NONINVASIVE MULTIMODAL DIFFUSE OPTICAL IMAGING OF VULNERABLE TISSUE HEMODYNAMICS

Measurement of tissue hemodynamics provides vital information for the assessment of tissue viability. This thesis reports three noninvasive near-infrared diffuse optical systems for spectroscopic measurements and tomographic imaging of tissue hemodynamics in vulnerable tissues with the goal of disease diagnosis and treatment monitoring. A hybrid near-infrared spectroscopy/diffuse correlation spectroscopy (NIRS/DCS) instrument with a contact fiber-optic probe was developed and utilized for simultaneous and continuous monitoring of blood flow (BF), blood oxygenation, and oxidative metabolism in exercising gastrocnemius. Results measured by the hybrid NIRS/DCS instrument in 37 subjects (mean age: 67 ± 6) indicated that vitamin D supplement plus aerobic training improved muscle metabolic function in older population. To reduce the interference and potential infection risk on vulnerable tissues caused by the contact measurement, a noncontact diffuse correlation spectroscopy/tomography (ncDCS/ncDCT) system was then developed. The ncDCS/ncDCT system employed optical lenses to project limited numbers of sources and detectors on the tissue surface. A motor-driven noncontact probe scanned over a region of interest to collect boundary data for three dimensional (3D) tomographic imaging of blood flow distribution. The ncDCS was tested for BF measurements in mastectomy skin flaps. Nineteen (19) patients underwent mastectomy and implant-based breast reconstruction were measured before and immediately after mastectomy. The BF index after mastectomy in each patient was normalized to its baseline value before surgery to get relative BF (rBF). Since rBF values in the patients with necrosis (n = 4) were significantly lower than those without necrosis (n = 15), rBF levels can be used to predict mastectomy skin flap necrosis. The ncDCT was tested for 3D imaging of BF distributions in chronic wounds of 5 patients. Spatial variations in BF contrasts over the wounded tissues were observed, indicating the capability of ncDCT in detecting tissue hemodynamic heterogeneities. To improve temporal/spatial resolution and avoid motion artifacts due to a long mechanical scanning of ncDCT, an electron-multiplying charge-coupled device based noncontact speckle contrast diffuse correlation tomography (scDCT) was developed. Validation of scDCT was done by imaging both high and low BF contrasts in tissue-like phantoms and human forearms. In a wound imaging study using scDCT, significant lower BF values were observed in the burned areas/volumes compared to surrounding normal tissues in two patients with burn. One limitation in this study was the potential influence of other unknown tissue optical properties such as tissue absorption coefficient (µa) on BF measurements. A new algorithm was then developed to extract both µa and BF using light intensities and speckle contrasts measured by scDCT at multiple source-detector distances. The new algorithm was validated using tissue-like liquid phantoms with varied values of µa and BF index. In-vivo validation and application of the innovative scDCT technique with the new algorithm is the subject of future work

Multi-scale volumetric dynamic optoacoustic and laser ultrasound (OPLUS) imaging enabled by semi-transparent optical guidance

Major biological discoveries have been made by interrogating living organisms with light. However, the limited penetration of unscattered photons within biological tissues severely limits the depth range covered by optical methods. Deep-tissue imaging has been achieved by combining light and ultrasound. Optoacoustic imaging uniquely exploits optical generation of ultrasound to render high-resolution images at depths unattainable with optical microscopy. Recently, laser ultrasound has further been suggested as a means of generating broadband acoustic waves for high-resolution pulse-echo ultrasound imaging. Herein, we propose an approach to simultaneously interrogate biological tissues with light and ultrasound based on layer-by-layer coating of silica optical fibers with a controlled degree of transparency. We exploit the time separation between optoacoustic signals and ultrasound echoes collected with a custom-made spherical array transducer for simultaneous three-dimensional optoacoustic and laser ultrasound (OPLUS) imaging with a single laser pulse. OPLUS is shown to enable large-scale comprehensive anatomical characterization of tissues along with functional multi-spectral imaging of spectrally-distinctive chromophores and assessment of cardiac dynamics at ultrafast rates only limited by the pulse repetition frequency of the laser. The suggested approach provides a flexible and scalable means for developing a new generation of systems synergistically combining the powerful capabilities of optoacoustics and ultrasound imaging in biology and medicine.Comment: 21 pages, 4 figure

Computer-Aided, Multi-Modal, and Compression Diffuse Optical Studies of Breast Tissue

Diffuse Optical Tomography and Spectroscopy permit measurement of important physiological parameters non-invasively through ~10 cm of tissue. I have applied these techniques in measurements of human breast and breast cancer. My thesis integrates three loosely connected themes in this context: multi-modal breast cancer imaging, automated data analysis of breast cancer images, and microvascular hemodynamics of breast under compression. As per the first theme, I describe construction, testing, and the initial clinical usage of two generations of imaging systems for simultaneous diffuse optical and magnetic resonance imaging. The second project develops a statistical analysis of optical breast data from many spatial locations in a population of cancers to derive a novel optical signature of malignancy; I then apply this data-derived signature for localization of cancer in additional subjects. Finally, I construct and deploy diffuse optical instrumentation to measure blood content and blood flow during breast compression; besides optics, this research has implications for any method employing breast compression, e.g., mammography

Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR).

