1
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Maniar KM, Lassarén P, Rana A, Yao Y, Tewarie IA, Gerstl JVE, Recio Blanco CM, Power LH, Mammi M, Mattie H, Smith TR, Mekary RA. Traditional Machine Learning Methods versus Deep Learning for Meningioma Classification, Grading, Outcome Prediction, and Segmentation: A Systematic Review and Meta-Analysis. World Neurosurg 2023; 179:e119-e134. [PMID: 37574189 DOI: 10.1016/j.wneu.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Meningiomas are common intracranial tumors. Machine learning (ML) algorithms are emerging to improve accuracy in 4 primary domains: classification, grading, outcome prediction, and segmentation. Such algorithms include both traditional approaches that rely on hand-crafted features and deep learning (DL) techniques that utilize automatic feature extraction. The aim of this study was to evaluate the performance of published traditional ML versus DL algorithms in classification, grading, outcome prediction, and segmentation of meningiomas. METHODS A systematic review and meta-analysis were conducted. Major databases were searched through September 2021 for publications evaluating traditional ML versus DL models on meningioma management. Performance measures including pooled sensitivity, specificity, F1-score, area under the receiver-operating characteristic curve, positive and negative likelihood ratios (LR+, LR-) along with their respective 95% confidence intervals (95% CIs) were derived using random-effects models. RESULTS Five hundred thirty-four records were screened, and 43 articles were included, regarding classification (3 articles), grading (29), outcome prediction (7), and segmentation (6) of meningiomas. Of the 29 studies that reported on grading, 10 could be meta-analyzed with 2 DL models (sensitivity 0.89, 95% CI: 0.74-0.96; specificity 0.91, 95% CI: 0.45-0.99; LR+ 10.1, 95% CI: 1.33-137; LR- 0.12, 95% CI: 0.04-0.59) and 8 traditional ML (sensitivity 0.74, 95% CI: 0.62-0.83; specificity 0.93, 95% CI: 0.79-0.98; LR+ 10.5, 95% CI: 2.91-39.5; and LR- 0.28, 95% CI: 0.17-0.49). The insufficient performance metrics reported precluded further statistical analysis of other performance metrics. CONCLUSIONS ML on meningiomas is mostly carried out with traditional methods. For meningioma grading, traditional ML methods generally had a higher LR+, while DL models a lower LR-.
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Affiliation(s)
- Krish M Maniar
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Philipp Lassarén
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aakanksha Rana
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; McGovern Institute for Brain Research, Massachusetts Institute of Technology, Boston, Massachusetts, United States
| | - Yuxin Yao
- Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences University, Boston, Massachusetts, United States
| | - Ishaan A Tewarie
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands; Faculty of Medicine, Erasmus University Rotterdam/Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jakob V E Gerstl
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States
| | - Camila M Recio Blanco
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; Northeast National University, Corrientes, Argentina; Prisma Salud, Puerto San Julian, Santa Cruz, Argentina
| | - Liam H Power
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; School of Medicine, Tufts University, Boston, Massachusetts, United States
| | - Marco Mammi
- Neurosurgery Unit, S. Croce e Carle Hospital, Cuneo, Italy
| | - Heather Mattie
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States
| | - Timothy R Smith
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; Department of Neurosurgery, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, United States
| | - Rania A Mekary
- Department of Neurosurgery, Computational Neurosciences Outcomes Center (CNOC), Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, United States; Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences University, Boston, Massachusetts, United States.
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2
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Anbunesan SN, Alfonso-Garcia A, Zhou X, Bec J, Lee HS, Jin LW, Bloch O, Marcu L. Intraoperative detection of IDH-mutant glioma using fluorescence lifetime imaging. JOURNAL OF BIOPHOTONICS 2023; 16:e202200291. [PMID: 36510639 PMCID: PMC10522274 DOI: 10.1002/jbio.202200291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Identifying isocitrate dehydrogenase (IDH)-mutation and glioma subtype during surgery instead of days later can aid in modifying tumor resection strategies for better survival outcomes. We report intraoperative identification of IDH-mutant glioma (N = 12 patients) with a clinically compatible fluorescence lifetime imaging (FLIm) device (excitation: 355 nm; emission spectral bands: 390/40 nm, 470/28 nm, 542/50 nm). The fluorescence-derived parameters were analyzed to study the optical contrast between IDH-mutant tumors and surrounding brain tissue. IDH-mutant oligodendrogliomas exhibited shorter lifetimes (3.3 ± 0.1 ns) than IDH-mutant astrocytomas (4.1 ± 0.1 ns). Both IDH-mutant glioma subtypes had shorter lifetimes than white matter (4.6 ± 0.4 ns) but had comparable lifetimes to cortex. Lifetimes also increased with malignancy grade within IDH-mutant oligodendrogliomas (grade 2: 2.96 ± 0.08 ns, grade 3: 3.4 ± 0.3 ns) but not within IDH-mutant astrocytomas. The current results support the feasibility of FLIm as a surgical adjuvant for identifying IDH-mutant glioma tissue.
