Advances in MR imaging of the skin

Diffusion-Weighted Imaging for Skin Pathologies of the Breast-A Feasibility Study

Several breast pathologies can affect the skin, and clinical pathways might differ significantly depending on the underlying diagnosis. This study investigates the feasibility of using diffusion-weighted imaging (DWI) to differentiate skin pathologies in breast MRIs. This retrospective study included 88 female patients who underwent diagnostic breast MRI (1.5 or 3T), including DWI. Skin areas were manually segmented, and the apparent diffusion coefficients (ADCs) were compared between different pathologies: inflammatory breast cancer (IBC; n = 5), benign skin inflammation (BSI; n = 11), Paget's disease (PD; n = 3), and skin-involved breast cancer (SIBC; n = 11). Fifty-eight women had healthy skin (H; n = 58). The SIBC group had a significantly lower mean ADC than the BSI and IBC groups. These differences persisted for the first-order features of the ADC (mean, median, maximum, and minimum) only between the SIBC and BSI groups. The mean ADC did not differ significantly between the BSI and IBC groups. Quantitative DWI assessments demonstrated differences between various skin-affecting pathologies, but did not distinguish clearly between all of them. More extensive studies are needed to assess the utility of quantitative DWI in supplementing the diagnostic assessment of skin pathologies in breast imaging.

Photoacoustic imaging for three-dimensional visualization and delineation of basal cell carcinoma in patients

BACKGROUND

Photoacoustic (PA) imaging is an emerging non-invasive biomedical imaging modality that could potentially be used to determine the borders of basal cell carcinomas (BCC) preoperatively in order to reduce the need for repeated surgery.

METHODS

Two- and three-dimensional PA images were obtained by scanning BCCs using 59 wavelengths in the range 680-970 nm. Spectral unmixing was performed to visualize the tumor tissue distribution. Spectral signatures from 38 BCCs and healthy tissue were compared ex vivo.

RESULTS AND DISCUSSION

The PA spectra could be used to differentiate between BCC and healthy tissue ex vivo (p < 0.05). Spectral unmixing provided visualization of the overall architecture of the lesion and its border.

CONCLUSION

PA imaging can be used to differentiate between BCC and healthy tissue and can potentially be used to delineate tumors prior to surgical excision.

Unique spectral signature of human cutaneous squamous cell carcinoma by photoacoustic imaging

Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer with metastatic potential. To reduce reoperations due to nonradical excision, there is a need to develop a technique for identification of tumor margins preoperatively. Photoacoustic (PA) imaging is a novel imaging technology that combines the strengths of laser optics and ultrasound. Our aim was to determine the spectral signature of cSCC using PA imaging and to use this signature to visualize tumor architecture and borders. Two-dimensional PA images of 33 cSCCs and surrounding healthy skin were acquired ex vivo, using 59 excitation wavelengths from 680 to 970 nm. The spectral response of the cSCCs was compared to healthy tissue, and the difference was found to be greatest at wavelengths in the range 765 to 960 nm (P < .05). Three-dimensional PA images were constructed from spectra obtained in the y-z plane using a linear stepper motor moving along the x-plane. Spectral unmixing was then performed which provided a clear three-dimensional view of the distribution of tumor masses and their borders.

Comparison of optical coherence tomography and high frequency ultrasound imaging in mice for the assessment of skin morphology and intradermal volumes

Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS), two established imaging modalities in the field of dermatology, were evaluated and compared regarding their applicability for visualization of skin tissue morphology and quantification of murine intradermal structures. The accuracy and reproducibility of both methods were assessed ex vivo and in vivo using a standardized model for intradermal volumes based on injected soft tissue fillers. OCT revealed greater detail in skin morphology, allowing for detection of single layers due to the superior resolution. Volumetric data measured by OCT (7.9 ± 0.3 μl) and HFUS (7.7 ± 0.5 μl) were in good agreement and revealed a high accuracy when compared to the injected volume of 7.98 ± 0.8 µl. In vivo, OCT provided a higher precision (relative SD: 26% OCT vs. 42% HFUS) for the quantification of intradermal structures, whereas HFUS offered increased penetration depth enabling the visualization of deeper structures. A combination of both imaging technologies might be valuable for tumor assessments or other dermal pathologies in clinical settings.

