Non-muscle invasive bladder cancer (NMIBC) is a form of cancer with a relatively high 5-year survival rate but also very high recurrence rate. Photodynamic diagnosis is commonly used in standard clinical practice to visualize bladder cancer lesions as part of a TURBT procedure but photodynamic treatments utilizing photosensitive drugs have had limited success in clinical setting partly because of limitations in light sources and light delivery optics. Bladder is somewhat challenging environment for PDT as it needs to be accessed cystoscopically and lesions might be difficult to target with traditional light delivery optics for example because of their close proximity to bladder entrance. The properties of different tumor types (papillary vs carcinoma in situ (CIS)) also require different illumination methods, so laser parameters and illumination modes need to be designed accordingly.
Modulight has developed its ML7710 laser platform further to optimally support a novel photosensitive drug for treatment of NMIBC in clinical setting. The laser system and its light delivery mechanism enable both focused illumination of localized papillary lesions and overall illumination of the entire bladder to cover possible scattered CIS lesions. Clinicians have been consulted on feasibility of different illumination modes and other practical matters related to e.g., treatment duration. The optimization of Modulight’s system for NMIBC has also included compatibility testing with flexible cystoscopes and investigation of the light delivery system performance in bladder-like environment. Connectivity features of the laser system have been tailored to support documentation requirements in clinical trials by enabling treatment configuration and realized treatment log storage in Modulight Cloud.
Non-muscle invasive bladder cancer (NMIBC) is a form of cancer with a high recurrence rate and limited treatment options. Currently best results are achieved when BCG (Bacillus Calmette-Guerin) is used together with photodynamic diagnosis (PDD) and TURBT (trans urethral resection of bladder tumor) but majority of NMIBC still recur after the initial treatment. Even though PDD is commonly used to visualize the lesions as part of a TURBT procedure, photosensitive drug compounds have had limited success in clinical setting partly because of limitations in light sources and light delivery optics.
Modulight has extended its multi-indication laser platform to support the use of a novel photosensitive drug for NMIBC. The properties of different tumor types (papillary vs carcinoma in situ (CIS)) require different illumination methods and laser parameters and illumination modes have been defined accordingly. Laser system has been designed to support both focused illumination of localized lesions and overall illumination of the entire bladder to cover possible scattered CIS lesions. Light delivery system optimization has included compatibility testing with flexible cystoscopes and investigation of the light delivery system performance in bladder environment. Connectivity features of the laser system have been tailored to support documentation requirements in clinical trials by enabling treatment configuration and realized treatment log storage in Modulight cloud. Ongoing work and future plans include treatment monitoring and imaging capabilities integration in treatment flow with the aim to have a comprehensive laser platform that can support white light imaging, fluorescence imaging, and a variety of light-based treatment modalities
Personalized medicine is one of the main directions in current cancer care. To support this trend, Modulight has designed a laser illumination platform with real-time spectral monitoring to adjust treatments based on each patient’s optical properties of the tissue, providing more personalization to light-based treatments. The laser has been designed to illuminate and retrieve spectral data from the tumor tissue simultaneously from up to eight different locations. The medical laser is cloud-connected, and all diagnostic data is downloaded in real time into the analytics server to assist in the personalized treatment decisions. This enables machine learning and AI-based data analytics to process recorded data to make more informed treatment decisions and deliver the best treatment outcomes to patients. The laser with this optical monitoring feature is currently being evaluated in glioblastoma trials where illumination can be tailored through spectral monitoring of the fluorescent drug and optical properties of the treated tissue.
Here we present novel cloud-connected theranostic medical laser platform specifically designed for activating and simultaneously monitoring multi-component oncological treatment processes. It may incorporate multiple wavelengths for inducing therapeutic effect or monitoring treatment in real-time. The same low-invasive optical probers can be used for treatment and monitoring. We believe that this theranostic laser platform will allow clinicians to develop improved treatment outcomes for cancer patients that may be based on machine learning and AI in the future.
