Comparison of time-resolved and -unresolved measurements of deoxyhemoglobin in brain

Breast cancer detection by mapping hemoglobin concentration and oxygen saturation

Near-infrared (NIR) spectroscopic imaging technology provides a new modality for measuring changes in total hemoglobin concentration (HbT) and blood oxygen saturation (SO2) in human tissue. The technology can be used to detect breast cancer because cancers may cause greater vascularization and greater oxygen consumption than in normal tissue. Based on the NIR technology, ViOptix, Inc., has developed an optical device that provides two-dimensional mapping of HbT and SO2 in human tissue. As an adjunctive tool to mammography, the device was preliminarily tested in a clinical trial with 50 mammogram-positive patients at the Massachusetts General Hospital. The results of the clinical trial demonstrate that the device can reach as much as 92% diagnostic sensitivity and 67% specificity in detecting ductal carcinoma. These results may indicate that the NIR technology can potentially be used as an adjunct to mammography for breast cancer detection to reduce the number of biopsies performed.

Functional near-infrared optical imaging: Utility and limitations in human brain mapping

Although near-infrared spectroscopy (NIRS) was developed as a tool for clinical monitoring of tissue oxygenation, it also has potential for neuroimaging. A wide range of different NIRS instruments have been developed, and instruments for continuous intensity measurements with fixed spacing [continuous wave (CW)-type instruments], which are most readily available commercially, allow us to see dynamic changes in regional cerebral blood flow in real time. However, quantification, which is necessary for imaging of brain functions, is impossible with these CW-type instruments. Over the past 20 years, many different approaches to quantification have been tried, and several multichannel time-resolved and frequency-domain instruments are now in common use for imaging. Although there are still many problems with this technique, such as incomplete knowledge of how light propagates through the head, NIRS will not only open a window on brain physiology for subjects who have rarely been examined until now, but also provide a new direction for functional mapping studies.

State-estimation approach to the nonstationary optical tomography problem

We propose a new numerical approach to the nonstationary optical (diffusion) tomography (OT) problem. The assumption in the method is that the absorption and/or diffusion coefficients are nonstationary in the sense that they may exhibit significant changes during the time that is needed to measure data for one traditional image frame. In the proposed method, the OT problem is formulated as a state-estimation problem. Within the state-estimation formulation, the absorption and/or diffusion coefficients are considered a stochastic process. The objective is to estimate a sequence of states for the process when the state evolution model for the process, the observation model for OT experiments, and data on the exterior boundary are given. In the proposed method, the state estimates are computed by using Kalman filtering techniques. The performance of the proposed method is evaluated on the basis of synthetic data. The simulations also illustrate that further improvements to the results in nonstationary applications can be obtained by adjustment of the measurement protocol.

An event-related optical topography study of cortical activation induced by single-pulse transcranial magnetic stimulation

To visualize cortical activations during transcranial magnetic stimulation (TMS), it is necessary to measure those activations at high spatiotemporal resolution while preventing interference with the magnetic property of a coil. One suitable method that satisfies these demands is optical topography (OT), which has been used in cortical activation studies. In the present study, single-pulse TMS was applied to the left primary motor area, and cortical responses at the stimulation site were measured simultaneously with event-related OT. When TMS was applied at 110% motor threshold (MT), we observed significant oxyhemoglobin increases that were both time-locked and correlated with the hemodynamic basis function. Moreover, when TMS was applied at 90% MT, significant oxyhemoglobin increases were detected even though there were no motor-evoked potentials. These results demonstrate that OT can directly measure cortical responses to subthreshold single-pulse TMS, independent of the afferent feedback from the peripheral neuromuscular activity.

Quantitative Brain Tissue Oximetry, Phase Spectroscopy and Imaging the Range of Homeostasis in Piglet Brain

The quantification of tissue oxygen by frequency or time domain methods has been discussed in a number of prior publications where the meaning of the tissue hemoglobin oxygen saturation was unclear and where the CW instruments were unsuitable for proper quantitative measurements [1, 2]. The development of the IQ Phase Meter has greatly simplified and made reliable the difficult determination of precise phase and amplitude signals from brain. This contribution reports on the calibration of the instrument in model systems and the use of the instrument to measure tissue saturation (StO2) in a small animal model. In addition, a global interpretation of the meaning of tissue oxygen has been formulated based on the idea that autoregulation will maintain tissue oxygen at a fixed value over a range of arterial and venous oxygen values over the range of autoregulation. Beyond that range, the tissue oxygen is still correctly measured but, as expected, approaches the arterial saturation at low metabolic rates and the venous saturation at high metabolic rates of mitochondria.

Non-invasive neuroimaging using near-infrared light

This article reviews diffuse optical brain imaging, a technique that employs near-infrared light to non-invasively probe the brain for changes in parameters relating to brain function. We describe the general methodology, including types of measurements and instrumentation (including the tradeoffs inherent in the various instrument components), and the basic theory required to interpret the recorded data. A brief review of diffuse optical applications is included, with an emphasis on research that has been done with psychiatric populations. Finally, we discuss some practical issues and limitations that are relevant when conducting diffuse optical experiments. We find that, while diffuse optics can provide substantial advantages to the psychiatric researcher relative to the alternative brain imaging methods, the method remains substantially underutilized in this field.

Regional cerebral blood flow changes associated with emotions in children

Combining a wireless telemetry system and a portable near-infrared instrument, we developed a movable optical spectroscopy system for monitoring cerebral hemodynamic changes. The patient carries a miniaturized near-infrared spectroscopy instrument on the back, and data are sent by a wireless telemetry system to a computer, without restricting patient movement. We used this system to detect hemodynamic changes associated with being startled, anticipation, and pleasant and unpleasant emotions in the bilateral prefrontal cortices of 16 right-handed 4- to 6-year-old preschool children while they were watching a 21-minute video clip consisting of various scenes that elicited emotional responses, interpolated with neutral scenes for comparison. The children were relaxed and cooperative when they were studied. Anticipation was associated with increases in cerebral blood flow in the left prefrontal cortex of the 6-year-old children, and unpleasant emotion was associated with decreases in cerebral blood flow bilaterally compared with neutral emotion, irrespective of age. No hemodynamic changes associated with the startle response were observed. Although this study should be considered preliminary, it is suggested that the emotional response is age-dependent and that the left prefrontal cortex participates in anticipation. Our newly developed system will open a window into brain physiology in children.

