Prospective evaluation of 110 patients following ultrasound-guided photodynamic therapy for deep seated pathologies Waseem Jerjes, MBBS PhD, Tahwinder.

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Prospective evaluation of 110 patients following ultrasound-guided photodynamic therapy for deep seated pathologies Waseem Jerjes, MBBS PhD, Tahwinder Upile, Charles Alexander Mosse, Zaid Hamdoon, Mira Morcos, Simon Morley, Colin Hopper Photodiagnosis and Photodynamic Therapy Volume 8, Issue 4, Pages 297-306 (December 2011) DOI: 10.1016/j.pdpdt.2011.08.002 Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 1 Ultrasound image showing neurofibroma of the arm. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 2 Ultrasound image showing carcinoma of floor of the mouth and enlarged cervical lymph node (inset) prior to needle insertion. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 3 Ultrasound image showing needle insertion in bilateral tongue base carcinoma followed by insertion of polished tip optical fibre. The patient also had necrotic cervical lymph node (inset) treated at the same time. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 4 Ultrasound image showing needle insertion in a vascular malformation of the arm followed by diffuser fibre insertion. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 5 US-guided interstitial photodynamic therapy of haemangioma of the left infraorbital region. (A) Patient draped, prepped and eye shield applied; (B) intraoperative ultrasound scanning of the centre and periphery of the lesions; (C) marking the path for needle insertion; (D) first needle insertion under US-guidance; (E) further needles inserted; (F) complete needle insertion to ensure coverage of the whole lesion width and depth; (G) measuring needle length inside the tissue to ensure that the tip is not too close to the skin surface which can lead to necrosis, this was followed by optical diffuser fibres insertion; and (H) light delivered to the diseased tissue. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 6 Needle insertion under US-guidance in a patient with bilateral tongue base and floor of mouth carcinoma with multiple reactive cervical lymphnodes. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 7 Interstitial photodynamic therapy of neurofibroma of the left forearm. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 8 Axial MRI scanning of SCC of the posterio-lateral tongue. Left: pre-PDT; right: post-PDT showing extensive necrosis of the tumour area. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 9 Axial MRI scanning of chondrosarcoma of the neck. Left: pre-PDT; middle: response after 2 rounds of PDT showing central necrosis and good response on the T2-wight scan; right: after the 3rd round of PDT showing significant tumour shrinkage and good response on the T2-weight scan with increase in airway patency. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 10 Axial MRI scanning of neurofibroma of the neck. Left: pre-PDT showing extensive lesion compressing the airway. Right (top and bottom): post-PDT scans slightly upper and lower to the pre-PDT scan level showing significant shrinkage with increase in airway patency. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions

Figure 11 Healing of 3rd degree skin burn following inadvertent sun exposure. Photodiagnosis and Photodynamic Therapy 2011 8, 297-306DOI: (10.1016/j.pdpdt.2011.08.002) Copyright © 2011 Elsevier B.V. Terms and Conditions