Effect of a thin superficial layer on the estimate of hemodynamic changes in a two-layer medium by time domain NIRS

Real-time fetal monitoring using photoacoustic measurement of placental oxygen saturation in a rabbit hypoxia model

INTRODUCTION

Ensuring adequate fetal oxygenation is an essential aim of fetal monitoring. The purpose of this study was to establish a basic technique for real-time measurement of blood oxygen saturation of the placenta by photoacoustic (PA) technique as a new fetal monitoring method.

METHODS

The hypoxia model established in our previous study was applied to 7 pregnant rabbits. Three phases were induced: normal phase, hypoxia phase, and recovery phase. Three methods were simultaneously used for real-time fetal monitoring: fetal heat rate (FHR) monitoring, oxygen saturation (SO2) measurement by near-infrared spectroscopy (SNO2), and placenta SO2 measured by PA technique (SplO2). The maternal hypoxia was assessed by skin SO2 measured by PA technique (SsO2), and arterial blood SO2 by blood gas analysis (SaO2).

RESULTS

The average of SplO2 in normal phase was 52.6 ± 13.9 %. The averages of SNO2, SSO2, and SplO2 in the seven rabbits changed in parallel from the normal phase to hypoxia phase. In the recovery phase, the SplO2 rose in parallel with recovery of SaO2. There was lag in increase of the FHR compared to the change in the other values. In the detailed analysis of PA signals from the labyrinth and decidua, a unique change in oxygen saturation was seen in one case.

DISCUSSION

Results of this study showed that sensitivity of our novel PA technique in detecting tissue hypoxia was similar to near-infrared spectroscopy (NIRS). As an advantage, unlike NIRS, monitoring with PA technique was unaffected by ischemia and surface changes in oxygen saturation because of its higher spatial resolution. We conclude that PA technique provides more accurate information about fetal blood placenta than NIRS. Ultrasound imaging, combined with oxygen saturation monitoring by PA technique, would improve fetal monitoring and fetal diagnosis in the future.

Single-distance and dual-slope frequency-domain near-infrared spectroscopy to assess skeletal muscle hemodynamics

Significance

Non-invasive optical measurements of deep tissue (e.g., muscle) need to take into account confounding contributions from baseline and dynamic optical properties of superficial tissue (adipose tissue).

Aim

Discriminate superficial and deep tissue hemodynamics using data collected with frequency-domain (FD) near-infrared spectroscopy (NIRS) in a dual-slope (DS) configuration.

Approach

Experimental data were collected in vivo on the forearm of three human subjects during a 3-min arterial occlusion or 1-min venous occlusion. Theoretical data were generated using diffusion theory for two-layered media with varying values of the reduced scattering coefficient (μ s ' ) (range: 0.5 to 1.1    mm - 1 ) and absorption coefficient (μ a ) (range: 0.005 - 0.015    mm - 1 ) of the two layers, and top layer thickness (range: 2 to 8 mm). Data were analyzed using diffusion theory for a homogeneous semi-infinite medium.

Results

Experimental data in vivo were consistent with simulated data for a two-layered medium with a larger μ s ' in the top layer, comparable absorption changes in the top and bottom layers during venous occlusion, and smaller absorption changes in the top vs. bottom layers during arterial occlusion.

Conclusions

The dataset generated by DS FD-NIRS may allow for discrimination of superficial and deep absorption changes in two-layered media, thus lending itself to individual measurements of hemodynamics in adipose and muscle tissue.

Theoretical investigation of photon partial pathlengths in multilayered turbid media

Functional near infrared spectroscopy (fNIRS) is a valuable tool for assessing oxy- and deoxyhemoglobin concentration changes (Δ[HbO] and Δ[HbR], respectively) in the human brain. To this end, photon pathlengths in tissue are needed to convert from light attenuation to Δ[HbO] and Δ[HbR]. Current techniques describe the human head as a homogeneous medium, in which case these pathlengths are easily computed. However, the head is more appropriately described as a layered medium; hence, the partial pathlengths in each layer are required. The current way to do this is by means of Monte Carlo (MC) simulations, which are time-consuming and computationally expensive. In this work, we introduce an approach to theoretically calculate these partial pathlengths, which are computed several times faster than MC simulations. Comparison of our approach with MC simulations show very good agreement. Results also suggest that these analytical expressions give much more specific information about light absorption in each layer than in the homogeneous case.