In vivo spectroscopy: a novel approach for simultaneously estimating nitric oxide and hemodynamic parameters in the rat brain

Nitric oxide (NO) is a versatile molecule involved in a wide range of biological processes. Under physiological conditions, NO reacts with oxyhemoglobin (OxyHb) to form methemoglobin (MetHb) at a very high rate. Microdialysis studies have used hemoglobin solutions as a trapping method to quantify NO in vivo. The methodology described here uses the microcapillary network with endogenous OxyHb instead of microdialysis probe with exogenous OxyHb for monitoring MetHb as an indirect index of NO levels by in vivo spectroscopy using optical fibers. This new method has been validated in rat cerebral cortex by the infusion of NO or well-known drug-induced changes in NO concentration (NMDA agonists and a NO-synthase inhibitor) and by comparing results with simultaneous voltammetric recordings. Results indicate that this spectroscopy technique is able to record large increases in MetHb levels and to detect reductions of its basal levels. In addition, data show that similar changes and kinetics can be observed with both techniques. Thus, intravascular MetHb can be used as an indirect index of NO levels. It is proposed that in vivo spectroscopy may be a useful tool to gain insight into the roles of NO in hemodynamic parameters and in other physiological processes such as the regulation of the mitochondrial respiratory chain.

Technical foundations for noninvasive assessment of changes in the width of the subarachnoid space with near-infrared transillumination-backscattering sounding (NIR-TBSS)

This paper presents technical foundations for a new technique of near-infrared transillumination-backscattering sounding, which is designed to enable noninvasive detection and monitoring of changes in the width of the subarachnoid space (SAS) and magnitude of cerebrovascular pulsation in humans. The key novelty of the technique is elimination of influence of blood flow in the scalp on the signals received from two infrared sensors-proximal and distal. A dedicated digital algorithm is used to estimate on line the ratio of the powers of received signals, referred to as two-sensor distal-to-proximal received power quotient, TQ (t). The propagation duct for NIR radiation reaching the distal sensor is the SAS filled with translucent cerebrospinal fluid. Information on slow fluctuations of the average width of the SAS is contained in the slow-variable part of the TQ (t), called the subcardiac component, and in TQ itself. Variations in frequency and magnitude of faster oscillations of the width of that space around the baseline value, dependent on cerebrovascular pulsation, are reflected in instantaneous frequency and envelope of the fast-variable component. Frequency and magnitude of the cerebrovascular pulsation depend on the action of the heart, so this fast-variable component is referred to as the cardiac component.

Optoacoustic technique for noninvasive monitoring of blood oxygenation: a feasibility study

Replacement of invasive monitoring of cerebral venous oxygenation with noninvasive techniques offers great promise in the management of life-threatening neurologic illnesses including traumatic brain injury. We developed and built an optoacoustic system to noninvasively monitor cerebral venous oxygenation; the system includes a nanosecond Nd:YAG laser and a specially designed optoacoustic probe. We tested the system in vitro in sheep blood with experimentally varied oxygenation. Our results demonstrated that (1) the amplitude and temporal profile of the optoacoustic waves increase with blood oxygenation in the range from 24% to 92%, (2) optoacoustic signals can be detected despite optical and acoustic attenuation by thick bone, and (3) the system is capable of real-time and continuous measurements. These results suggest that the optoacoustic technique is technically feasible for continuous, noninvasive monitoring of cerebral venous oxygenation.

Lateralized activation in the inferior frontal cortex during syntactic processing: event-related optical topography study

Functional imaging with near-infrared light has the potential to provide novel information that cannot be obtained with other imaging techniques. An event-related paradigm has not been fully established for studying human cognitive functions with near-infrared optical imaging. We conducted language experiments to develop an event-related paradigm with optical topography (OT). We directly compared cortical activation during syntactic and semantic decision tasks, both of which involved error detection in a sentence stimulus that consisted of a noun phrase and a verb. In the syntactic decision task, subjects judged whether the presented sentence is syntactically correct, where the syntactic knowledge about the distinction between transitive and intransitive verbs was required. In the semantic decision task, subjects judged whether the presented sentence is semantically correct, where the lexico-semantic knowledge about selectional restrictions was indispensable. We found local increases in oxyhemoglobin concentration, which were selectively associated with the syntactic decision task. Activation in the left inferior frontal gyrus was detected when syntactically anomalous sentences were presented, whereas there was no significant activation in this region when semantically anomalous sentences were presented. Moreover, identical stimuli of normal sentences elicited activation in the left inferior frontal gyrus, only when the employment of syntactic knowledge was required. This task-selective activation was not observed in any other measured regions, including the right homologous region. These results demonstrate that OT techniques, when coupled with the event-related paradigm, are useful for studying the higher cognitive functions of the human cerebral cortex.

Concentration measurement of gas embedded in scattering media by employing absorption and time-resolved laser spectroscopy

Diode-laser-based absorption spectroscopy for the evaluation of embedded gas concentrations in porous materials is demonstrated in measurements of molecular oxygen dispersed throughout scattering polystyrene foam, used here as a generic test material. The mean path length of light scattered in the material is determined with the temporal characteristics of the radiation transmitted through the sample. This combined with sensitive gas-absorption measurements employing wavelength-modulation spectroscopy yields an oxygen concentration in polystyrene foam of 20.4% corresponding to a foam porosity of 98%, which is consistent with manufacturing specifications. This feasibility study opens many possibilities for quantitative measurements by using the method of gas-in-scattering-media absorption spectroscopy.

