Lasers in Surgery and Medicine最新文献

{"title":"Multiphoton Microscopy Assessment of Healing From Tendon Laceration and Microthermal Coagula in a Rat Model.","authors":"Jenna E Montague, Gabrielle V Hutchens, Caitlin C Howard, Photini F S Rice, David G Besselsen, Michael Slayton, Urs Utzinger, Jennifer K Barton, Travis W Sawyer","doi":"10.1002/lsm.23871","DOIUrl":"https://doi.org/10.1002/lsm.23871","url":null,"abstract":"<p><strong>Objectives: </strong>To study the healing response of rat Achilles tendon when lacerated or treated with intense therapeutic ultrasound (ITU) via utilization of multiphoton microscopy (MPM) imaging and histology.</p><p><strong>Materials and methods: </strong>The right Achilles tendon of each Sprague Dawley rat within a cohort was partially lacerated. 1 to 2 days post-surgery, each rat received ITU treatment of the Achilles tendon on either the right or left leg. Rats were euthanized in groups at 1, 3, 7, 14, or 28 days posttreatment and their tendons were explanted, formalin fixed, paraffin embedded, sectioned, and placed on slides for imaging. Slides from each time point were imaged using a laboratory built MPM with a 780 nm Ti:Sapphire laser. The resulting second harmonic generation (SHG) and two-photon excited fluorescence (2PEF) signals were captured, assessed, and compared to brightfield microscopy images of the same section subsequently stained with hematoxylin and eosin.</p><p><strong>Results: </strong>At early timepoints, 2PEF images show the presence of red blood cells, infiltration of inflammatory cells and formation of a fibrin clot at laceration sites, and attraction of fibroblasts to ITU coagula. SHG images indicate an absence of organized collagen in both types of lesions. At later timepoints, new organized collagen can be seen at the laceration sites, and the concentration of inflammatory cells has noticeably decreased. Automated detection of red blood cells and infiltrative cells, as well as analysis of SHG signal intensity and homogeneity was performed at laceration locations. Results show that all quantities except SHG signal intensity approach normal values by day 28. Thus, combined analysis of 2PEF and SHG images elucidates tendon healing processes that align with and complement histological findings.</p><p><strong>Conclusion: </strong>These results indicate that multiphoton imaging can effectively visualize the healing response to mechanical (laceration) and thermal (ITU) injury, including the organization of new collagen which is more difficult to visualize with histology.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Immune Responses to Ablative Fractional Laser, Heat- and Cold-Based Dermatological Procedures.","authors":"Rikke L Christensen, Heehwa G Son, Eray Yihui Zhou, Uffe H Olesen, Lilit Garibyan, William A Farinelli, Fernanda H Sakamoto, R Rox Anderson, Merete Haedersdal, Shadmehr Demehri","doi":"10.1002/lsm.23868","DOIUrl":"https://doi.org/10.1002/lsm.23868","url":null,"abstract":"<p><strong>Objective: </strong>Physical treatment modalities, such as ablative fractional laser (AFL), electrocautery, and cryotherapy, are extensively used in the field of dermatology. This study aimed to characterize the short-term innate and adaptive immune responses induced by AFL compared with heat- and cold-based procedures.</p><p><strong>Materials and methods: </strong>Innate (CD11b⁺Ly6G⁺ neutrophils) and adaptive (CD8⁺CD3⁺ T cells) immune cell infiltration and histopathological changes were examined in murine skin on Days 1 and 7, following AFL, monopolar-electrocautery (RF), thermocautery, and cryotherapy. Interventions were standardized to reach the reticular dermis. Clinical skin reactions were photo-documented daily. As a comparator, the adaptive immune response was examined in murine basal cell carcinomas (BCC) on Day 7 after AFL exposure.</p><p><strong>Results: </strong>Baseline histopathology confirmed immediate deep dermal tissue impact by all procedures. Immune cell dynamics varied across treatments throughout the progression of clinical and histopathological responses. On Day 1, AFL and heat-based procedures triggered an innate immune response, characterized by CD11b⁺Ly6G⁺ neutrophil cell infiltration that correlated with histopathological findings and immediate onset of clinical skin reactions. In addition, heat-based procedures led to an increase in overall dermal CD45⁺ cells (Day 1), which continued to rise for AFL and RF-electrocautery at Day 7 posttreatment. On the contrary, cryotherapy did not induce immediate (Day 1) innate immune responses, but instead a delayed increase in neutrophil and CD45⁺ cell infiltration (Day 7), which coincided with the late onset of clinical reaction. CD3⁺ T cells and CD8⁺CD3⁺ T cells demonstrated a similar pattern, with an increase observed for heat-based procedures on Day 1 and a delayed increase for cryotherapy on Day 7. Distinctive for AFL-treated skin, the level of dermal CD3⁺ T cells increased over time, significant by Day 7, and AFL-treated mouse BCCs responded with increased CD8⁺ T cell infiltration at Day 7 posttreatment.