Wedge-shaped applicator for additional light delivery and dosimetry in thediaphragmal sinus during photodynamic therapy for malignant pleural mesothelioma
Rlp. Van Veen et al., Wedge-shaped applicator for additional light delivery and dosimetry in thediaphragmal sinus during photodynamic therapy for malignant pleural mesothelioma, PHYS MED BI, 46(7), 2001, pp. 1873-1883
In situ light dosimetry during photodynamic therapy (PDT) of malignant pleu
ral mesothelioma (MPM) after tumour resection facilitates the delivery of a
controlled light distribution to the inner thoracic surface. Illumination
of the diaphragm-induced sinus, however, remains difficult. Our aim was to
develop a wedge-shaped light applicator with incorporated light dosimetry t
o deliver an additional fluence limited to the sinus. The wedge-shaped appl
icator contains a cylindrical diffuser for light delivery and two isotropic
detectors for simultaneous light dosimetry. These detectors were placed at
strategic positions where the fluence rate is maximal or minimal (middle a
nd edge). Prior to its clinical use, the performance of the sinus light app
licator was tested in several optical tissue phantoms with different optica
l properties. The fluence rate distribution over the surface of the applica
tor showed little change when the wedge was submerged in four different opt
ical phantoms. During clinical PDT of MPM the applicator had to be re-locat
ed manually four times in order to give an additional fluence of approximat
ely 2 J cm(-2) to the entire sinus. The light applicator enables dosimetry-
control led light delivery for additional illumination of the sinus region
that is often under-illuminated during thoracic integral illumination of MP
M.