Objective assessment of dermal fibrosis in cutaneous scarring, using optical coherence tomography, high-frequency ultrasound and immunohistomorphometry of human skin

Background

Noninvasive quantitative assessment of dermal fibrosis remains a challenge. Optical coherence tomography (OCT) and high‐frequency ultrasound (HFUS) can accurately measure structural and physiological changes in skin.

Objectives

To perform quantitative analysis of cutaneous fibrosis.

Methods

Sixty‐two healthy volunteers underwent multiple sequential skin biopsies (day 0 and 1–8 weekly thereafter), with OCT and HFUS measurements at each time point supported with immunohistomorphometry analysis.

Results

HFUS and OCT provided quantitative measurements of skin thickness, which increased from uninjured skin (1·18 and 1·2 mm, respectively) to week 1 (1·28 mm, P = 0·01; 1·27 mm, P = 0·02), and compared favourably with haematoxylin and eosin. Spearman correlation showed good agreement between techniques (P < 0·001). HFUS intensity corresponded to dermal density, with reduction from uninjured skin (42%) to week 8 (29%) (P = 0·02). The OCT attenuation coefficient linked with collagen density and was reduced at week 8 (1·43 mm, P < 0·001). Herovici analysis showed that mature collagen levels were highest in uninjured skin (72%) compared with week 8 (42%, P = 0·04). Fibronectin was greatest at week 4 (0·72 AU) and reduced at week 8 (0·56 AU); and α‐smooth muscle actin increased from uninjured skin (11·5%) to week 8 (67%, P = 0·003).

Conclusions

Time‐matched comparison images between haematoxylin and eosin, OCT and HFUS demonstrated that epidermal and dermal structures were better distinguished by OCT. HFUS enabled deeper visualization of the dermis including the subcutaneous tissue. Choice of device was dependent on the depth of scar type, parameters to be measured and morphological detail required in order to provide better objective quantitative indices of the quality and extent of dermal fibrosis.

What's already known about this topic?

Objective studies of the progression of scar formation and the properties of mature scars are necessary in order to evaluate clinical treatment, and for research focused on developing novel methods for management of dermal fibrosis.

Optical coherence tomography (OCT) and high‐frequency ultrasound (HFUS) are two known noninvasive techniques that are used effectively for measuring structural and physiological changes in cutaneous tissue.

What does this study add?

OCT and HFUS are useful tools for noninvasive monitoring of cutaneous fibrosis, enabling quantitative sequential temporal measurements of cutaneous thickness similarly to histology.

OCT attenuation coefficient (better in resolution) and HFUS intensity (better in depth) provide an indication of collagen deposition in skin over the course of healing, supported by immunohistochemical analysis.

Choice of device is dependent upon wound and scar type, the parameters to be measured and the morphological detail required.

https://doi.org/10.1111/bjd.18394 available online

https://www.bjdonline.com/article/Objective-assessment-of-dermal-fibrosis-in-cutaneous-scarring-using-optical-coherence-tomography-high-frequency-ultrasound-and-immunohistomorphometry-of-human-skin/

Preoperative measurement of cutaneous melanoma and nevi thickness with photoacoustic imaging

Photoacoustic imaging (PAI) is an emerging biomedical imaging technology, which can potentially be used in the clinic to preoperatively measure melanoma thickness and guide biopsy depth and sample location. We recruited 27 patients with pigmented cutaneous lesions suspicious for melanoma to test the feasibility of a handheld linear-array photoacoustic probe in imaging lesion architecture and measuring tumor depth. The probe was assessed in terms of measurement accuracy, image quality, and ease of application. Photoacoustic scans included single wavelength, spectral unmixing, and three-dimensional (3-D) scans. The photoacoustically measured lesion thickness gave a high correlation with the histological thickness measured from resected surgical samples (r=0.99, P<0.001 for melanomas, r=0.98, P<0.001 for nevi). Thickness measurements were possible for 23 of 26 cases for nevi and all (6) cases for melanoma. Our results show that handheld, linear-array PAI is highly reliable in measuring cutaneous lesion thickness in vivo, and can potentially be used to inform biopsy procedure and improve patient management.

Diagnostic value of 18F-FDG PET/CT for cutaneous extranodal natural killer/T-cell lymphoma, nasal type

OBJECTIVE

To evaluate the use of fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) in the diagnosis of cutaneous extranodal natural killer/T-cell lymphoma, nasal type (C-ENK/T-NT).

