Towards accurate in vivo spectroscopy of the human prostate

Broadband Time Domain Diffuse Optical Reflectance Spectroscopy: A Review of Systems, Methods, and Applications

This review presents recent developments and a wide overview of broadband time domain diffuse optical spectroscopy (TD-DOS). Various topics including physics of photon migration, advanced instrumentation, methods of analysis, applications covering multiple domains (tissue chromophore, in vivo studies, food, wood, pharmaceutical industry) are elaborated. The key role of standardization and recent studies in that direction are discussed. Towards the end, a brief outlook is presented on the current status and future trends in broadband TD-DOS.

Determination of optical properties of turbid medium from relative interstitial CW radiance measurements using the incomplete P3 approximation

Interstitial determination of the tissue optical properties is important in biomedicine, especially for interstitial laser therapies. Continuous wave (CW) radiance techniques which examine light from multiple directions have been proposed as minimally invasive methods for determining the optical properties under an interstitial probe arrangement. However, both the fitting algorithm based on the P3 approximation and the analytical method based on the diffusion approximation (DA), which are currently used recovery algorithms, cannot extract the optical properties of tissue with low transport albedos accurately from radiance measurements. In this paper, we proposed an incomplete P3 approximation for the radiance, the P3_in for short, which is the asymptotic part of the solution for the P3 approximation. The relative differences between the P3_in and the P3 were within 0.48% over a wide range of clinically relevant optical properties for measurements at source detector separations (SDS) from 5 mm to 10 mm and angles from 0° to 160°. Based on the P3_in, we developed an analytical method for extracting the optical properties directly using simple expressions constructed from the radiance measurements at only two SDSs and four angles. The developed recovery algorithm was verified by simulated and experimental radiance data. The results show that both the absorption and reduced scattering coefficients were recovered accurately with relative errors within 5.28% and 3.86%, respectively, from the simulated data and with relative errors within 10.82% and 10.67%, respectively, from the experimental data over a wide range of albedos from 0.5 to 0.99. Since the developed P3_in-based radiance technique can obtain the optical properties rapidly from the measurements at only two SDSs and four angles, it is expected to be used for in vivo and in situ determination of the optical properties in online treatment planning during laser therapies.

Evaluation of Frequency Domain Analysis of a Multiwavelength Photoacoustic Signal for Differentiating Malignant From Benign and Normal Prostates: Ex Vivo Study With Human Prostates

OBJECTIVES

The purpose of this study was to investigate the feasibility of differentiating malignant prostate from benign prostatic hyperplasia (BPH) and normal prostate tissue by performing frequency domain analysis of photoacoustic images acquired at 2 different wavelengths.

METHODS

We performed multiwavelength photoacoustic imaging on freshly excised human prostate specimens taken from a total of 30 patients undergoing prostatectomy for biopsy-confirmed prostate cancer. Histologic slides marked by a genitourinary pathologist were used as ground truth to define regions of interest (ROIs) in the photoacoustic images. Primarily, 3 different prostate tissue categories, namely malignant, BPH, and normal, were considered, while a fourth category named nonmalignant was formed by combining the ROIs corresponding to BPH and normal tissue together. We extracted 3 spectral parameters, namely slope, midband fit, and intercept, from power spectra of the radiofrequency photoacoustic signals corresponding to the 3 primary tissue categories.

RESULTS

We analyzed data from 53 ROIs selected from the photoacoustic images of 30 patients. According to the histopathologic analysis, 19 ROIs were malignant, 8 were BPH, and 26 were normal. All the 3 spectral parameters and C-scan grayscale photoacoustic image pixel values were found to be significantly different (P < .01) between malignant and nonmalignant prostate as well as malignant and normal prostate.

CONCLUSIONS

Preliminary results of our ex vivo human prostate study suggest that spectral parameters obtained by performing frequency domain analysis of photoacoustic signals can be used to differentiate between malignant and nonmalignant prostate.

Sensitivity analysis for oblique incidence reflectometry using Monte Carlo simulations

Oblique incidence reflectometry has developed into an effective, noncontact, and noninvasive measurement technology for the quantification of both the reduced scattering and absorption coefficients of a sample. The optical properties are deduced by analyzing only the shape of the reflectance profiles. This article presents a sensitivity analysis of the technique in turbid media. Monte Carlo simulations are used to investigate the technique and its potential to distinguish the small changes between different levels of scattering. We present various regions of the dynamic range of optical properties in which system demands vary to be able to detect subtle changes in the structure of the medium, translated as measured optical properties. Effects of variation in anisotropy are discussed and results presented. Finally, experimental data of milk products with different fat content are considered as examples for comparison.