Time-domain NIRS system based on supercontinuum light source and multi-wavelength detection: validation for tissue oxygenation studies

We present and validate a multi-wavelength time-domain near-infrared spectroscopy (TD-NIRS) system that avoids switching wavelengths and instead exploits the full capability of a supercontinuum light source by emitting and acquiring signals for the whole chosen range of wavelengths. The system was designed for muscle and brain oxygenation monitoring in a clinical environment. A pulsed supercontinuum laser emits broadband light and each of two detection modules acquires the distributions of times of flight of photons (DTOFs) for 16 spectral channels (used width 12.5 nm / channel), providing a total of 32 DTOFs at up to 3 Hz. Two emitting fibers and two detection fiber bundles allow simultaneous measurements at two positions on the tissue or at two source-detector separations. Three established protocols (BIP, MEDPHOT, and nEUROPt) were used to quantitatively assess the system's performance, including linearity, coupling, accuracy, and depth sensitivity. Measurements were performed on 32 homogeneous phantoms and two inhomogeneous phantoms (solid and liquid). Furthermore, measurements on two blood-lipid phantoms with a varied amount of blood and Intralipid provide the strongest validation for accurate tissue oximetry. The retrieved hemoglobin concentrations and oxygen saturation match well with the reference values that were obtained using a commercially available NIRS system (OxiplexTS) and a blood gas analyzer (ABL90 FLEX), except a discrepancy occurs for the lowest amount of Intralipid. In-vivo measurements on the forearm of three healthy volunteers during arterial (250 mmHg) and venous (60 mmHg) cuff occlusions provide an example of tissue monitoring during the expected hemodynamic changes that follow previously well-described physiologies. All results, including quantitative parameters, can be compared to other systems that report similar tests. Overall, the presented TD-NIRS system has an exemplary performance evaluated with state-of-the-art performance assessment methods.

Sustained fatigue assessment during isometric exercises with time-domain near infrared spectroscopy and surface electromyography signals

The effect of sustained fatigue during an upper limb isometric exercise is presented to investigate a group of healthy subjects with simultaneous time-domain (TD) NIRS and surface electromyography (sEMG) recordings on the deltoid lateralis muscle. The aim of the work was to understand which TD-NIRS parameters can be used as descriptors for sustained muscular fatigue, focusing on the slow phase of this process and using median frequency (MF) computed from sEMG as gold standard measure. It was found that oxygen saturation and deoxy-hemoglobin are slightly better descriptors of sustained fatigue, than oxy-hemoglobin, since they showed a higher correlation with MF, while total-hemoglobin correlation with MF was lower.

Time-Gated Single-Photon Detection in Time-Domain Diffuse Optics: A Review

This work reviews physical concepts, technologies and applications of time-domain diffuse optics based on time-gated single-photon detection. This particular photon detection strategy is of the utmost importance in the diffuse optics field as it unleashes the full power of the time-domain approach by maximizing performances in terms of contrast produced by a localized perturbation inside the scattering medium, signal-to-noise ratio, measurement time and dynamic range, penetration depth and spatial resolution. The review covers 15 years of theoretical studies, technological progresses, proof of concepts and design of laboratory systems based on time-gated single-photon detection with also few hints on other fields where the time-gated detection strategy produced and will produce further impact.

Analysis of estimation of optical properties of sub superficial structures in multi layered tissue model using distribution function method

BACKGROUND AND OBJECTIVE

This paper is focused on the analysis of a method of estimation of the absorption and scattering coefficients of nonhomogeneous two layered structures in time resolved near infrared spectroscopy using method based on cumulative distributions of time of flight of photons.

METHODS

The research is based on the analysis of the superposition of cumulative distributions of time of flight of photons. This approach allows for detailed analysis of small variations in characteristics of time of flight of photons caused by an electromagnetic propagation in highly scattering non-homogeneous media. The method presented, based on the variation of statistical minimum distance estimation, is compared to the method of standard curve fitting. It is analyzed by fitting the results obtained from Monte-Carlo simulations of light propagation in the turbid medium to the data from the simulated measurements.

RESULTS

The analysis is carried out for a vast range of optical properties of two layered medium in reflectance geometry.

CONCLUSIONS

The method allows the estimation of the optical parameters despite the noise in the measured signal, with higher accuracy and generally with smaller number of error function evaluations.

Implementation of the extended Kalman filter for determining the optical and geometrical properties of turbid layered media by time-resolved single distance measurements

In this article we propose an implementation of the extended Kalman filter (EKF) for the retrieval of optical and geometrical properties in two-layered turbid media assuming a dynamic setting, where absorption of each layer was changed in different steps. Prior works implemented the EKF in frequency-domain with several pairs of light sources and detectors and for static parameters estimation problems. Here we explore the use of the EKF in single distance, time-domain measurements, together with a corresponding forward model. Results show good agreement between retrieved and nominal values, with rather narrow analytical credibility intervals, indicating that the recovery process has low uncertainty, especially for the absorption coefficients.