</p><p><strong>Conclusion: </strong>Heat- and cold-based procedures developed distinct cutaneous immune responses, with cryotherapy resulting in a delayed response compared to immediate immune responses from heat-based procedures. The substantial T cell response induced by AFL in the skin and BCC tumors indicates a potential for AFL as an adjuvant in immunotherapeutic treatments of keratinocyte cancers.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of Tumors of the Upper Respiratory Tract Using Optical Metabolic Imaging.","authors":"Dennis Eggert, David Gaertner, Adrian Rühm, Ronald Sroka, Christoph Arens, Nikolaos Davaris, Konrad Birkmeier, Andreas Brodschelm, Patrick Leisching, Hauke Studier, Wolfgang Becker, Karsten König, Christan S Betz","doi":"10.1002/lsm.23870","DOIUrl":"https://doi.org/10.1002/lsm.23870","url":null,"abstract":"<p><strong>Objectives: </strong>With over 184,000 new cases and more than 99,000 deaths per year, malignancies of the larynx are a global health problem. Currently, a dedicated screening method enabling a direct onsite diagnosis is missing. This can lead to delayed diagnosis and worse outcomes of the patients. An endoscopic optical method enabling a direct distinction between healthy tissue, dysplastic tissue and cancerous tissue would be an ideal tool for the detection of tumors of the upper aerodigestive tract (UADT). Healthy and tumor cells differ significantly in their metabolic state due to the different metabolic pathways they use (more oxidative phosphorylation in healthy cells, more glycolysis in tumor cells). Optical metabolic imaging (OMI) measuring relative intracellular concentration of NAD(P)H and FAD redox pairs could be a promising approach for early tumor detection and differentiation of suspicious mucosal lesions.</p><p><strong>Methods: </strong>In this study, a specially designed endoscopic two-beam two-photon fluorescence lifetime imaging (FLIM) system was used to perform two-photon two-beam FLIM of NAD(P)H and FAD to image the metabolic state in different tissue samples of the UADT. FLIM data sets of 27 tissue samples from 16 patients were recorded directly after surgery ex vivo in a special tissue culture medium at 37°C on a dedicated microscope using multiphoton excitation.</p><p><strong>Results: </strong>Based on the FLIM measurements of NAD(P)H and FAD, six of the most common indices for the characterization of the cells' metabolism were calculated. Three of them, the ratio of the exponential coefficients (amplitudes) of the short and long lifetime components both for NAD(P)H and FAD (NAD(P)H a1/a2 ratio and FAD a1/a2 ratio) and the fluorescence lifetime redox ratio (FLIRR) enabled differentiation between healthy tissue, benign lesions, dysplastic tissue, and cancer tissue with statistical significance.</p><p><strong>Conclusions: </strong>We showed by measurements on freshly collected tissue samples that mucosal lesions of the UADT can be differentiated using our newly designed endoscopic FLIM device. In vivo measurements in healthy volunteers were also possible. By means of this technology, differentiation of cancerous, pre-cancerous, and healthy tissue in the UADT by OMI could be possible. Of six indices used to characterize cell metabolism we calculated, the FLIRR showed the most significant differences between tissue types.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 595-nm Wavelength Pulsed Dye Laser for Pediatric Port-Wine Birthmarks and Infantile Hemangiomas: A Systematic Review.","authors":"David A Hashemi, Joy Tao, Jordan V Wang, Roy G Geronemus","doi":"10.1002/lsm.23864","DOIUrl":"https://doi.org/10.1002/lsm.23864","url":null,"abstract":"<p><strong>Introduction: </strong>The 595-nm wavelength pulsed dye laser (PDL) is well-established in the treatment of vascular lesions. In June 2023, it received FDA clearance for the treatment of port-wine birthmarks (PWB) and infantile hemangiomas (IH) in the pediatric population.