Spatial frequency domain imaging of port wine stain biochemical composition in response to laser therapy: A pilot study

Amaan Mazhar,J David Cuccia,Seyed A Sharif,Kristen M Kelly,J Stuart Nelson,Anthony J Durkin

doi:10.1002/lsm.22067

Abstract

Objective methods to assess port wine stain (PWS) response to laser treatment have been the subject of various research efforts for several years. Herein, we present a pilot study using a newly developed, light emitting diode (LED) based spatial frequency domain imaging (SFDI) device to record quantitatively biochemical compositional changes in PWS after laser therapy. A SFDI system was used to image before, and after, five PWS treatment sessions [n = 4 subjects (one subject was imaged before and after two consecutive laser treatments)]. SFDI derived wide-field optical properties (absorption and scattering) and tissue chromophore concentrations including oxy-hemoglobin (ctO(2) Hb), deoxy-hemoglobin (ctHHb), total hemoglobin (ctTHb), and tissue oxygen saturation (stO(2) ) are presented for skin imaged prior to and immediately after laser treatment. The SFDI derived images were analyzed by comparing the above measurements in PWS to those of normal skin and tracking changes immediately after laser exposure. Elevated oxy-hemoglobin (>20%) and tissue oxygen saturation (>5%) were measured in all PWS lesions and compared to values for normal skin prior to treatment. Laser treatment resulted in an increase in deoxy-hemoglobin (>100%), decrease in tissue oxygen saturation (>10%), and reduced scattering (>15%) in all PWS lesions. One subject was followed before and after two consecutive laser treatments and the overall improvement in PWS lesion blanching was quantitatively assessed by measuring a 45% decrease in dermal blood volume. SFDI is a rapid non-contact wide-field optical technique that shows potential as an imaging device that can be used to quantify biochemical compositional changes in PWS after laser therapy. Future work will investigate the potential of SFDI to provide intra-operative guidance for laser therapy of PWS lesions on an individual patient basis.

Highlights

Port wine stain (PWS) birthmarks are congenital progressive vascular malformations that typically occur on the head or neck [1]
spatial frequency domain imaging (SFDI) is a rapid non-contact wide-field optical technique that shows potential as an imaging device that can be used to quantify biochemical compositional changes in port wine stain (PWS) after laser therapy
Future work will investigate the potential of SFDI to provide intra-operative guidance for laser therapy of PWS lesions on an individual patient basis

Summary

Introduction

Port wine stain (PWS) birthmarks are congenital progressive vascular malformations that typically occur on the head or neck [1]. These lesions are difficult to conceal and are often the cause of physical and emotional disability due to facial asymmetry and deformity [2]. During PWS laser-treatment, the surgeon will methodically move the hand piece over the entire birthmark. Due to the heterogeneity of blood vessel geometry in PWS lesions, it is often difficult to assess treatment efficacy. Objective methods to assess port wine stain (PWS) response to laser treatment have been the subject of various research efforts for several years. We present a pilot study using a newly developed, light emitting diode (LED) based spatial frequency domain imaging (SFDI) device to record quantitatively biochemical compositional changes in PWS after laser therapy

Methods

Results

Conclusion