Accuracy of noninvasive in vivo measurements of photosensitizer uptake based on a diffusion model of reflectance spectroscopy

Non-invasive and quantitative in vivo monitoring of gold nanoparticle concentration and tissue hemodynamics by hybrid optical spectroscopies

Owing to their unique combination of chemical and physical properties, inorganic nanoparticles show a great deal of potential as suitable agents for early diagnostics and less invasive therapies. Yet, their translation to the clinic has been hindered, in part, by the lack of non-invasive methods to quantify their concentration in vivo while also assessing their effect on the tissue physiology. In this work, we demonstrate that diffuse optical techniques, employing near-infrared light, have the potential to address this need in the case of gold nanoparticles which support localized surface plasmons. An orthoxenograft mouse model of clear cell renal cell carcinoma was non-invasively assessed by diffuse reflectance and correlation spectroscopies before and over several days following a single intravenous tail vein injection of polyethylene glycol-coated gold nanorods (AuNRs-PEG). Our platform enables to resolve the kinetics of the AuNR-PEG uptake by the tumor in quantitative agreement with ex vivo inductively coupled plasma mass spectroscopy. Furthermore, it allows for the simultaneous monitoring of local tissue hemodynamics, enabling us to conclude that AuNRs-PEG do not significantly alter the animal physiology. We note that the penetration depth of this current probe was a few millimeters but can readily be extended to centimeters, hence gaining clinical relevance. This study and the methodology presented here complement the nanomedicine toolbox by providing a flexible platform, extendable to other absorbing agents that can potentially be translated to human trials.

Pre-clinical longitudinal monitoring of hemodynamic response to anti-vascular chemotherapy by hybrid diffuse optics

The longitudinal effect of an anti-vascular endothelial growth factor receptor 2 (VEGFR-2) antibody (DC 101) therapy on a xenografted renal cell carcinoma (RCC) mouse model was monitored using hybrid diffuse optics. Two groups of immunosuppressed male nude mice (seven treated, seven controls) were measured. Tumor microvascular blood flow, total hemoglobin concentration and blood oxygenation were investigated as potential biomarkers for the monitoring of the therapy effect twice a week and were related to the final treatment outcome. These hemodynamic biomarkers have shown a clear differentiation between two groups by day four. Moreover, we have observed that pre-treatment values and early changes in hemodynamics are highly correlated with the therapeutic outcome demonstrating the potential of diffuse optics to predict the therapy response at an early time point.

Fluorescent property of indocyanine green (ICG) rubber ring using LED and laser light sources

Fluorescent properties of ICG depends on solvent. Fluorescent characteristics of ICG rubber rings and optimized detection system condition were identified. The fluorescent rubber rings are produced by drying mixture of ICG solution and liquid rubber. LED and laser light sources were used to test differences between them. Other variables are ICG molar concentration (100, 80, 60, 40, 20, 10μM), excitation light spectrum (740, 760, 785nm) and angle of view (0~80°). We observed that ICG ring emitted fluorescence at longer wavelength than in blood and aqueous state. Observation angle between 0 and 50 provided similar brightness of images, while others are significantly less luminous. Excitation light between 740~760nm ensured non-overlapping spectrums of excitation light and fluorescence emission.

Scanning, non-contact, hybrid broadband diffuse optical spectroscopy and diffuse correlation spectroscopy system

A scanning system for small animal imaging using non-contact, hybrid broadband diffuse optical spectroscopy (ncDOS) and diffuse correlation spectroscopy (ncDCS) is presented. The ncDOS uses a two-dimensional spectrophotometer retrieving broadband (610-900 nm) spectral information from up to fifty-seven source-detector distances between 2 and 5 mm. The ncDCS data is simultaneously acquired from four source-detector pairs. The sample is scanned in two dimensions while tracking variations in height. The system has been validated with liquid phantoms, demonstrated in vivo on a human fingertip during an arm cuff occlusion and on a group of mice with xenoimplanted renal cell carcinoma.

Determination of detection depth of optical probe in pedicle screw measurement device

BACKGROUND

There is a high probability of accidental perforation of the vertebral pedicle wall in pedicle screw insertion surgery. A pedicle screw (PS) measurement device with an optical probe has been reported to send out a warning signal before the PS tip breaking the vertebral pedicle wall.

METHODS

In this study, we explored the detection depth of optical probe in this measurement device, which was closely related to the effective alarm distance. In the boundary, the vertebrae tissues could be treated as 2-layer models including spongy bones and compact bones. The Monte Carlo simulation and phantom models were performed to analyse and define the detection depth. Then the porcine vertebrae models were performed to obtain optical spectrum and reduced scattering coefficient, based on which the detection depths were deduced. Moreover, a comparison was made to explore the most significant pattern factor from the experiment results.

RESULTS

According to the pattern factor, an alarm threshold was successfully deduced to define the alarm distance during pedicle screw monitoring.

CONCLUSIONS

Thus, the proposed alarm standard based on detection depth provides a potential for guiding pedicle screw in surgery.

Fluorescence sensing system by Soret-band LED light excitation for estimating relative talaporfin sodium concentration in skin

The purpose of this study is to establish a sensing system to estimate relative talaporfin sodium concentration in skin to evaluate the risk of skin photosensitivity after photodynamic therapy (PDT) using percutaneous fluorescence spectroscopy. A prototype fluorescence sensing probe was made using a pair of 5-cm-long diffuse tips of plastic optical fibers for excitation light irradiation and fluorescence collection. Talaporfin sodium (2.5mg/kg) was intravenously administrated to three pigs, and the talaporfin sodium concentration in plasma was measured. The fluorescence sensing probe was attached to the skin and excited by a LED light with a peak wavelength of 409 ± 16 nm to obtain the mean area of the talaporfin sodium fluorescence spectral peak (Sfluo). The time history of the talaporfin sodium concentration in tissue was estimated using a two-compartment pharmacokinetic model. The time history of Sfluo was described as a composite function of the time history of the measured talaporfin sodium concentration in plasma and that of the estimated concentration in tissue as a double exponential decay function. The relative talaporfin sodium concentration in tissue and the relative contributions of fluorescence from tissue and plasma to Sfluo were estimated by the fluorescence system with the numerical pharmacokinetic model. Results also show that tissue compression equivalent to venous pressure might be effective to suppress the contribution of talaporfin sodium fluorescence in plasma.

