Gen-2 Hand-Held Optical Imager towards Cancer Imaging: Reflectance and Transillumination Phantom Studies

Hand-held near-infrared (NIR) optical imagers are developed by various researchers towards non-invasive clinical breast imaging. Unlike these existing imagers that can perform only reflectance imaging, a generation-2 (Gen-2) hand-held optical imager has been recently developed to perform both reflectance and transillumination imaging. The unique forked design of the hand-held probe head(s) allows for reflectance imaging (as in ultrasound) and transillumination or compressed imaging (as in X-ray mammography). Phantom studies were performed to demonstrate two-dimensional (2D) target detection via reflectance and transillumination imaging at various target depths (1–5 cm deep) and using simultaneous multiple point illumination approach. It was observed that 0.45 cc targets were detected up to 5 cm deep during transillumination, but limited to 2.5 cm deep during reflectance imaging. Additionally, implementing appropriate data post-processing techniques along with a polynomial fitting approach, to plot 2D surface contours of the detected signal, yields distinct target detectability and localization. The ability of the gen-2 imager to perform both reflectance and transillumination imaging allows its direct comparison to ultrasound and X-ray mammography results, respectively, in future clinical breast imaging studies

Obtaining Adequate Surgical Margins in Breast-Conserving Therapy for Patients with Early-Stage Breast Cancer: Current Modalities and Future Directions

Inadequate surgical margins represent a high risk for adverse clinical outcome in breast-conserving therapy (BCT) for early-stage breast cancer. The majority of studies report positive resection margins in 20% to 40% of the patients who underwent BCT. This may result in an increased local recurrence (LR) rate or additional surgery and, consequently, adverse affects on cosmesis, psychological distress, and health costs. In the literature, various risk factors are reported to be associated with positive margin status after lumpectomy, which may allow the surgeon to distinguish those patients with a higher a priori risk for re-excision. However, most risk factors are related to tumor biology and patient characteristics, which cannot be modified as such. Therefore, efforts to reduce the number of positive margins should focus on optimizing the surgical procedure itself, because the surgeon lacks real-time intraoperative information on the presence of positive resection margins during breast-conserving surgery. This review presents the status of pre- and intraoperative modalities currently used in BCT. Furthermore, innovative intraoperative approaches, such as positron emission tomography, radioguided occult lesion localization, and near-infrared fluorescence optical imaging, are addressed, which have to prove their potential value in improving surgical outcome and reducing the need for re-excision in BCT

Optical imaging for breast cancer prescreening

Anuradha Godavarty,1 Suset Rodriguez,1 Young-Jin Jung,2 Stephanie Gonzalez1 1Optical Imaging Laboratory, Department of Biomedical Engineering, Florida International University, Miami, FL, USA; 2Department of Radiological Science, Dongseo University, Busan, South Korea Abstract: Breast cancer prescreening is carried out prior to the gold standard screening using X-ray mammography and/or ultrasound. Prescreening is typically carried out using clinical breast examination (CBE) or self-breast examinations (SBEs). Since CBE and SBE have high false-positive rates, there is a need for a low-cost, noninvasive, non-radiative, and portable imaging modality that can be used as a prescreening tool to complement CBE/SBE. This review focuses on the various hand-held optical imaging devices that have been developed and applied toward early-stage breast cancer detection or as a prescreening tool via phantom, in vivo, and breast cancer imaging studies. Apart from the various optical devices developed by different research groups, a wide-field fiber-free near-infrared optical scanner has been developed for transillumination-based breast imaging in our Optical Imaging Laboratory. Preliminary in vivo studies on normal breast tissues, with absorption-contrasted targets placed in the intramammary fold, detected targets as deep as 8.8 cm. Future work involves in vivo imaging studies on breast cancer subjects and comparison with the gold standard X-ray mammography approach. Keywords: diffuse optical imaging, near-infrared, hand-held devices, breast cancer, prescreening, early detection&nbsp

A comparison of exact and approximate adjoint sensitivities in fluorescence tomography

