Differential diffuse optical tomography

AAPM Task Group Report 311: Guidance for performance evaluation of fluorescence-guided surgery systems

The last decade has seen a large growth in fluorescence-guided surgery (FGS) imaging and interventions. With the increasing number of clinical specialties implementing FGS, the range of systems with radically different physical designs, image processing approaches, and performance requirements is expanding. This variety of systems makes it nearly impossible to specify uniform performance goals, yet at the same time, utilization of different devices in new clinical procedures and trials indicates some need for common knowledge bases and a quality assessment paradigm to ensure that effective translation and use occurs. It is feasible to identify key fundamental image quality characteristics and corresponding objective test methods that should be determined such that there are consistent conventions across a variety of FGS devices. This report outlines test methods, tissue simulating phantoms and suggested guidelines, as well as personnel needs and professional knowledge bases that can be established. This report frames the issues with guidance and feedback from related societies and agencies having vested interest in the outcome, coming from an independent scientific group formed from academics and international federal agencies for the establishment of these professional guidelines.

Development of a new bioactivatable fluorescent probe for quantification of apolipoprotein A-I proteolytic degradation in vitro and in vivo

BACKGROUND AND AIMS

The potential benefits of high-density lipoproteins (HDL) against atherosclerosis are attributed to its major protein component, apolipoprotein A-I (apoA-I). Most of the apoA-I in the vascular wall appears to be in its lipid-poor form. The latter, however, is subjected to degradation by proteases localized in atherosclerotic plaques, which, in turn, has been shown to negatively impact its atheroprotective functions. Here, we report the development and in vivo use of a bioactivatable near-infrared full-length apoA-I-Cy5.5 fluorescent probe for the assessment of apoA-I-degrading proteolytic activities.

METHODS

Fluorescence quenching was obtained by saturation of Cy5.5 fluorophore molecules on apoA-I protein. ApoA-I cleavage led to near-infrared fluorescence enhancement. In vitro proteolysis of the apoA-I probe by a variety of proteases including serine, cysteine, and metalloproteases resulted in an up to 11-fold increase in fluorescence (n = 5, p ≤ 0.05).

RESULTS

We detected activation of the probe in atherosclerotic mice aorta sections using in situ zymography and showed that broad-spectrum protease inhibitors protected the probe from degradation, resulting in decreased fluorescence (-54%, n = 6 per group, p ≤ 0.0001). In vivo, the injected probe showed stronger fluorescence emission in the aorta of human apoB transgenic Ldlr^-/- atherosclerotic mice (ATX) as compared to wild-type mice. In vivo observations were confirmed by ex vivo aorta imaging quantification where a 10-fold increase in fluorescent signal in ATX mice (p ≤ 0.05 vs. control mice) was observed.

CONCLUSIONS

The use of this probe in different applications may help to assess new molecular mechanisms of atherosclerosis and may improve current HDL-based therapies by enhancing apoA-I functionality.

Quantification and normalization of noise variance with sparsity regularization to enhance diffuse optical tomography

Conventional reconstruction of diffuse optical tomography (DOT) is based on the Tikhonov regularization and the white Gaussian noise assumption. Consequently, the reconstructed DOT images usually have a low spatial resolution. In this work, we have derived a novel quantification method for noise variance based on the linear Rytov approximation of the photon diffusion equation. Specifically, we have implemented this quantification of noise variance to normalize the measurement signals from all source-detector channels along with sparsity regularization to provide high-quality DOT images. Multiple experiments from computer simulations and laboratory phantoms were performed to validate and support the newly developed algorithm. The reconstructed images demonstrate that quantification and normalization of noise variance with sparsity regularization (QNNVSR) is an effective reconstruction approach to greatly enhance the spatial resolution and the shape fidelity for DOT images. Since noise variance can be estimated by our derived expression with relatively limited resources available, this approach is practically useful for many DOT applications.

Compensation of optode sensitivity and position errors in diffuse optical tomography using the approximation error approach

Diffuse optical tomography is highly sensitive to measurement and modeling errors. Errors in the source and detector coupling and positions can cause significant artifacts in the reconstructed images. Recently the approximation error theory has been proposed to handle modeling errors. In this article, we investigate the feasibility of the approximation error approach to compensate for modeling errors due to inaccurately known optode locations and coupling coefficients. The approach is evaluated with simulations. The results show that the approximation error method can be used to recover from artifacts in reconstructed images due to optode coupling and position errors.