</p><p><strong>Objective: </strong>Review the evidence regarding the efficacy, safety, and implications of using PDL for management of pediatric PWB and IH.</p><p><strong>Methods: </strong>A systematic literature search was performed to identify peer-reviewed articles and clinical trials published between July 2002 and December 2022 in which PDL was used to treat pediatric PWB and IH.</p><p><strong>Results: </strong>After application of criteria, 33 journal articles with 7725 total patients were included. Only 16 (0.8%) of the 2,033 patients with PWB and 11 (0.2%) of the 5692 patients with hemangioma reported permanent adverse effects including scarring, keloids, or permanent pigmentation change, and none reported blindness or other serious injury. Good, excellent, or complete clearance after PDL-on average or in greater than 50% of patients-was reported in 17 of 19 studies (89%) that reported these measures for PWB, and seven of the seven studies (100%) for IH.</p><p><strong>Conclusion: </strong>The 595-nm PDL is an excellent treatment option for early intervention in pediatric patients with PWB or IH.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Papain-Urea for Enzymatic Debridement of Coagulation Zones Following Ablative Fractional Laser Treatment.","authors":"Joshua Zev Glahn, Michael Wang-Evers, Abigail R Carlson, Haley Marks, Daniel Karasik, Felix Hilge, Jeremy Goverman, Dieter Manstein","doi":"10.1002/lsm.23865","DOIUrl":"https://doi.org/10.1002/lsm.23865","url":null,"abstract":"<p><strong>Background: </strong>Ablative fractional CO₂ laser (10,600 nm) treatment creates an array of microscopic treatment zones composed of an ablation zone (AZ) surrounded by a denatured coagulation zone (CZ). The CZ is believed to play a functional role in skin tightening, posttreatment inflammation, and laser-assisted drug delivery. This study investigates the viability of enzymatic post-processing to remove the CZ without affecting the surrounding tissue.</p><p><strong>Methods: </strong>Ex vivo skin samples were treated with either control, papain, urea, or papain-urea solutions before being covered with occlusive dressing and incubated at 37°C for 1 h. Tissue viability as well as AZ and CZ geometries were assessed histologically.</p><p><strong>Results: </strong>Treatment with all three experimental solutions resulted in a decrease in CZ. The largest average reduction in CZ area was observed in the papain-urea group (44%, p < 0.001), followed by the papain (14%, p < 0.001) and urea (11%, p < 0.001) only groups. Only the papain-urea group showed a significant increase in AZ (14%) and changes in lesion geometry.</p><p><strong>Conclusion: </strong>This exploratory study of enzymatic post-processing with papain-urea highlighted the potential of selectively removing the CZ after treatment with ablative fractional laser therapy. If results can be translated to in vivo studies, these findings could expand the use of high-fluence CO₂ laser therapy with functional implications for lowering posttreatment recovery time, providing clinicians more control over skin tightening, and enabling a broader range of laser-assisted drug delivery.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histologic Effects of Fractional Lasers and Energy-Based Devices on Intradermally Injected Hyaluronic Acid Filler for Improving Skin Smoothness.","authors":"Shealinna Ge, Hye Jin Chung, Robert A Weiss","doi":"10.1002/lsm.23863","DOIUrl":"https://doi.org/10.1002/lsm.23863","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown that energy-based devices (EBDs) over pre-injected hyaluronic acid (HA) fillers do not significantly affect clinical outcomes. However, the impact of EBDs over newly FDA-approved HA filler for improving skin smoothness is still undetermined.</p><p><strong>Objective: </strong>To evaluate the immediate histologic changes after various popular EBDs are performed over pre-injected, newly FDA-approved intradermal HA filler.</p><p><strong>Materials and methods: </strong>Abdominoplasty skin was injected with HA superficially. Zone 1 was used as untreated control, while the other zones treated with the 755-nm picosecond laser with diffractive lens array, 1064-nm picosecond and 1064-nm Q-switched lasers, radiofrequency with insulated microneedles, volumetric directional thermal impact ultrasound (VDTI), and thermomechanical fractional injury (TMFI) devices.