Quantification of cerebral oxygenation by full-spectrum near-infrared spectroscopy using a two-point method

The aim of this study was to quantify the relative concentrations of oxyhemoglobin and deoxyhemoglobin within the light path of the brain and to estimate cerebral hemoglobin (Hb) oxygen saturation using full-spectrum near-infrared spectroscopy (fsNIRS). For this purpose, we developed a novel exponential correction equation as well as a two-point spectroscopy method to estimate the relative concentrations of Hb and Hb oxygen saturation in biological tissues. The results of evaluation of measurements using an in vitro model indicated that our fsNIRS method enables accurate and non-invasive measurements of Hb content and saturation in a highly scattered medium such as the human brain. According to the results of analysis using a hypoxic piglet model, the mean cerebral Hb oxygen saturation (SbO(2)) of newborn piglets at an inspired oxygen gas concentration of 0.21 was estimated to be 63+/-4% (mean+/-S.D.). Umbilical arterial and left internal jugular venous Hb oxygen saturation were simultaneously estimated to be 96+/-2% and 52+/-11%, respectively. SbO(2) and arterial Hb oxygen saturation values had a linear relationship. The average oxygenation state of cerebral tissue is comparable with that of the cerebral vein. The results of this study showed that our method can be used to monitor Hb oxygen saturation in the neonatal brain at the bedside in an intensive care unit.

Haemoglobin oxygenation of a two-layer tissue-simulating phantom from time-resolved reflectance: effect of top layer thickness

A dual wavelength time-resolved reflectance system was developed for monitoring haemoglobin saturation noninvasively. At each wavelength, the time-resolved reflectance data were fitted to a diffusion model of light propagation in a homogeneous, semi-infinite medium to yield the absolute scattering and absorption coefficients. The absorption coefficients were then used to calculate haemoglobin saturation. A two-layer phantom containing human erythrocytes in a scattering solution in the bottom layer was used to study system performance under more realistic conditions. The top layer was chosen to simulate either skin or fat and the oxygenation of the bottom layer, which corresponded to muscle, was controlled. The thickness of the fat layer was varied from 1.5 to 10 mm to investigate the effects of increasing the top layer thickness. These results, obtained with the simple diffusion model, were compared with simultaneous measurements of oxygenation made directly in the bottom layer. Errors in estimating haemoglobin saturation with this method ranged from 5-11% depending on the thickness of the top layer and its optical properties.

In vivo near-infrared spectroscopy

Interrogation of tissue with light offers the potential for noninvasive chemical measurement, and penetration with near-infrared wavelengths (750-1000 nm) is greater than with visible light. Specific absorption by clinically relevant compounds such as oxy- and deoxyhemoglobin and the intracellular respiratory enzyme cytochrome oxidase enable in vivo measurement of these to be performed safely and conveniently. This is the basis of in vivo near-infrared spectroscopy (ivNIRS). Multiple scattering of the interrogating beam by tissues leads to an optical path that is considerably longer than the simple physical pathlength and this complicates the analysis. Modeling of photon propagation through tissues with, for example, finite element and Monte Carlo methods, is assisting in improving the ivNIRS methodology. Instrumentation has advanced from simple continuous wave approaches, through time-resolved methods based on either time-domain or frequency-domain approaches, to spatially resolved measurement based on diffuse reflectance. Initial clinical applications were for monitoring the brain in the neonate and fetus and muscle in adults. Currently, use in adults and children for neurological assessments are of growing interest.

Quantification of optical properties of a breast tumor using random walk theory

For the first time we use a random walk methodology based on time-dependent contrast functions to quantify the optical properties of breast tumors (invasive ductal carcinoma) of two patients. Previously this theoretical approach was successfully applied for analysis of embedded objects in several phantoms. Data analysis was performed on distributions of times of flight for photons transmitted through the breast which were recorded in vivo using a time-domain scanning mammograph at 670 and 785 nm. The size of the tumors, their optical properties, and those of the surrounding tissue were reconstructed at both wavelengths. The tumors showed increased absorption and scattering. From the absorption coefficients at both wavelengths blood oxygen saturation was estimated for the tumors and the surrounding tissue.

Absorbance of opaque microstructures in optically diffuse media

In this study experimental measurements are used to determine that the observed absorbance of opaque microstructures in optically diffuse media correlates with the total surface area rather than the attenuation as calculated in a nonscattering environment. The data suggest that it may be possible to use remote measurements of optical diffuse transmission to quantify surface areas of microcapillaries that are highly absorbing or larger blood vessels that can have high intrinsic attenuation because of hematocrit alone. Results obtained in a transmission geometry are insensitive to the position of the microstructure along the line between source and detector, whereas those collected in a remission geometry are highly sensitive to the depth at which the structure is located. These types of measurement involving microscopic structures embedded in diffuse media have potential application in quantifying blood vessel surface areas that contain contrast agents or other microparticles within tissue.

Estimation of regional cerebral blood flow distribution in infants by near-infrared topography using indocyanine green

Near-infrared topography with indocyanine green was used to measure regional cerebral blood flow (rCBF) in the temporal lobes of infants. The mean rCBF in infants without neural abnormality was 14.5 +/- 3.1 ml/100 g/min, and the rCBFs in the fronto-temporal, temporal, and occipito-temporal regions were 15.1 +/- 3.9, 15.4 +/- 3.3, and 14.6 +/- 3.3 ml/100 g/min, respectively. Moreover, in one asphyxiated infant with infarction and one infant with subdural and intracerebellar hemorrhage, it was demonstrated that the area of defective blood flow could be detected as well as it can by SPECT. This technique makes it possible to estimate rCBF distribution in infants at the bedside. Thus, in the future, evaluation of various neonatal illnesses should be feasible.

