Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study

Abstract Spinal metastases often occur in the advanced stages of breast, lung or prostate cancer, resulting in a significant impact on the patient’s quality of life. Current treatment modalities for spinal metastases include both systemic and localized treatments that aim to decrease pain, improve m...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Abdul-Amir Yassine, William C. Y. Lo, Tina Saeidi, Dallis Ferguson, Cari M. Whyne, Margarete K. Akens, Vaughn Betz, Lothar Lilge
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/226e53f81f054c20a169119dfed5db97
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:226e53f81f054c20a169119dfed5db97
record_format	dspace
spelling	oai:doaj.org-article:226e53f81f054c20a169119dfed5db972021-12-02T17:19:15ZPhotodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study10.1038/s41598-021-97407-z2045-2322https://doaj.org/article/226e53f81f054c20a169119dfed5db972021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97407-zhttps://doaj.org/toc/2045-2322Abstract Spinal metastases often occur in the advanced stages of breast, lung or prostate cancer, resulting in a significant impact on the patient’s quality of life. Current treatment modalities for spinal metastases include both systemic and localized treatments that aim to decrease pain, improve mobility and structural stability, and control tumour growth. With the development of non-toxic photosensitizer drugs, photodynamic therapy (PDT) has shown promise as a minimally invasive non-thermal alternative in oncology, including for spinal metastases. To apply PDT to spinal metastases, predictive algorithms that optimize tumour treatment and minimize the risk of spinal cord damage are needed to assess the feasibility of the treatment and encourage a broad acceptance of PDT in clinical trials. This work presents a framework for PDT modelling and planning, and simulates the feasibility of using a BPD-MA mediated PDT to treat bone metastases at two different wavelengths (690 nm and 565 nm). An open-source software for PDT planning, PDT-SPACE, is used to evaluate different configurations of light diffusers (cut-end and cylindrical) fibres with optimized power allocation in order to minimize the damage to spinal cord or maximize tumour destruction. The work is simulated on three CT images of metastatically involved vertebrae acquired from three patients with spinal metastases secondary to colorectal or lung cancer. Simulation results show that PDT at a 565 nm wavelength has the ability to treat 90% of the metastatic lesion with less than 17% damage to the spinal cord. However, the energy required, and hence treatment time, to achieve this outcome with the 565 nm is infeasible. The energy required and treatment time for the longer wavelength of 690 nm is feasible ( $${\sim }\,40$$ ∼ 40 min), but treatment aimed at 90% of the metastatic lesion would severely damage the proximal spinal cord. PDT-SPACE provides a simulation platform that can be used to optimize PDT delivery in the metastatic spine. While this work serves as a prospective methodology to analyze the feasibility of PDT for tumour ablation in the spine, preclinical studies in an animal model are ongoing to elucidate the spinal cord damage extent as a function of PDT dose, and the resulting short and long term functional impairments. These will be required before there can be any consideration of clinical trials.Abdul-Amir YassineWilliam C. Y. LoTina SaeidiDallis FergusonCari M. WhyneMargarete K. AkensVaughn BetzLothar LilgeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Abdul-Amir Yassine William C. Y. Lo Tina Saeidi Dallis Ferguson Cari M. Whyne Margarete K. Akens Vaughn Betz Lothar Lilge Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
description	Abstract Spinal metastases often occur in the advanced stages of breast, lung or prostate cancer, resulting in a significant impact on the patient’s quality of life. Current treatment modalities for spinal metastases include both systemic and localized treatments that aim to decrease pain, improve mobility and structural stability, and control tumour growth. With the development of non-toxic photosensitizer drugs, photodynamic therapy (PDT) has shown promise as a minimally invasive non-thermal alternative in oncology, including for spinal metastases. To apply PDT to spinal metastases, predictive algorithms that optimize tumour treatment and minimize the risk of spinal cord damage are needed to assess the feasibility of the treatment and encourage a broad acceptance of PDT in clinical trials. This work presents a framework for PDT modelling and planning, and simulates the feasibility of using a BPD-MA mediated PDT to treat bone metastases at two different wavelengths (690 nm and 565 nm). An open-source software for PDT planning, PDT-SPACE, is used to evaluate different configurations of light diffusers (cut-end and cylindrical) fibres with optimized power allocation in order to minimize the damage to spinal cord or maximize tumour destruction. The work is simulated on three CT images of metastatically involved vertebrae acquired from three patients with spinal metastases secondary to colorectal or lung cancer. Simulation results show that PDT at a 565 nm wavelength has the ability to treat 90% of the metastatic lesion with less than 17% damage to the spinal cord. However, the energy required, and hence treatment time, to achieve this outcome with the 565 nm is infeasible. The energy required and treatment time for the longer wavelength of 690 nm is feasible ( $${\sim }\,40$$ ∼ 40 min), but treatment aimed at 90% of the metastatic lesion would severely damage the proximal spinal cord. PDT-SPACE provides a simulation platform that can be used to optimize PDT delivery in the metastatic spine. While this work serves as a prospective methodology to analyze the feasibility of PDT for tumour ablation in the spine, preclinical studies in an animal model are ongoing to elucidate the spinal cord damage extent as a function of PDT dose, and the resulting short and long term functional impairments. These will be required before there can be any consideration of clinical trials.
format	article
author	Abdul-Amir Yassine William C. Y. Lo Tina Saeidi Dallis Ferguson Cari M. Whyne Margarete K. Akens Vaughn Betz Lothar Lilge
author_facet	Abdul-Amir Yassine William C. Y. Lo Tina Saeidi Dallis Ferguson Cari M. Whyne Margarete K. Akens Vaughn Betz Lothar Lilge
author_sort	Abdul-Amir Yassine
title	Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
title_short	Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
title_full	Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
title_fullStr	Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
title_full_unstemmed	Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
title_sort	photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/226e53f81f054c20a169119dfed5db97
work_keys_str_mv	AT abdulamiryassine photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT williamcylo photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT tinasaeidi photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT dallisferguson photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT carimwhyne photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT margaretekakens photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT vaughnbetz photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy AT lotharlilge photodynamictherapyoutcomemodellingforpatientswithspinalmetastasesasimulationbasedstudy
_version_	1718381014562111488

Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study

Ejemplares similares