Thermal coagulation-induced changes of the optical properties of normal and adenomatous human colon tissues in vitro in the spectral range 400-1,100 nm

Transient simulation of laser ablation based on Monte Carlo light transport with dynamic optical properties model

Laser ablation is a minimally invasive therapeutic technique to denature tumors through coagulation and/or vaporization. Computational simulations of laser ablation can evaluate treatment outcomes quantitatively and provide numerical indices to determine treatment conditions, thus accelerating the technique's clinical application. These simulations involve calculations of light transport, thermal diffusion, and the extent of thermal damage. The optical properties of tissue, which govern light transport through the tissue, vary during heating, and this affects the treatment outcomes. Nevertheless, the optical properties in conventional simulations of coagulation and vaporization remain constant. Here, we propose a laser ablation simulation based on Monte Carlo light transport with a dynamic optical properties (DOP) model. The proposed simulation is validated by performing optical properties measurements and laser irradiation experiments on porcine liver tissue. The DOP model showed the replicability of the changes in tissue optical properties during heating. Furthermore, the proposed simulation estimated coagulation areas that were comparable to experimental results at low-power irradiation settings and provided more than 2.5 times higher accuracy when calculating coagulation and vaporization areas than simulations using static optical properties at high-power irradiation settings. Our results demonstrate the proposed simulation's applicability to coagulation and vaporization region calculations in tissue for retrospectively evaluating the treatment effects of laser ablation.

Tissue Phantoms for Biomedical Applications in Raman Spectroscopy: A Review

Raman spectroscopy is a group of analytical techniques, currently applied in several research fields, including clinical diagnostics. Tissue-mimicking optical phantoms have been established as an essential intermediate stage for medical applications with their employment from spectroscopic techniques to be constantly growing. This review outlines the types of tissue phantoms currently employed in different biomedical applications of Raman spectroscopy, focusing on their composition and optical properties. It is therefore an attempt to present an informed range of options for potential use to the researchers.

Picosecond Laser-Induced Photothermal Skin Damage Evaluation by Computational Clinical Trial

Background and Objectives

Computational clinical trial (CCT) in the field of laser medicine promotes clinical application of novel laser devices, because this trial carried out based on numerical modeling of laser-tissue interactions and simulation of a series of treatment process. To confirm the feasibility of the computational clinical trial of skin treatment with a novel picosecond laser, this paper presents an evaluation method of the safety.

Study Design/Materials and Methods

In this method, the light propagation and thermal diffusion process after ultrashort light pulse irradiation to a numerical skin model is calculated and the safety based on the photothermal damage is evaluated by computational modeling and simulation. As an example, the safety of a novel picosecond laser device was examined by comparing with several laser devices approved for clinical use.

Results

The ratio of the maximum thermal damage induced by picosecond laser irradiation was 1.2 × 10^-2 % at the epidermis, while that caused by approved laser irradiation was 99 % at the capillary vessels. The numerical simulation demonstrated that less thermal damage was observed compared with the approved devices. The results show the safety simulated by photothermal damage calculation was consistent with the reported clinical trials.

Conclusions

This computational clinical trial shows the feasibility of applying computational clinical trials for the safety evaluation of novel medical laser devices. In contrast to preclinical and clinical tests, the proposed computational method offers regulatory science for appropriately and quickly predicting and evaluating the safety of a novel laser device.

Methods of extraction of optical properties from diffuse reflectance measurements of ex-vivo human colon tissue using thin film silicon photodetector arrays

Spatially resolved diffuse reflectance spectroscopy (SRDRS) is a promising technique for characterization of colon tissue. Herein, two methods for extracting the reduced scattering and absorption coefficients ( μ s ' ( λ ) and μ a ( λ ) ) from SRDRS data using lookup tables of simulated diffuse reflectance are reported. Experimental measurements of liquid tissue phantoms performed with a custom multi-pixel silicon SRDRS sensor spanning the 450 - 750 nm wavelength range were used to evaluate the extraction methods, demonstrating that the combined use of spatial and spectral data reduces extraction error compared to use of spectral data alone. Additionally, SRDRS measurements of normal and tumor ex-vivo human colon tissue are presented along with μ s ' ( λ ) and μ a ( λ ) extracted from these measurements.