Analysis of gas dispersed in scattering media

Monitoring of free gas embedded in scattering media, such as wood, fruits, and synthetic materials, is demonstrated by use of diode laser spectroscopy combined with sensitive modulation techniques. Gas detection is made possible by the contrast of the narrow absorptive feature of the free-gas molecules with the slow wavelength dependence of the absorption and scattering cross sections in solids and liquids. An absorption sensitivity of 2.5 x 10(-4), corresponding to a 1.25-mm air column, is demonstrated by measurements of dispersed molecular oxygen. These techniques open up new possibilities for characterization and diagnostics, including internal gas pressure and gas-exchange assessment, in organic and synthetic materials.

Developments toward diagnostic breast cancer imaging using near-infrared optical measurements and fluorescent contrast agents

The use of near-infrared (NIR) light to interrogate deep tissues has enormous potential for molecular-based imaging when coupled with NIR excitable dyes. More than a decade has now passed since the initial proposals for NIR optical tomography for breast cancer screening using time-dependent measurements of light propagation in the breast. Much accomplishment in the development of optical mammography has been demonstrated, most recently in the application of time-domain, frequency-domain, and continuous-wave measurements that depend on endogenous contrast owing to angiogenesis and increased hemoglobin absorbance for contrast. Although exciting and promising, the necessity of angiogenesis-mediated absorption contrast for diagnostic optical mammography minimizes the potential for using NIR techniques to assess sentinel lymph node staging, metastatic spread, and multifocality of breast disease, among other applications. In this review, we summarize the progress made in the development of optical mammography, and focus on the emerging work underway in the use of diagnostic contrast agents for the molecular-based, diagnostic imaging of breast.

Intracerebral hemodynamics probed by near infrared spectroscopy in the transition between wakefulness and sleep

Previous imaging studies have shown that cerebral metabolism is gradually reduced at the beginning of sleep. Few studies have examined the sleep state transition periods from wakefulness to sleep and sleep to wakefulness. The current study used the Near Infrared Spectroscopy (NIRS) technique to describe the intracerebral hemodynamics at the frontal pole in the circumscribed period between wakefulness and sleep. Nine healthy young adults were studied during afternoon naps. Optical probes were placed on the forehead and EEG electrodes on the scalp. At sleep onset oxygenated hemoglobin (oxy-Hb) was reduced (P<0.01) and deoxygenated hemoglobin (deoxy-Hb) showed a near significant reduction (P<0.063). At sleep offset there were increases in oxy-Hb (P<0.005) and deoxy-Hb (P<0.05). In 18 of 26 transitions to sleep there was a coordinated fall in both NIRS parameters, we call the Switch Point, that lasted a mean of 3.6 s. In 32 of 36 transitions to wakefulness there was an analogous Switch Point that lasted a mean of 3.4 s. Before and after the Switch Point, changes were small and the relationship between oxy-Hb and deoxy-Hb was a combination of parallel and reciprocal fluctuations. A synchronized, parallel and short-lived change in oxy-Hb and deoxy-Hb is a discrete event in the transition period between wakefulness and sleep. The concentration of these light absorbing molecules is abruptly set to a new level at sleep-wake transitions and probably reflects the different perfusion demands of these states.

Calibration of near-infrared frequency-domain tissue spectroscopy for absolute absorption coefficient quantitation in neonatal head-simulating phantoms

Frequency-domain tissue spectroscopy is a method to measure the absolute absorption coefficient of bulk tissues, assuming that a representative model can be found to recover the optical properties from measurements. While reliable methods exist to calculate absorption coefficients from source-detector measurements less than a few centimeters apart along a flat tissue volume, it is less obvious what methods can be used for transmittance through the larger tissue volumes typically associated with neonatal cerebral monitoring. In this study we compare the use of multiple distance frequency-domain measurements processed with (i) a modified Beer-Lambert law method, (ii) an analytic infinite-medium diffusion theory expression, and (iii) a numerical finite element solution of the diffusion equation, with the goal of recovering the absolute absorption coefficient of the medium. Based upon our observations, the modified Beer-Lambert method provides accurate absolute changes in the absorption coefficient, while analytic infinite-medium diffusion theory solutions or finite element-based numerical solutions can be used to calculate the absolute absorption coefficient, assuming that the data can be measured at multiple source-detector distances. We recommend that the infinite-medium multi-distance method or the finite element method be used across large tissue regions for calculation of the absolute absorption coefficient using frequency-domain near-infrared measurements at multiple positions along the head.

In vivo optical/near-infrared spectroscopy and imaging of metalloproteins

A number of medical applications of near-infrared spectroscopy are growing closer to clinical acceptance, and new techniques involving both spectroscopy and imaging are evolving rapidly. In vivo spectroscopy and, more recently, imaging techniques are largely based upon optical electronic transitions involving the metal centers of hemoglobin (blood), myoglobin (muscle) and cytochrome aa3 (mitochondria). The wide variety of near-IR based applications includes heart and stroke research, monitoring cerebral oxygenation of premature babies, and 'functional activation' (response of brain to mental tasks). All of these applications are founded upon changes in hemoglobin O2 saturation; these changes are monitored by following trends in the near-infrared absorptions of deoxyhemoglobin (760 nm) and oxyhemoglobin (920 nm). The same absorptions provide a basis for imaging regional variations in blood oxygenation. This report presents and discusses examples, both from the literature and from our recent work, of near-infrared spectroscopy and imaging in medical applications.