A review of indocyanine green fluorescent imaging in surgery

The purpose of this paper is to give an overview of the recent surgical intraoperational applications of indocyanine green fluorescence imaging methods, the basics of the technology, and instrumentation used. Well over 200 papers describing this technique in clinical setting are reviewed. In addition to the surgical applications, other recent medical applications of ICG are briefly examined.

In-vivo Tumor detection using diffusion reflection measurements of targeted gold nanorods - a quantitative study

The ability to quantitatively and non-invasively detect nanoparticles has important implications on their development as an in-vivo cancer diagnostic tool. The Diffusion Reflection (DR) method is a simple, non-invasive imaging technique which has been proven useful for the investigation of tissue's optical parameters. In this study, Monte Carlo (MC) simulations, tissue-like phantom experiments and in-vivo measurements of the reflected light intensity from tumor bearing mice are presented. Following intravenous injection of antibody conjugated poly (ethylene glycol)-coated (PEGylated) gold nanorods (GNR) to tumor-bearing mice, accumulation of GNR in the tumor was clearly detected by the DR profile of the tumor. The ability of DR measurements to quantitate in-vivo the concentration of the GNR in the tumor was demonstrated and validated with Flame Atomic Absorption spectroscopy results. With GNR as absorbing contrast agents, DR has important potential applications in the image guided therapy of superficial tumors such as head and neck cancer, breast cancer and melanoma.

Optical method for monitoring of photodynamic inactivation of bacteria

Photodynamic inactivation is a new promising approach to treat bacterial infections. Usually, the evaluation of the efficacy of this method is done through time-consuming and labor-intensive microbiological test methods. This paper describes the development and implementation of an optical method to evaluate the photodynamic inactivation of bacteria based on non-invasive diffuse reflectance measurements. Five Staphylococcus aureus cultures and 15 mice have been used in this study. A skin lesion was created on the back of all animals, and it was contaminated with S. aureus (5.16 ± 0.013 log CFU/ml). Toluidine Blue O (c = 8.67 × 10 (- 3) M) has been used as a photosensitiser agent. The bacterial cultures and animals were exposed to laser radiation (λ = 635 nm, P = 15 mW, DE = 8.654 J/cm(2)) for 20 min. The photodynamic inactivation of bacteria was monitored by acquiring the wounds' reflection spectra at different time points and by microbiological exams on the bioptical material. The good correlation between the diffuse reflectance and colony-forming units demonstrates the value of this optical method based on diffuse reflectance measurements as a rapid technique to monitor photodynamic bacterial inactivation.

The use of magnetic field effects on photosensitizer luminescence as a novel probe for optical monitoring of oxygen in photodynamic therapy

The effect of a magnetic field on the steady-state and time-resolved optical emission of a custom fullerene-linked photosensitizer (PS) in liposome cell phantoms was studied at various oxygen concentrations (0.19-190 microM). Zeeman splitting of the triplet state and hyperfine coupling, which control intersystem crossing between singlet and triplet states, are altered in the presence of low magnetic fields (B < 320 mT), perturbing the luminescence intensity and lifetime as compared to the triplet state at B = 0. Measurements of the luminescence intensity and lifetime were performed using a time-domain apparatus integrated with a magnet. We propose that by probing magnet-affected optical emissions, one can monitor the state of oxygenation throughout the course of photodynamic therapy. Since the magnetic field effect (MFE) operates primarily by affecting the radical ion pairs related to type I photodynamic action, the enhancement or suppression of the MFE can be used as a measure of the dynamic equilibrium between the type I and II photodynamic pathways. The unique photo-initiated charge-transfer properties of the PS used in this study allow it to serve as both cytotoxic agent and oxygen probe that can provide in situ dosimetric information at close to real time.

In vivo measurement of vascular modulation in experimental tumors using a fluorescent contrast agent

We compared the effectiveness of three optical techniques based on fluorescence imaging and spectroscopy with indocyanine green (ICG) contrast agent to evaluate in vivo the disruption of the active vasculature induced by a vascular targeting agent. The blood perfusion of the MDA-MB-435 tumor model transplanted in nude mice was estimated from the signal of the contrast agent measured immediately after its systemic injection in mice. Optical measurements were performed using a fluorescence imaging setup and a fiber-based time correlated single photon counting (TCSPC) apparatus. This latter apparatus was used to measure the tumor fluorescence in transmittance geometry and the change in the basal optical absorption induced by the contrast agent, thus providing an alternative estimation of the blood content in the tumor. Mice were divided into four groups. Three groups were treated with different doses of the vascular disrupting agent ZD6126, the fourth group (control group) received the drug vehicle only. Optical measurements were carried out 3 h after pharmacologic treatment. After 24 h, mice were killed, tumors were excised and the extent of necrosis was evaluated with standard histologic analysis. On fluorescence imaging ICG emission from tumors of mice treated with ZD6126 significantly was lower compared with the emission from control mice. The histologic sections also showed a significantly higher amount of necrosis in tumors of treated mice. Both these findings, which correlate with each other, indicate an effective vascular shutdown induced by the drug. However, ICG fluorescence measured with the TCSPC apparatus in transmittance geometry and the estimate of the change in optical absorption did not allow a statistically significant differentiation between treated and control groups.