Computer simulations of thermal tissue remodeling during transvaginal and transurethral laser treatment of female stress urinary incontinence

BACKGROUND AND OBJECTIVES

A non-surgical method is being developed for treating female stress urinary incontinence by laser thermal remodeling of subsurface tissues with applied surface tissue cooling. Computer simulations of light transport, heat transfer, and thermal damage in tissue were performed, comparing transvaginal and transurethral approaches.

STUDY DESIGN/MATERIALS AND METHODS

Monte Carlo (MC) simulations provided spatial distributions of absorbed photons in the tissue layers (vaginal wall, endopelvic fascia, and urethral wall). Optical properties (n,μa ,μs ,g) were assigned to each tissue at λ = 1064 nm. A 5-mm-diameter laser beam and incident power of 5 W for 15 seconds was used, based on previous experiments. MC output was converted into absorbed energy, serving as input for finite element heat transfer simulations of tissue temperatures over time. Convective heat transfer was simulated with contact probe cooling temperature set at 0°C. Variables used for thermal simulations (κ,c,ρ) were assigned to each tissue layer. MATLAB code was used for Arrhenius integral thermal damage calculations. A temperature matrix was constructed from ANSYS output, and finite sum was incorporated to approximate Arrhenius integral calculations. Tissue damage properties (Ea ,A) were used to compute Arrhenius sums.

RESULTS

For the transvaginal approach, 37% of energy was absorbed in the endopelvic fascia target layer with 0.8% deposited beyond it. Peak temperature was 71°C, the treatment zone was 0.8-mm-diameter, and 2.4 mm of the 2.7-mm-thick vaginal wall was preserved. For transurethral approach, 18% energy was absorbed in endopelvic fascia with 0.3% deposited beyond the layer. Peak temperature was 80°C, treatment zone was 2.0-mm-diameter, and 0.6 mm of 2.4-mm-thick urethral wall was preserved.

CONCLUSIONS

Computer simulations suggest that transvaginal approach is more feasible than transurethral approach. Lasers Surg. Med. 49:198-205, 2017. © 2016 Wiley Periodicals, Inc.

Optical clearing of vaginal tissues, ex vivo, for minimally invasive laser treatment of female stress urinary incontinence

Near-infrared laser energy in conjunction with applied tissue cooling is being investigated for thermal remodeling of the endopelvic fascia during minimally invasive treatment of female stress urinary incontinence. Previous computer simulations of light transport, heat transfer, and tissue thermal damage have shown that a transvaginal approach is more feasible than a transurethral approach. However, results were suboptimal, and some undesirable thermal insult to the vaginal wall was still predicted. This study uses experiments and computer simulations to explore whether application of an optical clearing agent (OCA) can further improve optical penetration depth and completely preserve the vaginal wall during subsurface treatment of the endopelvic fascia. Several different mixtures of OCA’s were tested, and 100% glycerol was found to be the optimal agent. Optical transmission studies, optical coherence tomography, reflection spectroscopy, and computer simulations [including Monte Carlo (MC) light transport, heat transfer, and Arrhenius integral model of thermal damage] using glycerol were performed. The OCA produced a 61% increase in optical transmission through porcine vaginal wall at 37°C after 30 min. The MC model showed improved energy deposition in endopelvic fascia using glycerol. Without OCA, 62%, 37%, and 1% of energy was deposited in vaginal wall, endopelvic fascia, and urethral wall, respectively, compared with 50%, 49%, and 1% using OCA. Use of OCA also resulted in 0.5-mm increase in treatment depth, allowing potential thermal tissue remodeling at a depth of 3 mm with complete preservation of the vaginal wall.

