Non-invasive determination of port wine stain anatomy and physiology for optimal laser treatment strategies.

The treatment of port wine stains (PWSs) using a flashlamp-pumped pulsed dye laser is often performed using virtually identical irradiation parameters. Although encouraging clinical results have been reported, we propose that lasers will only reach their full potential provided treatment parameters match individual PWS anatomy and physiology. The purpose of this paper is to review the progress made on the technical development and clinical implementation of (i) infrared tomography (IRT), optical reflectance spectroscopy (ORS) and optical low-coherence reflectometry (OLCR) to obtain in vivo diagnostic data on individual PWS anatomy and physiology and (ii) models of light and heat propagation, predicting irreversible vascular injury in human skin, to select optimal laser wavelength, pulse duration, spot size and radiant exposure for complete PWS blanching in the fewest possible treatment sessions. Although non-invasive optical sensing techniques may provide significant diagnostic data, development of a realistic model will require a better understanding of relevant mechanisms for irreversible vascular injury.

[1]  D. Smithies,et al.  Depth determination of chromophores in human skin by pulsed photothermal radiometry. , 1996, Applied Optics.

[2]  J M Casparian,et al.  Thermal relaxation of port-wine stain vessels probed in vivo: the need for 1-10-millisecond laser pulse treatment. , 1995, The Journal of investigative dermatology.

[3]  B. S. Tanenbaum,et al.  A theoretical study of the thermal response of skin to cryogen spray cooling and pulsed laser irradiation: implications for treatment of port wine stain birthmarks. , 1995, Physics in medicine and biology.

[4]  B. S. Tanenbaum,et al.  Depth profiling of laser-heated chromophores in biological tissues by pulsed photothermal radiometry. , 1995, Journal of the Optical Society of America. A, Optics, image science, and vision.

[5]  B. S. Tanenbaum,et al.  Dynamic epidermal cooling during pulsed laser treatment of port-wine stain. A new methodology with preliminary clinical evaluation. , 1995, Archives of dermatology.

[6]  P. Butler,et al.  Modelling the distribution of laser light in port-wine stains with the Monte Carlo method. , 1995, Physics in medicine and biology.

[7]  B. S. Tanenbaum,et al.  Selective cooling of biological tissues: application for thermally mediated therapeutic procedures. , 1995, Physics in medicine and biology.

[8]  K. Wiss Management and Treatment of Benign Cutaneous Vascular Lesions , 1993 .

[9]  P. Morrison,et al.  585 nm for the treatment of port-wine stains. , 1990, Plastic and reconstructive surgery.

[10]  J. Pickering,et al.  Computed temperature distributions around ectatic capillaries exposed to yellow (578 nm) laser light. , 1989, Physics in medicine and biology.

[11]  O T Tan,et al.  Action spectrum of vascular specific injury using pulsed irradiation. , 1989, The Journal of investigative dermatology.

[12]  J. Mulliken,et al.  Vascular Birthmarks: Hemangiomas and Malformations , 1988 .

[13]  R.R. Anderson,et al.  Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. , 1983, Science.

[14]  J. W. Hudson,et al.  Forward looking infrared systems , 1975 .

[15]  G. Ripandelli,et al.  Optical coherence tomography. , 1998, Seminars in ophthalmology.

[16]  W Verkruysse,et al.  Modelling light distributions of homogeneous versus discrete absorbers in light irradiated turbid media. , 1997, Physics in medicine and biology.

[17]  W Verkruysse,et al.  Wavelengths for port wine stain laser treatment: influence of vessel radius and skin anatomy. , 1997, Physics in medicine and biology.

[18]  B. S. Tanenbaum,et al.  Imaging laser heated subsurface chromophores in biological materials: determination of lateral physical dimensions. , 1996, Physics in medicine and biology.

[19]  W Verkruysse,et al.  Light distributions in a port wine stain model containing multiple cylindrical and curved blood vessels , 1996, Lasers in surgery and medicine.

[20]  A. Welch,et al.  Wavelengths for laser treatment of port wine stains and telangiectasia , 1995, Lasers in surgery and medicine.

[21]  O. Tan Management and treatment of benign cutaneous vascular lesions , 1992 .

[22]  Robert F. Bonner,et al.  Principles of Laser-Doppler Flowmetry , 1990 .

[23]  J. Goodman Statistical Optics , 1985 .

[24]  J. Parrish,et al.  Microvasculature Can Be Selectively Damaged Using Dye Lasers: A Basic Theory and Experimental Evidence in Human Skin , 1981, Lasers in surgery and medicine.