METHODS

A total of 39 patients with newly diagnosed C-ENK/T-NT were enrolled between May 2006 and November 2013. Anatomic regions (n=429; five cutaneous and six extracutaneous regions per patient) were assessed using an F-FDG PET/CT scan and conventional staging methods (CSMs). F-FDG PET/CT and CSMs were compared and evaluated for their ability to detect tumor lesions and their influence on the staging and treatment strategies. Biopsy and clinical follow-up were used as the gold standard for diagnosis.

RESULTS

In total, 139 lesions were detected by CSMs and F-FDG PET/CT, of which there were 50 cutaneous and 89 extracutaneous-positive regions. F-FDG PET/CT detected 48 cutaneous and 88 extracutaneous regions. CSMs, however, detected only 34 cutaneous lesions and 61 extracutaneous lesions that were positive for malignancy (cutaneous comparison of PET/CT vs. CSMs, P<0.001; extracutaneous comparison of PET/CT vs. CSMs, P<0.05). Using F-FDG PET/CT, 8 (42%) patients were in stage I-II and 31 patients (58%) were in stage III-IV. F-FDG PET/CT staging was consistent with the final stage determination in 94.9% (37/39) of patients, whereas CSMs staging was correct in final stage determination in 74.4% (29/39) of patients (P=0.025).

CONCLUSION

Our study showed that F-FDG PET/CT scanning is a valuable modality for the detection of cutaneous and extracutaneous lesions of C-ENK/T-NT. F-FDG PET/CT may therefore influence future staging and treatment strategies.

Multiparametric Classification of Skin from Osteogenesis Imperfecta Patients and Controls by Quantitative Magnetic Resonance Microimaging

The purpose of this study is to evaluate the ability of quantitative magnetic resonance imaging (MRI) to discriminate between skin biopsies from individuals with osteogenesis imperfecta (OI) and skin biopsies from individuals without OI. Skin biopsies from nine controls (unaffected) and nine OI patients were imaged to generate maps of five separate MR parameters, T₁, T₂, k_m, MTR and ADC. Parameter values were calculated over the dermal region and used for univariate and multiparametric classification analysis. A substantial degree of overlap of individual MR parameters was observed between control and OI groups, which limited the sensitivity and specificity of univariate classification. Classification accuracies ranging between 39% and 67% were found depending on the variable of investigation, with T₂ yielding the best accuracy of 67%. When several MR parameters were considered simultaneously in a multivariate analysis, the classification accuracies improved up to 89% for specific combinations, including the combination of T₂ and k_m. These results indicate that multiparametric classification by quantitative MRI is able to detect differences between the skin of OI patients and of unaffected individuals, which motivates further study of quantitative MRI for the clinical diagnosis of OI.

High-Resolution Microscopy-Coil MR Imaging of Skin Tumors: Techniques and Novel Clinical Applications

High-resolution magnetic resonance (MR) imaging performed with a microscopy coil is a robust radiologic tool for the evaluation of skin lesions. Microscopy-coil MR imaging uses a small surface coil and a 1.5-T or higher MR imaging system. Simple T1- and T2-weighted imaging protocols can be implemented to yield high-quality, high-spatial-resolution images that provide an excellent depiction of dermal anatomy. The primary application of microscopy-coil MR imaging is to delineate the deep margins of skin tumors, thereby providing a preoperative road map for dermatologic surgeons. This information is particularly useful for surgeons who perform Mohs micrographic surgery and in cases of nasofacial neoplasms, where the underlying anatomy is complex. Basal cell carcinoma is the most common nonmelanocytic skin tumor and has a predilection to manifest on the face, where it can be challenging to achieve complete surgical excision while preserving the cosmetic dignity of the patient. Microscopy-coil MR imaging provides dermatologic surgeons with valuable preoperative anatomic information that is not available at conventional clinical examination.

Elastic wave induced by friction as a signature of human skin ageing and gender effect

BACKGROUND

In this work, we propose an innovative approach based on a rotary tribometer coupled with laser velocimetry for measuring the elastic wave propagation on the skin.

