In Vivo Vascular Imaging with Photoacoustic Microscopy

Photoacoustic (PA) tomography (PAT) has received extensive attention in the last decade for its capability to provide label-free structural and functional imaging in biological tissue with highly scalable spatial resolution and penetration depth. Compared to modern optical modalities, PAT offers speckle-free images and is more sensitive to optical absorption contrast (with 100% relative sensitivity). By implementing different regimes of optical wavelength, PAT can be used to image diverse light-absorbing biomolecules. For example, hemoglobin is of particular interest in the visible wavelength regime owing to its dominant absorption, and lipids and water are more commonly studied in the near-infrared regime. In this dissertation, one challenge was to quantitatively investigate red-blood-cell dynamics in nailfold capillaries with single-cell resolution PA microscopy (PAM). We recruited healthy volunteers and measured multiple hemodynamic parameters based on individual red blood cells (RBCs). Statistical analysis revealed the process of oxygen release and changes in flow speed for RBCs in a capillary. For the first time on record, oxygen release from individual RBCs in human capillaries was imaged with nearly real-time speed, and the work paved the way for our following study of a specific blood disorder. We next conducted a pilot study on sickle cell disease (SCD), measuring and comparing the parameters related to RBC dynamics between healthy subjects and patients with SCD. In the patient group, we found that capillaries tended to be more tortuous, dilated, and had higher number density. In addition, abnormal RBCs tended to have lower oxygenation in the inlet of a capillary, from where they flowed slower and released a larger fraction of oxygen than normal RBCs. As the only imaging modality able to observe the real-time dynamics of the oxygen release of individual RBCs, PAM provides medically valuable information for diagnostic purposes. As the last focus of this dissertation, we tackled the limited view problem in PAM by introducing an off-axis illumination technique for complementing the original detection view. We demonstrated this technique numerically and then experimentally on phantoms and animals. This simple but very effective method revealed abundant vertical vasculature in a mouse brain that had long been missed by conventional top-illumination PAM. This technique greatly advances future studies on neurovascular responses in mouse brains

Laser doppler perfusion imaging of the normal and diseased vulva.

Vulval lichen sclerosus (LS) and high-grade intraepithelial neoplasia (VIN 3) are two common and distressing diseases. Significant morbidity is caused by symptoms of persistent pruritus and surgical treatment of skin areas suspicious of malignancy. The risk of developing cancer in a background of LS and VIN 3 is poorly defined. The methods currently available for clinical assessment of the vulva are limited. There is abundant research on the application of the LASER Doppler technique - laser Doppler Flowmetry (LDF) - showing changes in perfusion within the small blood vessels of the skin as a useful parameter for more accurate disease classification. There is also research on immunohistochemical microvessel density (MVD) studies showing increases in blood supply in tissues prone to develop cancer or as a prognostic marker of cancer outcome. The Laser Doppler perfusion imager (LDPI) provides a rapid, real time, non-invasive and non-contact method to measure skin blood flow in an area as opposed to a single point by the LDF, making the LDPI more suitable for application to the vulva. This thesis reports for the first time, the application of the LDPI to the vulva. Initially the LDPI was applied to the clinically normal vulva to study perfusion variance related to menstrual cycle, age and local skin temperature provocation. The application was then extended to vulval disease, LS and VIN 3, and validated against morphological differences in MVD. The LDPI and MVD studies suggest that in VIN 3 there is an actual increase in skin perfusion. In LS the situation is more complex and suggests that the LDPI measured perfusion at a greater depth than the MVD. Studies on base line perfusion variance of vulval LS to topical therapy show that there is no overall difference in baseline perfusion in spite of symptom improvement. Temperature provocation studies suggest differences in skin blood flow response in diseased compared to the normal vulva

A Review of Indocyanine Green Fluorescent Imaging in Surgery

The purpose of this paper is to give an overview of the recent surgical intraoperational applications of indocyanine green fluorescence imaging methods, the basics of the technology, and instrumentation used. Well over 200 papers describing this technique in clinical setting are reviewed. In addition to the surgical applications, other recent medical applications of ICG are briefly examined

Microenvironmental Control in Microfluidic Bioreactors for Long Term Culture of Bone Marrow Cells.

The goal of this research is to create in vitro microenvironments for long term culture of hematopoeitic stem cell (HSC) in microfluidic bioreactors. In vivo, HSCs reside in the bone marrow osteoblastic and vascular niches in adult mammals. Defining features of their in vivo niche include: small number of HSCs, heterogeneous population of bone marrow cells that support HSCs, and low oxygen tension. We engineer niche elements in microfluidic bioreactors by modulating oxygen tension, optimizing attachment and growth of HSC-supporting bone marrow stromal cells, and culturing small numbers of HSCs in their physiologically relevant ratios between HSCs and supporting cells. By using a combination of a mathematical model and quantitative experiments, we have created a design tool to manipulate and control oxygen tension for cell culture inside the poly(dimethyl siloxane) (PDMS) microbioreactors. Dissolved oxygen concentrations in the microbioreactor are quantified in real time using fluorescence lifetime imaging of an oxygen sensitive dye. Experimental results are consistent with the mathematical model and give insight into operating conditions required for a desired oxygen tension in cell culture regions of the microbioreactor. We used microfluidic perfusion systems to develop nanocoatings made from electrostatic self assembly of PDDA (poly(diallyldimethyl ammonium chloride)), clay, type IV collagen and fibronectin to optimize attachment of primary murine bone marrow cells (support cells for HSCs) onto PDMS bioreactors. PDDA-topped coatings were found to be cytotoxic, while coatings with two or more bilayers of proteins collagen and fibronectin were found to optimize spreading, proliferation, and viability as compared to other surfaces. On-chip erythropoiesis was achieved with a 3-D co-culture of HSCs with supporting cells in PDMS bioreactors. In addition, an optimal ratio of support cells to HSCs was found to maximize self renewal potential of HSCs in vitro. By the combination of hypoxia (which simulates in vivo bone marrow oxygen tension), biofunctional surfaces, and 3-D co-cultures, we are moving towards a ‘microfluidic HSC niche’, in which hypothesis-driven studies about crosstalk between HSCs and stromal cells can be carried out.Ph.D.Biomedical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/60852/1/mehtagee_1.pd