Progress in Port-Wine Stains Lesion Structure and Its Optical Imaging Technique in Vascular-Targeted Photodynamic Therapy

Yidi Liu; Defu Chen; Jing Zeng; Haixia Qiu; Ying Gu

doi:10.3788/CJL202249.1507102

Chinese Journal of Lasers, Volume. 49, Issue 15, 1507102(2022)

Progress in Port-Wine Stains Lesion Structure and Its Optical Imaging Technique in Vascular-Targeted Photodynamic Therapy

Yidi Liu^1,2, Defu Chen³, Jing Zeng², Haixia Qiu^2、**, and Ying Gu^2,3,4、*

Author Affiliations

¹Medical School of Chinese PLA, Beijing 100853, China

²Department of Laser Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China

³School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China

⁴Precision Laser Medical Diagnosis and Treatment Innovation Unit, Chinese Academy of Medical Sciences, Beijing 100730, China

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Figures & Tables(5)

Fig. 1. Principle of V-PDT used for treating PWS

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Fig. 2. Imaging results of PWS under common optical imaging equipment. (a) OCT^[32]; (b) RCM^[36]; (c) dermoscope ^[38]; (d) PAI ^[43]; (e) ODT ^[58]; (f) OCTA^[47]; (g) LDI^[52]; (h) LSI^[70]

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Table 1. Optical modality for obtaining PWS lesion structure

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Table 1. Optical modality for obtaining PWS lesion structure

Imaging method	Modality	Observation	Ref.	Advantage	Limitation
Structural imaging	OCT	Epidermis thickness, vascular diameter/depth	[32-35]	Non-contact imaging, quick imaging, high resolution	Shallow imaging depth
	RCM	Vascular diameter/depth	[36-37]	Fast imaging, high resolution	Being sensitive to motion，shallow imaging depth
	Dermoscope	Vascular morphology	[38-39]	User-friendliness	Two-dimensional imaging，shallow imaging depth
Functional imaging	PAI	Melanin, vascular diameter/depth/morphology	[24，40-44]	Deep imaging depth(>1 mm)	Contact measuring
	ODT/OCTA	Epidermis thickness, vascular diameter/depth/morphology	[45-48]	Non-contact imaging, quick, imaging, high resolution	Shallow imaging depth
	LDI	Blood perfusion	[49-52]	Mature technique	Two-dimensional imaging
	LSI	Blood perfusion	[53-54]	Fast imaging	Two-dimensional imaging

Table 2. Clinical classification of PWS

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Table 2. Clinical classification of PWS

Ref.	Method	Classification	Characteristic
[88]	Histopathology	A: constricted type B: dilated type C: intermediate type D: deep located type	A: blood vessels are differed little from the normal pattern and their number is not more than that in normal skin B: vessels are considerably enlarged and often contain red cells C: this type shows histological features common to those of A and B types D: vessels scatter throughout dermis
[93]	Histopathology	Type I：dilated type Type II：dilated type with cavernous vascular malformation Type III：functional developmental type Type IV：cobblestone	Type I: number of vessels increase or blood vessels dilate, and surrounding tissues are normal Type II: this type shows dilated vessels with cavernous vascular malformation Type III: this type shows formation of single or multiple nodules Type IV：dilatation of blood vessels is throughout lesion
[38]	Dermoscope	Type I：blobs Type II：rings Type III：containing I and II	Type I: this type shows superficial, tortuous, dilated end capillary loops Type II: this type shows dilated vessels in superficial horizontal vascular plexus Type III: this type contains I and II
[27]	Histopathology	Grade I Grade II Grade III Grade IV Grade V	Grade I: vessel diameter is 50－80 μm Grade II: vessel diameter is 80－100 μm Grade III: vessel diameter is 100－120 μm Grade IV: vessel diameter is 120－150 μm Grade V: vessel diameter is >150 μm
[19]	Naked eyes	1: pink (red) 2: purple 3: thickening (nodules)	1: ectatic vessels are mostly located in papillary layer (pink); ectatic vessels are mostly located in middle dermis layer (red) 2: dilated vessels are mostly located in papillary and middle dermis layers, however, some are located in deep dermis and presented like cluster 3: dilated vessels are distributed from superficial to deep dermis layers and even to subcutaneous tissue, presenting like cluster^[94]

Table 3. Relationship between PWS lesion structure and V-PDT efficacy

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Table 3. Relationship between PWS lesion structure and V-PDT efficacy

Factor	Optical method	Relationship	Reason
Melanin	PAI	(－)	It is located in epidermis, influencing optical absorbance
Epidermis thickness	PAI	(－)	It varies for different individuals and parts of body and influences light penetration depth
Epidermis thickness	OCT	(－)
Vascular diameter	PAI	(－)	The larger the vessels, the less light can reach and cover entire vessel
	OCT/ODT/OCTA
	RCM
Vascular depth	PAI	(－)	The deeper vessels are, the less energy of light that vessels can absorb
	OCT/ODT/OCTA
	RCM
Vascular morphology	PAI	Perpendicular (－)	Perpendicular vessels absorb less light than curved ones
	OCT/ODT/OCTA
	Dermoscope
Blood perfusion	LDI	Decreased after V-PDT (＋)	Decreased blood perfusion is equal to decreased number of dilated vessels
Blood perfusion	LSI	Decreased after V-PDT (＋)

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Yidi Liu, Defu Chen, Jing Zeng, Haixia Qiu, Ying Gu. Progress in Port-Wine Stains Lesion Structure and Its Optical Imaging Technique in Vascular-Targeted Photodynamic Therapy[J]. Chinese Journal of Lasers, 2022, 49(15): 1507102

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Paper Information

Category: Optical Diagnostics and Therapy

Received: Jan. 6, 2022

Accepted: Feb. 17, 2022

Published Online: Jul. 29, 2022

The Author Email: Qiu Haixia (qiuhxref@126.com), Gu Ying (guyinglaser301@163.com)

DOI:10.3788/CJL202249.1507102

Topics

laser devices and laser physics

Lasers and Laser Optics

Laser physics

laser manufacturing

Instrumentation, Measurement and Metrology