METHODS

The method is based on a dynamic contact with the control of the normal force (Fn ), the contact length and speed. During the test a quantification of the friction force is produced. The elastic wave generated by friction is measured at the surface of the skin 35 mm from the source of friction exciter. In order to quantify the spectral range and the energy property of the wave generated, we have used laser velocimetry whose spot laser diameter is 120 μm, which samples the elastic wave propagation at a frequency which may reach 100 kHz. In this configuration, the speaker is the friction exciter and the listener the laser velocimetry. In order to perform non-invasive friction tests, the normal stress has been set to 0.3 N and the rotary velocity to 3 revolutions per second, which involves a sliding velocity of 63 mm/s.

RESULTS AND CONCLUSIONS

This newly developed innovative tribometer has been used for the analysis of the elastic wave propagation induced by friction on human skin during chronological ageing and gender effect. Measurements in vivo have been made on 60 healthy men and women volunteers, aged from 25 to 70. The results concerning the energy of the elastic wave signature induced by friction show a clear difference between the younger and older groups in the range of a low band of frequencies (0-200 Hz). The gender effect was marked by a 20% decrease in the energy of elastic wave propagation in the female group.

Handheld photoacoustic probe to detect both melanoma depth and volume at high speed in vivo

We applied a linear-array-based photoacoustic probe to detect melanin-containing melanoma tumor depth and volume in nude mice in vivo. This system can image melanomas at five frames per second (fps), which is much faster than our previous handheld single transducer system (0.1 fps). We first theoretically show that, in addition to the higher frame rate, almost the entire boundary of the melanoma can be detected by the linear-array-based probe, while only the horizontal boundary could be detected by the previous system. Then we demonstrate the ability of this linear-array-based system in measuring both the depth and volume of melanoma through phantom, ex vivo, and in vivo experiments. The volume detection ability also enables us to accurately calculate the rate of growth of the tumor, which is an important parameter in quantifying the tumor activity. Our results show that this system can be used for clinical melanoma diagnosis and treatment in humans at the bedside. Linear-array-based PA images of melanoma acquired in vivo on day 3 (a) and day 6 (b).

In vivo assessment of aged human skin with a unilateral NMR scanner

Human skin undergoes morphological and biochemical changes as a result of chronological aging and exposure to solar ultraviolet irradiation (photoaging). Noninvasive detection of these changes may aid in the prevention and treatment of both types of aging. This article presents a noninvasive method for the evaluation of aging skin with a unilateral stray field NMR scanner. These portable and inexpensive scanners may be suitable for in-depth skin characterization. In vivo profiles of sun-protected and sun-exposed skin from the forearms of female subjects of different ages (n = 9) were measured. Skin biopsies for histopathological examination were used as reference. T2 analysis with a bi-exponential decay model was applied and the extracted parameters were examined as markers for dermal aging. In the upper reticular dermis, a significant increase in the fraction of the slow T2 component and in the T2 value itself was found to correlate with chronological aging. For most subjects, there was an additional increase in the values of the slow T2 component and the T2 values from the sun-exposed forearm, superimposed on that measured for the sun-protected forearm. These results are in agreement with the decline in collagen content and the increase in free water content with aging. The results suggest that such a technique can be used as a tool for the assessment of aging, and that bi-exponential fitting can produce sensitive fingerprint parameters for the dermal alterations that occur during aging.

Handheld photoacoustic microscopy to detect melanoma depth in vivo

We developed handheld photoacoustic microscopy (PAM) to detect melanoma and determine tumor depth in nude mice in vivo. Compared to our previous PAM system for melanoma imaging, a new light delivery mechanism is introduced to improve light penetration. We show that melanomas with 4.1 and 3.7 mm thicknesses can be successfully detected in phantom and in in vivo experiments, respectively. With its deep melanoma imaging ability and handheld design, this system can be tested for clinical melanoma diagnosis, prognosis, and surgical planning for patients at the bedside.

In vivo MR imaging of the human skin at subnanoliter resolution using a superconducting surface coil at 1.5 Tesla

PURPOSE

To demonstrate the feasibility of a highly sensitive superconducting surface coil for microscopic MRI of the human skin in vivo in a clinical 1.5 Tesla (T) scanner.

MATERIALS AND METHODS

A 12.4-mm high-temperature superconducting coil was used at 1.5T for phantom and in vivo skin imaging. Images were inspected to identify fine anatomical skin structures. Signal-to-noise ratio (SNR) improvement by the high-temperature superconducting (HTS) coil, as compared to a commercial MR microscopy coil was quantified from phantom imaging; the gain over a geometrically identical coil made from copper (cooled or not) was theoretically deduced. Noise sources were identified to evaluate the potential of HTS coils for future studies.