The physics, biophysics and technology of photodynamic therapy

Photodynamic therapy (PDT) uses light-activated drugs to treat diseases ranging from cancer to age-related macular degeneration and antibiotic-resistant infections. This paper reviews the current status of PDT with an emphasis on the contributions of physics, biophysics and technology, and the challenges remaining in the optimization and adoption of this treatment modality. A theme of the review is the complexity of PDT dosimetry due to the dynamic nature of the three essential components -- light, photosensitizer and oxygen. Considerable progress has been made in understanding the problem and in developing instruments to measure all three, so that optimization of individual PDT treatments is becoming a feasible target. The final section of the review introduces some new frontiers of research including low dose rate (metronomic) PDT, two-photon PDT, activatable PDT molecular beacons and nanoparticle-based PDT.

Fluorescence and absorption assessment of a lipid mTHPC formulation following topical application in a non-melanotic skin tumor model

Although the benefits of topical sensitizer administration have been confirmed for photodynamic therapy (PDT), ALA-induced protoporphyrin IX is the only sensitizer clinically used with this administration route. Unfortunately, ALA-PDT results in poor treatment response for thicker lesions. Here, selectivity and depth distribution of the highly potent sensitizer meso-tetra(hydroxyphenyl)chlorin (mTHPC), supplied in a novel liposome formulation was investigated following topical administration for 4 and 6 h in a murine skin tumor model. Extraction data indicated an average [+/- standard deviation (SD)] mTHPC concentration within lesions of 6.0(+/-3.1) ngmg tissue with no significant difference (p<0.05) between 4- and 6-h application times and undetectable levels of generalized photosensitivity. Absorption spectroscopy and chemical extraction both indicated a significant selectivity between lesion and normal surrounding skin at 4 and 6 h, whereas the more sensitive fluorescence imaging setup revealed significant selectivity only for the 4-h application time. Absorption data showed a significant correlation with extraction, whereas the results from the fluorescence imaging setup did not correlate with the other methods. Our results indicate that this sensitizer formulation and administration path could be interesting for topical mTHPC-PDT, decreasing the effects of extended skin photosensitivity associated with systemic mTHPC administration.

Evaluation of a fiberoptic-based system for measurement of optical properties in highly attenuating turbid media

Background

Accurate measurements of the optical properties of biological tissue in the ultraviolet A and short visible wavelengths are needed to achieve a quantitative understanding of novel optical diagnostic devices. Currently, there is minimal information on optical property measurement approaches that are appropriate for in vivo measurements in highly absorbing and scattering tissues. We describe a novel fiberoptic-based reflectance system for measurement of optical properties in highly attenuating turbid media and provide an extensive in vitro evaluation of its accuracy. The influence of collecting reflectance at the illumination fiber on estimation accuracy is also investigated.

Methods

A neural network algorithm and reflectance distributions from Monte Carlo simulations were used to generate predictive models based on the two geometries. Absolute measurements of diffuse reflectance were enabled through calibration of the reflectance system. Spatially-resolved reflectance distributions were measured in tissue phantoms at 405 nm for absorption coefficients (μ_a) from 1 to 25 cm^-1 and reduced scattering coefficients (μ′s MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuaH8oqBgaqbamaaBaaaleaacqqGZbWCaeqaaaaa@3007@) from 5 to 25 cm^-1. These data and predictive models were used to estimate the optical properties of tissue-simulating phantoms.

Results

By comparing predicted and known optical properties, the average errors for μ_a and μ′s MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuaH8oqBgaqbamaaBaaaleaacqqGZbWCaeqaaaaa@3007@ were found to be 3.0% and 4.6%, respectively, for a linear probe approach. When bifurcated probe data was included and samples with μ_a values less than 5 cm^-1 were excluded, predictive errors for μ_a and μ′s MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuaH8oqBgaqbamaaBaaaleaacqqGZbWCaeqaaaaa@3007@ were further reduced to 1.8% and 3.5%.

Conclusion

Improvements in system design have led to significant reductions in optical property estimation error. While the incorporation of a bifurcated illumination fiber shows promise for improving the accuracy of μ′s MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuaH8oqBgaqbamaaBaaaleaacqqGZbWCaeqaaaaa@3007@ estimates, further study of this approach is needed to elucidate the source of discrepancies between measurements and simulation results at low μ_a values.

Oral cancer detection using diffuse reflectance spectral ratio R540/R575 of oxygenated hemoglobin bands

A low-cost, fast, and noninvasive method for early diagnosis of malignant lesions of oral mucosa based on diffuse reflectance spectral signatures is presented. In this technique, output of a tungsten halogen lamp is guided to the tissue through the central fiber of a reflection probe whose surrounding six fibers collects tissue reflectance. Ex vivo diffuse reflectance spectra in the 400 to 600-nm region is measured from surgically removed oral cavity lesions using a miniature fiber optic spectrometer connected to a computer. Reflectance spectral intensity is higher in malignant tissues and shows dips at 542 and 577 nm owing to absorption from oxygenated hemoglobin (HbO2). Measurements carried out, within an hour of surgical excision, on malignant lesion and adjoining uninvolved mucosa show that these absorption features are more prominent in neoplastic tissues owing to increased microvasculature and blood content. It is observed that reflectance intensity ratio of hemoglobin bands, R540/R575, from malignant sites are always lower than that from normal sites and vary according to the histological grade of malignancy. The diffuse reflectance intensity ratio R540/R575 of the hemoglobin bands appears to be a useful tool to discriminate between malignant lesions and normal mucosa of the oral cavity in a clinical setting.

Estimation of kinetic model parameters in fluorescence optical diffusion tomography

We present a technique for reconstructing the spatially dependent dynamics of a fluorescent contrast agent in turbid media. The dynamic behavior is described by linear and nonlinear parameters of a compartmental model or some other model with a deterministic functional form. The method extends our previous work in fluorescence optical diffusion tomography by parametrically reconstructing the time-dependent fluorescent yield. The reconstruction uses a Bayesian framework and parametric iterative coordinate descent optimization, which is closely related to Gauss-Seidel methods. We demonstrate the method with a simulation study.

