Topical Application of Photofrin® for Photodynamic Diagnosis of Malignant Cutaneous Neoplasms

Publication date: Available online 23 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Yu-Te Lin, Yen-Chang Hsiao, Yu-Fan Chiang, Cheng-Jen Chang
ObjectivesThe prognosis of patients suffering from malignant cutaneous neoplasms can be improved by early diagnosis. Exact demarcation of tumor margins could contribute to optimum results in surgical excision and reconstruction. The purpose of our study is to evaluate Photofrin^® with a new diagnostic procedure, photodynamic diagnosis (PDD), for the detection of Bowen's disease (squamous cell carcinoma in situ), squamous cell carcinoma (SCC), and basal cell carcinoma (BCC).Materials and methodsSixty patients with cutaneous neoplasms received 2.5mg/mL Photofrin^® solution topically. After a period of three hours, the patients underwent fluorescence illumination (λex = 370-450 nm). Guided by their visible fluorescence, lesions were biopsied at four suspicious sites on each patient. All specimens were analyzed and measured by a pathologist. A quantitative analysis of the fluorescence contrast between the neoplasms and healthy tissue was performed using the RGB Mode (Red, Blue, Green) and GS (Gray Scale). Statistical analysis was performed by means of the ANOVA test for multiple comparisons.ResultsOf the 60 patients (20 Bowen's disease, 20 squamous cell carcinoma, and 20 basal cell carcinoma), malignant neoplasms could be clearly distinguished from adjacent healthy tissue under fluorescence illumination (P<0.0001). The sensitivity of the malignant neoplasms could be evaluated using the RGB and GS modes combined and shown in image results of 92.74%. The specificity of the malignant neoplasms evaluated using the RGB and GS modes combined showed 95.77%.ConclusionLight-induced fluorescence detection using topical Photofrin^® provides a sensitive, non-invasive technique for the early identification of malignant cutaneous neoplasms.