Compensation of optode sensitivity and position errors in diffuse optical tomography using the approximation error approach

Diffuse optical tomography is highly sensitive to measurement and modeling errors. Errors in the source and detector coupling and positions can cause significant artifacts in the reconstructed images. Recently the approximation error theory has been proposed to handle modeling errors. In this article, we investigate the feasibility of the approximation error approach to compensate for modeling errors due to inaccurately known optode locations and coupling coefficients. The approach is evaluated with simulations. The results show that the approximation error method can be used to recover from artifacts in reconstructed images due to optode coupling and position errors.

Optimal analysis method for dynamic contrast-enhanced diffuse optical tomography

Diffuse Optical Tomography (DOT) is an optical imaging modality that has various clinical applications. However, the spatial resolution and quantitative accuracy of DOT is poor due to strong photon scatting in biological tissue. Structural a priori information from another high spatial resolution imaging modality such as Magnetic Resonance Imaging (MRI) has been demonstrated to significantly improve DOT accuracy. In addition, a contrast agent can be used to obtain differential absorption images of the lesion by using dynamic contrast enhanced DOT (DCE-DOT). This produces a relative absorption map that consists of subtracting a reconstructed baseline image from reconstructed images in which optical contrast is included. In this study, we investigated and compared different reconstruction methods and analysis approaches for regular endogenous DOT and DCE-DOT with and without MR anatomical a priori information for arbitrarily-shaped objects. Our phantom and animal studies have shown that superior image quality and higher accuracy can be achieved using DCE-DOT together with MR structural a priori information. Hence, implementation of a combined MRI-DOT system to image ICG enhancement can potentially be a promising tool for breast cancer imaging.

Diffuse Optics for Tissue Monitoring and Tomography

This review describes the diffusion model for light transport in tissues and the medical applications of diffuse light. Diffuse optics is particularly useful for measurement of tissue hemodynamics, wherein quantitative assessment of oxy- and deoxy-hemoglobin concentrations and blood flow are desired. The theoretical basis for near-infrared or diffuse optical spectroscopy (NIRS or DOS, respectively) is developed, and the basic elements of diffuse optical tomography (DOT) are outlined. We also discuss diffuse correlation spectroscopy (DCS), a technique whereby temporal correlation functions of diffusing light are transported through tissue and are used to measure blood flow. Essential instrumentation is described, and representative brain and breast functional imaging and monitoring results illustrate the workings of these new tissue diagnostics.

Direct reconstruction of pharmacokinetic-rate images of optical fluorophores from NIR measurements

In this paper, we present a new method to form pharmacokinetic-rate images of optical fluorophores directly from near infra-red (NIR) boundary measurements. We first derive a mapping from spatially resolved pharmacokinetic rates to NIR boundary measurements by combining compartmental modeling with a diffusion based NIR photon propagation model. We express this mapping as a state-space equation. Next, we introduce a spatio-temporal prior model for the pharmacokinetic-rate images and combine it with the state-space equation. We address the image formation problem using the extended Kalman filtering framework. We analyze the computational complexity of the resulting algorithms and evaluate their performance in numerical simulations. An important feature of our approach is that the reconstruction of fluorescence concentrations and compartmental modeling are combined into a single step 1) to take advantage of the inherent temporal correlations in dynamic NIR measurements, and 2) to incorporate spatio-temporal a priori information on pharmacokinetic-rate images. Simulation results show that the resulting algorithms are more robust and lead to higher signal-to-noise ratio as compared to existing approaches where the reconstruction of concentrations and compartmental modeling are treated separately. Additionally, we reconstructed pharmacokinetic-rate images using in vivo data obtained from three patients with breast tumors. The reconstruction results show that the pharmacokinetic rates of indocyanine green are higher inside the tumor region as compared to the surrounding tissue.

A cerebrovascular response model for functional neuroimaging including dynamic cerebral autoregulation

Functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and near-infrared spectroscopy (NIRS) can be used to isolate an evoked response to a stimulus from significant background physiological fluctuations. Data analysis approaches typically use averaging or linear regression to remove this physiological baseline with varying degrees of success. Biophysical model-based analysis of the functional hemodynamic response has also been advanced previously with the Balloon and Windkessel models. In the present work, a biophysical model of systemic and cerebral circulation and gas exchange is applied to resting state NIRS neuroimaging data from 10 human subjects. The model further includes dynamic cerebral autoregulation, which modulates the cerebral arteriole compliance to control cerebral blood flow. This biophysical model allows for prediction, from noninvasive blood pressure measurements, of the background hemodynamic fluctuations in the systemic and cerebral circulations. Significantly higher correlations with the NIRS data were found using the biophysical model predictions compared to blood pressure regression and compared to transfer function analysis (multifactor ANOVA, p<0.0001). This finding supports the further development and use of biophysical models for removing baseline activity in functional neuroimaging analysis. Future extensions of this work could model changes in cerebrovascular physiology that occur during development, aging, and disease.