Noninvasive measurement of cerebral hemoglobin oxygen saturation using two near infrared spectroscopy approaches

Spatially resolved spectroscopy (SRS) is a new near infrared spectroscopy (NIRS) method that, using the multi-distance approach, measures local cerebral cortex hemoglobin oxygen saturation [J. Matcher, P. Kirkpatrick, K. Nahid, M. Cope, and D. T. Delpy, Proc. SPIE 2389, 486-495 (1995)]. Using a conventional continuous wave NIRS photometer, cerebral venous oxygen saturation (SvO2) can be calculated from oxyhemoglobin and total hemoglobin rise induced by partial occlusion of jugular vein [C. E. Elwell, S. J. Matcher, L. Tyszczuk, J. H. Meek, and D. T. Delpy, Adv. Exp. Med. Biol. 411, 453-460 (1997)]. The aim of this study was to compare direct measurements of forehead tissue oxygenation index (TOI) with the calculated SvO2 during venous occlusion in 16 adult volunteers using a clinical two-channel SRS oximeter (NIRO-300). Measured TOI and calculated SvO2 values of either right or left forehead did not significantly differ. A good agreement between the two NIRS methods was also demonstrated. On 16 other subjects, no significant differences were found between the right and left forehead TOI values measured simultaneously, and between the TOI values measured by channel 1 or 2 on the same side. The results confirm that cerebral cortex hemoglobin oxygen saturation, measured directly by the SRS method, reflects predominantly the saturation of the intracranial venous compartment of circulation.

Non-invasive in vivo characterization of breast tumors using photon migration spectroscopy

Frequency-domain photon migration (FDPM) is a non-invasive optical technique that utilizes intensity-modulated, near-infrared (NIR) light to quantitatively measure optical properties in thick tissues. Optical properties (absorption, mu(a), and scattering, mu(s)', parameters) derived from FDPM measurements can be used to construct low-resolution (0.5 to 1 cm) functional images of tissue hemoglobin (total, oxy-, and deoxy-forms), oxygen saturation, blood volume fraction, water content, fat content and cellular structure. Unlike conventional NIR transillumination, FDPM enables quantitative analysis of tissue absorption and scattering parameters in a single non-invasive measurement. The unique functional information provided by FDPM makes it well-suited to characterizing tumors in thick tissues. In order to test the sensitivity of FDPM for cancer diagnosis, we have initiated clinical studies to quantitatively determine normal and malignant breast tissue optical and physiological properties in human subjects. Measurements are performed using a non-invasive, multi-wavelength, diode-laser FDPM device optimized for clinical studies. Results show that ductal carcinomas (invasive and in situ) and benign fibroadenomas exhibit 1.25 to 3-fold higher absorption than normal breast tissue. Within this group, absorption is greatest for measurements obtained from sites of invasive cancer. Optical scattering is approximately 20% greater in pre-menopausal versus post-menopausal subjects due to differences in gland/cell proliferation and collagen/fat content. Spatial variations in tissue scattering reveal the loss of differentiation associated with breast disease progression. Overall, the metabolic demands of hormonal stimulation and tumor growth are detectable using photon migration techniques. Measurements provide quantitative optical property values that reflect changes in tissue perfusion, oxygen consumption, and cell/matrix development.

Rapid cortical hemoglobin deoxygenation after heroin and methadone injection in humans: a preliminary report

The short-term effects of intravenous opioids (heroin 20-300 mg, methadone 30-180 mg) on cortical hemoglobin oxygenation were examined by near infrared spectroscopy in ten opioid-dependent subjects and were compared with the effects of saline in ten age-matched normal controls. Heroin and methadone produced a rapid and dramatic decrease in cortical hemoglobin oxygenation. Saline had no effects. Opioid-induced acute deoxygenation of cortical hemoglobin is most likely associated with respiratory depression. Thorough medical monitoring is strongly recommended in intravenous opioid maintenance treatments.

Higher-order brain function analysis by trans-cranial dynamic near-infrared spectroscopy imaging

Near-infrared spectroscopy is discussed from the viewpoint of human higher-order brain function analysis. Pioneering work in this field is reviewed; then we describe our concept of noninvasive trans-cranial dynamic optical topography and its instrumentation. Also, the validity of its functional images is assessed from both physical and physiological viewpoints. After confirming the validity of this method, we have applied it to a wide variety of fields such as clinical medicine, cognitive science, and linguistics in collaboration with researchers at several other institutes. Further application possibilities and the future of trans-cranial dynamic optical topography are also discussed. © 1999 Society of Photo-Optical Instrumentation Engineers.

Spectroscopic analysis of changes in remitted illumination: the response to increased neural activity in brain

Imaging of neural activation has been used to produce maps of functional architecture and metabolic activity. There is some uncertainty associated with the sources underlying the intrinsic signals. It has been reported that following increased neural activity there was little increased oxygen consumption ( approximately 5%), although glucose consumption increased by approximately 50%. The research we describe uses a modification of the Beer-Lambert Law called path-length scaling analysis (PLSA) to analyze the spectra of the hemodynamic and metabolic responses to vibrissal stimulation in rat somatosensory cortex. The results of the PLSA algorithm were compared with those obtained using a linear spectrographic analysis method (we refer to this as LMCA). There are differences in the results of the analysis depending on which of the two algorithms (PLSA or LMCA) is used. Using the LMCA algorithm, we obtain results showing an increase in the volume of Hbr at approximately 2 s, following onset of stimulation but no complementary decrease in oxygenated haemoglobin (HbO(2)). These results are similar to a previous report. In contrast, after using the PLSA algorithm, the time series of the chromophore changes shows no evidence for an increase in the volume of deoxygenated haemoglobin (Hbr). However, after further analysis of the time series from the PLSA using general linear models (GLM) to remove contributions from low frequency baseline oscillations, both the HbO(2) and Hbr times series of the response to stimulation were found to be biphasic with an early decrease in saturation peaking approximately 1 s after onset of stimulation followed by a larger increase in saturation peaking at approximately 3 s. Finally, following the PLSA-then-GLM analysis procedure, we do not find convincing evidence for an increase in cytochrome oxidation following stimulation, though we demonstrate the PLSA algorithm to be capable of disassociating changes in cytochrome oxidation state from changes in hemoglobin oxygenation.