RESULTS

In vivo skin images with isotropic 80 μm resolution were demonstrated revealing fine anatomical structures. The HTS coil improved SNR by a factor 32 over the reference coil in a nonloading phantom. For calf imaging, SNR gains of 380% and 30% can be expected over an identical copper coil at room temperature and 77 K, respectively.

CONCLUSION

The high sensitivity of HTS coils allows for microscopic imaging of the skin at 1.5T and could serve as a tool for dermatology in a clinical setting.

A parallel imaging approach to wide-field MR microscopy

Magnetic resonance microscopy, suggested in the earliest papers on MRI, has always been limited by the low signal-to-noise ratio resulting from the small voxel size. Magnetic resonance microscopy has largely been enabled by the use of microcoils that provide the signal-to-noise ratio improvement required to overcome this limitation. Concomitant with the small coils is a small field-of-view, which limits the use of magnetic resonance microscopy as a histological tool or for imaging large regions in general. This article describes initial results in wide field-of-view magnetic resonance microscopy using a large array of narrow, parallel coils, which provides a signal-to-noise ratio enhancement as well as the ability to use parallel imaging techniques. Comparison images made between a volume coil and the proposed technique demonstrate reductions in imaging time of more than 100 with no loss in signal-to-noise ratio or resolution.

The physiological origin of task-evoked systemic artefacts in functional near infrared spectroscopy

A major methodological challenge of functional near-infrared spectroscopy (fNIRS) is its high sensitivity to haemodynamic fluctuations in the scalp. Superficial fluctuations contribute on the one hand to the physiological noise of fNIRS, impairing the signal-to-noise ratio, and may on the other hand be erroneously attributed to cerebral changes, leading to false positives in fNIRS experiments. Here we explore the localisation, time course and physiological origin of task-evoked superficial signals in fNIRS and present a method to separate them from cortical signals. We used complementary fNIRS, fMRI, MR-angiography and peripheral physiological measurements (blood pressure, heart rate, skin conductance and skin blood flow) to study activation in the frontal lobe during a continuous performance task. The General Linear Model (GLM) was applied to analyse the fNIRS data, which included an additional predictor to account for systemic changes in the skin. We found that skin blood volume strongly depends on the cognitive state and that sources of task-evoked systemic signals in fNIRS are co-localized with veins draining the scalp. Task-evoked superficial artefacts were mainly observed in concentration changes of oxygenated haemoglobin and could be effectively separated from cerebral signals by GLM analysis. Based on temporal correlation of fNIRS and fMRI signals with peripheral physiological measurements we conclude that the physiological origin of the systemic artefact is a task-evoked sympathetic arterial vasoconstriction followed by a decrease in venous volume. Since changes in sympathetic outflow accompany almost any cognitive and emotional process, we expect scalp vessel artefacts to be present in a wide range of fNIRS settings used in neurocognitive research. Therefore a careful separation of fNIRS signals originating from activated brain and from scalp is a necessary precondition for unbiased fNIRS brain activation maps.

Characterization of skin abnormalities in a mouse model of osteogenesis imperfecta using high resolution magnetic resonance imaging and Fourier transform infrared imaging spectroscopy

Evaluation of the skin phenotype in osteogenesis imperfecta (OI) typically involves biochemical measurements, such as histologic or biochemical assessment of the collagen produced from biopsy-derived dermal fibroblasts. As an alternative, the current study utilized non-invasive magnetic resonance imaging (MRI) microscopy and optical spectroscopy to define biophysical characteristics of skin in an animal model of OI. MRI of skin harvested from control, homozygous oim/oim and heterozygous oim/+ mice demonstrated several differences in anatomic and biophysical properties. Fourier transform infrared imaging spectroscopy (FT-IRIS) was used to interpret observed MRI signal characteristics in terms of chemical composition. Differences between wild-type and OI mouse skin included the appearance of a collagen-depleted lower dermal layer containing prominent hair follicles in the oim/oim mice, accounting for 55% of skin thickness in these. The MRI magnetization transfer rate was lower by 50% in this layer as compared to the upper dermis, consistent with lower collagen content. The MRI transverse relaxation time, T2, was greater by 30% in the dermis of the oim/oim mice compared to controls, consistent with a more highly hydrated collagen network. Similarly, an FT-IRIS-defined measure of collagen integrity was 30% lower in the oim/oim mice. We conclude that characterization of phenotypic differences between the skin of OI and wild-type mice by MRI and FT-IRIS is feasible, and that these techniques provide powerful complementary approaches for the analysis of the skin phenotype in animal models of disease.