Inspiratory contrast for in vivo optical imaging

We demonstrate the use of inspired oxygen and carbon dioxide as a possible route to increase contrast in optical imaging of cancerous tissue. Differential imaging in human xenograft rodent models of cancer exhibits significant variation in signal between normal and cancerous tissue. This differential cancer-specific contrast is stronger and more consistent than the conventional static contrast. This differential technique exploits the response of abnormal tumor vasculature to inhaled gases and could provide a promising alternative to supplement mainstream cancer imaging modalities such as x-rays and MRI.

Quantitative diffuse optical tomography for small animals using an ultrafast gated image intensifier

The quantitative accuracy of fluorescence and bioluminescence imaging of small animals can be improved by knowledge of the in situ optical properties of each animal. Obtaining in situ optical property maps is challenging, however, due to short propagation distances, requirements for high dynamic range, and the need for dense spatial, temporal, and spectral sampling. Using an ultrafast gated image intensifier and a pulsed laser source, we have developed a small animal diffuse optical tomography system with multiple synthetic modulation frequencies up to >1 GHz. We show that amplitude and phase measurements with useful contrast-to-noise ratios can be obtained for modulation frequencies over the range of approximately 250 to 1250 MHz. Experiments with tissue simulating phantoms demonstrate the feasibility of reconstructing the absorption and scattering optical properties in a small animal imaging system.

Hyperthermic effects of gold nanorods on tumor cells

Plasmon-resonant gold nanorods, which have large absorption cross sections at near-infrared frequencies, are excellent candidates as multifunctional agents for image-guided therapies based on localized hyperthermia. The controlled modification of the surface chemistry of the nanorods is of critical importance, as issues of cell-specific targeting and nonspecific uptake must be addressed prior to clinical evaluation. Nanorods coated with cetyltrimethylammonium bromide (a cationic surfactant used in nanorod synthesis) are internalized within hours into KB cells by a nonspecific uptake pathway, whereas the careful removal of cetyltrimethylammonium bromide from nanorods functionalized with folate results in their accumulation on the cell surface over the same time interval. In either case, the nanorods render the tumor cells highly susceptible to photothermal damage when irradiated at the nanorods' longitudinal plasmon resonance, generating extensive blebbing of the cell membrane at laser fluences as low as 30 J/cm2.

Optical brain imaging in vivo: techniques and applications from animal to man

Optical brain imaging has seen 30 years of intense development, and has grown into a rich and diverse field. In-vivo imaging using light provides unprecedented sensitivity to functional changes through intrinsic contrast, and is rapidly exploiting the growing availability of exogenous optical contrast agents. Light can be used to image microscopic structure and function in vivo in exposed animal brain, while also allowing noninvasive imaging of hemodynamics and metabolism in a clinical setting. This work presents an overview of the wide range of approaches currently being applied to in-vivo optical brain imaging, from animal to man. Techniques include multispectral optical imaging, voltage sensitive dye imaging and speckle-flow imaging of exposed cortex, in-vivo two-photon microscopy of the living brain, and the broad range of noninvasive topography and tomography approaches to near-infrared imaging of the human brain. The basic principles of each technique are described, followed by examples of current applications to cutting-edge neuroscience research. In summary, it is shown that optical brain imaging continues to grow and evolve, embracing new technologies and advancing to address ever more complex and important neuroscience questions.

Spectral derivative based image reconstruction provides inherent insensitivity to coupling and geometric errors

A reconstruction algorithm for multiwavelength diffuse optical tomography is presented, where instead of using data at each wavelength separately or even simultaneously, the difference in data for multiple wavelength pairs is used to reconstruct absolute concentration maps of chromophores. The results indicate a dramatic improvement in image reconstruction and the elimination of image artifacts, which are often associated with unknown measurement errors such as coupling coefficients and external boundary variations, because these errors are often less dependent on wavelength, and are effectively removed from the data set of the first derivative of intensity with respect to wavelength.

Grundlagen optischer und fluoreszenzgestützter Tomographie in diffusen Medien

Three-dimensional, tomographic imaging of biological tissues by means of visible light is becoming increasingly important. Current progress in the mathematical-physical modelling of photon propagation in scattering media allows spatially-resolved reconstructions of optical parameters with common computing hardware. Especially in the field of molecular imaging, optical tomography promises a transfer of knowledge from successful in vitro assays (as evaluated by fluorescence microscopy) to in vivo imaging of living animals. In the latter case, spatial resolution is not as critical as the ability to quantify the concentration of fluorescence-labelled probes, a task not solvable by the use of common planar imaging techniques. In this article, the theoretical foundations of optical tomography are introduced along with some examples of applications.