Multi-layer imaging of human organs by measurement of laser backscattered radiation

Laser backscattered radiations from tissue phantoms and human forearms are measured by a reflectance imager. Laser radiations are guided by an optical fibre, and the backscattered radiations are collected by three optical fibres in the measurement probe assembly, placed at distances of 2 mm, 4 mm and 6 mm from the input fibre. By placing the measurement probe on the phantom or tissue surface and matching the outline on the computer monitor, the reflectance data from the organ or the phantom are collected. These data, after digitisation, interpolation and filtering, are colour coded and displayed on the computer monitor. Using this imaging procedure, the abnormalities embedded at different depths in the phantoms are located. The structural changes due to colour, composition and blood flow in the multi-layer of human forearms of various subjects are qualitatively shown in reflectance images obtained by this procedure.

Retrograde cerebral perfusion versus selective cerebral perfusion as evaluated by cerebral oxygen saturation during aortic arch reconstruction

BACKGROUND

Time limits for neuroprotection by retrograde cerebral perfusion (RCP) and selective cerebral perfusion (SCP) in aortic arch aneurysm repair or dissection are undergoing definition.

METHODS

Using near-infrared optical spectroscopy, changes in regional cerebrovascular oxygen saturation (rSO2) were compared between the two perfusion methods.

RESULTS

Immediately before cardiopulmonary bypass, baseline rSO2 was 63.9%+/-6.9% for the RCP and 66.1%+/-5.3% for the SCP group (no significant difference). As patients were core-cooled to 20 degrees C, rSO2 increased to 73.1%+/-8.8% and 74.1%+/-7.9% in the RCP and SCP groups, respectively. With circulatory arrest, rSO2 suddenly decreased. After starting cerebral perfusion, rSO2 returned to prearrest values in the SCP group but continued decreasing steadily in the RCP group, to levels below baseline after about 25 minutes. At the end of perfusion, rSO2 was 57.4%+/-12.2% for the RCP group and 71.7%+/-6.9% for the SCP group, and the ratio of rSO2 to baseline value was 0.89 for RCP and 1.08 for SCP despite a shorter brain perfusion time for RCP (38.8+/-18.0 versus 103.3+/-43.3 minutes). Three of 5 patients whose ratios of rSO2 to baseline at the end of brain protection were 0.7 or less had neurologic deficits.

CONCLUSIONS

Although SCP showed no clinically important time limitation, rSO2 continued to decrease with time during RCP. An rSO2 ratio less than 0.7 could represent a critical lower limit.

The determination of in vivo human tissue optical properties and absolute chromophore concentrations using spatially resolved steady-state diffuse reflectance spectroscopy

A method is described for measuring optical properties and deriving chromophore concentrations from diffuse reflection measurements at the surface of a turbid medium. The method uses a diffusion approximation model for the diffuse reflectance, in combination with models for the absorption and scattering coefficients. An optical fibre-based set-up, capable of measuring nine spectra from 400 to 1050 nm simultaneously, is used to test the method experimentally. Results of the analyses of phantom and in vivo measurements are presented. These demonstrate that in the wavelength range from 600 to 900 nm, tissue scattering can be described as a simple power dependence of the wavelength and that the tissue absorption can be accurately described by the addition of water, oxy- and deoxyhaemoglobin absorption.

Analysis of optical signals evoked by peripheral nerve stimulation in rat somatosensory cortex: dynamic changes in hemoglobin concentration and oxygenation

The origins of reflected light changes associated with neuronal activity (optical signals) were investigated in rat somatosensory cortex with optical imaging, microspectrophotometry, and laser-Doppler flowmetry, and dynamic changes in local hemoglobin concentration and oxygenation were focused on. Functional activation was carried out by 2-second, 5-Hz electrical stimulation of the hind limb under chloralose anesthesia. These measurements were performed at the contralateral parietal cortex through a thinned skull. Regional cortical blood flow (rCBF) started to rise 1.5 seconds after the stimulus onset, peaked at 3.5 seconds (26.7% +/- 9.7% increase over baseline), and returned to near baseline by 10 seconds. Optical signal responses at 577, 586, and 805 nm showed a monophasic increase in absorbance coincident with the increase in rCBF; however, the signal responses at 605 and 760 nm were biphasic (an early increase and late decrease in absorbance) and microanatomically heterogeneous. The spectral changes of absorbance indicated that the concentrations of both total hemoglobin and oxyhemoglobin increased together with rCBF; deoxyhemoglobin, increased slightly but distinctly (P = 0.016 at 1.0 seconds, P = 0.00038 at 1.5 seconds) just before rCBF increases, then decreased. The authors conclude that activity-related optical signals are greatly associated with a moment-to-moment adjustment of rCBF and metabolism to neuronal activity.

Development and comparison of models for light-pulse transport through scattering-absorbing media

We examine the transport of short light pulses through scattering-absorbing media through different approximate mathematical models. It is demonstrated that the predicted optical signal characteristics are significantly influenced by the various models considered, such as P(N) expansion, two-flux, and discrete ordinates. The effective propagation speed of the scattered radiation, the predicted magnitudes of the transmitted and backscattered fluxes, and the temporal shape and spread of the optical signals are functions of the models used to represent the intensity distributions. A computationally intensive direct numerical integration scheme that does not utilize approximations is also implemented for comparison. Results of some of the models asymptotically approach those of direct numerical simulation if the order of approximation is increased. In this study therefore we identify the importance of model selection in analyzing short-pulse laser applications such as optical tomography and remote sensing and highlight the parameters, such as wave speed, that must be examined before a model is adopted for analysis.