Multiple clinically approved dyes and several new dyes currently in clinical studies are used for fluorescence-guided surgery, diagnosis and imaging. These present a wide range of absorption and emission spectra and create a demand for endoscopic illumination sources with multiple wavelengths. Fluorescent imaging with simultaneous white light overlay image benefit from laser light sources for fluorescence excitation and white light illumination to allow for easy spectral filtering on imaging side. Emerging applications with imaging of two or more complementary fluorescent dyes further adds to desire for a configurable multi-wavelength endoscopic light source. The multi-wavelength configurable and cloud connected oncology laser platform Modulight ML7710 was developed further to accommodate the light engine requirements of real-time multi-wavelength endoscopic fluorescence imaging. The configurable medical illumination platform enables simultaneous multi-wavelength fluorescence excitation with wide dynamic range and color balance adjustable RGB white light illumination. Multi-wavelength light output functionality was further developed to support industry standard endoscopic light guides without the need of additional external optical elements. Laser light sources for imaging typically suffer from unwanted speckle patterns. This issue is solved with internal speckle remover which greatly reduces speckle contrast even when used with high-speed imaging applications. The platform also offers possibility for spectral measurement of fluorescence from the target to the supplement or facilitate high-resolution imaging. The configurable touchscreen user interface allows for simple application for specific operation and cloud-based connectivity enables modern configuration, data logging, planning and control with platform for future machine learning and AI analysis.
Photodynamic therapy is a cancer treatment modality with great potential but moderate clinical success. One reason for the sub-optimal clinical success is the limited knowledge about light distribution in tissues and lack of ways to monitor treatment real-time. Modulight has developed a laser platform for glioblastoma which will utilize real-time treatment monitoring based on spectral properties of the tissue and the drug. This therapy modality is based on photodynamic therapy with 5-aminolevulinic acid (5-ALA) primarily because the approved use of 5-ALA in fluorescence guided resections for glioblastoma and because of the known photobleaching properties of 5-ALA metabolite Protoporphyrin-IX (PPIX). Photobleaching means the photochemical alteration of a dye or a fluorophore in a way that it becomes permanently unable to fluoresce, and the real-time spectral monitoring is based on monitoring the intensity of PPIX fluorescence emission at 703 nm upon excitation with treatment wavelength 635 nm. Modulight glioblastoma platform enables monitoring PPIX fluorescence throughout the treatment to inspect the decline in fluorescence intensity. This photobleaching phenomenon represents the time region where the maximal therapeutic effect occurs so the ability to monitor this would ultimately enable optimizing the treatment time individually for each patient. Novel Modulight lasers are internet connected so that the treatment monitoring data can be immediately uploaded to cloud improving data management and review and possible future machine learning and AI based medicine.
Autonomous driving and automated ships are in increasing demand and the performance for pattern recognition and safety functions are essential. Harsh weather conditions lower the atmospheric transmission for useable eye-safe wavelengths and water vapor peaks prevent most laser light propagation for longer distances. In LIDAR application this problem can be solved with increased peak power. However, high peak power solutions with high repetition rate do not exist or they are bulky and expensive. Moreover, not all applications need the highest peak powers or high repetition rates. We present a collection of eye-safe LIDAR laser sources with varying laser pulse parameters for demanding conditions. Wavelengths ranging from 1400 nm to 1560 nm with peak powers from a few Watts to up to 18 kW and repetition rates up to 100 kHz. Naturally, for a good temporal resolution a short pulse operation is necessary and best sources presented here produce sub-10 ns pulses. Such high peak power, high repetition rate lasers present the state-ofthe-art performance for long range LIDAR, enabling hundreds of meters detection distance in poor weather, currently unavailable in earlier commercial solutions.
Different wavelength lasers are widely used in ophthalmology for example for selectively heating certain tissues of the eye or unleashing the potential of photoactive pharmaceuticals. The problem with many ophthalmic laser-based treatments such as photodynamic therapy for age-related macular degeneration is that the laser technology is outdated and no longer supported despite the wide clinical use of these therapy modalities. Modulight has developed a configurable cloud-connected ophthalmic laser device that can house any of Modulight’s semiconductor lasers and is wirelessly controlled with an iPad. In addition to novel ophthalmic laser technology, Modulight has also developed a novel beam shaping unit which yields superior beam quality and enables exceptionally large treatment spots eliminating the need for multi-spot treatment for larger lesions.
Traditionally one of the biggest challenges with light-based treatment modalities such as photodynamic therapy or different tumor ablation techniques is to determine how much light should be applied to the tissue and how that will be distributed to activate a bio-photonic process or a drug. Different tools have been developed to model light distribution in tissue, but this has not solved the problem of how to know what happens in the tissue during the treatment. Modulight has assessed this problem and developed a state-of-the-art laser platform with real-time treatment monitoring capability. Modulight ML7710i platform enables illumination and detection with up to eight illumination channels on same or different wavelength(s). Spectral measurements can be measured and collected with the same fibers that are used for illumination which is minimally invasive and eliminates the need for complicated measurement set-ups with moving fibers around in the tumor tissue or having separate monitoring probes. The system also is connected to cloud making treatment planning, data collection and analysis easy and reliable enabling machine learning and AI based medicine in the future. ML7710i type of medical device makes it possible not only to measure the light intensity at tumor margins but also monitor the progress of the treatment by measuring photosensitizer photobleaching, drug release or activation of multimodal drugs. Photobleaching monitoring with ML7710i is currently utilized in 5-ALA mediated clinical trials for glioblastoma and the data looks very promising. In addition, also drug release from novel light activated nanoparticles or other drug carriers can be effectively monitored for pharmaceuticals that possess fluorescent potential or carry fluorescence labels.