In vivo continuous-wave optical breast imaging enhanced with Indocyanine Green

We investigate the uptake of a nontargeted contrast agent by breast tumors using a continuous wave diffuse optical tomography apparatus. The instrument operates in the near-infrared spectral window and employs 16 sources and 16 detectors to collect light in parallel on the surface of the tumor-bearing breast (coronal geometry). In our protocol an extrinsic contrast agent, Indocyanine Green (ICG), was injected by bolus. Three clinical scenarios with three different pathologies were investigated. A two-compartment model was used to analyze the pharmacokinetics of ICG and preprocess the data, and diffuse optical tomography was used for imaging. Localization and delineation of the tumor was achieved in good agreement with a priori information. Moreover, different dynamical features were observed for differing pathologies. The malignant cases exhibited slower rate constants (uptake and outflow) compared to healthy tissue. These results provide further evidence that in vivo pharmacokinetics of ICG in breast tumors may be a useful diagnostic tool for differentiation of benign and malignant pathologies.

Three-dimensional diffuse optical tomography in the parallel plane transmission geometry: evaluation of a hybrid frequency domain/continuous wave clinical system for breast imaging

Three-dimensional diffuse optical tomography (DOT) of breast requires large data sets for even modest resolution (1 cm). We present a hybrid DOT system that combines a limited number of frequency domain (FD) measurements with a large set of continuous wave (cw) measurements. The FD measurements are used to quantitatively determine tissue averaged absorption and scattering coefficients. The larger cw data sets (10(5) measurements) collected with a lens coupled CCD, permit 3D DOT reconstructions of a 1-liter tissue volume. To address the computational complexity of large data sets and 3D volumes we employ finite difference based reconstructions computed in parallel. Tissue phantom measurements evaluate imaging performance. The tests include the following: point spread function measures of resolution, characterization of the size and contrast of single objects, field of view measurements and spectral characterization of constituent concentrations. We also report in vivo measurements. Average tissue optical properties of a healthy breast are used to deduce oxy- and deoxy-hemoglobin concentrations. Differential imaging with a tumor simulating target adhered to the surface of a healthy breast evaluates the influence of physiologic fluctuations on image noise. This tomography system provides robust, quantitative, full 3D image reconstructions with the advantages of high data throughput, single detector-tissue coupling path, and large (1L) imaging domains. In addition, we find that point spread function measurements provide a useful and comprehensive representation of system performance.

Optical tomographic imaging of dynamic features of dense-scattering media

Methods used in optical tomography have thus far proven to produce images of complex target media (e.g., tissue) having, at best, relatively modest spatial resolution. This presents a challenge in differentiating artifact from true features. Further complicating such efforts is the expectation that the optical properties of tissue for any individual are largely unknown and are likely to be quite variable due to the occurrence of natural vascular rhythms whose amplitudes are sensitive to a host of autonomic stimuli that are easily induced. We recognize, however, that rather than frustrating efforts to validate the accuracy of image features, the time-varying properties of the vasculature can be exploited to aid in such efforts, owing to the known structure-dependent frequency response of the vasculature and to the fact that hemoglobin is a principal contrast feature of the vasculature at near-infrared wavelengths. To accomplish this, it is necessary to generate a time series of image data. In this report we have tested the hypothesis that through analysis of time-series data, independent contrast features can be derived that serve to validate, at least qualitatively, the accuracy of imaging data, in effect establishing a self-referencing scheme. A significant finding is the observation that analysis of such data can produce high-contrast images that reveal features that are mainly obscured in individual image frames or in time-averaged image data. Given the central role of hemoglobin in tissue function, this finding suggests that a wealth of new features associated with vascular dynamics can be identified from the analysis of time-series image data.

Influence of Systematic Errors in Reference States on Image Quality and on Stability of Derived Information for dc Optical Imaging

Optical measurements of tissue can be performed in discrete, time-averaged, and time-varying data collection modes. This information can be evaluated to yield estimates of either absolute optical coefficient values or some relative change in these values compared with a defined state. In the case of time-varying data, additional analysis can be applied to define various dynamic features. Here we have explored the accuracy with which such information can be recovered from dense scattering media using linear perturbation theory, as a function of the accuracy of the reference medium that serves as the initial guess. Within the framework of diffusion theory and a first-order solution, we have observed the following inequality regarding the sensitivity of computed measures to inaccuracy in the reference medium: Absolute measures ? relative measures > dynamic measures. In fact, the fidelity of derived dynamic measures was striking; we observed that accurate measures of dynamic behavior could be defined even if the quality of the image data from which these measures were derived was comparatively modest. In other studies we identified inaccuracy in the estimates of the reference detector values, and not to corresponding errors in the image operators, as the primary factor responsible for instability of absolute measures. The significance of these findings for practical imaging studies of tissue is discussed.

