-05-01159263610.3390/cancers15092636Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway ObstructionEmily Oakley0Evgueni Parilov1Karl Beeson2Mary Potasek3Nathaniel Ivanick4Lawrence Tworek5Alan Hutson6Gal Shafirstein7Department of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USASimphotek, Inc., 211 Warren St., Newark, NJ 07103, USASimphotek, Inc., 211 Warren St., Newark, NJ 07103, USASimphotek, Inc., 211 Warren St., Newark, NJ 07103, USADepartment of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USADepartment of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USADepartment of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USADepartment of Cell Stress Biology, Photodynamic Therapy Center, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USAThere 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<sup>®</sup> 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<sup>2</sup> when the irradiance is ≥8.6 mW/cm<sup>2</sup> (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.https://www.mdpi.com/2072-6694/15/9/2636interstitial photodynamic therapyI-PDTmalignant central airway obstructionMCAOtreatment planningcomputational optimization |
| spellingShingle | Emily Oakley Evgueni Parilov Karl Beeson Mary Potasek Nathaniel Ivanick Lawrence Tworek Alan Hutson Gal Shafirstein Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction Cancers interstitial photodynamic therapy I-PDT malignant central airway obstruction MCAO treatment planning computational optimization |
| title | Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction |
| title_full | Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction |
| title_fullStr | Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction |
| title_full_unstemmed | Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction |
| title_short | Computational Optimization of Irradiance and Fluence for Interstitial Photodynamic Therapy Treatment of Patients with Malignant Central Airway Obstruction |
| title_sort | computational optimization of irradiance and fluence for interstitial photodynamic therapy treatment of patients with malignant central airway obstruction |
| topic | interstitial photodynamic therapy I-PDT malignant central airway obstruction MCAO treatment planning computational optimization |
| url | https://www.mdpi.com/2072-6694/15/9/2636 |
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