Fluorescence detection of deep intramucosal cancer excited by green light for photodynamic diagnosis using protoporphyrin IX induced by 5-aminolevulinic acid: an ex vivo study

5-氨基乙酰丙酸诱导原卟啉IX进行绿光激发深部黏膜内癌荧光检测及光动力诊断:体外研究

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作者:Daisuke Ihara, Hisanao Hazama, Takahiro Nishimura, Yoshinori Morita, Kunio Awazu

Aim

The reason is that the excitation light, whose wavelength is determined by the highest absorption peak of PpIX (∼405 nm), is strongly attenuated by mucosal tissues. We investigated an excitation wavelength that can extend the diagnostic depth of PpIX fluorescence at the mucosal subsurface. Approach: By calculating the depth-dependent intensity of the excitation light in porcine gastric mucosa for each wavelength, relationships among the wavelength, fluorophore depth, and fluorescence intensity were assessed and fluorescence images of PpIX pellets located at different fluorophore depths were compared experimentally by changing the excitation wavelength.

Conclusion

The experimental results suggest that the diagnosis depth of PDD with PpIX for intramucosal cancer can be extended by 505-nm excitation light.

Results

The numerical calculation showed that a 505-nm excitation light provided the highest fluorescence intensities at a fluorophore depth deeper than 1.1 mm. In the fluorescence observation, the fluorescence intensities at fluorophore depths of 0 and 1.0 mm at 405 nm were 5.4 × 103 and 1.0 × 103 arb. units, whereas those at 505 nm were 5.3 × 101 and 1.9 × 102 arb. units, respectively.

Significance

The diagnostic depth of photodynamic diagnosis (PDD) for gastric cancer with protoporphyrin IX (PpIX) is limited, which leads to missing intramucosal cancers in screening and surgery. Aim: The reason is that the excitation light, whose wavelength is determined by the highest absorption peak of PpIX (∼405 nm), is strongly attenuated by mucosal tissues. We investigated an excitation wavelength that can extend the diagnostic depth of PpIX fluorescence at the mucosal subsurface. Approach: By calculating the depth-dependent intensity of the excitation light in porcine gastric mucosa for each wavelength, relationships among the wavelength, fluorophore depth, and fluorescence intensity were assessed and fluorescence images of PpIX pellets located at different fluorophore depths were compared experimentally by changing the excitation wavelength. Results: The numerical calculation showed that a 505-nm excitation light provided the highest fluorescence intensities at a fluorophore depth deeper than 1.1 mm. In the fluorescence observation, the fluorescence intensities at fluorophore depths of 0 and 1.0 mm at 405 nm were 5.4 × 103 and 1.0 × 103 arb. units, whereas those at 505 nm were 5.3 × 101 and 1.9 × 102 arb. units, respectively. Conclusion: The experimental results suggest that the diagnosis depth of PDD with PpIX for intramucosal cancer can be extended by 505-nm excitation light.

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