Experimental and numerical study on the mechanical behavior of the superficial layers of the face

BACKGROUND/PURPOSE

This paper reports a study on the quasi-static mechanical response of the superficial soft tissue of the face, in particular the skin and the superficial muscoloaponeurotic system (SMAS) plus the superficial fat. The mechanical characterization of soft tissues represents one of the main uncertainties of previously developed numerical models for face simulation.

METHODS

Two instruments based on the suction method were used for collecting experimental data: the Cutometer(®) (2 mm probe aperture diameter) and the Aspiration device (8 mm). Tests were performed in five different regions of the face (jaw, nasolabial, parotideomasseteric, zygomatic and forehead) on the same subject whose magnetic resonance imaging (MRI) scans were used to generate a full 3D finite element model of the face and for whom a series of experimental results for different loading cases are already available. The mechanical parameters of the tissue layers were determined through an inverse finite element analysis. Anatomical data (tissue layers' thickness) were determined through the analysis of a set of high-resolution MRI scans and ultrasound measurements performed in the regions tested.

RESULTS

The results of Cutometer(®) measurements show a relatively homogeneous mechanical response in different face regions, while the results of aspiration device measurements, which involve deeper tissues, show a larger variability. Mechanical model parameters of the skin and SMAS were determined for two constitutive model equations: a hyperelastic model based on the Rubin-Bodner formulation and a reduced polynomial model of second order.

CONCLUSION

The results reported in this work suggest that for simulations of the global behavior of facial soft tissue, such as craniofacial and maxillofacial surgery planning, the skin could be considered as a layer of uniform thickness and of uniform mechanical response through the different regions. Additionally, mechanical models were determined for skin and SMAS that could be used for simulations of surgical procedures requiring a distinction between these tissue layers.

State of the art in non-invasive imaging of cutaneous melanoma

BACKGROUND

This review focuses on looking at recent developments in the non-invasive imaging of skin, in particular at how such imaging may be used at present or in the future to detect cutaneous melanoma.

METHODS

A MEDLINE search was performed for papers using imaging techniques to evaluate cutaneous melanoma, including melanoma metastasis.

RESULTS

Nine different techniques were found: dermoscopy, confocal laser scanning microscopy (including multiphoton microscopy), optical coherence tomography, high frequency ultrasound, positron emission tomography, magnetic resonance imaging, and Fourier, Raman, and photoacoustic spectroscopies. This review contrasts the effectiveness of these techniques when seeking to image melanomas in skin.

CONCLUSIONS

Despite the variety of techniques available for detecting melanoma, there remains a critical need for a high-resolution technique to answer the question of whether tumours have invaded through the basement membrane.

Dynamic in vivo mapping of model moisturiser ingress into human skin by GARfield MRI

We describe the development of in vivo one-dimensional MRI (profiling) using a GARField (Gradient At Right angles to Field) magnet for the characterisation of side-of-hand human skin. For the first time and in vivo, we report measurements of the NMR longitudinal and transverse relaxation parameters and self-diffusivity of the upper layers of human skin with a nominal spatial resolution better than 10 µm. The results are correlated with in vivo confocal Raman spectroscopy measurements of water concentration and natural moisturiser factors, and discussed in terms of known skin biology and microstructure of the stratum corneum and viable epidermis. The application of model moisturiser solutions to the skin is followed and their dynamics of ingress are characterised using the MRI methodology developed. Selected hydrophilic and lipophilic formulations are studied. The results are corroborated by standard in vivo measurements of transepidermal water loss and hydration status. A further insight into moisturisation mechanisms is gained. The effect of two different penetration enhancers on a commonly used skin care oil is also discussed, and different timescales of oil penetration into the skin are reported depending on the type of enhancer.