Vertical-cavity surface-emitting lasers (VCSELs) have just recently started generating a lot of interest as the illumination source in the multitude of commercial applications. VCSELs capability to provide narrow spectrum emission with low temperature sensitivity and high beam quality, coupled with the possibility of nanosecond pulses generation, makes VCSELs an excellent laser platform for the outdoors, high-precision time-of-flight (ToF) and structured light applications. These advantageous features of VCSELs emission arise from their vertical cavity geometry, which also enables possible VCSELs direct integration onto circuitry and allows power scaling by arranging single-emitting VCSELs into compact high-power 2D arrays. These benefits have made VCSEL the current most popular illumination source for the 3D sensing applications both in the consumer market (e.g. proximity sensors for face and gesture recognition) as well as in the industrial sector (e.g. automotive short- to middle-range LiDAR and in-cabin monitoring). We present development results of both high-efficiency VCSEL single-emitters and multi-Watt VCSEL arrays emitting at the 940 nm purposed for 3D sensing applications. The VCSEL development involved optimization of epitaxial design in terms of DBR doping concentrations and the material content of the bottom DBR and oxide layer. While, on the other hand, optimization of the device parameters and processes targeted oxide aperture and mesa diameters, as well as etching depth. Wet thermal oxidation process has been specifically developed to facilitate precise oxidation depth control, run-torun reproducibility, and uniformity on the wafer scale. Successful VCSEL development is attributed to the Modulight’s full-cycle in-house semiconductor fabrication capabilities.
Fighting cancer involves more and more combination of modalities and drugs to maximize the long-term tumor resistance and cure. The rationale for combination therapy is to use treatment modalities or drug combinations that work by different mechanisms, decreasing the likelihood that resistant cancer cells will develop. The combination of light induced therapy like photodynamic therapy (PDT) and chemotherapy has the potential to overcome the limitations traditionally associated with light-based therapies and simultaneously limit the well-known adverse effects of chemotherapy by controlling local release and dose. Modulight ML7710i medical laser systems have not only been shown to unleash the cytotoxic potential of different photochemotherapeutic compounds but also to effectively monitor the drug release process providing clinicians real-time information on treatment progress and preliminary projections on treatment outcome. In vitro and in vivo experiments suggest that Modulight ML7710i lasers are capable of inducing drug release from liposomes with different mechanisms depending on the nano-construct and laser wavelength. Near infrared wavelengths such as 808 nm are capable of disturbing liposomal bilayer upon light energy conversion to heat by dyes like indocyanine green.1 Red wavelengths such as 665 nm in turn can induce photodynamic effect also causing drug release from hydrophobic core of the liposome.2 Modulight ML7710i medical lasers are being validated for both use-cases and also for use with other dyes. The only limitation in using treatment monitoring capability is that the chemotherapeutic must have fluorescent potential. Modulight medical lasers can host multiple wavelengths within one system so that the drug release and the excitation can happen with different wavelengths if required.
Photodynamic therapy (PDT) is bringing new, effective, and less invasive, possibilities for cancer treatment. ML7710 (Modulight Inc.) medical laser system offers a platform for performing PDT for multiple indications and drugs. Latest avenue is glioblastoma treatment with 5-Aminolevulinic acid (ALA-5) and 635-nm light, where clinical trials are about to begin. Preliminary work suggests major advantages in treatment control, including active in-situ feedback. ML7710 platform has already proven itself for clinical work with intrabronchial obstructive tumors. Preliminary result with 10 patients show that intrabronchial tumors, that strongly affect both the survival and the performance of the patient, can be significantly reduced with ML7710 operated at 665 nm and sodium chlorine E6 photosensitizer. The aim in most of the patients has been a palliative recanalization of the bronchial lumen in order to alleviate the symptoms such as breathlessness and hemoptysis. The illumination dose for the target area was 50–75 J/cm2. All the patients have received multimodality cancer treatment using other intrabronchial interventions, radiotherapy and chemotherapy as needed. In most of the patients, satisfactory treatment results were achieved and it was possible to restart chemotherapy in several patients. In one patient with local cancer a complete remission was established. PDT has also the advantage that it is possible to give PDT after a maximum dose of radiation therapy has already been used and fewer side effects if used in locally advanced intraluminar lung cancer.
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