Abstract

A unique Monte Carlo program capable of accommodating an arbitrarily complex geometry was used to determine the energy deposition in a true port wine stain anatomy. Serial histologic sections taken from a biopsy of a dark red, laser therapy resistant stain were digitized and used to create the program input for simulation at wavelengths of 532 and 585 nm. At both wavelengths, the greatest energy deposition occurred in the superficial blood vessels, and subsequently decreased with depth as the laser beam was attenuated. However, more energy was deposited in the epidermis and superficial blood vessels at 532 nm than at 585 nm.

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References

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  1. M.J.C. van Gemert, A.J. Welch, O.T. Tan, J.A. Parrish, Limitations of carbon dioxide lasers for treatment of port-wine stains, Arch. Dermatol. 123, 71-73 (1987).
    [CrossRef] [PubMed]
  2. O.T. Tan, P. Morrison, A.K. Kurban 585 nm for the treatment of port-wine stains, Plastic and Reconstructive Surg. 86, 1112-1117 (1990).
  3. J.M. Garden, O.T. Tan, R. Kerschmann, J. Boll, H. Furumoto, R.R. Anderson, J.A. Parrish. "Effect of dye laser pulse duration on selective cutaneous vascular injury." J. Invest. Dermatol. 87, 653-657 (1986).
    [CrossRef] [PubMed]
  4. O.T. Tan, M. Motemedi, A.J. Welch, A.K. Kurban, Spotsize effects on guinea pig skin following pulsed irradiation, J. Invest. Dermatol. 90, 877-881 (1988).
    [CrossRef] [PubMed]
  5. M.J.C. van Gemert, A.J. Welch, A.P. Amin, Is there an optimal laser treatment for port wine stains?, Lasers Surg. Med. 6, 76-83 (1986).
    [CrossRef] [PubMed]
  6. A. Kienle, R. Hibst, A new optimal wavelength for treatment of port wine stains?, Phys. Med. Biol. 40, 1559-1576 (1995).
    [CrossRef] [PubMed]
  7. C.C. Dierickx, J.M. Casparian, V. Venugopalan, W.A. Farinelli, R.R. Anderson, Thermal relaxation of port-wine stain vessels probed in vivo: the need for 1-10-millisecond laser pulse treatment, J. Invest. Dermatol. 105, 709-714 (1995).
    [CrossRef] [PubMed]
  8. M. Keijzer, J.W. Pickering, M.J.C. van Gemert, Laser beam diameter for port wine stain treatment, Lasers Surg. Med. 11, 601-605 (1991).
    [CrossRef] [PubMed]
  9. T.J. Pfefer, J.K. Barton, E.K. Chan, M.G. Ducros, B.S. Sorg, T.E. Milner, J.S. Nelson, A.J. Welch, A three-dimensional modular adaptable grid numerical model for light propagation during laser irradiation of skin tissue, IEEE J. Sel. Top. Quantum. Electron. 2, 934-942 (1996).
    [CrossRef]
  10. S.L. Jacques, L. Wang, Monte Carlo modeling of light transport in tissues, in Optical-Thermal Response of laser-irradiated tissue, A.J. Welch and M.J.C. van Gemert, ed. (Plenum Press, New York 1995).
  11. D.J. Smithies, M.J.C. van Gemert, M.K. Hansen, T.E. Milner, J. S. Nelson, Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections, Phys. Med. Biol. 12, 1013-17 (1997).
  12. M.J.C. van Gemert, A.J. Welch, J.W. Pickering, O.T. Tan, Laser treatment of port wine stains, in Optical-Thermal Response of laser-irradiated tissue, A.J. Welch and M.J.C. van Gemert, ed. (Plenum Press, New York 1995).
  13. G.W. Lucassen, W. Verkruysse, M. Keijzer, M.J.C. van Gemert. Light distributions in a port wine stain model containing multiple cylindrical and curved blood vessels, Lasers Surg. Med. 19, 345-357 (1996).
    [CrossRef]
  14. R.M. Adrian, E.A. Tanghetti. Long pulse 532-nm laser treatment of facial telangiectasia, Dermatol. Surg. 24, 71-74 (1998).
    [CrossRef] [PubMed]

Other

M.J.C. van Gemert, A.J. Welch, O.T. Tan, J.A. Parrish, Limitations of carbon dioxide lasers for treatment of port-wine stains, Arch. Dermatol. 123, 71-73 (1987).
[CrossRef] [PubMed]

O.T. Tan, P. Morrison, A.K. Kurban 585 nm for the treatment of port-wine stains, Plastic and Reconstructive Surg. 86, 1112-1117 (1990).

