Differential oblique angle spectroscopy of the oral epithelium

Coupled forward-adjoint Monte Carlo simulation of spatial-angular light fields to determine optical sensitivity in turbid media

We present a coupled forward-adjoint Monte Carlo (cFAMC) method to determine the spatially resolved sensitivity distributions produced by optical interrogation of three-dimensional (3-D) tissue volumes. We develop a general computational framework that computes the spatial and angular distributions of the forward-adjoint light fields to provide accurate computations in mesoscopic tissue volumes. We provide full computational details of the cFAMC method and provide results for low- and high-scattering tissues probed using a single pair of optical fibers. We examine the effects of source-detector separation and orientation on the sensitivity distributions and consider how the degree of angular discretization used in the 3-D tissue model impacts the accuracy of the resulting absorption sensitivity profiles. We discuss the value of such computations for optical imaging and the design of optical measurements.

Radiative transport produced by oblique illumination of turbid media with collimated beams

We examine the general problem of light transport initiated by oblique illumination of a turbid medium with a collimated beam. This situation has direct relevance to the analysis of cloudy atmospheres, terrestrial surfaces, soft condensed matter, and biological tissues. We introduce a solution approach to the equation of radiative transfer that governs this problem, and develop a comprehensive spherical harmonics expansion method utilizing Fourier decomposition (SHEF(N)). The SHEF(N) approach enables the solution of problems lacking azimuthal symmetry and provides both the spatial and directional dependence of the radiance. We also introduce the method of sequential-order smoothing that enables the calculation of accurate solutions from the results of two sequential low-order approximations. We apply the SHEF(N) approach to determine the spatial and angular dependence of both internal and boundary radiances from strongly and weakly scattering turbid media. These solutions are validated using more costly Monte Carlo simulations and reveal important insights regarding the evolution of the radiant field generated by oblique collimated beams spanning ballistic and diffusely scattering regimes.

Not significant but important

Armstrong and colleagues report the result of a large Phase IIb randomized trial evaluating the effectiveness of a preparation of the Bowman Birk Inhibitor compared with an oral placebo in reversing the extent of oral leukoplakia as measured visually by pathology or a battery of intermediate end points. In this editorial, we review the report of this negative clinical trials result to highlight the clinical trial process used in evaluating this previously promising chemoprevention agent. Publishing this report is important to address concerns with publication bias. The challenges in running a chemoprevention trial are reviewed with suggestions to enhance progress going forward. Conceptually, developing drugs to intercept the early stages of carcinogenesis is very attractive, but progress in this area has been slow. Two opportunities to overcome this reality are discussed. These measures include the broader use of neoadjuvant, window-of-opportunity trials with new candidate chemoprevention agents to get more textured information about the mechanistic impact of the drug exposure in previously untreated early tumor tissue. In addition, we discuss the use of new intermediate end point markers such as with optical imaging tools to obtain a more objective and quantitative assessment of drug response.

Improved depth resolution in near-infrared diffuse reflectance spectroscopy using obliquely oriented fibers

We demonstrate a significant improvement of depth selectivity when using obliquely oriented fibers for near-infrared (NIR) diffuse reflectance spectroscopy. This is confirmed by diffuse reflectance measurements of a two-layer tissue-mimicking phantom across the spectral range from 1,000 to 1,940 nm. The experimental proof is supported by Monte Carlo simulations. The results reveal up to fourfold reduction in the mean optical penetration depth, twofold reduction in its variation, and a decrease in the number of scattering events when a single fiber is oriented at an angle of 60 deg. The effect of reducing the mean optical penetration depth is enhanced by orienting both fibers inwardly. Using outwardly oriented fibers enables more selective probing of deeper layers, while reducing the contribution from surface layers. We further demonstrate that the effect of an inward oblique arrangement can be approximated to a decrease in fiber-to-fiber separation in the case of a perpendicular fiber arrangement. This approximation is valid in the weak- or absorption-free regime. Our results assert the advantages of using obliquely oriented fibers when attempting to specifically address superficial tissue layers, for example, for skin cancer detection, or in noninvasive glucose monitoring. Such flexibility could be further advantageous in a range of minimally invasive applications, including catheter-based interventions.

Perturbation and differential Monte Carlo methods for measurement of optical properties in a layered epithelial tissue model

The use of perturbation and differential Monte Carlo (pMC/dMC) methods in conjunction with nonlinear optimization algorithms were proposed recently as a means to solve inverse photon migration problems in regionwise heterogeneous turbid media. We demonstrate the application of pMC/dMC methods for the recovery of optical properties in a two-layer extended epithelial tissue model from experimental measurements of spatially resolved diffuse reflectance. The results demonstrate that pMC/dMC methods provide a rapid and accurate approach to solve two-region inverse photon migration problems in the transport regime, that is, on spatial scales smaller than a transport mean free path and in media where optical scattering need not dominate absorption. The pMC/dMC approach is found to be effective over a broad range of absorption (50 to 400%) and scattering (70 to 130%) perturbations. The recovery of optical properties from spatially resolved diffuse reflectance measurements is examined for different sets of source-detector separation. These results provide some guidance for the design of compact fiber-based probes to determine and isolate optical properties from both epithelial and stromal layers of superficial tissues.