Feasibility of photoacoustic‐guided ultrasound treatment for port wine stains

• Published in: Lasers in surgery and medicine 2023-01, Vol.55 (1), p.46-60
• Main Authors: Chua, Chloe J., Pandey, Prabodh K., Kelly, Kristen M., Xiang, Liangzhong
• Format: Article
• Language: English
• Subjects: Blood vessels; Capillaries; Cicatrix; Convergence; Discoloration; Feasibility Studies; high‐intensity focused ultrasound (HIFU); Humans; Laser beam heating; Lasers; Methodology; photoacoustic (PA)‐guided ultrasound (US); photoacoustics (PA); port wine stain (PWS); Port-Wine Stain - diagnostic imaging; Port-Wine Stain - therapy; Selectivity; Spectrum Analysis; time‐reversal (TR); Tissues; Transducers; Ultrasonic imaging; Ultrasonic processing; Ultrasound; Wine
• ISSN: 0196-8092; 1096-9101
• DOI: 10.1002/lsm.23609

Background and Objectives Port wine birthmark, also known as port wine stain (PWS) is a skin discoloration characterized by red/purple patches caused by vascular malformation. PWS is typically treated by using lasers to destroy abnormal blood vessels. The laser heating facilitates selective photothermolysis of the vessels and attenuates quickly in the tissue due to high optical scattering. Therefore, residual abnormal capillaries deep in the tissue survive and often lead to the resurgence of PWS. Ultrasound (US) has also been proposed to treat PWS, however, it is nonselective with respect to the vasculature but penetrates deeper into the tissue. We aim to study the feasibility of a hybrid PWS treatment modality combining the advantages of both modalities. Materials and Methods In this manuscript, we propose a photoacoustic (PA) guided US focusing methodology for PWS treatment which combines the optical contrast‐based selectivity with US penetration to focus the US energy onto the vasculature. The PA signals collected by the transducers, when time‐reversed, amplified, and transmitted, converge onto the PWS, thus minimally affecting the neighboring tissue. We performed two‐ and three‐dimensional simulations that mimic realistic transducers and medium properties in this proof of concept study. Results The time‐reversed PA signals when transmitted from the transducers converged onto the vasculature, as expected, thus reducing the heating of the neighboring tissue. We observed that while the US focus is indeed affected due to experimental factors such as limited‐view, large detector separation and finite detection bandwidth, and so forth, the US did focus completely or partially onto the vasculature demonstrating the feasibility of the proposed methodology. Conclusion The results demonstrate the potential of the proposed methodology for PWS treatment. This treatment method can destroy the deeper capillaries while minimally heating the neighboring tissue, thus reducing the chances of the resurgence of PWS and as well as cosmetic scarring.