Three-dimensional time-resolved optical tomography of a conical breast phantom

A 32-channel time-resolved imaging device for medical optical tomography has been employed to evaluate a scheme for imaging the human female breast. The fully automated instrument and the reconstruction procedure have been tested on a conical phantom with tissue-equivalent optical properties. The imaging protocol has been designed to obviate compression of the breast and the need for coupling fluids. Images are generated from experimental data with an iterative reconstruction algorithm that employs a three-dimensional (3D) finite-element diffusion-based forward model. Embedded regions with twice the background optical properties are revealed in separate 3D absorption and scattering images of the phantom. The implications for 3D time-resolved optical tomography of the breast are discussed.

Diffuse optical tomography of highly heterogeneous media

We investigate the performance of diffuse optical tomography to image highly heterogeneous media, such as breast tissue, as a function of background heterogeneity. To model the background heterogeneity, we have employed the functional information derived from Gadolinium-enhanced magnetic resonance images of the breast. We demonstrate that overall image quality and quantification accuracy worsens as the background heterogeneity increases. Furthermore we confirm the appearance of characteristic artifacts at the boundaries that scale with background heterogeneity. These artifacts are very similar to the ones seen in clinical examinations and can be misinterpreted as actual objects if not accounted for. To eliminate the artifacts and improve the overall image reconstruction, we apply a data-correction algorithm that yields superior reconstruction results and is virtually independent of the degree of the background heterogeneity.

Recovery of optical parameters in multiple-layered diffusive media: theory and experiments

Diffuse photon density waves have lately been used both to characterize diffusive media and to locate and characterize hidden objects, such as tumors, in soft tissue. In practice, most biological media of medical interest consist of various layers with different optical properties, such as the fat layer in the breast or the different layers present in the skin. Also, most experimental setups consist of a multilayered system, where the medium to be characterized (i.e., the patient's organ) is usually bounded by optically diffusive plates. Incorrect modeling of interfaces may induce errors comparable to the weak signals obtained from tumors embedded deep in highly heterogeneous tissue and lead to significant reconstruction artifacts. To provide a means to analyze the data acquired in these configurations, the basic expressions for the reflection and transmission coefficients for diffusive-diffusive and diffusive-nondiffusive interfaces are presented. A comparison is made between a diffusive slab and an ordinary dielectric slab, thus establishing the limiting distance between the two interfaces of the slab for multiple reflections between them to be considered important. A rigorous formulation for multiple-layered (M-layered) diffusive media is put forward, and a method for solving any M-layered medium is shown. The theory presented is used to characterize a two-layered medium from transmission measurements, showing that the coefficients of scattering, mu'(s) , and absorption, mu(a) , are retrieved with great accuracy. Finally, we demonstrate the simultaneous retrieval of both mu;(s) and mu(a).

Near-field diffraction tomography with diffuse photon density waves

An angular spectrum algorithm is presented for fast, near-field diffraction tomographic imaging with diffuse photon density waves in highly scattering media. A general relation in K space is derived that connects the spatial variations of the optical properties of heterogeneities to the spatial spectra of the measured scattered diffuse photon density waves. The theory is verified experimentally for situations when boundary effects can be neglected. We further describe how to reconstruct absorption and scattering properties simultaneously, and how to incorporate boundary conditions into this angular spectrum algorithm for a turbid medium of finite size (e.g., the slab medium). Limitations and potential improvements of the near-field diffraction tomography are also discussed.

Concurrent MRI and diffuse optical tomography of breast after indocyanine green enhancement

We present quantitative optical images of human breast in vivo. The images were obtained by using near-infrared diffuse optical tomography (DOT) after the administration of indocyanine green (ICG) for contrast enhancement. The optical examination was performed concurrently with a magnetic resonance imaging (MRI) exam on patients scheduled for excisional biopsy or surgery so that accurate image coregistration and histopathological information of the suspicious lesions was available. The ICG-enhanced optical images coregistered accurately with Gadolinium-enhanced magnetic resonance images validating the ability of DOT to image breast tissue. In contrast to simple transillumination, we found that DOT provides for localization and quantification of exogenous tissue chromophore concentrations. Additionally our use of ICG, an albumin bound absorbing dye in plasma, demonstrates the potential to differentiate disease based on the quantified enhancement of suspicious lesions.