Significance: Peripheral pitting edema is a clinician-administered measure for grading edema. Peripheral edema is graded 0, 1 + , 2 + , 3 + , or 4 + , but subjectivity is a major limitation of this technique. A pilot clinical study for short-wave infrared (SWIR) molecular chemical imaging (MCI) effectiveness as an objective, non-contact quantitative peripheral edema measure is underway.
Aim: We explore if SWIR MCI can differentiate populations with and without peripheral edema. Further, we evaluate the technology for correctly stratifying subjects with peripheral edema.
Approach: SWIR MCI of shins from healthy subjects and heart failure (HF) patients was performed. Partial least squares discriminant analysis (PLS-DA) was used to discriminate the two populations. PLS regression (PLSR) was applied to assess the ability of MCI to grade edema.
Results: Average spectra from edema exhibited higher water absorption than non-edema spectra. SWIR MCI differentiated healthy volunteers from a population representing all pitting edema grades with 97.1% accuracy (N = 103 shins). Additionally, SWIR MCI correctly classified shin pitting edema levels in patients with 81.6% accuracy.
Conclusions: Our study successfully achieved the two primary endpoints. Application of SWIR MCI to monitor patients while actively receiving HF treatment is necessary to validate SWIR MCI as an HF monitoring technology.
Significance: Noninvasive diffuse optical spectroscopy (DOS) is a promising adjunct diagnostic imaging technique for distinguishing benign and malignant breast lesions. Most DOS approaches require normalizing lesion biomarkers to healthy tissue since major tissue constituents exhibit large interpatient variations. However, absolute optical biomarkers are desirable as it avoids reference measurements which may be difficult or impractical to acquire.
Aim: Our goal is to determine whether absolute measurements of minor absorbers such as collagen and methemoglobin (metHb) can successfully distinguish lesions. We hypothesize that metHb would exhibit less interpatient variability and be more suitable as an absolute metric for malignancy. However, we would expect collagen to exhibit more variability, because unlike metHb, collagen is also present in the healthy tissue.
Approach: In this retrospective clinical study, 30 lesions with breast imaging reporting and database system score ( BIRADS ) > = 3 (12 benign and 18 malignant) measured with broadband quantitative DOS were analyzed for their oxyhemoglobin (HbO), deoxyhemoglobin (HHb), water, lipids, collagen, metHb concentrations, and optical scattering characteristics. Wilcoxon rank sum test was used to compare benign and malignant lesions for all variables in both normalized and absolute forms.
Results: Among all absolute DOS parameters considered, only absolute metHb was observed to be significant for lesion discrimination (0.43 ± 0.18 μM for benign versus 0.87 ± 0.32 μM for malignant, p = 0.0002). Absolute metHb concentration was also determined to be the best predictor of malignancy with an area under the curve of 0.89.
Conclusions: Our findings demonstrate that lesion metHb concentration measured by DOS can improve noninvasive optical diagnosis of breast malignancies. Since metHb concentration found in normal breast tissue is extremely low, metHb may be a more direct indicator of malignancy that does not depend on other biomarkers found in healthy tissue with significant variability. Furthermore, absolute parameters require reduced measurement time and can be utilized in cases where healthy reference tissue is not available.
Noninvasive diffuse optical spectroscopy (DOS) is promising as an adjunct diagnostic imaging technique for distinguishing benign and malignant breast lesions. However, most DOS approaches require normalizing lesion optical biomarkers to healthy values in reference tissue since major tissue constituents exhibit large inter-patient variations. Our goal is to determine whether absolute measurements of minor optical absorbers such as collagen and methemoglobin (metHb) can successfully distinguish benign and malignant breast lesions. In this retrospective clinical study, 30 lesions with BIRADS score >= 3 (12 benign and 18 malignant lesions from 28 subjects) measured with broadband quantitative DOS were analyzed for their oxy-, deoxy- hemoglobin, water, lipids, collagen, and metHb concentrations as well as their optical scattering characteristics. Amongst all absolute DOS parameters (i.e., without normalization to healthy tissue) considered, only absolute metHb was observed to be significant for lesion discrimination (0.43±0.18 μM for benign vs 0.87±0.32 μM for malignant, p = 0.0002). Our findings demonstrate that lesion metHb concentration measured by quantitative DOS can improve noninvasive optical diagnosis of breast malignancies.
Near infrared spectroscopy (NIRS) is used for a wide variety of applications due to its noninvasiveness, ease of use, quick acquisition time, and affordability. In this study we investigate the effectiveness of spatial frequency domain imaging (SFDI), a widefield noncontact quantitative NIRS technique, to assess peripheral artery disease progression in vivo. SFDI measures absolute (i.e. optical scattering-corrected) tissue concentrations of oxy- hemoglobin and deoxyhemoglobin, and therefore total hemoglobin concentration and tissue oxygen saturation. Female apolipoprotein E-deficient mice (n=9) underwent femoral artery ligation to induce unilateral ischemia in the left hindlimb. Brie y, the left femoral artery was exposed and ligated via suture midway between the aortic trifurcation and division into the saphenous and popliteal arteries. SFDI was acquired for both the ischemic and control limbs over 4 weeks to track changes in vascular perfusion. We also acquired high frequency pulsed-wave Doppler ultrasound images and performed histological analysis, both of which confirmed occlusion of the left femoral artery post-ligation. The ischemic to control ratio for tissue oxygen saturation was 0.96±0.06 at baseline and 0.86±0.10 at day 1, 0.94±0.06 at day 3, 0.95±0.14 at day 7, 0.91±0.09 at day 14, 0.90±0.09 at day 21, and 1.01±0.09 at day 28. These results demonstrate the ability of NIRS to detect a decrease in tissue oxygen saturation in the ischemic limb within a week of ischemic injury, followed by recovery at 4 weeks post-ligation. Our work provides evidence for the potential of SFDI to accurately and noninvasively quantify peripheral artery disease progression in a preclinical murine model.
Reflectance-based, handheld diffuse optical tomography (DOT) uses multi-spectral frequency-domain (FD) and/or continuous-wave (CW) discrete wavelength sources. During DOT reconstruction, spectral constraints are commonly applied assuming a limited number of chromophores in the tissue in order to more accurately recover chromophore concentrations and scattering parameters. However, there are cases where spectral recovery cannot be applied, such as for the quantification of unknown tissue absorbers, where the chromophore extinction spectra are not known a priori. Therefore, we have worked toward a hyperspectral, hybrid FD and CW-DOT approach that can accurately recover tissue absorption and scattering spectra without needing a spectral constraint. Our approach increases the number of recoverable chromophores continuously across a 650 - 1050 nm spectrum. We have implemented and evaluated this technique in a prototype handheld probe for reflectance-mode breast imaging. Currently, no handheld portable DOT probe has this broadband hyperspectral capability. We simulated the accuracy of optical property recovery, showing that hybrid DOT successfully recovers the absorption spectra with average of 10% error across 650 − 1000 nm spectrum. We have also validated this technique by successfully imaging an inhomogeneous physical phantom with optical properties mimicking breast tissue. The methodology for the probe design along with the results of simulations and phantom studies are presented.
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