Towards next-generation time-domain diffuse optics for extreme depth penetration and sensitivity

Light is a powerful tool to non-invasively probe highly scattering media for clinical applications ranging from oncology to neurology, but also for molecular imaging, and quality assessment of food, wood and pharmaceuticals. Here we show that, for a paradigmatic case of diffuse optical imaging, ideal yet realistic time-domain systems yield more than 2-fold higher depth penetration and many decades higher contrast as compared to ideal continuous-wave systems, by adopting a dense source-detector distribution with picosecond time-gating. Towards this aim, we demonstrate the first building block made of a source-detector pair directly embedded into the probe based on a pulsed Vertical-Cavity Surface-Emitting Laser (VCSEL) to allow parallelization for dense coverage, a Silicon Photomultiplier (SiPM) to maximize light harvesting, and a Single-Photon Avalanche Diode (SPAD) to demonstrate the time-gating capability on the basic SiPM element. This paves the way to a dramatic advancement in terms of increased performances, new high impact applications, and availability of devices with orders of magnitude reduction in size and cost for widespread use, including quantitative wearable imaging.

Computationally effective solution of the inverse problem in time-of-flight spectroscopy

Photon time-of-flight (PTOF) spectroscopy enables the estimation of absorption and reduced scattering coefficients of turbid media by measuring the propagation time of short light pulses through turbid medium. The present investigation provides a comparison of the assessed absorption and reduced scattering coefficients from PTOF measurements of intralipid 20% and India ink-based optical phantoms covering a wide range of optical properties relevant for biological tissues and dairy products. Three different models are used to obtain the optical properties by fitting to measured temporal profiles: the Liemert-Kienle model (LKM), the diffusion model (DM) and a white Monte-Carlo (WMC) simulation-based algorithm. For the infinite space geometry, a very good agreement is found between the LKM and WMC, while the results obtained by the DM differ, indicating that the LKM can provide accurate estimation of the optical parameters beyond the limits of the diffusion approximation in a computational effective and accurate manner. This result increases the potential range of applications for PTOF spectroscopy within industrial and biomedical applications.

Spatial resolution in depth for time-resolved diffuse optical tomography using short source-detector separations

Diffuse optical tomography for medical applications can require probes with small dimensions involving short source-detector separations. Even though this configuration is seen at first as a constraint due to the challenge of depth sensitivity, we show here that it can potentially be an asset for spatial resolution in depth. By comparing two fiber optic probes on a test object, we first show with simulations that short source-detector separations improve the spatial resolution down to a limit depth. We then confirm these results in an experimental study with a state-of-the-art setup involving a fast-gated single-photon avalanche diode allowing maximum depth sensitivity. We conclude that short source-detector separations are an option to consider for the design of probes so as to improve image quality for diffuse optical tomography in reflectance.

Exploiting breakdown of the similarity relation for diffuse light transport: simultaneous retrieval of scattering anisotropy and diffusion constant

As manifested in the similarity relation of diffuse light transport, it is difficult to assess single scattering characteristics from multiply scattered light. We take advantage of the limited validity of the diffusion approximation of light transport and demonstrate, experimentally and numerically, that even deep into the multiple scattering regime, time-resolved detection of transmitted light allows simultaneous assessment of both single scattering anisotropy and scattering mean free path, and therefore also macroscopic parameters like the diffusion constant and the transport mean free path. This is achieved via careful assessment of early light and matching against Monte Carlo simulations of radiative transfer.

Time-resolved diffuse optical tomography using fast-gated single-photon avalanche diodes

We present the first experimental results of reflectance Diffuse Optical Tomography (DOT) performed with a fast-gated single-photon avalanche diode (SPAD) coupled to a time-correlated single-photon counting system. The Mellin-Laplace transform was employed to process time-resolved data. We compare the performances of the SPAD operated in the gated mode vs. the non-gated mode for the detection and localization of an absorbing inclusion deeply embedded in a turbid medium for 5 and 15 mm interfiber distances. We demonstrate that, for a given acquisition time, the gated mode enables the detection and better localization of deeper absorbing inclusions than the non-gated mode. These results obtained on phantoms demonstrate the efficacy of time-resolved DOT at small interfiber distances. By achieving depth sensitivity with limited acquisition times, the gated mode increases the relevance of reflectance DOT at small interfiber distance for clinical applications.

