Non-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy.

2.50
Hdl Handle:
http://hdl.handle.net/10541/81277
Title:
Non-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy.
Authors:
Allan, Ernest; Pye, David A; Levine, Edward; Moore, James V
Abstract:
The probability of local control of basal cell carcinomas (BCC) treated by photodynamic therapy (PDT) depends strongly on lesion thickness, thicker lesions often requiring two treatments. We examine the utility of 20 MHz pulsed ultrasound (US) for the non-invasive measurement of thickness and rate of regression after PDT treatment. PDT was by topically applied 20% aminolaevulinic acid, followed at 6 h by a standard 100 J/cm(2) of 630 nm light. Patients ( n=60) were selected as being difficult to treat with existing modalities for reasons of likely poor quality of healing or of cosmesis in this very largely elderly population. Ultrasound 'A' scans were made immediately before treatment, and at first and subsequent follow-ups. Parameters measured non-invasively for BCC, adjacent normal skin, and for fibroses after previous conventional therapies, were (a) thickness of skin or lesion, (b) linear density of ultrasound echoes and (c) linear density of high-amplitude echoes. Prior to treatment, median skin thickness (to the dermal/subcutaneous boundary) was 2.6 mm (range 1.2-5.7), fibroses 2.5 mm (1.4-5.6) and BCC 1.5 mm (0.5-4.4). Median linear density of echoes for normal skin, fibroses and BCC plus underlying tissue were 5.6, 5.5 and 4.5, respectively, the BCC values being significantly lower ( p=0.002). The corresponding medians for high-amplitude echoes were 1.9, 1.9 and 1.1 (skin or fibrosis versus BCC, p=0.001). Patients whose BCCs appeared clinically to be controlled at up to 220 days after a single treatment, all had values of ultrasound parameters corresponding to skin/fibrosis and were significantly different from measurements on the same site prior to treatment. Patients whose tumours appeared to be reverting to the original BCC ultrasound pattern were subsequently found to be recurring as judged clinically. Non-invasive pulsed ultrasound indicates that rates of resolution vary widely between BCC of similar initial thickness and that the probability of clearance of BCC by PDT is determined largely by the deepest, sometimes small, regions within a lesion, with the overall area being relatively unimportant.
Affiliation:
Dept of Clinical Oncology, Christie Hospital, Manchester, UK.
Citation:
Non-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy. 2002, 17 (4):230-7 Lasers Med Sci
Journal:
Lasers in Medical Science
Issue Date:
2002
URI:
http://hdl.handle.net/10541/81277
DOI:
10.1007/s101030200034
PubMed ID:
12417976
Type:
Article
Language:
en
ISSN:
0268-8921
Appears in Collections:
All Christie Publications ; All Paterson Institute for Cancer Research

Full metadata record

DC FieldValue Language
dc.contributor.authorAllan, Ernest-
dc.contributor.authorPye, David A-
dc.contributor.authorLevine, Edward-
dc.contributor.authorMoore, James V-
dc.date.accessioned2009-09-16T13:11:22Z-
dc.date.available2009-09-16T13:11:22Z-
dc.date.issued2002-
dc.identifier.citationNon-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy. 2002, 17 (4):230-7 Lasers Med Scien
dc.identifier.issn0268-8921-
dc.identifier.pmid12417976-
dc.identifier.doi10.1007/s101030200034-
dc.identifier.urihttp://hdl.handle.net/10541/81277-
dc.description.abstractThe probability of local control of basal cell carcinomas (BCC) treated by photodynamic therapy (PDT) depends strongly on lesion thickness, thicker lesions often requiring two treatments. We examine the utility of 20 MHz pulsed ultrasound (US) for the non-invasive measurement of thickness and rate of regression after PDT treatment. PDT was by topically applied 20% aminolaevulinic acid, followed at 6 h by a standard 100 J/cm(2) of 630 nm light. Patients ( n=60) were selected as being difficult to treat with existing modalities for reasons of likely poor quality of healing or of cosmesis in this very largely elderly population. Ultrasound 'A' scans were made immediately before treatment, and at first and subsequent follow-ups. Parameters measured non-invasively for BCC, adjacent normal skin, and for fibroses after previous conventional therapies, were (a) thickness of skin or lesion, (b) linear density of ultrasound echoes and (c) linear density of high-amplitude echoes. Prior to treatment, median skin thickness (to the dermal/subcutaneous boundary) was 2.6 mm (range 1.2-5.7), fibroses 2.5 mm (1.4-5.6) and BCC 1.5 mm (0.5-4.4). Median linear density of echoes for normal skin, fibroses and BCC plus underlying tissue were 5.6, 5.5 and 4.5, respectively, the BCC values being significantly lower ( p=0.002). The corresponding medians for high-amplitude echoes were 1.9, 1.9 and 1.1 (skin or fibrosis versus BCC, p=0.001). Patients whose BCCs appeared clinically to be controlled at up to 220 days after a single treatment, all had values of ultrasound parameters corresponding to skin/fibrosis and were significantly different from measurements on the same site prior to treatment. Patients whose tumours appeared to be reverting to the original BCC ultrasound pattern were subsequently found to be recurring as judged clinically. Non-invasive pulsed ultrasound indicates that rates of resolution vary widely between BCC of similar initial thickness and that the probability of clearance of BCC by PDT is determined largely by the deepest, sometimes small, regions within a lesion, with the overall area being relatively unimportant.en
dc.language.isoenen
dc.subjectSkin Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshCarcinoma, Basal Cell-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPhotochemotherapy-
dc.subject.meshSkin-
dc.subject.meshSkin Neoplasms-
dc.titleNon-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy.en
dc.typeArticleen
dc.contributor.departmentDept of Clinical Oncology, Christie Hospital, Manchester, UK.en
dc.identifier.journalLasers in Medical Scienceen
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