</p><p><strong>Results: </strong>Histology shows HA in the superficial to mid dermis. Treatment with fractional Q-switched and picosecond lasers showed expected laser-induced optical breakdown in the epidermis and dermis. RF microneedling, VDTI, and TMFI devices caused thermal damage of collagen bundles with dermal dehydration.</p><p><strong>Conclusion: </strong>No immediate morphological changes to HA were noted following device treatment. However, the effect of heat-generating devices on the molecular integrity of HA fillers, which are composed of HA and water, remains uncertain.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical Clearing of Ex Vivo Adipose Tissue","authors":"Irina Yu. Yanina,&nbsp;Elina A. Genina,&nbsp;Daria K. Tuchina,&nbsp;Polina A. Timoshina,&nbsp;Nikita A. Navolokin,&nbsp;Alla B. Bucharskaya,&nbsp;Galina N. Maslyakova,&nbsp;Valery V. Tuchin","doi":"10.1002/lsm.23860","DOIUrl":"10.1002/lsm.23860","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The paper focuses on the development of technology of adipose tissue optical clearing using different complex hyperosmotic optical clearing agents and tissue permeability enhancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To quantify optical clearing efficiency, reduced scattering coefficient was estimated from the ex vivo spatially resolved backreflectance measurements using a multi-distant fiber optical device. Tissue morphology modification was monitored with the help of histological studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kinetics and efficiency of the optical clearing were evaluated for ex vivo abdominal fat tissue at action of dimethyl sulfoxide, diatrizoic acid, metrizoic acid, sucrose, and fructose solutions accompanied by tissue permeability enhancers, such as various modes of fractional laser microablation and sonophoresis and their combinations. Histological studies allowed us to find agents that cause minimal morphological changes of the adipose tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maximal optical clearing efficiency of 83.5% was observed for the samples subjected to action of the fructose-ethanol solution during 90 min in combination with gentle modes of fractional laser microablation and sonophoresis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"829-835"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Therapeutic Potential of Microneedle Patch Laser With Multiple Wavelengths in Allergic Rhinitis: Insights From an Allergic Rhinitis Mouse Model","authors":"Reiza Ventura,&nbsp;Jun-Sang Bae,&nbsp;Eun Hee Kim,&nbsp;A. Young Kim,&nbsp;Min Hyuck Oh,&nbsp;Ji Hye Kim,&nbsp;Shin Hyuk Yoo,&nbsp;Gwanghui Ryu,&nbsp;Ji-Hun Mo","doi":"10.1002/lsm.23862","DOIUrl":"10.1002/lsm.23862","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is insufficient evidence to determine the effectiveness of treating allergic rhinitis with a patch laser affix to the skin as opposed to direct intranasal irradiation of the nasal mucosa. We aimed to evaluate the effect of the microneedle patch laser with multiple wavelengths in an allergic rhinitis (AR) mouse model and its underlying mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The microneedle patch laser was attached to the skin above the mouse's nasal cavity, transmitting light to the nasal mucosa. For 10 days, the microneedle patch laser administered simultaneous exposure to wavelengths of 670, 780, 850, and 910 nm at either 10 or 20 min each day. Multiple allergic parameters were evaluated following the microneedle patch laser treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Microneedle patch laser treatment decreased allergic symptoms and inhibited OVA-specific IgE levels. Additionally, it significantly reduced eosinophil infiltration, epithelial thickness of the nasal mucosa, and IL-4 cytokine levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The light emitted by the microneedle patch laser attached to the skin, penetrated effectively to the nasal mucosa within the nasal cavity, suggesting potential for treating allergic rhinitis in mice and could be extended in clinical applications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"854-864"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Time-Resolved Fluorescence Detection of Liver Cancer Supported by Machine Learning","authors":"Elena V. Potapova,&nbsp;Valery V. Shupletsov,&nbsp;Viktor V. Dremin,&nbsp;Evgenii A. Zherebtsov,&nbsp;Andrian V. Mamoshin,&nbsp;Andrey V. Dunaev","doi":"10.1002/lsm.23861","DOIUrl":"10.1002/lsm.23861","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>One of the widely