Measuring Tumor Cycling Hypoxia and Angiogenesis Using a Side-firing Fiber Optic Probe

Hypoxia and angiogenesis can significantly influence the efficacy of cancer therapy and the behavior of surviving tumor cells. There is a growing demand for technologies to measure tumor hypoxia and angiogenesis temporally in vivo to enable advances in drug development and optimization. This paper reports the use of frequency-domain photon migration with a side-firing probe to quantify tumor oxygenation and hemoglobin concentrations in nude rats bearing human head/neck tumors administered with carbogen gas, cycling hypoxic gas or just room air. Significant increase (with carbogen gas breathing) or decrease (with hypoxic gas breathing) in tumor oxygenation was observed. The trend in tumor oxygenation during forced cycling hypoxia (CH) followed that of the blood oxygenation measured with a pulse oximeter. Natural CH was also observed in rats under room air. The studies demonstrated the potential of the technology for longitudinal monitoring of tumor CH during tumor growth or in response to therapy

Spectral diagnosis of skin cancer

textThe number of skin cancer cases reported in the United States is increasing every year and nearly equals the total cancer cases detected from every other part of the body. Current detection strategies of skin cancers include a visual examination followed by a tissue biopsy. This procedure is subjective, invasive and time-consuming. Therefore, considering the number of cancer cases reported and the number biopsies performed, there is a critical need for a non-invasive diagnostic aid to help clinicians reduce the significantly large numbers of unnecessary biopsies. This dissertation presents a quantitative method based on optical spectroscopy for performing a non-invasive ‘optical biopsy’ of melanoma and non-melanoma skin cancers. We have developed the hardware, software and optical algorithms necessary to implement such a device. First, we present a novel lookup table-based model for determining the optical properties of tissue that is valid for fiber-based probe geometries with close source-detector separations and in highly absorbing tissue. These optical properties are quantitative parameters that can be correlated with the physiology of tissue. Second, we present experimental validation of the effects of microvasculature pigment packaging on diffuse reflectance spectra. We have conducted experiments using microfluidic devices over a physiologically relevant range of optical properties and blood vessel sizes. Third, we present the development of a probe-based portable and clinically compatible instrument capable of in vivo spectral measurements. The instrument combines two modalities – diffuse reflectance and intrinsic fluorescence spectroscopy – to provide complementary information regarding tissue morphology, function and biochemical composition. Finally, we present the results of a pilot clinical study using our portable instrument to determine the accuracy of spectral diagnosis of non-melanoma skin cancers. Our results show that the mean optical properties and fluorophore contributions of normal skin and non-melanoma skin cancers are significantly different from each other and can potentially be used as biomarkers for non-invasive diagnosis of skin cancer.Biomedical Engineerin

Current State of Non-wearable Sensor Technologies for Monitoring Activity Patterns to Detect Symptoms of Mild Cognitive Impairment to Alzheimer’s Disease

Mild cognitive impairment (MCI) could be a transitory stage to Alzheimer’s disease (AD) and underlines the importance of early detection of this stage. In MCI stage, though the older adults are not completely dependent on others for day-to-day tasks, mild impairments are seen in memory, attention, etc., subtly affecting their daily activities/routines. Smart sensing technologies, such as wearable and non-wearable sensors, coupled with advanced predictive modeling techniques enable daily activities/routines based early detection of MCI symptoms. Non-wearable sensors are less intrusive and can monitor activities at naturalistic environment with no interference to an individual’s daily routines. This review seeks to answer the following questions: (1) What is the evidence for use of non-wearable sensor technologies in early detection of MCI/AD utilizing daily activity data in an unobtrusive manner? (2) How are the machine learning methods being employed in analyzing activity data in this early detection approach? A systematic search was conducted in databases such as IEEE Explorer, PubMed, Science Direct, and Google Scholar for the papers published from inception till March 2019. All studies that fulfilled the following criteria were examined: a research goal of detecting/predicting MCI/AD, daily activities data to detect MCI/AD, noninvasive/non-wearable sensors for monitoring activity patterns, and machine learning techniques to create the prediction models. Out of 2165 papers retrieved, 12 papers were eligible for inclusion in this review. This review found a diverse selection of aspects such as sensors, activity domains/features, activity recognition methods, and abnormality detection methods. There is no conclusive evidence on superiority of one or more of these aspects over the others, especially on the activity feature that would be the best indicator of cognitive decline. Though all these studies demonstrate technological developments in this field, they all suggest it is far in the future it becomes an effective diagnostic tool in real-life clinical practice

Probe pressure effects on human skin diffuse reflectance and fluorescence spectroscopy measurements

Diffuse reflectance and fluorescence spectroscopy are popular research techniques for noninvasive disease diagnostics. Most systems include an optical fiber probe that transmits and collects optical spectra in contact with the suspected lesion. The purpose of this study is to investigate probe pressure effects on human skin spectroscopic measurements. We conduct an in-vivo experiment on human skin tissue to study the short-term (<2 s) and long-term (>30 s) effects of probe pressure on diffuse reflectance and fluorescence measurements. Short-term light probe pressure (P0 < 9 mN∕mm2) effects are within 0 ± 10% on all physiological properties extracted from diffuse reflectance and fluorescence measurements, and less than 0 ± 5% for diagnostically significant physiological properties. Absorption decreases with site-specific variations due to blood being compressed out of the sampled volume. Reduced scattering coefficient variation is site specific. Intrinsic fluorescence shows a large standard error, although no specific pressure-related trend is observed. Differences in tissue structure and morphology contribute to site-specific probe pressure effects. Therefore, the effects of pressure can be minimized when the pressure is small and applied for a short amount of time; however, long-term and large pressures induce significant distortions in measured spectra

Non-invasive, simultaneous quantification of vascular oxygenation and glucose uptake in tissue.