Monitoring of tissue optical properties during thermal coagulation of ex vivo tissues

BACKGROUND AND OBJECTIVE

Real-time monitoring of tissue status during thermal ablation of tumors is critical to ensure complete destruction of tumor mass, while avoiding tissue charring and excessive damage to normal tissues. Currently, magnetic resonance thermometry (MRT), along with magnetic resonance imaging (MRI), is the most commonly used technique for monitoring and assessing thermal ablation process in soft tissues. MRT/MRI is very expensive, bulky, and often subject to motion artifacts. On the other hand, light propagation within tissue is sensitive to changes in tissue microstructure and physiology which could be used to directly quantify the extent of tissue damage. Furthermore, optical monitoring can be a portable, and cost-effective alternative for monitoring a thermal ablation process. The main objective of this study, is to establish a correlation between changes in tissue optical properties and the status of tissue coagulation/damage during heating of ex vivo tissues.

MATERIALS AND METHODS

A portable diffuse reflectance spectroscopy system and a side-firing fiber-optic probe were developed to study the absorption (μa (λ)), and reduced scattering coefficients (μ's (λ)) of native and coagulated ex vivo porcine, and chicken breast tissues. In the first experiment, both porcine and chicken breast tissues were heated at discrete temperature points between 24 and 140°C for 2 minutes. Diffuse reflectance spectra (430-630 nm) of native and coagulated tissues were recorded prior to, and post heating. In a second experiment, porcine tissue samples were heated at 70°C and diffuse reflectance spectra were recorded continuously during heating. The μa (λ) and μ's (λ) of the tissues were extracted from the measured diffuse reflectance spectra using an inverse Monte-Carlo model of diffuse reflectance. Tissue heating was stopped when the wavelength-averaged scattering plateaued.

RESULTS

The wavelength-averaged optical properties, <μ's (λ)> and <μa (λ)>, for native porcine tissues (n = 66) at room temperature, were 5.4 ± 0.3 cm(-1) and 0.780 ± 0.008 cm(-1) (SD), respectively. The <μ's (λ)> and <μa (λ)> for native chicken breast tissues (n = 66) at room temperature, were 2.69 ± 0.08 cm(-1) and 0.29 ± 0.01 cm(-1) (SD), respectively. In the first experiment, the <μ's (λ)> of coagulated porcine and chicken breast tissue rose to 56.4 ± 3.6 cm(-1) at 68.7 ± 1.7°C (SD), and 52.8 ± 1 cm(-1) at 57.1 ± 1.5°C (SD), respectively. Correspondingly, the <μa (λ)> of coagulated porcine (140.6°C), and chicken breast tissues (130°C) were 0.75 ± 0.05 cm(-1) and 0.263 ± 0.004 cm(-1) (SD). For both tissues, charring was observed at temperatures above 80°C. During continuous monitoring of porcine tissue (with connective tissues) heating, the <μ's (λ)> started to rise rapidly from 13.7 ± 1.5 minutes and plateaued at 19 ± 2.5 (SD) minutes. The <μ's (λ)> plateaued at 11.7 ± 3 (SD) minutes for porcine tissue devoid of connective tissue between probe and tissue surface. No charring was observed during continuous monitoring of thermal ablation process.

CONCLUSION

The changes in optical absorption and scattering properties can be continuously quantified, which could be used as a diagnostic biomarker for assessing tissue coagulation/damage during thermal ablation. Lasers Surg. Med. 48:686-694, 2016. © 2016 Wiley Periodicals, Inc.