used optical biopsy methods for monitoring cellular and tissue metabolism is time-resolved fluorescence. The use of this method in optical liver biopsy has a high potential for studying the shift in energy-type production from oxidative phosphorylation to glycolysis and changes in the antioxidant defense of malignant cells. On the other hand, machine learning methods have proven to be an excellent solution to classification problems in medical practice, including biomedical optics. We aim to combine time-resolved fluorescence measurements and machine learning to automate the division of liver parenchyma and tumors (primary malignant, metastases and benign tumors) into classes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An optical biopsy was performed using a developed setup with a fine-needle optical probe in clinical conditions under ultrasound control. Fluorescence decays were recorded in a conditionally healthy liver and lesions during percutaneous needle biopsy. The labeled data set was created on the basis of the recorded fluorescence results and the histopathological classification of the biopsies obtained. Several machine learning methods were trained using different separation strategies of the training test set, and their respective accuracy was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our results show that each of the tumor types had its own characteristic metabolic shifts recorded by the time-resolved fluorescence spectroscopy. The application of machine learning demonstrates a reliable separation of the liver and all tumor types into cancer and noncancer classes with sensitivity, specificity and corresponding accuracy greater than 0.91, 0.79 and 0.90, using the random forest method. We also show that our method is capable of giving a preliminary diagnosis of the type of liver tumor (primary malignant, metastases and benign tumors) with a sensitivity, specificity and accuracy of at least 0.80, 0.95 and 0.90.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These promising results highlight its potential as a key tool in the future development of diagnostic and therapeutic strategies for liver cancers. Lasers Surg. Med. 00:00–00, 2024. 2024 Wiley Periodicals LLC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"836-844"},"PeriodicalIF":2.2,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Photoplethysmography (iPPG) in Head and Neck Reconstructive Surgery: A Novel Technique for Noninvasive Flap Perfusion Monitoring","authors":"S. D. van der Stel,&nbsp;M. Lai,&nbsp;H. C. Groen,&nbsp;R. Dirven,&nbsp;M. B. Karakullukcu,&nbsp;L. H. E. Karssemakers,&nbsp;M. van Gastel,&nbsp;B. H. W. Hendriks,&nbsp;T. J. M. Ruers,&nbsp;W. H. Schreuder","doi":"10.1002/lsm.23859","DOIUrl":"10.1002/lsm.23859","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evaluate imaging photoplethysmography (iPPG) as a novel noninvasive technique to assess flap perfusion in head and neck free flap reconstructive (FFR) surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Intraoperative iPPG was performed in 17 patients undergoing FFR surgery. Imaging consisted of a 30-s video from which perfusion maps were extracted, providing detailed information about blood flow and pulsatility in the flap microvasculature. During each procedure, iPPG acquisitions were acquired representing distinct perfusion conditions of the flap (fully perfused/ischemic/reperfused). When possible, postoperative measurements were performed to assess flap recovery during the critical time period (3 days) and long-term follow-up (30 days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Perfusion maps, displaying iPPG amplitude and delay times, correlated strongly (<i>p</i> &lt; 0.001) with the perfusion status of the tissue. One case of postoperative thrombosis, leading to flap failure, was identified with iPPG. After surgical revision in this case, flap perfusion was restored and confirmed by iPPG. Postoperative follow-up imaging allowed for objective visualization of flap recovery short term (3 days) and up to 30 days after the surgical procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows that iPPG is suitable for objective and noninvasive assessment of flap perfusion in head and neck FFR surgery. In addition, postoperative monitoring shows potential for assessing flap perfusion in patients with increased risk of postoperative complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"811-820"},"PeriodicalIF":2.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}