J.M. Garden, O.T. Tan, R. Kerschmann, J. Boll, H. Furumoto, R.R. Anderson, J.A. Parrish. "Effect of dye laser pulse duration on selective cutaneous vascular injury." J. Invest. Dermatol. 87, 653-657 (1986).
[CrossRef] [PubMed]

O.T. Tan, M. Motemedi, A.J. Welch, A.K. Kurban, Spotsize effects on guinea pig skin following pulsed irradiation, J. Invest. Dermatol. 90, 877-881 (1988).
[CrossRef] [PubMed]

M.J.C. van Gemert, A.J. Welch, A.P. Amin, Is there an optimal laser treatment for port wine stains?, Lasers Surg. Med. 6, 76-83 (1986).
[CrossRef] [PubMed]

A. Kienle, R. Hibst, A new optimal wavelength for treatment of port wine stains?, Phys. Med. Biol. 40, 1559-1576 (1995).
[CrossRef] [PubMed]

C.C. Dierickx, J.M. Casparian, V. Venugopalan, W.A. Farinelli, R.R. Anderson, Thermal relaxation of port-wine stain vessels probed in vivo: the need for 1-10-millisecond laser pulse treatment, J. Invest. Dermatol. 105, 709-714 (1995).
[CrossRef] [PubMed]

M. Keijzer, J.W. Pickering, M.J.C. van Gemert, Laser beam diameter for port wine stain treatment, Lasers Surg. Med. 11, 601-605 (1991).
[CrossRef] [PubMed]

T.J. Pfefer, J.K. Barton, E.K. Chan, M.G. Ducros, B.S. Sorg, T.E. Milner, J.S. Nelson, A.J. Welch, A three-dimensional modular adaptable grid numerical model for light propagation during laser irradiation of skin tissue, IEEE J. Sel. Top. Quantum. Electron. 2, 934-942 (1996).
[CrossRef]

S.L. Jacques, L. Wang, Monte Carlo modeling of light transport in tissues, in Optical-Thermal Response of laser-irradiated tissue, A.J. Welch and M.J.C. van Gemert, ed. (Plenum Press, New York 1995).

D.J. Smithies, M.J.C. van Gemert, M.K. Hansen, T.E. Milner, J. S. Nelson, Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections, Phys. Med. Biol. 12, 1013-17 (1997).

M.J.C. van Gemert, A.J. Welch, J.W. Pickering, O.T. Tan, Laser treatment of port wine stains, in Optical-Thermal Response of laser-irradiated tissue, A.J. Welch and M.J.C. van Gemert, ed. (Plenum Press, New York 1995).

G.W. Lucassen, W. Verkruysse, M. Keijzer, M.J.C. van Gemert. Light distributions in a port wine stain model containing multiple cylindrical and curved blood vessels, Lasers Surg. Med. 19, 345-357 (1996).
[CrossRef]

R.M. Adrian, E.A. Tanghetti. Long pulse 532-nm laser treatment of facial telangiectasia, Dermatol. Surg. 24, 71-74 (1998).
[CrossRef] [PubMed]

Supplementary Material (2)

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Figures (6)

Fig. 1.
Fig. 1.

A three dimensional rendering of the PWS material properties matrix is shown with epidermis and blood vessels in shades of blue and red, respectively. Air and dermis have been made transparent for clarity.

Fig. 2.
Fig. 2.

Quicktime movie, energy deposition (J/cm 3 ) in a PWS with an infinite incident beam at 532 nm and 1 J/cm 2 radiant exposure. [Media 1]

Fig. 3.
Fig. 3.

Quicktime movie, energy deposition (J/cm 3 ) in a PWS with an infinite incident beam at 585 nm and 1 J/cm 2 radiant exposure. [Media 2]

Fig. 4.
Fig. 4.

A single transverse slice 0.25 mm wide by 0.5 mm deep of the energy deposition (J/cm 3 ) in a PWS. An infinite incident beam at 532 nm with 1 J/cm 2 radiant exposure was simulated.

Fig. 5.
Fig. 5.

A single transverse slice 0.25 mm wide by 0.5 mm deep of the energy deposition (J/cm 3 ) in a PWS. An infinite incident beam at 585 nm with 1 J/cm 2 radiant exposure was simulated.

Fig. 6.
Fig. 6.

Energy deposition (J/cm 3 ) for corresponding columns of the transverse slices shown in Figures 4 and 5. Infinite incident beam at 532 and 585 nm, with 1 J/cm 2 radiant exposure.

Tables (1)

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Table 1. Optical Properties

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