Quantitative broadband near-infrared spectroscopy of tissue-simulating phantoms containing erythrocytes

We report the use of steady-state diffuse reflectance spectroscopy (SSDRS) to measure the near-infrared absorption spectrum of liquid phantoms containing human erythrocytes in aqueous suspensions of polystyrene spheres which simulate the scattering properties of tissue. The absorption spectra obtained from these SSDRS measurements of intact red cells under oxygenated and deoxygenated conditions are compared with several published spectra of 'stripped' haemoglobin prepared from lysed cells. Two fitting algorithms (nonlinear least squares and singular value decomposition) which exploit the broad spectral range provided by these measurements (170 data points spanning 164 nm in a single acquisition) are used to determine haemoglobin oxygen saturation (SO2) from SSDR spectra collected over a wide range of measured oxygen partial pressures. The validity of these algorithms is assessed by comparing literature values of p50 (the oxygen tension at which haemoglobin is 50% saturated) and the Hill coefficient to values of these parameters determined from the SO2 estimates. The singular value decomposition algorithm can also be used to reconstruct the non-haemoglobin background absorption spectrum without a priori assumptions regarding its constituent chromophores or their concentrations. Using this technique, the absorption spectrum of a small amount of India ink (maximum absorption coefficient (mu(a max)) approximately 0.0006 mm(-1)) added to a phantom containing red cells (mu(a max) approximately 0.026 mm(-1)) was reconstructed over a full range of oxygen saturations. The implications of these measurements for detection of weakly absorbing chromophores (such as cytochrome aa3) in the presence of haemoglobin are discussed.

Fast algorithm to determine optical properties of a turbid medium from time-resolved measurements

After analytical expressions for the time-resolved reflectance are introduced from the diffusion approximation under the three most commonly used boundary conditions, a novel algorithm is demonstrated for determining the reduced scattering and the absorption coefficients from time-resolved reflectance (or backscatter) measurements at two positions on the surface of biotissue. The algorithm is straightforward and fast and involves only some simple mathematical operations, avoiding complicated iterative nonlinear fitting to the time-resolved curve. The derived reduced scattering coefficient is not affected by whatever boundary condition is applied. The algorithm was verified with time-resolved data from the Monte Carlo model. Both a semi-infinite medium and a turbid slab medium were tested. In contrast to the nonlinear fitting method, this algorithm allows both the scattering and the absorption coefficients to be determined to a high accuracy.

Spatially localized ballistic two-photon excitation in scattering media

We describe spatially localized two-photon excitation in scattering media. Using femtosecond pulses at 770 nm from a Ti: Sapphire laser, we were able to excite fluorophores in capillary tubes under up to 1.5 mm of 0.5% intralipid. Displacement of the laser beam relative to the embedded samples indicates that highly localized excitation was possible with two-photon excitation, whereas one-photon excitation resulted in loss of spatial resolution due to excitation by the diffusely scattered photons. These results indicate that two-photon excitation in the scattering solution is due only to the ballistic photons, a result confirmed by frequency-domain time-resolved measurements. Selective excitation of adjacent embedded samples was found possible for two but not one-photon excitation.

Time-resolved spectroscopy of mitochondria, cells and tissues under normal and pathological conditions

In this study, the detailed dependence of light scattering on tissue architecture and intracellular composition has been investigated. Firstly, we simulated the reduced scattering coefficient (mu(s)') of the rat liver using the Mie theory, the Rayleigh-Debye-Gans approximation and electron microscopy data. Then, the reduced scattering coefficient of isolated rat liver mitochondria, isolated hepatocytes and various rat tissues (i.e. perfused liver, brain, muscle, tumors) was measured at 780 nm by using time-resolved spectroscopy and a sample-substitution protocol. The comparison of the isolated mitochondria data with the isolated hepatocyte and whole liver measurements suggests that the mitochondrial compartment is the primary factor for light propagation in hepatic tissue, thus strengthening the relevance of the preliminary theoretical study. Nevertheless, the possibility that other intracellular components, such as peroxisomes and lysosomes, interfere with light propagation in rat liver is discussed. Finally, we demonstrate that light scattering in normal rat tissues and tumors is roughly proportional to the mitochondrial content, according to estimates of the mitochondrial protein content of the tissues.

Sensitivity of near infrared spectroscopy to cerebral and extra-cerebral oxygenation changes is determined by emitter-detector separation

OBJECTIVE

To examine the effect of two emitter-detector separations (2.7 and 5.5 cm) on the detection of changes in cerebral and extra-cerebral tissue oxygenation using near infrared spectroscopy (NIRS).

METHODS

Two NIR detectors were placed on the scalp 2.7 and 5.5 cm from a single NIR emitter. Changes in deoxyhaemoglobin (HHb), oxyhaemoglobin (O2Hb),oxidised cytochrome C oxidase (Cyt) and total haemoglobin (tHb) were recorded from each detector during the induction of cerebral oligaemia (transition from hypercapnia to hypocapnia) and scalp hyperaemia (following release of a scalp tourniquet).

RESULTS

Cerebral oligaemia (mean decrease in middle cerebral artery blood flow velocity of 44%) induced by a mean reduction in end tidal CO2 of 18 mmHg was accompanied by a significant increase in the spectroscopic signal for HHb and a decrease in the O2Hb signal. The signal change per unit photon path length detected at 5.5 cm was significantly greater for HHb (p = 0.007) than that detected at 2.7 cm. In contrast, the increase in all chromophores detected at 5.5 cm during scalp hyperaemia was significantly less than that detected at 2.7 cm (p<0.001).

CONCLUSIONS

The differing sensitivity of the proximal and distal channels to changes in cerebral and extracerebral oxygenation is compatible with theoretical models of NIR light transmission in the adult head and may provide a basis for spatially resolving these changes. The optimal emitter-detector separation for adult NIRS requires further investigation and may differ between individuals.