In vivo absorption spectroscopy of tumor sensitizers with femtosecond white light

A system based on a femtosecond white-light continuum and a streak camera was used for recordings of the in vivo absorption spectra of the tumor-seeking agent disulphonated aluminum phthalocyanine. Measurements for different drug doses were performed on tumor tissue (muscle-implanted adenocarcinoma) and normal muscle tissue in rats. It was found that the shape of the spectrum is tissue dependent. The peak of the absorption spectrum is blueshifted in tumor tissue as compared with the muscle. Thus the contrast in the drug-related absorption can be altered by up to a factor of 2 from the primary drug molecular-concentration contrast between normal muscle and tumor by the proper selection of the illumination wavelength.

Quantification of fluorophore concentration in vivo using two simple fluorescence-based measurement techniques

The effect of photodynamic therapy treatments depends on the concentration of photosensitizer at the treatment site; thus a simple method to quantify concentration is desirable. This study compares the concentration of a fluorophore and sensitizer, aluminum phthalocyanine tetrasulfonate (AlPcS4), measured by two simple fluorescence-based techniques in vivo to post mortem chemical extraction and fluorometric assay of those tissues: skin, muscle, fascia, liver, and kidney (cortex and medulla). Fluorescence was excited and detected by a single optical fiber, or by an instrument that measured the ratio of the fluorescence and excitation reflectance. The in vivo measurements were compared to calibration measurements made in tissue-simulating phantoms to estimate the tissue concentrations. Reasonable agreement was observed between the concentration estimates of the two instruments in the lighter colored tissues (skin, muscle, and fascia). The in vivo measurements also agreed with the chemical extractions at low (< 0.6 microg/g) tissue concentrations, but underestimated higher tissue concentrations. Measurements of fluorescence lifetime in vivo demonstrated that AlPcS4 retains its mono-exponential decay in skin, muscle, and fascia tissues with a lifetime similar to that measured in aqueous tissue-simulating phantoms. In liver and kidney an additional short lifetime component was evident.

Optical measurements of absorption changes in two-layered diffusive media

We have used Monte Carlo simulations for a two-layered diffusive medium to investigate the effect of a superficial layer on the measurement of absorption variations from optical diffuse reflectance data processed by using: (a) a multidistance, frequency-domain method based on diffusion theory for a semi-infinite homogeneous medium; (b) a differential-pathlength-factor method based on a modified Lambert-Beer law for a homogeneous medium and (c) a two-distance, partial-pathlength method based on a modified Lambert-Beer law for a two-layered medium. Methods (a) and (b) lead to a single value for the absorption variation, whereas method (c) yields absorption variations for each layer. In the simulations, the optical coefficients of the medium were representative of those of biological tissue in the near-infrared. The thickness of the first layer was in the range 0.3-1.4 cm, and the source-detector distances were in the range 1-5 cm, which is typical of near-infrared diffuse reflectance measurements in tissue. The simulations have shown that (1) method (a) is mostly sensitive to absorption changes in the underlying layer, provided that the thickness of the superficial layer is approximately 0.6 cm or less; (2) method (b) is significantly affected by absorption changes in the superficial layer and (3) method (c) yields the absorption changes for both layers with a relatively good accuracy of approximately 4% for the superficial layer and approximately 10% for the underlying layer (provided that the absorption changes are less than 20-30% of the baseline value). We have applied all three methods of data analysis to near-infrared data collected on the forehead of a human subject during electroconvulsive therapy. Our results suggest that the multidistance method (a) and the two-distance partial-pathlength method (c) may better decouple the contributions to the optical signals that originate in deeper tissue (brain) from those that originate in more superficial tissue layers.

A pilot study of ICG laser therapy of acne vulgaris: photodynamic and photothermolysis treatment

BACKGROUND AND OBJECTIVES

The near-infrared (NIR) laser radiation due to its high penetration depth is widely used in phototherapy. In application to skin appendages, a high selectivity of laser treatment is needed to prevent light action on surrounding tissues. Indocyanine green (ICG) dye may provide a high selectivity of treatment due to effective ICG uploading by a target and its narrow band of considerable absorption just at the wavelength of the NIR diode laser. The goal of this study is to demonstrate the efficacy of the NIR diode laser phototherapy in combination with topical application of ICG suggested for soft and thermal treatment of acne vulgaris.

STUDY DESIGN/MATERIALS AND METHODS

Twenty-two volunteers with facile or back-located acne were enrolled. Skin sites of subjects were stained by ICG and irradiated by NIR laser-diode light (803 or 809 nm). One mg/ml solution of ICG was applied for 5 or 15 minutes to the cleaned skin site. Untreated, only stained and only light irradiated skin areas served as controls. For soft acne treatment, the low-intensity (803 nm, 10-50 mW/cm(2), 5-10 minutes) or the medium-intensity (809 nm, 150-190 mW/cm(2), 15 minutes) protocols were used. The single and multiple (up to 8-9) treatments were provided. The individual acne lesions were photothermally treated at 18 W/cm(2) (803 nm, 0.5 seconds) without skin surface cooling or at 200 W/cm(2) (809 nm, 0.5 seconds) with cooling.

RESULTS

The observations during 1-2 months showed that soft acne treatment decreased the number of active elements, reduced erythema and inflammation, and considerably improved the skin state without any side effects. At high power densities (up to 200 W/cm(2)), ICG stained acne inflammatory elements were destroyed for light exposures of 0.5 seconds.

