Assessment of tissue perfusion changes in port wine stains after vascular targeted photodynamic therapy: A short-term follow-up study

The occlusion effect of vascular targeted photodynamic therapy (V-PDT) for malformed vessels in port wine stains (PWS) often last for some time after the treatment. A relatively longer period after V-PDT is needed to accurately assess the final response of PWS microcirculation to the treatment. In this study, we intended to use laser speckle imaging (LSI) to assess the tissue perfusion changes of PWS at follow-up after V-PDT and preliminarily analyze the relationship between perfusion change and color bleaching. Seventeen patients with 40 PWS lesions were scanned by LSI before and 3-6 months after they received V-PDT. The speckle flow indices of PWS lesions and normal skin before and at follow-up after V-PDT were recorded. We also performed analyses on the correlation between perfusion changes and color bleaching. Before V-PDT, the 40 PWS lesions showed higher perfusion than the normal skin (1,421±463 and 1,115±386 perfusion unit (PU), respectively, P<0.01). The PWS lesions scanned at follow-up showed decreased perfusion level compared to the preoperative values (1,282±460 and 1,421±463 PU, respectively, P<0.01). After V-PDT, the perfusion change rates coincide well with the color bleaching rates (correlation coefficient, 0.73). In conclusion, the LSI system is capable of imaging PWS perfusion precisely, and it has shown promising results in assessing the changes of tissue perfusion of V-PDT for PWS, with objective and quantitative data, real-time images, and a shorter detection time. It may also provide an effectiveness assessment method for the treatment of PWS.