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Affiliation(s)
- Silvia Noble Anbunesan
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Alba Alfonso-Garcia
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Xiangnan Zhou
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Julien Bec
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Han Sung Lee
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California, USA
| | - Lee-Way Jin
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
| | - Laura Marcu
- Department of Biomedical Engineering, University of California Davis, Davis, California, USA
- Department of Neurological Surgery, University of California Davis, Sacramento, California, USA
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3
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Alfonso-Garcia A, Bec J, Weyers B, Marsden M, Zhou X, Li C, Marcu L. Mesoscopic fluorescence lifetime imaging: Fundamental principles, clinical applications and future directions. JOURNAL OF BIOPHOTONICS 2021; 14:e202000472. [PMID: 33710785 PMCID: PMC8579869 DOI: 10.1002/jbio.202000472] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 05/16/2023]
Abstract
Fluorescence lifetime imaging (FLIm) is an optical spectroscopic imaging technique capable of real-time assessments of tissue properties in clinical settings. Label-free FLIm is sensitive to changes in tissue structure and biochemistry resulting from pathological conditions, thus providing optical contrast to identify and monitor the progression of disease. Technical and methodological advances over the last two decades have enabled the development of FLIm instrumentation for real-time, in situ, mesoscopic imaging compatible with standard clinical workflows. Herein, we review the fundamental working principles of mesoscopic FLIm, discuss the technical characteristics of current clinical FLIm instrumentation, highlight the most commonly used analytical methods to interpret fluorescence lifetime data and discuss the recent applications of FLIm in surgical oncology and cardiovascular diagnostics. Finally, we conclude with an outlook on the future directions of clinical FLIm.
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Affiliation(s)
- Alba Alfonso-Garcia
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Julien Bec
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Brent Weyers
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Mark Marsden
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Xiangnan Zhou
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Cai Li
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Laura Marcu
- Department of Biomedical Engineering, University of California, Davis, Davis, California
- Department Neurological Surgery, University of California, Davis, California
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4
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Laser induced autofluorescence lifetime to identify larynx squamous cell carcinoma: Short series ex vivo study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 202:111724. [PMID: 31785446 DOI: 10.1016/j.jphotobiol.2019.111724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 02/08/2023]
Abstract
Laser induced autofluorescence (LIAF) lifetime is useful to distinguish between normal laryngeal tissues and squamous cell carcinoma (SCC) based on variations of their biochemical composition and structure alterations. LIAF was collected from samples constituted by pairs of normal and malignant tissue, which were excised from three patients. Exclusion criteria for samples harvest were: (i) macroscopic changes of normal vocal cord observed during surgery; (ii) previous surgical intervention on vocal cord, (iii) patients treated only with chemotherapy or radiotherapy for carcinoma. Inclusion conditions: men, aged 57-68, non-smokers. A pulsed laser diode excited LIAF at 375 nm and 31 MHz repetition rate; beam full-time width at half-maximum was 87 ps at an average power of 0.49 mW. Mean LIAF lifetime for normal tissues was (3.75 ± 0.49) ns and for malignant (4.37 ± 0.85) ns: it is longer in malignant than in normal tissue. Variance analysis made with Fisher's test has shown no significant difference between patients for normal tissues; the same was true for malignant. Though, when malignant tissue was compared to normal for the same patients as well as between patients, a significant difference (significance level of 5%) was evidenced. Time-resolved LIAF may allow better differentiation between normal and malignant tissues in patients diagnosed with larynx SCC.