CONCLUSIONS

Based on the concept that hair follicle, especially sebaceous gland, can be intensively and selectively stained by ICG due to dye diffusion through pilosebaceous canal and its fast uptake by living microorganisms, by vital keratinocytes of epithelium of the canal and sebaceous duct, and by rapidly proliferating sebocytes, new technologies of soft and thermal acne lesions treatment that could be used in clinical treatment of acne were proposed.

Photodynamic Actinometry Using Microspheres: Concept, Development and Responsivity¶

Photodynamic therapy (PDT) relies on three main ingredients, oxygen, light and photoactivating compounds, although the PDT response is definitively contingent on the site and level of reactive oxygen species (ROS) generation. This study describes the development of a novel, fluorescent-based actinometer microsphere system as a means of discerning spatially resolved dosimetry of total fluence and ROS production. Providing a high resolution, localized, in situ measurement of fluence and ROS generation is critical for developing in vivo PDT protocols. Alginate-poly-L-lysine-alginate microspheres were produced using ionotropic gelation of sodium alginate droplets, ranging from 80 to 200 microm in diameter, incorporating two dyes, ADS680WS (ADS) and Rhodophyta-phycoerythrin (RPE), attached to the spheres' inside and outside layers, respectively. To test the responsivity and dynamic range of RPE for ROS detection, the production of ROS was initiated either chemically using increasing concentrations of potassium perchromate or photochemically using aluminum tetrasulphonated phthalocyanine. The generation of singlet oxygen was confirmed by phosphorescence at 1270 nm. The resulting photodegradation and decrease in fluorescence of RPE was found to correlate with increased perchromate or PDT treatment fluence, respectively. This effect was independent of pH (6.5-8) and could be inhibited using sodium azide. RPE was not susceptible to photobleaching with light alone (670 nm; 150 Jcm(-2)). ADS, which absorbs light between 600 and 750 nm, showed a direct correlation between radiant exposure (670 nm; 0-100 Jcm(-2)) and diminished fluorescence. Photobleaching was independent of irradiance (10-40 mW cm(-2)). We propose that actinometer microspheres may provide a means for obtaining high spatial resolution information regarding delivered PDT dose within model systems during investigational PDT development and dosimetric information for clinical extracorporeal PDT as in the case of ex vivo bone marrow purging.

Measurement of dye diffusion in agar gel by use of low-coherence interferometry

We demonstrate low-coherence interferometry for diffusion measurements. We have measured the diffusion coefficient of a phthalocyanine dye in 1.5% agar gel with a two-wavelength interferometer; one wavelength was matched to the absorption peak of the dye at 675 nm, while the other, 805 nm, was not affected by the dye. The diffusion coefficient of the dye was found by fitting a mathematical model for the interferometer signal to the measured low-coherence interferometry amplitude. A 95% confidence interval for the diffusion coefficient was found to be D = (2.5 +/- 0.2) x 10(-10) m2/s. The influence of speckle averaging and experiment time on the determination of the diffusion coefficient has been studied. The presented technique allows in situ characterization of diffusion in semitransparent media.

In vivo quantification of optical contrast agent dynamics in rat tumors by use of diffuse optical spectroscopy with magnetic resonance imaging coregistration

We present a study of the dynamics of optical contrast agents indocyanine green (ICG) and methylene blue (MB) in an adenocarcinoma rat tumor model. Measurements are conducted with a combined frequency-domain and steady-state optical technique that facilitates rapid measurement of tissue absorption in the 650-1000-nm spectral region. Tumors were also imaged by use of contrast-enhanced magnetic resonance imaging (MRI) and coregistered with the location of the optical probe. The absolute concentrations of contrast agent, oxyhemoglobin, deoxyhemoglobin, and water are measured simultaneously each second for approximately 10 min. The differing tissue uptake kinetics of ICG and MB in these late-stage tumors arise from differences in their effective molecular weights. ICG, because of its binding to plasma proteins, behaves as a macromolecular contrast agent with a low vascular permeability. A compartmental model describing ICG dynamics is used to quantify physiologic parameters related to capillary permeability. In contrast, MB behaves as a small-molecular-weight contrast agent that leaks rapidly from the vasculature into the extravascular, extracellular space, and is sensitive to blood flow and the arterial input function.

Optical spectroscopy for detection of neoplasia

Fluorescence and reflectance spectroscopy provide the ability to assess tissue structure and metabolism in vivo in real time, providing improved diagnosis of pre-cancerous lesions. Reflectance spectroscopy can probe changes in epithelial nuclei that are important in pre-cancer detection, such as mean nuclear diameter, nuclear size distribution and nuclear refractive index. Fluorescence spectroscopy can probe changes in epithelial cell metabolism, by assessing mitochondrial fluorophores, and epithelial-stromal interactions, by assessing the decrease in collagen crosslink fluorescence that occurs with pre-cancer. Thus, fluorescence and reflectance spectroscopy provide complementary information useful for pre-cancer diagnosis. Tissue engineering provides three-dimensional cell cultures that can be used to further explore the relationship between tissue structure and biological events important in cancer development and progression. In the future, improving our understanding of the biological changes that can be assessed using spectroscopy will not only improve optical techniques but also provide new tools to better understand cancer biology.

In vitro and in vivo study of dye diffusion into the human skin and hair follicles

We present experimental results on the in vitro and in vivo study of dye diffusion into human skin and hair follicles. We have studied some commercially available dyes for potential using in the laser selective thermolysis. The degree and the depth of hair follicle dyeing inside the skin were determined. For hairs in different stages the sebaceous gland was stated as a reservoir for a dye administration. It was found that the penetration depth of dyes is about 1.2 mm from the skin surface. We have developed the biocompatible Indocyanine Green lotions and the method for in vivo dyeing and dye in depth monitoring. Shift on 16-21 nm of absorption peak of Indocyanine Green to the longer wavelengths due to Indocyanine Green binding with cell proteins in the human skin was found.