Depth-resolved assessment of changes in concentration of chromophores using time-resolved near-infrared spectroscopy: estimation of cytochrome-c-oxidase uncertainty by Monte Carlo simulations

Time-resolved near-infrared spectroscopy (TR-NIRS) measurements can be used to recover changes in concentrations of tissue constituents ( Δ C ) by applying the moments method and the Beer-Lambert law. In this work we carried out the error propagation analysis allowing to calculate the standard deviations of uncertainty in estimation of the Δ C . Here, we show the process of choosing wavelengths for the evaluation of hemodynamic (oxy-, deoxyhemoglobin) and metabolic (cytochrome-c-oxidase (CCO)) responses within the brain tissue as measured with an in-house developed TR-NIRS multi-wavelength system, which measures at 16 consecutive wavelengths separated by 12.5 nm and placed between 650 and 950 nm. Data generated with Monte Carlo simulations on three-layered model (scalp, skull, brain) for wavelengths range from 650 to 950 nm were used to carry out the error propagation analysis for varying choices of wavelengths. For a detector with a spectrally uniform responsivity, the minimal standard deviation of the estimated changes in CCO within the brain layer, σ Δ C CCO brain  = 0.40 µM, was observed for the 16 consecutive wavelengths from 725 to 912.5 nm. For realistic a detector model, i.e. the spectral responsivity characteristic is considered, the minimum, σ Δ C CCO brain  = 0.47 µM, was observed at the 16 consecutive wavelengths from 688 to 875 nm. We introduce the method of applying the error propagation analysis to data as measured with spectral TR-NIRS systems to calculate uncertainty of recovery of tissue constituents concentrations.

NIRS-EMG for Clinical Applications: A Systematic Review

In this review, we present an overview of the applications and computed parameters of electromyography (EMG) and near-infrared spectroscopy (NIRS) methods on patients in clinical practice. The eligible studies were those where both techniques were combined in order to assess muscle characteristics from the electrical and hemodynamic points of view. With this aim, a comprehensive screening of the literature based on related keywords in the most-used scientific data bases allowed us to identify 17 papers which met the research criteria. We also present a brief overview of the devices designed specifically for muscular applications with EMG and NIRS sensors (a total of eight papers). A critical analysis of the results of the review suggests that the combined use of EMG and NIRS on muscle has been only partially exploited for assessment and evaluation in clinical practice and, thus, this field shows promises for future developments.

Time-Domain Near-Infrared Spectroscopy and Imaging: A Review

This article reviews the past and current statuses of time-domain near-infrared spectroscopy (TD-NIRS) and imaging. Although time-domain technology is not yet widely employed due to its drawbacks of being cumbersome, bulky, and very expensive compared to commercial continuous wave (CW) and frequency-domain (FD) fNIRS systems, TD-NIRS has great advantages over CW and FD systems because time-resolved data measured by TD systems contain the richest information about optical properties inside measured objects. This article focuses on reviewing the theoretical background, advanced theories and methods, instruments, and studies on clinical applications for TD-NIRS including some clinical studies which used TD-NIRS systems. Major events in the development of TD-NIRS and imaging are identified and summarized in chronological tables and figures. Finally, prospects for TD-NIRS in the near future are briefly described.

Lawrence K, Amendolia O, Quattrone F, Balu R, Kofke WA, Yodh AG. Noninvasive continuous optical monitoring of absolute cerebral blood flow in critically ill adults

We investigate a scheme for noninvasive continuous monitoring of absolute cerebral blood flow (CBF) in adult human patients based on a combination of time-resolved dynamic contrast-enhanced near-infrared spectroscopy (DCE-NIRS) and diffuse correlation spectroscopy (DCS) with semi-infinite head model of photon propogation. Continuous CBF is obtained via calibration of the DCS blood flow index (BFI) with absolute CBF obtained by intermittent intravenous injections of the optical contrast agent indocyanine green. A calibration coefficient ( γ ) for the CBF is thus determined, permitting conversion of DCS BFI to absolute blood flow units at all other times. A study of patients with acute brain injury ( N = 7 ) is carried out to ascertain the stability of γ . The patient-averaged DCS calibration coefficient across multiple monitoring days and multiple patients was determined, and good agreement between the two calibration coefficients measured at different times during single monitoring days was found. The patient-averaged calibration coefficient of 1.24 × 10 9    ( mL / 100    g / min ) / ( cm 2 / s ) was applied to previously measured DCS BFI from similar brain-injured patients; in this case, absolute CBF was underestimated compared with XeCT, an effect we show is primarily due to use of semi-infinite homogeneous models of the head.