We report the development of non-invasive, fiber-based diffuse optical spectroscopy for simultaneously quantifying vascular oxygenation (SO2) and glucose uptake in solid tumors in vivo. Glucose uptake was measured using a fluorescent glucose analog, 2-[N-(7-nitrobenz-2-oxa-1,3-diaxol-4-yl)amino]-2-deoxyglucose (2-NBDG). Quantification of label-free SO2 and 2-NBDG-fluorescence-based glucose uptake 60 minutes after administration of the tracer (2-NBDG60) was performed using computational models of light-tissue interaction. This study was carried out on normal tissue and 4T1 and 4T07 murine mammary tumor xenografts in vivo. Injection of 2-NBDG did not cause a significant change in optical measurements of SO2, demonstrating its suitability as a functional reporter of tumor glucose uptake. Correction of measured 2-NBDG-fluorescence for the effects of absorption and scattering significantly improved contrast between tumor and normal tissue. The 4T1 and 4T07 tumors showed significantly decreased SO2, and 4T1 tumors demonstrated increased 2-NBDG60 compared with normal tissue (60 minutes after the administration of 2-NBDG when perfusion-mediated effects have cleared). 2-NBDG-fluorescence was found to be highly sensitive to food deprivation-induced reduction in blood glucose levels, demonstrating that this endpoint is indeed sensitive to glycolytic demand. 2-NBDG60 was also found to be linearly related to dose, underscoring the importance of calibrating for dose when comparing across animals or experiments. 4T1 tumors demonstrated an inverse relationship between 2-NBDG60 and SO2 that was consistent with the Pasteur effect, particularly when exposed to hypoxic gas breathing. Our results illustrate the potential of optical spectroscopy to provide valuable information about the metabolic status of tumors, with important implications for cancer prognosis

Delivery-corrected imaging of fluorescently-labeled glucose reveals distinct metabolic phenotypes in murine breast cancer.

When monitoring response to cancer therapy, it is important to differentiate changes in glucose tracer uptake caused by altered delivery versus a true metabolic shift. Here, we propose an optical imaging method to quantify glucose uptake and correct for in vivo delivery effects. Glucose uptake was measured using a fluorescent D-glucose derivative 2-(N-(7-Nitrobenz-2-oxa-1,3-diazol-4-yl)Amino)-2-deoxy-D-glucose (2-NBDG) in mice implanted with dorsal skin flap window chambers. Additionally, vascular oxygenation (SO2) was calculated using only endogenous hemoglobin contrast. Results showed that the delivery factor proposed for correction, "RD", reported on red blood cell velocity and injected 2-NBDG dose. Delivery-corrected 2-NBDG uptake (2-NBDG60/RD) inversely correlated with blood glucose in normal tissue, indicating sensitivity to glucose demand. We further applied our method in metastatic 4T1 and nonmetastatic 4T07 murine mammary adenocarcinomas. The ratio 2-NBDG60/RD was increased in 4T1 tumors relative to 4T07 tumors yet average SO2 was comparable, suggesting a shift toward a "Warburgian" (aerobic glycolysis) metabolism in the metastatic 4T1 line. In heterogeneous regions of both 4T1 and 4T07, 2-NBDG60/RD increased slightly but significantly as vascular oxygenation decreased, indicative of the Pasteur effect in both tumors. These data demonstrate the utility of delivery-corrected 2-NBDG and vascular oxygenation imaging for differentiating metabolic phenotypes in vivo

Delivery rate affects uptake of a fluorescent glucose analog in murine metastatic breast cancer.

We demonstrate an optical strategy using intravital microscopy of dorsal skin flap window chamber models to image glucose uptake and vascular oxygenation in vivo. Glucose uptake was imaged using a fluorescent glucose analog, 2-[N-(7-nitrobenz-2-oxa-1,3-diaxol-4-yl)amino]-2-deoxyglucose (2-NBDG). SO2 was imaged using the differential absorption properties of oxygenated [HbO2] and deoxygenated hemoglobin [dHb]. This study was carried out on two sibling murine mammary adenocarcinoma lines, 4T1 and 4T07. 2-NBDG uptake in the 4T1 tumors was lowest when rates of delivery and clearance were lowest, indicating perfusion-limited uptake in poorly oxygenated tumor regions. For increasing rates of delivery that were still lower than the glucose consumption rate (as measured in vitro), both 2-NBDG uptake and the clearance rate from the tumor increased. When the rate of delivery of 2-NBDG exceeded the glucose consumption rate, 2-NBDG uptake decreased with any further increase in rate of delivery, but the clearance rate continued to increase. This inflection point was not observed in the 4T07 tumors due to an absence of low delivery rates close to the glucose consumption rate. In the 4T07 tumors, 2-NBDG uptake increased with increasing rates of delivery at low rates of clearance. Our results demonstrate that 2-NBDG uptake in tumors is influenced by the rates of delivery and clearance of the tracer. The rates of delivery and clearance are, in turn, dependent on vascular oxygenation of the tumors. Knowledge of the kinetics of tracer uptake as well as vascular oxygenation is essential to make an informed assessment of glucose demand of a tumor