Noninvasive measurement of fluorophore concentration in turbid media with a simple fluorescence /reflectance ratio technique

Measurement of the concentration of fluorescent compounds in turbid media is difficult because the absorption and multiple scattering of excitation and emission of light has a large effect on the detected fluorescence. For surface measurements with optical fibers we demonstrate by experiments and numerical simulation that this effect can be minimized by measurement of the fluorescence at one source-detector distance, the diffusely reflected excitation light at a second distance, and with the ratio of these two signals as an indicator of fluorophore concentration. For optical properties typical of soft tissue in the red and the near infrared the optimum performance is obtained by measurement of fluorescence at 0.65 mm and reflectance at 1.35 mm. This choice reduces the rms error in fluorophore concentration to 14.6% over a wide range of absorption and scattering coefficients.

Experimental verification of the effect of refractive index mismatch on the light fluence in a turbid medium

Diffusion theory is often used to model the transport of light within tissue. It can be used to calculate the light fluence rate in tissue, for example, during photodynamic therapy, or to measure the absorption and scattering properties of tissue. For both of these applications, the influence of the interface between the tissue and the exterior medium on the fluence rate inside the tissue must be known in order to make accurate calculations. We present an experimental investigation of the effect of the refractive index mismatch at the tissue interface on the internal light fluence rate and on the spatially resolved diffuse reflectance as the boundary conditions of the tissue/external medium are changed. The effects of changing the relative refractive index at the boundary are compared to predictions of diffusion theory. The effect of the refractive index mismatch is predicted correctly by diffusion theory.

Determination of the optical properties of two-layer turbid media by use of a frequency-domain hybrid monte carlo diffusion model

The general two-layer inverse problem in biomedical photon migration is to estimate the absorption and scattering coefficients of each layer as well as the top-layer thickness. We attempted to solve this problem, using experimental and simulated spatially resolved frequency-domain (FD) reflectance for optical properties typical of skin overlying muscle or skin overlying fat in the near infrared. Two forward models of light propagation were used: a two-layer diffusion solution [Appl. Opt. 37, 779 (1998)] and a hybrid Monte Carlo (MC) diffusion model [Appl. Opt. 37, 7401 (1998)]. MC-simulated FD reflectance data were fitted as relative measurements to the hybrid and the pure diffusion models. It was found that the hybrid model could determine all the optical properties of the two-layer media studied to ~5%. Also, the same accuracy could be achieved by means of fitting MC-simulated cw reflectance data as absolute measurements, but fitting them as relative ones is an ill-posed problem. In contrast, two-layer diffusion could not retrieve the top-layer optical properties as accurately for FD data and was ill-posed for both relative and absolute cw data. The hybrid and the pure diffusion models were also fitted to experimental FD reflectance measurements from two-layer tissue-simulating phantoms representative of skin-on-fat and skin-on-muscle baseline optical properties. Both the hybrid and the diffusion models could determine the optical properties of the lower layer. The hybrid model demonstrated its potential to retrieve quantitatively the transport scattering coefficient of skin (the upper layer), which was not possible with the pure diffusion model. Systematic discrepancies between model and experiment may compromise the accuracy of the deduced top-layer optical properties. Identifying and eliminating such discrepancies is critical to practical application of the method.

Photodynamic therapy in oncology

Photodynamic therapy (PDT) is a cancer treatment modality that is based on the administration of a photosensitiser, which is retained in tumour tissues more than in normal tissues, followed by illumination of the tumour with visible light in a wavelength range matching the absorption spectrum of the photosensitiser. The photosensitiser absorbs light energy and induces the production of reactive oxygen species in the tumour environment, generating a cascade of events that kills the tumour cells. The first generation photosensitiser, Photofrin (porfirmer sodium), has been approved for oesophageal and lung cancer in the US and has been under investigation for other malignant and non-malignant diseases. Sub-optimal light penetration at the treatment absorption peak of Photofrin and prolonged skin photosensitivity in patients are limiting factors for this preparation. Several new photosensitisers have improved properties, especially absorption of longer wavelength light which penetrates deeper into tissue and faster clearance from normal tissue. This paper reviews the current use of first- and second-generation photosensitisers in oncology. The use of PDT in oncology has been restricted to certain cancer indications and has not yet become an integral part of cancer treatment in general. The main advantage of PDT is that the treatment can be repeated multiple times safely, without producing immunosuppressive and myelosuppressive effects and can be administered even after surgery, chemotherapy or radiotherapy. The current work on new photosensitisers and light delivery equipment will address some of the present shortcomings of PDT. Much has been learned in recent years about the mechanisms of cellular and tissue responses to PDT and protocols designed to capitalise on this knowledge showed lead to additional improvements.

Quantifying the absorption and reduced scattering coefficients of tissuelike turbid media over a broad spectral range with noncontact Fourier-transform hyperspectral imaging

Absorption (mu(a)) and reduced scattering (mu(s)') spectra of turbid media were quantified with a noncontact imaging approach based on a Fourier-transform interferometric imaging system (FTIIS). The FTIIS was used to collect hyperspectral images of the steady-state diffuse reflectance from turbid media. Spatially resolved reflectance data from Monte Carlo simulations were fitted to the recorded hyperspectral images to quantify mu(a) and mu(s)' spectra in the 550-850-nm region. A simple and effective calibration approach was introduced to account for the instrument response. With reflectance data that were close to and far from the source (0.5-6.5 mm), mu(a) and mu(s)' of homogeneous, semi-infinite turbid phantoms with optical property ranges comparable with those of tissues were determined with an accuracy of +/-7% and +/-3%, respectively. Prediction accuracy for mu(a) and mu(s)' degraded to +/-12% and +/-4%, respectively, when only reflectance data close to the source (0.5-2.5 mm) were used. Results indicate that reflectance data close to and far from the source are necessary for optimal quantification of mu(a) and mu(s)'. The spectral properties of mu(a) and mu(s)' values were used to determine the concentrations of absorbers and scatterers, respectively. Absorber and scatterer concentrations of two-chromophore turbid media were determined with an accuracy of +/-5% and +/-3%, respectively.

