Attenuation corrected-optical coherence tomography for quantitative assessment of skin wound healing and scar morphology

Diagnosis of dental caries based on attenuation coefficients analysis of optical coherence tomography images

Quantitative analysis of optical attenuation based on optical coherence tomography images will offer an effective method to enhance diagnostic capabilities. In this paper, the optical attenuation in demineralized caries specimens was calculated to distinguish between normal teeth and carious teeth and further to differentiate the severity of caries, and thus come to the half-automated diagnosis of dental caries. Results show that the attenuation coefficient in carious regions is approximately 4.97 mm - 1 ± 0.206 , while that of normal teeth is about 3.69 mm - 1 ± 0.231 . Attenuation coefficient of carious regions is 35% higher than that of normal teeth. Moreover, five classes of caries were qualified and classified based on the optical attenuation coefficient. Compared with the healthy teeth, there is a noticeable disparity in the attenuation coefficients of carious teeth, both on the surface and at the dentinoenamel junction. This study provides a method for accurate caries diagnosis, particularly in detection of early lesions and subtle structural changes.

Molecular histopathology of matrix proteins through autofluorescence super-resolution microscopy

Extracellular matrix diseases like fibrosis are elusive to diagnose early on, to avoid complete loss of organ function or even cancer progression, making early diagnosis crucial. Imaging the matrix densities of proteins like collagen in fixed tissue sections with suitable stains and labels is a standard for diagnosis and staging. However, fine changes in matrix density are difficult to realize by conventional histological staining and microscopy as the matrix fibrils are finer than the resolving capacity of these microscopes. The dyes further blur the outline of the matrix and add a background that bottlenecks high-precision early diagnosis of matrix diseases. Here we demonstrate the multiple signal classification method-MUSICAL-otherwise a computational super-resolution microscopy technique to precisely estimate matrix density in fixed tissue sections using fibril autofluorescence with image stacks acquired on a conventional epifluorescence microscope. We validated the diagnostic and staging performance of the method in extracted collagen fibrils, mouse skin during repair, and pre-cancers in human oral mucosa. The method enables early high-precision label-free diagnosis of matrix-associated fibrotic diseases without needing additional infrastructure or rigorous clinical training.

Depth-dependent attenuation and backscattering characterization of optical coherence tomography by stationary iterative method

Significance

Extracting optical properties of tissue [e.g., the attenuation coefficient (μ ) and the backscattering fraction] from the optical coherence tomography (OCT) images is a valuable tool for parametric imaging and related diagnostic applications. Previous attenuation estimation models depend on the assumption of the uniformity of the backscattering fraction (R ) within layers or whole samples, which does not accurately represent real-world conditions.

Aim

Our aim is to develop a robust and accurate model that calculates depth-wise values of attenuation and backscattering fractions simultaneously from OCT signals. Furthermore, we aim to develop an attenuation compensation model for OCT images that utilizes the optical properties we obtained to improve the visual representation of tissues.

Approach

Using the stationary iteration method under suitable constraint conditions, we derived the approximated solutions of μ and R on a single scattering model. During the iteration, the estimated value of μ can be rectified by introducing the large variations of R , whereas the small ones were automatically ignored. Based on the calculation of the structure information, the OCT intensity with attenuation compensation was deduced and compared with the original OCT profiles.

Results

The preliminary validation was performed in the OCT A-line simulation and Monte Carlo modeling, and the subsequent experiment was conducted on multi-layer silicone-dye-TiO 2 phantoms and ex vivo cow eyes. Our method achieved robust and precise estimation of μ and R for both simulated and experimental data. Moreover, corresponding OCT images with attenuation compensation provided an improved resolution over the entire imaging range.

Conclusions

Our proposed method was able to correct the estimation bias induced by the variations of R and provided accurate depth-resolved measurements of both μ and R simultaneously. The method does not require prior knowledge of the morphological information of tissue and represents more real-life tissues. Thus, it has the potential to help OCT imaging based disease diagnosis of complex and multi-layer biological tissue.

Viewing life without labels under optical microscopes

Optical microscopes today have pushed the limits of speed, quality, and observable space in biological specimens revolutionizing how we view life today. Further, specific labeling of samples for imaging has provided insight into how life functions. This enabled label-based microscopy to percolate and integrate into mainstream life science research. However, the use of labelfree microscopy has been mostly limited, resulting in testing for bio-application but not bio-integration. To enable bio-integration, such microscopes need to be evaluated for their timeliness to answer biological questions uniquely and establish a long-term growth prospect. The article presents key label-free optical microscopes and discusses their integrative potential in life science research for the unperturbed analysis of biological samples.

