Photothermal therapy (PTT) involves the application of normally benign light wavelengths in combination with efficient photothermal (PT) agents that convert the absorbed light to heat to ablate selected cancers. The major challenge in PTT is the ability to confine heating and thus direct cellular death to precisely where PT agents are located. The dominant strategy in the field has been to create large libraries of PT agents with increased absorption capabilities and to enhance their delivery and accumulation to achieve sufficiently high concentrations in the tissue targets of interest. While the challenge of material confinement is important for achieving “heat and lethality confinement,” this review article suggests another key prospective strategy to make this goal a reality. In this approach, equal emphasis is placed on selecting parameters of light exposure, including wavelength, duration, power density, and total power supplied, based on the intrinsic properties and geometry of tissue targets that influence heat dissipation, to truly achieve heat confinement. This review highlights significant milestones researchers have achieved, as well as examples that suggest future research directions, in this promising technique, as it becomes more relevant in clinical cancer therapy and other noncancer applications.

A biodosimeter based on thermal-induced elastic shear wave (TIESW) in silicone acellular porcine dermis (SAPD) at thermal steady state has been proposed and demonstrated. A square slab SAPD treated with ionizing radiation was tested. The SAPD becomes a continuous homogeneous and isotropic viscoelastic medium due to the generation of randomly coiled collagen fibers formed from their bundle-like structure in the dermis. A harmonic TIESW then propagates on the surface of the SAPD as measured by a nanometer-scaled strain-stress response under thermal equilibrium conditions at room temperature. TIESW oscillation frequency was noninvasively measured in real time by monitoring the transverse displacement of the TIESW on the SAPD surface. Because the elastic shear modulus is highly sensitive to absorbed doses of ionizing radiation, this proposed biodosimeter can become a highly sensitive and noninvasive method for quantitatively determining tissue-absorbed dosage in terms of TIESW’s oscillation frequency. Detection sensitivity at 1 cGy and dynamic ranges covering 1 to 40 cGy and 80 to 500 cGy were demonstrated.

We investigated the axial resolution and signal-to-noise ratio (SNR) characteristics in deep-tissue imaging by 1.7-μm optical coherence tomography (OCT) with the axial resolution of 4.3  μm in tissue. Because 1.7-μm OCT requires a light source with a spectral width of more than 300 nm full-width at half maximum to achieve such high resolution, the axial resolution in the tissue might be degraded by spectral distortion and chromatic dispersion mismatching between the sample and reference arms. In addition, degradation of the axial resolution would also lead to reduced SNR. Here, we quantitatively evaluated the degradation of the axial resolution and the resulting decrease in SNR by measuring interference signals through a lipid mixture serving as a turbid tissue phantom with large scattering and absorption coefficients. Although the axial resolution was reduced by a factor of ∼6 after passing through a 2-mm-thick tissue phantom, our result clearly showed that compensation of the dispersion mismatching allowed us to achieve an axial resolution of 4.3  μm in tissue and improve the SNR by ∼5  dB compared with the case where dispersion mismatching was not compensated. This improvement was also confirmed in the observation of a hamster’s cheek pouch in a buffer solution.

Early neoplasia in Barrett’s esophagus (BE) is difficult to detect. Volumetric laser endomicroscopy (VLE) incorporates optical coherence tomography, providing a circumferential scan of the esophageal wall layers. The attenuation coefficient (μVLE) quantifies decay of detected backscattered light versus depth, and could potentially improve BE neoplasia detection. The aim is to investigate feasibility of μVLE for identification of early BE neoplasia. In vivo and ex vivo VLE scans with histological correlation from BE patients ± neoplasia were used. Quantification by μVLE was performed manually on areas of interest (AoIs) to differentiate neoplasia from nondysplastic (ND)BE. From ex vivo VLE scans from 16 patients (13 with neoplasia), 68 AoIs were analyzed. Median μVLE values (mm−1) were 3.7 [2.1 to 4.4 interquartile range (IQR)] for NDBE and 4.0 (2.5 to 4.9 IQR) for neoplasia, not statistically different (p=0.82). Fourteen in vivo scans were used: nine from neoplastic and five from NDBE patients. Median μVLE values were 1.8 (1.5 to 2.6 IQR) for NDBE and 2.1 (1.9 to 2.6 IQR) for neoplasia, with no statistically significant difference (p=0.37). In conclusion, there was no significant difference in μVLE values in VLE scans from early neoplasia versus NDBE. Future studies with a larger sample size should explore other quantitative methods for detection of neoplasia during BE surveillance.