Broadband absorption spectroscopy in turbid media by combined frequency-domain and steady-state methods

A technique for measuring broadband near-infrared absorption spectra of turbid media that uses a combination of frequency-domain (FD) and steady-state (SS) reflectance methods is presented. Most of the wavelength coverage is provided by a white-light SS measurement, whereas the FD data are acquired at a few selected wavelengths. Coefficients of absorption (mu(a)) and reduced scattering (mu(s)') derived from the FD data are used to calibrate the intensity of the SS measurements and to estimate mu(s)' at all wavelengths in the spectral window of interest. After these steps are performed, one can determine mu(a) by comparing the SS reflectance values with the predictions of diffusion theory, wavelength by wavelength. Absorption spectra of a turbid phantom and of human breast tissue in vivo, derived with the combined SSFD technique, agree well with expected reference values. All measurements can be performed at a single source-detector separation distance, reducing the variations in sampling volume that exist in multidistance methods. The technique uses relatively inexpensive light sources and detectors and is easily implemented on an existing multiwavelength FD system.

Monitoring photosensitizer concentration by use of a fiber-optic probe with a small source-detector separation

We present a noninvasive method to track the concentration of photodynamic therapy drugs in real time. The method is based on measurements of backscattered and fluorescent light with a steady-state fluorescence spectrometer. The ratio of the fluorescent light to the scattered light is found to be linearly proportional to the absorption coefficient of the photosensitizer. The fiber-optic probe used for the measurements has a small source-detector separation; therefore the measurements could be performed through the working channel of an endoscope.

Anisotropy of light propagation in human skin

Using spatially resolved, steady state diffuse reflectometry, a directional dependence was found in the propagation of visible and near infrared light through human skin in vivo. The skin's reduced scattering coefficient mu(s)' varies by up to a factor of two between different directions of propagation at the same position. This anisotropy is believed to be caused by the preferential orientation of collagen fibres in the dermis, as described by Langer's skin tension lines. Monte Carlo simulations that examine the effect of partial collagen fibre orientation support this hypothesis. The observation has consequences for non-invasive diagnostic methods relying on skin optical properties, and it could be used non-invasively to determine the direction of lines of cleavage in order to minimize scars due to surgical incisions.

Monte carlo diffusion hybrid model for photon migration in a two-layer turbid medium in the frequency domain

We propose a hybrid Monte Carlo (MC) diffusion model for calculating the spatially resolved reflectance amplitude and phase delay resulting from an intensity-modulated pencil beam vertically incident on a two-layer turbid medium. The model combines the accuracy of MC at radial distances near the incident beam with the computational efficiency afforded by a diffusion calculation at further distances. This results in a single forward calculation several hundred times faster than pure MC, depending primarily on model parameters. Model predictions are compared with MC data for two cases that span the extremes of physiologically relevant optical properties: skin overlying fat and skin overlying muscle, both in the presence of an exogenous absorber. It is shown that good agreement can be achieved for radial distances from 0.5 to 20 mm in both cases. However, in the skin-on-muscle case the choice of model parameters and the definition of the diffusion coefficient can lead to some interesting discrepancies.

In vivo determination of the optical properties of muscle with time-resolved reflectance using a layered model

We have investigated the possibility of determining the optical coefficients of muscle in the extremities with in vivo time-resolved reflectance measurements using a layered model. A solution of the diffusion equation for two layers was fitted to three-layered Monte Carlo calculations simulating the skin, the subcutaneous fat and the muscle. Relative time-resolved reflectance data at two distances were used to derive the optical coefficients of the layers. We found for skin and subcutaneous fat layer thicknesses (l2) of up to 10 mm that the estimated absorption coefficients of the second layer of the diffusion model have differences of less than 20% compared with those of the muscle layer of the Monte Carlo simulations if the thickness of the first layer of the diffusion model is also fitted. If l2 is known, the differences are less than 5%, whereas the use of a semi-infinite model delivers differences of up to 55%. Even if l2 is only approximately known the absorption coefficient of the muscle can be determined accurately. Experimentally, the time-resolved reflectance was measured on the forearms of volunteers at two distances from the incident beam by means of a streak camera. The thicknesses of the tissues involved were determined by ultrasound. The optical coefficients were derived from these measurements by applying the two-layered diffusion model, and results in accordance with the theoretical studies were observed.

Non-invasive measurement of chemotherapy drug concentrations in tissue: preliminary demonstrations of in vivo measurements

Measurements of the tissue concentrations of two chemotherapy agents have been made in vivo on an animal tumour model. The method used is based on elastic scattering spectroscopy (ESS) and utilizes a fibre-optic probe spectroscopic system. A broadband light source is used to acquire data over a broad range of wavelengths and, therefore, to facilitate the separation of absorptions from various chromophores. The results of the work include measurements of the time course of the drug concentrations as well as a comparison of the optical measurements with high performance liquid chromatography (HPLC) analysis of the drug concentrations at the time of sacrifice. It is found that the optical measurements correlate linearly with HPLC measurements, but give lower absolute values.

The determination of in vivo human tissue optical properties and absolute chromophore concentrations using spatially resolved steady-state diffuse reflectance spectroscopy

A method is described for measuring optical properties and deriving chromophore concentrations from diffuse reflection measurements at the surface of a turbid medium. The method uses a diffusion approximation model for the diffuse reflectance, in combination with models for the absorption and scattering coefficients. An optical fibre-based set-up, capable of measuring nine spectra from 400 to 1050 nm simultaneously, is used to test the method experimentally. Results of the analyses of phantom and in vivo measurements are presented. These demonstrate that in the wavelength range from 600 to 900 nm, tissue scattering can be described as a simple power dependence of the wavelength and that the tissue absorption can be accurately described by the addition of water, oxy- and deoxyhaemoglobin absorption.

