Quantification evaluation and outcomes analysis of photodynamic therapy for port-wine stains (PWS) is usually rely on the clinician subjective assessment. The aim of this study is focused on an objective assessment model for port-wine stains during the successive treatment sessions of photodynamic therapy. The assessments of the outcome were assessed in the clearance of the lesion area before and after treatment and the trace of the lesion across the entire color space in this paper. Firstly, 3D point clouds containing the lesion coordinates and color was achieved. Then, the obtained unorganized point cloud is projected onto a specified plane to generate an organized grid, and the depth image on that plane can be also obtained. Thirdly, the lesion region is separated by using the SLIC superpixel segmentation combined with the color feature of the lesion, and the lesion was re-projected to the original three-dimensional point cloud. In the end, depending on the color and location information of the 3D lesion skin points, triangulation reconstruction was performed by the greedy projection triangulation algorithm to calculate the irregular surface area of the lesion skin. The result show that the lesion skin area based on three-dimensional space are stable and reliable regardless of the scanning angle or distance difference and the chromaticity distribution in the color space can show the recovery trend of the lesion skin at different treatment stages, so three-dimensional scanning of patients can be an approach to monitor the progress of an individual’s PWS following treatments accurately and objectively.
Dose control is one of the key factors of clinical treatment for port wine stains (PWS) under vasculature-targeted photodynamic therapy. A skin simulation model was proposed to show the PDT Type II reaction around the microcapillaries, and to establish the optimal PDT protocol such as light modulation for different PWS vascular types. A simplified two-dimensional cross section of PWS vascular composed of a single superficial epidermal layer, a deeper dermal layer, and a microcapillaries was used. A series of capillary diameters of 40, 70, 100 and 130 micrometers were used to model typical PWS lesions with different blood flow rates. Oxygen and photosensitizers (PS) are pumped from the microartery at heartbeat frequency and exit the vasculature from the microvein, and a PDT type II reaction occurs near the vessel wall: PS excited by light absorption combines with free oxygen, which leads to a reactive singlet state of oxygen (SSO) that in turn causes direct endothelial cell damage. The mathematical simulation model equations are composed of light transmission, oxygen diffusion, photosensitizer diffusion, singlet oxygen generation and photobleaching, which were solved by finite element method. With the drug diffusion and optical absorption properties of human skin, the photon consumption, drugs and oxygen diffusion and photochemical processes within the vessel wall can be simulated. This simulation can provide a quantitative method to optimize the light and drug dose for clinical treatment of PWS.
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