Skin age testing criteria: characterization of human skin structures by 500 MHz MRI multiple contrast and image processing

Ex vivo magnetic resonance microimaging (MRM) image characteristics are reported in human skin samples in different age groups. Human excised skin samples were imaged using a custom coil placed inside a 500 MHz NMR imager for high-resolution microimaging. Skin MRI images were processed for characterization of different skin structures. Contiguous cross-sectional T1-weighted 3D spin echo MRI, T2-weighted 3D spin echo MRI and proton density images were compared with skin histopathology and NMR peaks. In all skin specimens, epidermis and dermis thickening and hair follicle size were measured using MRM. Optimized parameters TE and TR and multicontrast enhancement generated better MRI visibility of different skin components. Within high MR signal regions near to the custom coil, MRI images with short echo time were comparable with digitized histological sections for skin structures of the epidermis, dermis and hair follicles in 6 (67%) of the nine specimens. Skin % tissue composition, measurement of the epidermis, dermis, sebaceous gland and hair follicle size, and skin NMR peaks were signatures of skin type. The image processing determined the dimensionality of skin tissue components and skin typing. The ex vivo MRI images and histopathology of the skin may be used to measure the skin structure and skin NMR peaks with image processing may be a tool for determining skin typing and skin composition.

In vivo high-resolution magnetic resonance skin imaging at 1.5 T and 3 T

As a noninvasive modality, MR is attractive for in vivo skin imaging. Its unique soft tissue contrast makes it an ideal imaging modality to study the skin water content and to resolve the different skin layers. In this work, the challenges of in vivo high-resolution skin imaging are addressed. Three 3D Cartesian sequences are customized to achieve high-resolution imaging and their respective performance is evaluated. The balanced steady-state free precession (bSSFP) and gradient echo (GRE) sequences are fast but can be sensitive to off-resonance artifacts. The fast large-angle spin echo (FLASE) sequence provides a sharp depiction of the hypodermis structures but results in more specific absorption rate (SAR). The effect of increasing the field strength is assessed. As compared to 1.5 T, signal-to-noise ratio at 3 T slightly increases in the hypodermis and almost doubles in the dermis. The need for fat/water separation is acknowledged and a solution using an interleaved three-point Dixon method and an iterative reconstruction is shown to be effective. The effects of motion are analyzed and two techniques to prevent motion and correct for it are evaluated. Images with 117 x 117 x 500 microm(3) resolution are obtained in imaging times under 6 min.

Magnetic resonance imaging of the skin

A thorough examination of the skin is essential to screen various diseases accurately, evaluate the effectiveness of topically applied drugs and assess the results of dermatological surgeries such as skin grafts. The assessment of skin properties is also crucial in the cosmetics industry, where it is important to evaluate the effects skin care products have on these properties. The simplest and most widely used method of skin evaluation, the 'naked eye' assessment, enables researchers to assess only the skin surface and involves a large amount of inter-observer variability. Thanks to a great progress that has been made in physics, electronics and computer engineering in recent years, sophisticated imaging methods are increasingly available in day-to-day studies. The aim of this review was to present one of these techniques, namely the magnetic resonance imaging (MRI), and to discuss its possible use in skin examination and analysis. We present basic principles of MRI, as well as several interesting applications in the field of dermatology, and discuss the advantages and limitations of this method.

Electron paramagnetic resonance as a unique tool for skin and hair research

Electron paramagnetic resonance (EPR) spectroscopy and imaging (EPRI) are deeply rooted in the basic and quantum physics, but the spectrum of their applications in modern experimental and clinical dermatology and cosmetology is surprisingly wide. The main aim of this review was to show the physical foundation, technical limitations and versatility of this method in skin studies. Free radical and metal ion detection, EPR dosimetry, melanin study, spin trapping, spin labelling, oximetry and NO-metry, EPR imaging, new generation methods of EPR and EPR/NMR hybrid technology used under ex vivo and in vivo regime are portrayed in the context of clinical and experimental skin research to study problems such as oxidative and nitrosative stress generated by UV or inflammation, skin oxygenation, hydration of corneal layer of epidermis, transport and metabolism of drugs and cosmeceutics, skin carcinogenesis, skin tumors and many others. A part of the paper is devoted to hair and nail research. The review of dermatological applications of EPR is supplemented with a handful of advice concerning practical aspects of EPR experimentation and usage of EPR reagents.

