This study employed a commercially available, non-invasive, fluorescence imaging system (Dyaderm, Biocam,
Germany), to measure protoporphyrin IX (PpIX) concentration at several different stages during clinical dermatological
methyl aminolevulinate photodynamic therapy (MAL-PDT). We validated the system prior to use to ensure that the
PpIX changes witnessed were accurate and not due to environmental or user induced artifacts. The system was then
employed to acquire color (morphological) and fluorescent (physiological) images simultaneously during dermatological
PDT. Clinical data was collected from a range of licensed dermatological conditions (actinic keratosis, Bowen's disease
and superficial basal cell carcinoma) during initial and subsequent PDT treatment cycles. The initial clinical data
indicated that each type of licensed lesion considered responded in a similar manner following the application of
Metvix (Galderma, U.K.) and the subsequent light irradiation (Aktilite, Galderma, U.K.). Images acquired three
hours after Metvix application showed a significant increase in PpIX concentration within the lesion (P < 0.05), whilst
PpIX levels in the surrounding normal tissue remained unaltered. After irradiation, the PpIX concentration was
significantly decreased and returned to a level similar to the initial concentration originally observed. Lesions that
received subsequent treatment cycles accumulated significantly less PpIX (P < 0.05) prior to irradiation.
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