Quantitative broadband near-infrared spectroscopy of tissue-simulating phantoms containing erythrocytes

We report the use of steady-state diffuse reflectance spectroscopy (SSDRS) to measure the near-infrared absorption spectrum of liquid phantoms containing human erythrocytes in aqueous suspensions of polystyrene spheres which simulate the scattering properties of tissue. The absorption spectra obtained from these SSDRS measurements of intact red cells under oxygenated and deoxygenated conditions are compared with several published spectra of 'stripped' haemoglobin prepared from lysed cells. Two fitting algorithms (nonlinear least squares and singular value decomposition) which exploit the broad spectral range provided by these measurements (170 data points spanning 164 nm in a single acquisition) are used to determine haemoglobin oxygen saturation (SO2) from SSDR spectra collected over a wide range of measured oxygen partial pressures. The validity of these algorithms is assessed by comparing literature values of p50 (the oxygen tension at which haemoglobin is 50% saturated) and the Hill coefficient to values of these parameters determined from the SO2 estimates. The singular value decomposition algorithm can also be used to reconstruct the non-haemoglobin background absorption spectrum without a priori assumptions regarding its constituent chromophores or their concentrations. Using this technique, the absorption spectrum of a small amount of India ink (maximum absorption coefficient (mu(a max)) approximately 0.0006 mm(-1)) added to a phantom containing red cells (mu(a max) approximately 0.026 mm(-1)) was reconstructed over a full range of oxygen saturations. The implications of these measurements for detection of weakly absorbing chromophores (such as cytochrome aa3) in the presence of haemoglobin are discussed.

Modeling of photosensitizer fluorescence emission and photobleaching for photodynamic therapy dosimetry

Photon diffusion theory was used to model photobleaching and tissue necrosis resulting from broad-beam therapeutic light irradiation of tissue containing a photosensitizer. The photosensitizer fluorescence signal at the tissue surface was simulated with both broad-beam and pencil-beam excitation. The relationship between the decreasing fluorescence signal and the increasing depth of tissue photodynamic damage during treatment was examined. By analyzing spatially resolved fluorescence measured at the tissue surface in terms of an equivalent virtual point or planar source of fluorescence within the tissue, predictions of necrosis depth that are insensitive to a range of initial treatment parameters were shown to be possible. Preliminary measurements in tissue-simulating phantoms supported the main theoretical findings. The potential value and feasibility of this technique for photodynamic therapy dosimetry are discussed.

Accuracy of the diffusion approximation in determining the optical properties of a two-layer turbid medium

We have examined the possibility of determining the optical properties of a two-layer medium by using a diffusion approximation radiation transport model [Appl. Opt. 37, 779 (1998)]. Continuous-wave and frequency-domain (FD) low-noise Monte Carlo (MC) data were fitted to the model. Marquardt-Levenberg and a simulated annealing algorithm were used and compared as optimization techniques. Our particular choice of optical properties for the two-layer model was consistent with skin and underlying fat in the presence of an exogenous chromophore [Appl. Opt. 37, 1958 (1998)]. The results are therefore specific to this set of optical properties. It was found that the cw diffusion solution could never be used to estimate all optical properties reliably. The combined cw and FD solutions could not be used to estimate some of the top-layer optical properties to an accuracy of better than 10%, although the absorption and the transport scattering coefficients of the bottom layer could be estimated to within 7% and 0.5%, respectively. No improvement was found from simultaneously fitting MC data at three different modulation frequencies. These results point to the need for a more accurate radiation transfer model at small source-detector separations.

Investigation of two-layered turbid media with time-resolved reflectance

Light propagation in two-layered turbid media that have an infinitely thick second layer is investigated with time-resolved reflectance. We used a solution of the diffusion equation for this geometry to show that it is possible to derive the absorption and the reduced scattering coefficients of both layers if the relative reflectance is measured in the time domain at two distances and if the thickness of the first layer is known. Solutions of the diffusion equation for semi-infinite and homogeneous turbid media are also applied to fit the reflectance from the two-layered turbid media in the time and the frequency domains. It is found that the absorption coefficient of the second layer can be more precisely derived for matched than for mismatched boundary conditions. In the frequency domain, its determination is further improved if phase and modulation data are used instead of phase and steady-state reflectance data. Measurements of the time-resolved reflectance were performed on solid two-layered tissue phantoms that confirmed the theoretical results.

Influence of layered tissue architecture on estimates of tissue optical properties obtained from spatially resolved diffuse reflectometry

Most instruments used to measure tissue optical properties noninvasively employ data-analysis algorithms that rely on the simplifying assumption that the tissue is semi-infinite and homogeneous. The influence of a layered tissue architecture on the determination of the scattering and absorption coefficients has been investigated in this study. Reflectance as a function of distance from a point source for a two-layered tissue architecture that simulates skin overlying fat was calculated by using a Monte Carlocode. These data were analyzed by using a diffusion theory modelfor a homogeneous semi-infinite medium to calculate the scatter and absorption coefficients. Depending on the algorithm and the radial distance, the estimated tissue optical properties were different from those of either layer, and under some circumstances, physically impossible. In addition, the sensitivity and cross talk of the estimated optical properties to changes in input optical properties were calculated for different layered geometries. For typical optical properties of skin, the sensitivity to changes in optical properties is highly dependent on the layered architecture, the measurement distance, and the fitting algorithm. Furthermore, a change in the input absorption coefficient may result in an apparent change in the measured scatter coefficient, and a change in the in put scatter coefficient may result in an apparent change in the measured absorption coefficient.