Quantification method to objectively evaluate the fibrous structural status of tendons based on polarization-sensitive OCT

Histological analysis is widely used to evaluate injured tendons; however, it has the limitation of being semi-quantitative. Hence, we developed a quantification method to objectively evaluate the fibrous structure of tendons, exhibiting the optical property of birefringence, using polarization-sensitive optical coherence tomography (PS-OCT). We used a partial-rupture rat model in which the middle 0.75 cm of the Achilles tendon was cut with a blade. Rats were sacrificed at 2, 4 or 6 weeks after the injury, and PS-OCT and histological analyzes were performed. The PS-OCT phase retardation images and score well represented the structural changes of the injured tendon according to the wound healing state. Therefore, the proposed novel quantification method using PS-OCT can be used to evaluate the fibrous structural status of tendons.

Noise Reduction of OCT Images Based on the External Patch Prior Guided Internal Clustering and Morphological Analysis

Optical coherence tomography (OCT) is widely used in biomedical imaging. However, noise severely affects diagnosing and identifying diseased tissues on OCT images. Here, a noise reduction method based on the external patch prior guided internal clustering and morphological analysis (E2PGICMA) is developed to remove the noise of OCT images. The external patch prior guided internal clustering algorithm is used to reduce speckle noise. The morphological analysis algorithm is employed to the background for contrast enhancement. OCT images of in vivo normal skin tissues were analyzed to remove noise using the proposed method. The estimated standard deviations of the noise were chosen as different values for evaluating the quantitative metrics. The visual quality improvement includes more textures and fine detail preservation. The denoising effects of different methods were compared. Then, quantitative and qualitative evaluations of this proposed method were conducted. The results demonstrated that the SNR, PSNR, and XCOR were higher than those of the other noise-reduction methods, reaching 15.05 dB, 27.48 dB, and 0.9959, respectively. Furthermore, the presented method’s noise reduction ratio (NRR) reached 0.8999. This proposed method can efficiently remove the background and speckle noise. Improving the proposed noise reduction method would outperform existing state-of-the-art OCT despeckling methods.

Portable, handheld, and affordable blood perfusion imager for screening of subsurface cancer in resource-limited settings

Existing procedures of screening subsurface cancers are either prohibitively resource-intensive and expensive or are unable to provide direct quantitative estimates of the relevant physiological parameters for accurate classification accommodating interpatient variabilities and overlapping clinical manifestations. Here, we introduce a handheld and inexpensive blood perfusion imager that provides a noninvasive in situ screening approach for distinguishing precancer, cancer, and normal scenarios by precise quantitative estimation of the localized blood circulation in the tissue over an unrestricted region of interest without any unwarranted noise in the data, augmented by machine learning–based classification. Clinical trials in minimally resourced settings have established the efficacy of the method in differentiating cancerous and precancerous stages of suspected oral abnormalities, as verified by gold-standard biopsy reports.

Precise information on localized variations in blood circulation holds the key for noninvasive diagnostics and therapeutic assessment of various forms of cancer. While thermal imaging by itself may provide significant insights on the combined implications of the relevant physiological parameters, viz. local blood perfusion and metabolic balance due to active tumors as well as the ambient conditions, knowledge of the tissue surface temperature alone may be somewhat inadequate in distinguishing between some ambiguous manifestations of precancer and cancerous lesions, resulting in compromise of the selectivity in detection. This, along with the lack of availability of a user-friendly and inexpensive portable device for thermal-image acquisition, blood perfusion mapping, and data integration acts as a deterrent against the emergence of an inexpensive, contact-free, and accurate in situ screening and diagnostic approach for cancer detection and management. Circumventing these constraints, here we report a portable noninvasive blood perfusion imager augmented with machine learning–based quantitative analytics for screening precancerous and cancerous traits in oral lesions, by probing the localized alterations in microcirculation. With a proven overall sensitivity >96.66% and specificity of 100% as compared to gold-standard biopsy-based tests, the method successfully classified oral cancer and precancer in a resource-limited clinical setting in a double-blinded patient trial and exhibited favorable predictive capabilities considering other complementary modes of medical image analysis as well. The method holds further potential to achieve contrast-free, accurate, and low-cost diagnosis of abnormal microvascular physiology and other clinically vulnerable conditions, when interpreted along with complementary clinically evidenced decision-making perspectives.