Abstract—Many approaches to fluorescence tomography utilize some form of regularized nonlinear least-squares algorithm for data inversion, thus requiring repeated computation of the Jacobian sensitivity matrix relating changes in observable quantities, such as emission fluence, to changes in underlying optical parameters, such as fluorescence absorption. An exact adjoint formulation of these sensitivities comprises three terms, reflecting the individual contributions of 1) sensitivities of diffusion and decay coefficients at the emission wavelength, 2) sensitivities of diffusion and decay coefficients at the excitation wavelength, and 3) sensitivity of the emission source term. Simplifying linearity assumptions are computationally attractive in that they cause the first and second terms to drop out of the formulation. The relative importance of the three terms is thus explored in order to determine the extent to which these approximations introduce error. Computational experiments show that, while the third term of the sensitivity matrix has the largest magnitude, the second term becomes increasingly significant as target fluorophore concentration or volume increases. Image reconstructions from experimental data confirm that neglecting the second term results in overestimation of sensitivities and consequently overestimation of the value and volume of the fluorescent target, whereas contributions of the first term are so low that they are probably not worth the additional computational costs. Index Terms—Adjoint sensitivities, fluorescence tomography, Jacobian matrices, frequency domain photon migration

Tissue oxygenation measurements in diabetic foot ulcers using a smartphone based near infrared imaging device

Major challenges in diabetic foot ulcer (DFU) treatment include compliance and routine clinical visits to facilitate healing. Virtual Medicine (VM) can greatly impact DFU wound care management with tools for remote patient monitoring (RPM). Herein, a novel low-cost smartphone-based imaging device was developed to provide physiological (in terms of tissue oxygenation) and visual measurements of DFUs. Quantitative changes in tissue oxygenation between the wound and peri-wound in DFUs are obtained using SPOT device in an IRB approved pilot study. On a long-term, SPOT has potential to offer a low-cost alternative for VM and RPM in DFU wound care management

Investigation of Planning and Execution of Motor Skills in Healthy Adults using Simultaneous Near Infrared Spectroscopy and Kinematics Study

NIRS is used in conjunction with kinematic studies to correlate the brain's planning and execution activity during and with arm movement in healthy adults. The prefrontal region of the brain is non-invasively imaged using a custom built continuous wave based near infrared spectroscopy (NIRS) system. The kinematics of the arm using which the subject perform the task is recorded via a camera system. During the study, the subjects performed 30 sec of arm movement followed by 30 sec rest for 5 times, using both their dominant and non-dominant arm. The optical signal acquired from the NIRS system is processed to elucidate the activation and functional connectivity in the prefrontal regions. The kinematics data acquired is processed to determine the number of touches performed by the participants. The preliminary NIRS results indicate differences in activation between the task and rest conditions in the prefrontal cortex. Currently, the functional activity of the prefrontal cortex is correlated with the kinematics result, prior to performing further studies on motor cortex. The study has significant implication in elucidating the evolution in the functional activity of the brain during the physical movement of the arm, which can better aid physical therapists treating subjects with cerebral palsy

Visualization of antitumor treatment by means of fluorescence molecular tomography with an annexin V–Cy5.5 conjugate

In vivo imaging of treatment responses at the molecular level could have a significant impact on the speed of drug discovery and ultimately lead to personalized medicine. Strong interest has been shown in developing quantitative fluorescence-based technologies with good molecular specificity and sensitivity for noninvasive 3D imaging through tissues and whole animals. We show herein that tumor response to chemotherapy can be accurately resolved by fluorescence molecular tomography (FMT) with a phosphatidylserine-sensing fluorescent probe based on modified annexins. We observed at least a 10-fold increase of fluorochrome concentration in cyclophosphamide-sensitive tumors and a 7-fold increase of resistant tumors compared with control studies. FMT is an optical imaging technique developed to overcome limitations of commonly used planar illumination methods and demonstrates higher quantification accuracy validated by histology. It is further shown that a 3-fold variation in background absorption heterogeneity may yield 100% errors in planar imaging but only 20% error in FMT, thus confirming tomographic imaging as a preferred tool for quantitative investigations of fluorescent probes in tissues. Tomographic approaches are found essential for small-animal optical imaging and are potentially well suited for clinical drug development and monitoring