Separation of absorption and scattering properties of turbid media using relative spectrally resolved cw radiance measurements

We present a new method for extracting the effective attenuation coefficient and the diffusion coefficient from relative spectrally resolved cw radiance measurements using the diffusion approximation. The method is validated on both simulated and experimental radiance data sets using Intralipid-1% as a test platform. The effective attenuation coefficient is determined from a simple algebraic expression constructed from a ratio of two radiance measurements at two different source-detector separations and the same 90° angle. The diffusion coefficient is determined from another ratio constructed from two radiance measurements at two angles (0° and 180°) and the same source-detector separation. The conditions of the validity of the method as well as possible practical applications are discussed.

Single-fiber diffuse optical time-of-flight spectroscopy

We demonstrate interstitial diffuse optical time-of-fight spectroscopy based on a single fiber for both light delivery and detection. Detector saturation due to the massive short-time reflection is avoided by ultrafast gating of a single photon avalanche diode. We show that the effects of scattering and absorption are separable and that absorption can be assessed independently of scattering. Measurements on calibrated liquid phantoms and subsequent Monte Carlo-based evaluation illustrate that absorption coefficients can be accurately assessed over a wide range of medically relevant optical properties. Our findings pave the way to simplified and less invasive interstitial in vivo spectroscopy.

A review of in-vivo optical properties of human tissues and its impact on PDT

A thorough understanding of optical properties of biological tissues is critical to effective treatment planning for therapies such as photodynamic therapy (PDT). In the last two decades, new technologies, such as broadband diffuse spectroscopy, have been developed to obtain in vivo data in humans that was not possible before. We found that the in vivo optical properties generally vary in the ranges μ(a) = 0.03-1.6 cm⁻¹ and μ'(s) = 1.2-40 cm⁻¹, although the actual range is tissue-type dependent. We have also examined the overall trend of the absorption spectra (for μ(a) and μ'(s)) as a function of wavelength within a 95% confidence interval for various tissues in vivo. The impact of optical properties on light fluence rate is also discussed for various light application geometries including superficial, interstitial, and within a cavity.

Photoacoustic imaging of prostate brachytherapy seeds

Brachytherapy seed therapy is an increasingly common way to treat prostate cancer through localized radiation. The current standard of care relies on transrectal ultrasound (TRUS) for imaging guidance during the seed placement procedure. As visualization of individual metallic seeds tends to be difficult or inaccurate under TRUS guidance, guide needles are generally tracked to infer seed placement. In an effort to improve seed visualization and placement accuracy, the use of photoacoustic (PA) imaging, which is highly sensitive to metallic objects in soft tissue, was investigated for this clinical application. The PA imaging properties of bare (i.e., embedded in pure gelatin) and tissue-embedded (at depths of up to 13 mm) seeds were investigated with a multi-wavelength (750 to 1090 nm) PA imaging technique. Results indicate that, much like ultrasonic (US) imaging, an angular dependence (i.e., seed orientation relative to imaging transducer) of the PA signal exists. Despite this shortcoming, however, PA imaging offers improved contrast, over US imaging, of a seed in prostate tissue if sufficient local fluence is achieved. Additionally, although the PA signal of a bare seed is greatest for lower laser wavelengths (e.g., 750 nm), the scattering that results from tissue tends to favor the use of higher wavelengths (e.g., 1064 nm, which is the primary wavelength of Nd:YAG lasers) when the seed is located in tissue. A combined PA and US imaging approach (i.e., PAUS imaging) shows strong potential to visualize both the seed and the surrounding anatomical environment of the prostate during brachytherapy seed placement procedures.

Light penetration in the human prostate: a whole prostate clinical study at 763 nm

Photodynamic therapy (PDT) is being investigated as a treatment for localized prostate cancer. Photodynamic therapy uses a photosensitizing drug which is activated by a specific wavelength of light, in the presence of oxygen. The activated drug reacts with tissue oxygen to produce reactive oxygen species which are responsible for localized tissue necrosis. One of the determinants of the PDT effect is the penetration of light in the prostate. This study assesses the penetration depth of 763 nm light throughout the prostate. Eight men undergoing multiple hollow needle insertion for high dose rate brachytherapy were recruited. 763 nm light, produced by a diode laser, was delivered to the prostate using cylindrically diffusing optical fibers within the plastic needles. Light was detected at different distances from the source, using an isotropic detector within nearby needles. Penetration depth was calculated using the Boltzmann approximation to the diffusion equation. Delivery detector fiber separation was measured on computed tomography. The mean penetration depth was 0.57 cm, but there was within patient variation of a mean factor of 4.3. Further work is ongoing to assess the effect of such variability in light penetration, on the PDT effect.