Laser Treatment of Female Stress Urinary Incontinence: Optical, Thermal, and Tissue Damage Simulations

Treatment of female stress urinary incontinence (SUI) by laser thermal remodeling of subsurface tissues is studied. Light transport, heat transfer, and thermal damage simulations were performed for transvaginal and transurethral methods. Monte Carlo (MC) provided absorbed photon distributions in tissue layers (vaginal wall, endopelvic fascia, urethral wall). Optical properties (n,μ_a,μ_s,g) were assigned to each tissue at λ=1064 nm. A 5-mm-diameter laser beam and power of 5 W for 15 s was used, based on previous experiments. MC output was converted into absorbed energy, serving as input for ANSYS finite element heat transfer simulations of tissue temperatures over time. Convective heat transfer was simulated with contact cooling probe set at 0 °C. Thermal properties (κ,c,ρ) were assigned to each tissue layer. MATLAB code was used for Arrhenius integral thermal damage calculations. A temperature matrix was constructed from ANSYS output, and finite sum was incorporated to approximate Arrhenius integral calculations. Tissue damage properties (E_a,A) were used to compute Arrhenius sums. For the transvaginal approach, 37% of energy was absorbed in endopelvic fascia layer with 0.8% deposited beyond it. Peak temperature was 71°C, treatment zone was 0.8-mm-diameter, and almost all of 2.7-mm-thick vaginal wall was preserved. For transurethral approach, 18% energy was absorbed in endopelvic fascia with 0.3% deposited beyond it. Peak temperature was 80°C, treatment zone was 2.0-mm-diameter, and only 0.6 mm of 2.4-mm-thick urethral wall was preserved. A transvaginal approach is more feasible than transurethral approach for laser treatment of SUI.

Optical imaging of hemoglobin oxygen saturation using a small number of spectral images for endoscopic application

Tissue hypoxia is associated with tumor and inflammatory diseases, and detection of hypoxia is potentially useful for their detailed diagnosis. An endoscope system that can optically observe hemoglobin oxygen saturation (StO2) would enable minimally invasive, real-time detection of lesion hypoxia in vivo. Currently, point measurement of tissue StO2 via endoscopy is possible using the commercial fiber-optic oximeter T-Stat, which is based on visible light spectroscopy at many wavelengths. For clinical use, however, imaging of StO2 is desirable to assess the distribution of tissue oxygenation around a lesion. Here, we describe our StO2 imaging technique based on a small number of wavelength ranges in the visible range. By assuming a homogeneous tissue, we demonstrated that tissue StO2 can be obtained independently from the scattering property and blood concentration of tissue using four spectral bands. We developed a prototype endoscope system and used it to observe tissue-simulating phantoms. The StO2 (%) values obtained using our technique agreed with those from the T-Stat within 10%. We also showed that tissue StO2 can be derived using three spectral band if the scattering property is fixed at preliminarily measured values.

Trimodal color-fluorescence-polarization endoscopy aided by a tumor selective molecular probe accurately detects flat lesions in colitis-associated cancer

Colitis-associated cancer (CAC) arises from premalignant flat lesions of the colon, which are difficult to detect with current endoscopic screening approaches. We have developed a complementary fluorescence and polarization reporting strategy that combines the unique biochemical and physical properties of dysplasia and cancer for real-time detection of these lesions. Using azoxymethane-dextran sodium sulfate (AOM-DSS) treated mice, which recapitulates human CAC and dysplasia, we show that an octapeptide labeled with a near-infrared (NIR) fluorescent dye selectively identified all precancerous and cancerous lesions. A new thermoresponsive sol-gel formulation allowed topical application of the molecular probe during endoscopy. This method yielded high contrast-to-noise ratios (CNR) between adenomatous tumors (20.6 ± 1.65) and flat lesions (12.1 ± 1.03) and surrounding uninvolved colon tissue versus CNR of inflamed tissues (1.62±0.42) Incorporation of nanowire-filtered polarization imaging into NIR fluorescence endoscopy shows a high depolarization contrast in both adenomatous tumors and flat lesions in CAC, reflecting compromised structural integrity of these tissues. Together, the real-time polarization imaging provides real-time validation of suspicious colon tissue highlighted by molecular fluorescence endoscopy.

