Background

Photoimmunotherapy is a treatment modality that induces targeted cell death by binding a molecular-targeted drug activated by infrared light to the tumor cells and subsequently illuminating the lesion with infrared light. For deep lesions, a needle catheter is used to puncture the tumor, and an illumination fiber (cylindrical diffuser) is inserted into the catheter lumen for internal illumination. However, it can be challenging to place the cylindrical diffusers in an appropriate position as the deep lesions cannot be often confirmed accurately during surgery.

Materials and methods

We have developed "SlicerPIT", a planning simulation software for photoimmunotherapy. SlicerPIT allows users to place the cylindrical diffuser with its illumination range on preoperative images in 2D and 3D and export the planning data to external image-guided surgical navigation systems. We performed seven cycles of photoimmunotherapy with SlicerPIT in three patients with recurrent head and neck cancer.

Results

Preoperative planning for photoimmunotherapy was conducted using SlicerPIT, which could be imported into the navigation system. During the operation, we punctured the needle catheters along with the treatment plan on the navigation screen. Subsequently, intraoperative CT imaging was performed and overlaid with the preoperative treatment plan to confirm the alignment of the cylindrical diffusers as planned, followed by infrared light illumination. Postoperative imaging showed necrosis and shrinkage of the entire tumor in all cycles.

Conclusion

SlicerPIT allows for detailed preoperative treatment planning and accurate puncture. It may be a valuable tool to improve the accuracy of photoimmunotherapy for deep lesions and improve patient outcomes.

中文翻译：

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SlicerPIT：光免疫治疗中规划和图像引导治疗的软件开发和实施

背景

光免疫疗法是一种通过将红外光激活的分子靶向药物与肿瘤细胞结合并随后用红外光照射病变来诱导靶向细胞死亡的治疗方式。对于深部病变，用针状导管刺入肿瘤，将照明光纤（圆柱形扩散器）插入导管腔内进行内部照明。然而，将圆柱形扩散器放置在适当的位置可能具有挑战性，因为在手术过程中通常无法准确确认深层病变。

材料和方法

我们开发了光免疫治疗规划模拟软件“SlicerPIT”。 SlicerPIT 允许用户将圆柱形扩散器及其照明范围放置在 2D 和 3D 术前图像上，并将规划数据导出到外部图像引导手术导航系统。我们使用 SlicerPIT 对三名复发性头颈癌患者进行了七个周期的光免疫治疗。

结果

使用 SlicerPIT 进行光免疫治疗的术前计划，该计划可以导入导航系统。手术过程中，我们伴随着导航屏幕上的治疗计划穿刺了针导管。随后，进行术中 CT 成像并与术前治疗计划重叠，以确认圆柱形扩散器按计划对齐，然后进行红外光照明。术后影像学显示所有周期中整个肿瘤坏死和缩小。

结论

SlicerPIT 可实现详细的术前治疗计划和准确的穿刺。它可能是提高深层病变光免疫疗法的准确性并改善患者治疗效果的有价值的工具。