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5
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Multispectral Depth-Resolved Fluorescence Lifetime Spectroscopy Using SPAD Array Detectors and Fiber Probes. SENSORS 2019; 19:s19122678. [PMID: 31200569 PMCID: PMC6631026 DOI: 10.3390/s19122678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 01/29/2023]
Abstract
Single Photon Avalanche Diode (SPAD) arrays are increasingly exploited and have demonstrated potential in biochemical and biomedical research, both for imaging and single-point spectroscopy applications. In this study, we explore the application of SPADs together with fiber-optic-based delivery and collection geometry to realize fast and simultaneous single-point time-, spectral-, and depth-resolved fluorescence measurements at 375 nm excitation light. Spectral information is encoded across the columns of the array through grating-based dispersion, while depth information is encoded across the rows thanks to a linear arrangement of probe collecting fibers. The initial characterization and validation were realized against layered fluorescent agarose-based phantoms. To verify the practicality and feasibility of this approach in biological specimens, we measured the fluorescence signature of formalin-fixed rabbit aorta samples derived from an animal model of atherosclerosis. The initial results demonstrate that this detection configuration can report fluorescence spectral and lifetime contrast originating at different depths within the specimens. We believe that our optical scheme, based on SPAD array detectors and fiber-optic probes, constitute a powerful and versatile approach for the deployment of multidimensional fluorescence spectroscopy in clinical applications where information from deeper tissue layers is important for diagnosis.
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6
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Abstract
This article reviews the past and current statuses of time-domain near-infrared spectroscopy (TD-NIRS) and imaging. Although time-domain technology is not yet widely employed due to its drawbacks of being cumbersome, bulky, and very expensive compared to commercial continuous wave (CW) and frequency-domain (FD) fNIRS systems, TD-NIRS has great advantages over CW and FD systems because time-resolved data measured by TD systems contain the richest information about optical properties inside measured objects. This article focuses on reviewing the theoretical background, advanced theories and methods, instruments, and studies on clinical applications for TD-NIRS including some clinical studies which used TD-NIRS systems. Major events in the development of TD-NIRS and imaging are identified and summarized in chronological tables and figures. Finally, prospects for TD-NIRS in the near future are briefly described.
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7
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Blacker TS, Sewell MDE, Szabadkai G, Duchen MR. Metabolic Profiling of Live Cancer Tissues Using NAD(P)H Fluorescence Lifetime Imaging. Methods Mol Biol 2019; 1928:365-387. [PMID: 30725465 DOI: 10.1007/978-1-4939-9027-6_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Altered metabolism is a hallmark of cancer, both resulting from and driving oncogenesis. The NAD and NADP redox couples play a key role in a large number of the metabolic pathways involved. In their reduced forms, NADH and NADPH, these molecules are intrinsically fluorescent. As the average time for fluorescence to be emitted following excitation by a laser pulse, the fluorescence lifetime, is exquisitely sensitive to changes in the local environment of the fluorophore, imaging the fluorescence lifetime of NADH and NADPH offers the potential for label-free monitoring of metabolic changes inside living tumors. Here, we describe the biological, photophysical, and methodological considerations required to establish fluorescence lifetime imaging (FLIM) of NAD(P)H as a routine method for profiling the metabolism of living cancer cells and tissues.
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Affiliation(s)
- Thomas S Blacker
- Research Department of Cell & Developmental Biology, University College London, London, UK.
- UCL Consortium for Mitochondrial Research, University College London, London, UK.
- Department of Physics & Astronomy, University College London, London, UK.
| | - Michael D E Sewell
- Research Department of Cell & Developmental Biology, University College London, London, UK
| | - Gyorgy Szabadkai
- Research Department of Cell & Developmental Biology, University College London, London, UK
- UCL Consortium for Mitochondrial Research, University College London, London, UK
- The Francis Crick Institute, London, UK
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Michael R Duchen
- Research Department of Cell & Developmental Biology, University College London, London, UK
- UCL Consortium for Mitochondrial Research, University College London, London, UK
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8
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Zanello M, Poulon F, Pallud J, Varlet P, Hamzeh H, Abi Lahoud G, Andreiuolo F, Ibrahim A, Pages M, Chretien F, Di Rocco F, Dezamis E, Nataf F, Turak B, Devaux B, Abi Haidar D. Multimodal optical analysis discriminates freshly extracted human sample of gliomas, metastases and meningiomas from their appropriate controls. Sci Rep 2017; 7:41724. [PMID: 28150726 PMCID: PMC5288720 DOI: 10.1038/srep41724] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/23/2016] [Indexed: 01/20/2023] Open
Abstract
Delineating tumor margins as accurately as possible is of primordial importance in surgical oncology: extent of resection is associated with survival but respect of healthy surrounding tissue is necessary for preserved quality of life. The real-time analysis of the endogeneous fluorescence signal of brain tissues is a promising tool for defining margins of brain tumors. The present study aims to demonstrate the feasibility of multimodal optical analysis to discriminate fresh samples of gliomas, metastases and meningiomas from their appropriate controls. Tumor samples were studied on an optical fibered endoscope using spectral and fluorescence lifetime analysis and then on a multimodal set-up for acquiring spectral, one and two-photon fluorescence images, second harmonic generation signals and two-photon fluorescence lifetime datasets. The obtained data allowed us to differentiate healthy samples from tumor samples. These results confirmed the possible clinical relevance of this real-time multimodal optical analysis. This technique can be easily applied to neurosurgical procedures for a better delineation of surgical margins.