[Advances in optical coherence tomography]

Optical coherence tomography (OCT) has been able to establish itself in recent years not only in academic-scientific, but also in everyday dermatological practice. Its focus lies on epithelial tumors of the skin, which can be diagnosed intuitively and within a few seconds. Thus, basal cell carcinomas, actinic keratoses, and different stages of field cancerization can be diagnosed and monitored for response to therapy or possible recurrence. This often helps to avoid invasive sample extraction. Recently, the field of OCT and its latest advancement, dynamic OCT (D-OCT), has been expanded to include non-oncologic dermatological diseases. This encompasses inflammatory dermatoses and the analysis of physiological skin parameters such as hydration. Thanks to automated vascular imaging and the measurement of objective parameters such as epidermal thickness, blood flow at depth, optical attenuation coefficient, and skin roughness, more and more characteristics of the skin can be studied in a noninvasive and standardized way. New potential areas of application are eczema, contact allergic dermatitis, psoriasis, rosacea, telangiectasia, acute and chronic wounds, melasma and nevus flammeus but also melanocytic lesions.

The wound healing effect of local leukocyte platelet-rich plasma after total hip arthroplasty: A randomized controlled trial

Rapid wound closure is important after arthroplasty procedures to prevent postoperative complications. Platelets are rich in growth factors and leukocytes contribute to innate immunity. We hypothesized that topical leukocyte platelet-rich plasma (L-PRP) derived from the blood of patients would be beneficial to wound healing. In this randomized controlled trial, patients subjected to elective total hip arthroplasty (THA) were assigned by concealed allocation either L-PRP application onto the sutured fascia or no application (control) after the THA intervention. In addition, all patients received 1.5 g protein/kg, 5 g L-arginine, 500 mg vitamin C and 44 mg zinc daily over the 4-week postoperative period to obtain optimal nutrition. The primary endpoint was complete healing of the skin incision. The secondary endpoints were blood transfusions, length of hospital stay, pain and wound infections. Sixteen patients in the L-PRP group and 17 patients in the control group completed the trial. L-PRP treatment accelerated complete wound healing after 3 weeks (seven in the L-PRP group vs. zero in the control group, p = 0.003) and after 4 weeks (12 in the L-PRP group vs. six in the control group, p = 0.037). No postoperative superficial wound infections occurred within 4 weeks, and there were no significant differences in the other secondary outcomes. L-PRP generated in 10 sex-matched healthy volunteers revealed increased concentrations of platelets (5.8-fold) and leukocytes (2.3-fold) compared with those in whole blood. Furthermore, the concentration of keratinocyte mitogen epidermal growth factor in L-PRP (380 ± 130 pg/ml, mean ± SD) was higher (p < 0.001) than that in serum (130 ± 26 pg/ml). In conclusion, a single intraoperative local application of L-PRP promoted wound healing after THA, possibly mediated by EGF receptor agonists.

Arecanut-induced fibrosis display dual phases of reorganising glycans and amides in skin extracellular matrix

The habit of chewing arecanut leads to fibrosis in the oral tissues, which can lead to cancer. Despite high mortality, fibrosis has limited clinical success owing to organ-specific variations, genetic predispositions, and slow progression. Fibrosis is a progressive condition that is unresponsive to medications in the severe phase. To understand underlying macromolecular changes we studied the extracellular matrix's (ECM) key molecular modifications in the early and late phase of arecanut-induced fibrosis in skin. To study the fibrosis, we topically applied arecanut extract on the mice skin. We observed that the matrix changes observe early and late phases based on ECM characteristics including the matrix proteins and the glycans. A spike in the levels of proteoglycans and β-sheet structures are noted in the early phase. A significant drop in the proteoglycans and strengthening of amide covalent interactions is observed in the late phase. Although, almost no physical changes are noticeable only in the early phase; the late phase observes thick collagen bundling and a 4-fold stiffening of the skin tissue. The study indicates that the temporal interplay of proteins and glycans determine the matrix's severity state while opening avenues to research directed towards the phase-specific clinical discovery.