Cardiolog

MULTIMODAL NONCONTACT DIFFUSE OPTICAL REFLECTANCE IMAGING OF BLOOD FLOW AND FLUORESCENCE CONTRASTS

In this study we design a succession of three increasingly adept diffuse optical devices towards the simultaneous 3D imaging of blood flow and fluorescence contrasts in relatively deep tissues. These metrics together can provide future insights into the relationship between blood flow distributions and fluorescent or fluorescently tagged agents. A noncontact diffuse correlation tomography (ncDCT) device was firstly developed to recover flow by mechanically scanning a lens-based apparatus across the sample. The novel flow reconstruction technique and measuring boundary curvature were advanced in tandem. The establishment of CCD camera detection with a high sampling density and flow recovery by speckle contrast followed with the next instrument, termed speckle contrast diffuse correlation tomography (scDCT). In scDCT, an optical switch sequenced coherent near-infrared light into contact-based source fibers around the sample surface. A fully noncontact reflectance mode device finalized improvements by combining noncontact scDCT (nc_scDCT) and diffuse fluorescence tomography (DFT) techniques. In the combined device, a galvo-mirror directed polarized light to the sample surface. Filters and a cross polarizer in stackable tubes promoted extracting flow indices, absorption coefficients, and fluorescence concentrations (indocyanine green, ICG). The scDCT instrumentation was validated through detection of a cubical solid tissue-like phantom heterogeneity beneath a liquid phantom (background) surface where recovery of its center and dimensions agreed with the known values. The combined nc_scDCT/DFT identified both a cubical solid phantom and a tube of stepwise varying ICG concentration (absorption and fluorescence contrast). The tube imaged by nc_scDCT/DFT exhibited expected trends in absorption and fluorescence. The tube shape, orientation, and localization were recovered in general agreement with actuality. The flow heterogeneity localization was successfully extracted and its average relative flow values in agreement with previous studies. Increasing ICG concentrations induced notable disturbances in the tube region (≥ 0.25 μM/1 μM for 785 nm/830 nm) suggesting the graduating absorption (320% increase at 785 nm) introduced errors. We observe that 830 nm is lower in the ICG absorption spectrum and the correspondingly measured flow encountered less influence than 785 nm. From these results we anticipate the best practice in future studies to be utilization of a laser source with wavelength in a low region of the ICG absorption spectrum (e.g., 830 nm) or to only monitor flow prior to ICG injection or post-clearance. In addition, ncDCT was initially tested in a mouse tumor model to examine tumor size and averaged flow changes over a four-day interval. The next steps in forwarding the combined device development include the straightforward automation of data acquisition and filter rotation and applying it to in vivo tumor studies. These animal/clinical models may seek information such as simultaneous detection of tumor flow, fluorescence, and absorption contrasts or analyzing the relationship between variably sized fluorescently tagged nanoparticles and their tumor deposition relationship to flow distributions

Medical Imaging of Microrobots: Toward In Vivo Applications

Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications

Intravascular Detection of Microvessel Infiltration in Atherosclerotic Plaques: An Intraluminal Extension of Acoustic Angiography

Cardiovascular disease is the leading cause of death worldwide, surpassing both stroke and cancer related mortality with 17.5 million deaths in 2014 alone. Atherosclerosis is the build-up of fatty deposits within arteries and is responsible for the majority of cardiovascular related deaths. Over the past decade, research in atherosclerosis has identified that a key limitation in the appropriate management of the disease is detecting and identifying dangerous fatty plaque build-ups before they dislodge and cause major cardiovascular events, such as embolisms, stroke, or myocardial infarctions. It has been noted that plaques vulnerable to rupture have several key features that may be used to distinguish them from asymptomatic plaques. One key identifier of a dangerous plaque is the presence of blood flow within the plaque itself since this is an indicator of growth and instability of the plaque. Recently, a superharmonic imaging method known as “acoustic angiography” has been shown to resolve microvasculature with unprecedented quality and could be a possible method of detecting blood vessel infiltration within these plaques. This dissertation describes the material and methods used to move the application of “acoustic angiography” to a reduced form factor typical of intravascular catheters and to demonstrate its ability to detect microvasculature. The implementation of this approach is described in terms of the contrast agents used to generate superharmonic signals, the dual-frequency transducers to image them, and the hardware needed to operate them in order to establish how these design choices can impact the quality of the images produced. Furthermore, this dissertation demonstrates how image processing methods such as adaptive windowing or automated sound speed correction can further enhance image quality of vascular targets. The results of these chapters show how acoustic angiography may be optimized using engineering considerations both in signal acquisition and post processing. Overall, these studies demonstrate that acoustic angiography can be performed using a catheter-deployable dual-frequency transducer to detect microvasculature through superharmonic imaging methods.Doctor of Philosoph