Simulating photodynamic therapy for the treatment of glioblastoma using Monte Carlo radiative transport

Louise Finlayson; Lewis McMillan; Szabolcs Suveges; Douglas Steele; Raluca Eftimie; Dumitru Trucu; Christian Thomas A. Brown; Ewan Eadie; Kismet Hossain-Ibrahim; Kenneth Wood

doi:10.1117/1.JBO.29.2.025001

6 February 2024 Simulating photodynamic therapy for the treatment of glioblastoma using Monte Carlo radiative transport

Louise Finlayson, Lewis McMillan, Szabolcs Suveges, Douglas Steele, Raluca Eftimie, Dumitru Trucu, Christian Thomas A. Brown, Ewan Eadie, Kismet Hossain-Ibrahim, Kenneth Wood

Author Affiliations +

Journal of Biomedical Optics, Vol. 29, Issue 2, 025001 (February 2024). https://doi.org/10.1117/1.JBO.29.2.025001

Abstract

Significance

Glioblastoma (GBM) is a rare but deadly form of brain tumor with a low median survival rate of 14.6 months, due to its resistance to treatment. An independent simulation of the INtraoperative photoDYnamic therapy for GliOblastoma (INDYGO) trial, a clinical trial aiming to treat the GBM resection cavity with photodynamic therapy (PDT) via a laser coupled balloon device, is demonstrated.

Aim

To develop a framework providing increased understanding for the PDT treatment, its parameters, and their impact on the clinical outcome.

Approach

We use Monte Carlo radiative transport techniques within a computational brain model containing a GBM to simulate light path and PDT effects. Treatment parameters (laser power, photosensitizer concentration, and irradiation time) are considered, as well as PDT’s impact on brain tissue temperature.

Results

The simulation suggests that 39% of post-resection GBM cells are killed at the end of treatment when using the standard INDYGO trial protocol (light fluence = 200 J/cm2 at balloon wall) and assuming an initial photosensitizer concentration of 5 μM. Increases in treatment time and light power (light fluence = 400 J/cm2 at balloon wall) result in further cell kill but increase brain cell temperature, which potentially affects treatment safety. Increasing the p hotosensitizer concentration produces the most significant increase in cell kill, with 61% of GBM cells killed when doubling concentration to 10 μM and keeping the treatment time and power the same. According to these simulations, the standard trial protocol is reasonably well optimized with improvements in cell kill difficult to achieve without potentially dangerous increases in temperature. To improve treatment outcome, focus should be placed on improving the photosensitizer.

Conclusions

With further development and optimization, the simulation could have potential clinical benefit and be used to help plan and optimize intraoperative PDT treatment for GBM.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Louise Finlayson, Lewis McMillan, Szabolcs Suveges, Douglas Steele, Raluca Eftimie, Dumitru Trucu, Christian Thomas A. Brown, Ewan Eadie, Kismet Hossain-Ibrahim, and Kenneth Wood "Simulating photodynamic therapy for the treatment of glioblastoma using Monte Carlo radiative transport," Journal of Biomedical Optics 29(2), 025001 (6 February 2024). https://doi.org/10.1117/1.JBO.29.2.025001

Received: 11 September 2023; Accepted: 17 January 2024; Published: 6 February 2024

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KEYWORDS

Photodynamic therapy

Oxygen

Tumors

Monte Carlo methods

Resection

Tissues

Brain tissue

Significance

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