Feasibility study of 3-T MR imaging of the skin

The purpose of this study was to assess the quality of 3-T magnetic resonance (MR) imaging of the skin, to describe skin anatomy at 3 T and to discuss future prospects of skin MRI. A 7-cm single-element surface receiver coil was developed for our 3-T MRI system. Thin sections were obtained with a three-dimensional FIESTA acquisition sequence and a spin-echo T1-weighted sequence (SET1). Prospective analysis was performed twice by two radiologists independently. Thirty-six healthy volunteers were included and underwent MRI on the face and the calf. Image quality was assessed regarding visibility of skin layers and quantification of artefacts. High field strength MR enables imaging of the skin with a high spatial in-plane resolution (87-180 microm), the total examination lasting 15-20 min. Image quality was excellent for the calf (mean SET1 quality = 96%) with a high intra- and interobserver correlation (SET1 kappa coefficient concerning visibility of epidermis, dermis and hypodermis > or = 0.84). Motion artefacts resulted in a small loss of quality and reproducibility for the face. In conclusion, 3-T MR allows high spatial resolution imaging of the skin and can potentially provide an accurate noninvasive means of analysing the skin.

Reflectance confocal microscopy for in vivo skin imaging

Reflectance confocal microscopy (RCM) is a novel noninvasive technique for "in vivo" examination of the skin. In a confocal microscope, near- infrared light from a diode laser is focused on a microscopic skin target. As this light passes between cellular structures having different refraction indexes, it is naturally reflected, and this reflected light is then captured and recomposed into a two-dimensional gray scale image by computer software. Focusing the microscope (adjusting the focal point on the z-axis) allows images to be obtained of different levels within the skin. Commercially available microscope systems of this type can create images with enough detail for use in histological analysis. The first investigations using these microscopes served to identify the appearance of the various cell populations living in the different layers of normal skin. Today, the main interest has become focused on the use of these microscopes as a diagnostic tool: a means of investigating benign and malignant tumors of melanocytes and keratinocytes, and, more importantly, the findings of this field of study can be used to develop a diagnostic algorithm which would be not only highly sensitive but specific as well. The aim of the paper is to provide an updated literature review and an in-depth critique of the state-of-the-art of RCM for skin cancer imaging with a critical discussion of the possibilities and limitations for clinical use.

[High resolution MR imaging of the skin: normal imaging features]

PURPOSE

To describe the qualitative and quantitative MR imaging features of normal skin.

MATERIALS AND METHODS

Thirty-one normal subjects underwent MR evaluation on a 1.5 Tesla magnet using a dedicated coil. Several skin sites were evaluated (back at the scapular level, posterior calf and inferior heel). Two pulse sequences were acquired: a SE T1W and a gradient-echo sequence (FIESTA). Qualitative and quantitative analysis was performed for all three sites.

RESULTS

In normal subjects, the different skin layers (callus, epidermis, dermis, hypodermis and pilosebaceous follicles) can be separated and measured on MR. Epidermis and hypodermis are hyperintense whereas dermis is hypointense. Our results confirm the presence of qualitative and quantitative variations between different skin regions. In some cases, a differentiation between papillary and reticular dermis can be achieved. Pilosebaceous follicles and the deep vascular network were clearly depicted on the FIESTA sequence. Measurements for each skin layer were compared based on sex, site and MR pulse sequence.

CONCLUSION

MRI provides evaluation of the different skin layers, epidermis, dermis, and hypodermis, and their different components.

Magnetic resonance methods and applications in pharmaceutical research

This review presents an overview of some recent magnetic resonance (MR) techniques for pharmaceutical research. MR is noninvasive, and does not expose subjects to ionizing radiation. Some methods that have been used in pharmaceutical research MR include magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) methods, among them, diffusion-weighted MRI, perfusion-weighted MRI, functional MRI, molecular imaging and contrast-enhance MRI. Some applications of MR in pharmaceutical research include MR in metabonomics, in vivo MRS, studies in cerebral ischemia and infarction, degenerative joint diseases, oncology, cardiovascular disorders, respiratory diseases and skin diseases. Some of these techniques, such as cardiac and joint imaging, or brain fMRI are standard, and are providing relevant data routinely. Skin MR and hyperpolarized gas lung MRI are still experimental. In conclusion, considering the importance of finding and characterizing biomarkers for improved drug evaluation, it can be expected that the use of MR techniques in pharmaceutical research is going to increase in the near future.