Simultaneous retrieval of optical and geometrical parameters of multilayered turbid media via state-estimation algorithms

In the present paper we propose an implementation of the Kalman filter algorithm, which allows simultaneous recovery of the absorption coefficient, the reduced scattering coefficient and the thicknesses of multi-layered turbid media, with the deepest layer taken as semi-infinite. The approach is validated by both Monte Carlo simulations and experiments, showing good results in structures made up of four layers. As it is a Bayesian algorithm, prior knowledge can be included to improve the accuracy of the retrieved unknowns. One of the most promising applications of this approach is the capability of real-time monitoring of living organs by near infrared spectroscopy. In particular, determination of blood perfusion in the adult head is one of the desired goals, allowing continuous control of stroke patients. This demands accurate measurement of the optical properties, especially absorption, of the head layers, from scalp to the cortex.

Time Domain Near Infrared Spectroscopy Device for Monitoring Muscle Oxidative Metabolism: Custom Probe and In Vivo Applications

Measurement of muscle oxidative metabolism is of interest for monitoring the training status in athletes and the rehabilitation process in patients. Time domain near infrared spectroscopy (TD NIRS) is an optical technique that allows the non-invasive measurement of the hemodynamic parameters in muscular tissue: concentrations of oxy- and deoxy-hemoglobin, total hemoglobin content, and tissue oxygen saturation. In this paper, we present a novel TD NIRS medical device for muscle oxidative metabolism. A custom-printed 3D probe, able to host optical elements for signal acquisition from muscle, was develop for TD NIRS in vivo measurements. The system was widely characterized on solid phantoms and during in vivo protocols on healthy subjects. In particular, we tested the in vivo repeatability of the measurements to quantify the error that we can have by repositioning the probe. Furthermore, we considered a series of acquisitions on different muscles that were not yet previously performed with this custom probe: a venous-arterial cuff occlusion of the arm muscle, a cycling exercise, and an isometric contraction of the vastus lateralis.

Concurrent measurement of cerebral hemodynamics and electroencephalography during transcranial direct current stimulation

Transcranial direct current stimulation (tDCS) is currently being used for research and treatment of some neurological and neuropsychiatric disorders, as well as for improvement of cognitive functions. In order to better understand cerebral response to the stimulation and to redefine protocols and dosage, its effects must be monitored. To this end, we have used functional diffuse correlation spectroscopy (fDCS) and time-resolved functional near-infrared spectroscopy (TR-fNIRS) together with electroencephalography (EEG) during and after stimulation of the frontal cortex. Twenty subjects participated in two sessions of stimulation with two different polarity montages and twelve also underwent a sham session. Cerebral blood flow and oxyhemoglobin concentration increased during and after active stimulation in the region under the stimulation electrode while deoxyhemoglobin concentration decreased. The EEG spectrum displayed statistically significant power changes across different stimulation sessions in delta (2 to 4 Hz), theta (4 to 8 Hz), and beta (12 to 18 Hz) bands. Results suggest that fDCS and TR-fNIRS can be employed as neuromonitors of the effects of transcranial electrical stimulation and can be used together with EEG.

Probe-hosted silicon photomultipliers for time-domain functional near-infrared spectroscopy: phantom and in vivo tests

We report the development of a compact probe for time-domain (TD) functional near-infrared spectroscopy (fNIRS) based on a fast silicon photomultiplier (SiPM) that can be put directly in contact with the sample without the need of optical fibers for light collection. We directly integrated an avalanche signal amplification stage close to the SiPM, thus reducing the size of the detection channel and optimizing the signal immunity to electromagnetic interferences. The whole detection electronics was placed in a plastic screw holder compatible with the electroencephalography standard cap for measurement on brain or with custom probe holders. The SiPM is inserted into a transparent and insulating resin to avoid the direct contact of the scalp with the 100-V bias voltage. The probe was integrated in an instrument for TD fNIRS spectroscopy. The system was characterized on tissue phantoms in terms of temporal resolution, responsivity, linearity, and capability to detect deep absorption changes. Preliminary in vivo tests on adult volunteers were performed to monitor hemodynamic changes in the arm during a cuff occlusion and in the brain cortex during a motor task.