System for interstitial photodynamic therapy with online dosimetry: first clinical experiences of prostate cancer

The first results from a clinical study for Temoporfin-mediated photodynamic therapy (PDT) of low-grade (T1c) primary prostate cancer using online dosimetry are presented. Dosimetric feedback in real time was applied, for the first time to our knowledge, in interstitial photodynamic therapy. The dosimetry software IDOSE provided dose plans, including optical fiber positions and light doses based on 3-D tissue models generated from ultrasound images. Tissue optical property measurements were obtained using the same fibers used for light delivery. Measurements were taken before, during, and after the treatment session. On the basis of these real-time measured optical properties, the light-dose plan was recalculated. The aim of the treatment was to ablate the entire prostate while minimizing exposure to surrounding organs. The results indicate that online dosimetry based on real-time tissue optical property measurements enabled the light dose to be adapted and optimized. However, histopathological analysis of tissue biopsies taken six months post-PDT treatment showed there were still residual viable cancer cells present in the prostate tissue sections. The authors propose that the incomplete treatment of the prostate tissue could be due to a too low light threshold dose, which was set to 5 J∕cm2.

Photodynamic therapy for focal ablation of the prostate

Although in early stages of clinical development, photodynamic therapy (PDT) shows promise in delivering focal treatment of both primary and post-radiotherapy prostate cancer. This article will review the mechanism of action of PDT, previous research using PDT for treating prostate cancer including the development of newer vascular-acting photosensitizers, and the potential advantages and disadvantages of PDT in delivering focal therapy.

Chi2 analysis for estimating the accuracy of optical properties derived from time resolved diffuse-reflectance

Weighted residuals and the reduced chi(2) (chi(R) (2)) value are investigated with regard to their relevance for assessing optical property estimates using the diffusion equation for time-resolved measurements in turbid media. It is shown and explained, for all photon counting experiments including lifetime estimation, why chi(R) (2) increases linearly with the number of photons when there is a model bias. Only when a sufficient number of photons has been acquired, chi(R) (2) is a pertinent value for assessing the accuracy of mu(a) and mu(s)' estimates. It was concluded that chi(R) (2) is of particular interest for cases of small interfiber separation, low-level scattering, strong absorption and incorrect measurement of instrument response function. It was also found that chi(R) (2) is less pertinent for judging mu(a) in case of air boundary effects.

Clinical system for non-invasive in situ monitoring of gases in the human paranasal sinuses

We present a portable system for non-invasive, simultaneous sensing of molecular oxygen (O(2)) and water vapor (H(2)O) in the human paranasal cavities. The system is based on high-resolution tunable diode laser spectroscopy (TDLAS) and digital wavelength modulation spectroscopy (dWMS). Since optical interference and non-ideal tuning of the diode lasers render signal processing complex, we focus on Fourier analysis of dWMS signals and procedures for removal of background signals. Clinical data are presented, and exhibit a significant improvement in signal-to-noise with respect to earlier work. The in situ detection limit, in terms of absorption fraction, is about 5x10(-5) for oxygen and 5x10(-4) for water vapor, but varies between patients due to differences in light attenuation. In addition, we discuss the use of water vapor as a reference in quantification of in situ oxygen concentration in detail. In particular, light propagation aspects are investigated by employing photon time-of-flight spectroscopy.

Near-infrared photon time-of-flight spectroscopy of turbid materials up to 1400 nm

Photon time-of-flight spectroscopy (PTOFS) is a powerful tool for analysis of turbid materials. We have constructed a time-of-flight spectrometer based on a supercontinuum fiber laser, acousto-optical tunable filtering, and an InP/InGaAsP microchannel plate photomultiplier tube. The system is capable of performing PTOFS up to 1400 nm, and thus covers an important region for vibrational spectroscopy of solid samples. The development significantly increases the applicability of PTOFS for analysis of chemical content and physical properties of turbid media. The great value of the proposed approach is illustrated by revealing the distinct absorption features of turbid epoxy resin. Promising future applications of the approach are discussed, including quantitative assessment of pharmaceuticals, powder analysis, and calibration-free near-infrared spectroscopy.

Parallel computing with graphics processing units for high-speed Monte Carlo simulation of photon migration

General-purpose computing on graphics processing units (GPGPU) is shown to dramatically increase the speed of Monte Carlo simulations of photon migration. In a standard simulation of time-resolved photon migration in a semi-infinite geometry, the proposed methodology executed on a low-cost graphics processing unit (GPU) is a factor 1000 faster than simulation performed on a single standard processor. In addition, we address important technical aspects of GPU-based simulations of photon migration. The technique is expected to become a standard method in Monte Carlo simulations of photon migration.