Oblique incidence reflectometry: optical models and measurements using a side-viewing gradient index lens-based endoscopic imaging system

A side-viewing, 2.3-mm diameter oblique incidence reflectometry endoscope has been designed to obtain optical property measurements of turbid samples. Light from a single-mode fiber is relayed obliquely onto the tissue with a gradient index lens-based distal optics assembly and the resulting diffuse reflectance profile is imaged and collected with a 30,000 element, 0.72 mm clear aperture fiber bundle. Sampling the diffuse reflectance in two-dimensions allows for fitting of the reflected intensity profile to a well-known theoretical model, permitting the extraction of both absorption and reduced scattering coefficients of the tissue sample. Models and measurements of the endoscopic imaging system are presented in tissue phantoms and in vivo mouse colon, verifying the endoscope's capabilities to accurately measure effective attenuation coefficient and differentiate diseased from normal colon.

Dual-wavelength photoacoustic technique for monitoring tissue status during thermal treatments

Photoacoustic (PA) techniques have been exploited for monitoring thermal treatments. However, PA signals depend not only on tissue temperature but also on tissue optical properties which indicate tissue status (e.g., native or coagulated). The changes in temperature and tissue status often occur simultaneously during thermal treatments, so both effects cause changes to PA signals. A new dual-wavelength PA technique to monitor tissue status independent of temperature is performed. By dividing the PA signal intensities obtained at two wavelengths at the same temperature, a ratio, which only depends on tissue optical properties, is obtained. Experiments were performed with two experimental groups, one with untreated tissue samples and the other with high-intensity focused ultrasound treated tissue samples including thermal coagulated lesion, using ex vivo porcine myocardium specimens to test the technique. The ratio of PA signal intensities obtained at 700 and 800 nm was constant for both groups from 25 to 43°C, but with distinct values for the two groups. Tissue alteration during thermal treatment was then studied using water bath heating of tissue samples from 35 to 60°C. We found that the ratio stayed constant before it exhibited a marked increase at around 55°C, indicating tissue changes at this temperature.

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.

Short laser pulse-induced irreversible photothermal effects in red blood cells

BACKGROUND AND OBJECTIVES

Photothermal (PT) responses of individual red blood cells (RBC) to short laser pulses may depend upon PT interactions at microscale.

STUDY DESIGN/MATERIALS AND METHODS

A sequence of identical short laser pulses (0.5 and 10 nanoseconds, 532 nm) was applied to individual RBCs, and their PT properties were analyzed at microscale in real time after each single pulse.

RESULTS

PT interactions in RBC were found to be localized to sub-micrometer zones associated with Hb that may be responsible for overheating and evaporation at higher optical energies. At sub-ablative energies, a single short laser pulse induced irreversible changes in the optical properties of RBC that stimulated the transition from a heating-cooling response to ablative evaporation in individual erythrocytes during their exposure to subsequent, but identical pulses.

CONCLUSION

The PT response of RBCs to short laser pulses of specific energy includes localized irreversible modifications of cell structure, resulting in three different effects: thermal non-ablative response, ablative evaporation, and residual thermal response.

Preclinical photoacoustic imaging endoscope based on acousto-optic coaxial system using ring transducer array

We developed and fabricated a preclinical photoacoustic imaging endoscope (PAIE) with an acousto-optic coaxial structure for cavity imaging that integrates a Plexiglas tube, an optical fiber, a ring transducer array, a taper reflector, and an ultrasonic coupling medium. A photoacoustic image for a section of pig colorectal tissue embedded in a transparent gelatin phantom was reconstructed. Furthermore, human colorectal cancer and normal colorectal tissue were imaged ex vivo with a contrast ratio of approximately 2.3. Experimental results demonstrate that the PAIE has potential for detecting colorectal cancer in clinical use.