Noninvasive measurement of regional cerebral blood flow by near-infrared spectroscopy and indocyanine green

Clinicians lack a practical method for measuring CBF rapidly, repeatedly, and noninvasively at the bedside. A new noninvasive technique for estimation of cerebral hemodynamics by use of near-infrared spectroscopy (NIRS) and an intravenously infused tracer dye is proposed. Kinetics of the infrared tracer indocyanine green were monitored on the intact skull in pigs. According to an algorithm derived from fluorescein flowmetry, a relative blood flow index (BFI) was calculated. Data obtained were compared with cerebral and galeal blood flow values assessed by radioactive microspheres under baseline conditions and during hemorrhagic shock and resuscitation. Blood flow index correlated significantly (rs = 0.814, P < 0.001) with cortical blood flow but not with galeal blood flow (rs = 0.258). However, limits of agreement between BFI and CBF are rather wide (+/- 38.2 +/- 6.4 mL 100 g-1 min-1) and require further studies. Data presented demonstrate that detection of tracer kinetics in the cerebrovasculature by NIRS may serve as valuable tool for the noninvasive estimation of regional CBF. Indocyanine green dilution curves monitored noninvasively on the intact skull by NIRS reflect dye passage through the cerebral, not extracerebral, circulation.

A solid tissue phantom for photon migration studies

A solid tissue phantom made of agar, Intralipid and black ink is described and characterized. The preparation procedure is fast and easily implemented with standard laboratory equipment. An instrumentation for time-resolved transmittance measurements was used to determine the optical properties of the phantom. The absorption and the reduced scattering coefficients are linear with the ink and Intralipid concentrations, respectively. A systematic decrease of the reduced scattering coefficient dependent on the agar content is observed, but can easily be managed. The phantom is highly homogeneous and shows good repeatability among different preparations. Moreover, agar inclusions can be easily embedded in either solid or liquid matrixes, and no artefacts are caused by the solid-solid or solid-liquid interfaces. This allows one to produce reliable and realistic inhomogeneous phantoms with known optical properties, particularly interesting for studies on optical imaging through turbid media.

Near-simultaneous hemoglobin saturation and oxygen tension maps in mouse brain using an AOTF microscope

A newly developed microscope using acousto-optic tunable filters (AOTFs) was used to generate in vivo hemoglobin saturation (SO2) and oxygen tension (PO2) maps in the cerebral cortex of mice. SO2 maps were generated from the spectral analysis of reflected absorbance images collected at different wavelengths, and PO2 maps were generated from the phosphorescence lifetimes of an injected palladium-porphyrin compound using a frequency-domain measurement. As the inspiratory O2 was stepped from hypoxia (10% O2), through normoxia (21% O2), to hyperoxia (60% O2), measured SO2 and PO2 levels rose accordingly and predictably throughout. A plot of SO2 versus PO2 in different arterial and venous regions of the pial vessels conformed to the sigmoidal shape of the oxygen-hemoglobin dissociation curve, providing further validation of the two mapping procedures. The study demonstrates the versatility of the AOTF microscope for in vivo physiologic investigation, allowing for the generation of nearly simultaneous SO2 and PO2 maps in the cerebral cortex, and the frequency-domain detection of phosphorescence lifetimes. This class of study opens up exciting new possibilities for investigating the dynamics of hemoglobin and O2 binding during functional activation of neuronal tissues.

Cerebral hemoglobin and optical pathlength influence near-infrared spectroscopy measurement of cerebral oxygen saturation

Near-infrared spectroscopy (NIRS) is a noninvasive optical technique to monitor cerebral oxygen saturation at the bedside. Despite its applicability, NIRS has had limited clinical use because of concerns about accuracy, noted by intersubject variability in slope and intercept of the line between NIRS- and weighted-average arterial-cerebrovenous saturation (SMO2). This study evaluated transcranial optical pathlength and cerebral hemoglobin concentration as sources for this intersubject variability. Experiments were performed in an in vitro brain model and in piglets. Optical pathlength and cerebral hemoglobin concentration were measured by time-resolved spectroscopy (TRS). NIRS and TRS were recorded in the model, as perfusate blood saturation was varied (0%-100%) at several hemoglobin concentrations, and in piglets, as SMO2 was varied (15%-90%) before and after hemodilution. In the model, hemoglobin concentration significantly altered the NIRS versus blood saturation line slope and intercept, as well as optical pathlength. In piglets (before hemodilution), there was significant intersubject variability in NIRS versus SMO2 line slope (0.73-1.4) and intercept (-24 to 36) and in transcranial optical pathlength (13.4-16 cm) and cerebral hemoglobin concentration (0.58-1.1 g/dL). By adjusting the NIRS algorithm with optical pathlength or cerebral hemoglobin measurements, intersubject variability in slope (0.9-1.2) and intercept (-9 to 18) decreased significantly. Hemodilution significantly changed NIRS versus SMO2 line slope and intercept, as well as transcranial optical pathlength and cerebral hemoglobin concentration (before versus after hemodilution: slope 0.9 vs 0.78, intercept 13 vs 19, pathlength 13.9 vs 15.6 cm, cerebral hemoglobin 0.98 vs 0.73 g/dL). By adjusting the NIRS algorithm with the cerebral hemoglobin measurements, slope and intercept remained unchanged by hemodilution. These data indicate that intersubject variability in NIRS originates, in part, from biologic variations in transcranial optical pathlength and cerebral hemoglobin concentration. Instruments to account for these factors may improve NIRS cerebral oxygen saturation measurements.

Relationship between time-resolved and non-time-resolved Beer-Lambert law in turbid media

The time-resolved Beer-Lambert law proposed for oxygen monitoring using pulsed light was extended to the non-time-resolved case in a scattered medium such as living tissues with continuous illumination. The time-resolved Beer-Lambert law was valid for the phantom model and living tissues in the visible and near-infrared regions. The absolute concentration and oxygen saturation of haemoglobin in rat brain and thigh muscle could be determined. The temporal profile of rat brain was reproduced by Monte Carlo simulation. When the temporal profiles of rat brain under different oxygenation states were integrated with time, the absorbance difference was linearly related to changes in the absorption coefficient. When the simulated profiles were integrated, there was a linear relationship within the absorption coefficient which was predicted for fractional inspiratory oxygen concentration from 10 to 100% and, in the case beyond the range of the absorption coefficient, the deviation from linearity was slight. We concluded that an optical pathlength which is independent of changes in the absorption coefficient is a good approximation for near-infrared oxygen monitoring.