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Affiliation(s)
- Marc Zanello
- IMNC Laboratory, UMR 8165-CNRS/IN2P3, Paris-Saclay university, 91405 Orsay, France.,Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Fanny Poulon
- IMNC Laboratory, UMR 8165-CNRS/IN2P3, Paris-Saclay university, 91405 Orsay, France
| | - Johan Pallud
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Pascale Varlet
- Paris Descartes University, Paris, France.,Neuropathology Department, Sainte-Anne Hospital, France
| | - H Hamzeh
- Center of Advanced European Studies and Research (caesar), 53175 Bonn, Germany
| | - Georges Abi Lahoud
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Felipe Andreiuolo
- Paris Descartes University, Paris, France.,Neuropathology Department, Sainte-Anne Hospital, France
| | - Ali Ibrahim
- IMNC Laboratory, UMR 8165-CNRS/IN2P3, Paris-Saclay university, 91405 Orsay, France
| | - Mélanie Pages
- Paris Descartes University, Paris, France.,Neuropathology Department, Sainte-Anne Hospital, France
| | - Fabrice Chretien
- Paris Descartes University, Paris, France.,Neuropathology Department, Sainte-Anne Hospital, France
| | | | - Edouard Dezamis
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - François Nataf
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Baris Turak
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Bertrand Devaux
- Neurosurgery Department, Sainte-Anne Hospital, France.,Paris Descartes University, Paris, France
| | - Darine Abi Haidar
- IMNC Laboratory, UMR 8165-CNRS/IN2P3, Paris-Saclay university, 91405 Orsay, France.,Paris Diderot University, Sorbonne Paris Cité, F-75013, Paris, France
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9
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Zanello M, Poulon F, Varlet P, Chretien F, Andreiuolo F, Pages M, Ibrahim A, Pallud J, Dezamis E, Abi-Lahoud G, Nataf F, Turak B, Devaux B, Abi Haidar D. Multimodal optical analysis of meningioma and comparison with histopathology. JOURNAL OF BIOPHOTONICS 2017; 10:253-263. [PMID: 26871683 DOI: 10.1002/jbio.201500251] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/17/2015] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
Meningioma is the most frequent primary central nervous system tumor. The risk of recurrence and the prognosis are correlated with the extent of the resection that ideally encompasses the infiltrated dura mater and, if required, the infiltrated bone. No device can deliver real-time intraoperative histopathological information on the tumor environment to help the neurosurgeon to achieve a gross total removal. This study assessed the abilities of nonlinear microscopy to provide relevant and real-time data to help resection of meningiomas. Nine human meningioma samples (four World Health Organization Grade I, five Grade II) were analyzed using different optical modalities: spectral analysis and imaging, lifetime measurements, fluorescence lifetime imaging microscopy, fluorescence emitted under one- and two-photon excitation and the second-harmonic generation signal imaging using a multimodal setup. Nonlinear microscopy produced images close to histopathology as a gold standard. The second-harmonic generation signal delineated the collagen background and two-photon fluorescence underlined cell cytoplasm. The matching between fluorescence images and Hematoxylin and Eosin staining was possible in all cases. Grade I meningioma emitted less autofluorescence than Grade II meningioma and Grade II meningioma exhibited a distinct lifetime value. Autofluorescence was correlated with the proliferation rates and seemed to explain the observed differences between Grade I and II meningiomas. This preliminary multimodal study focused on human meningioma samples confirms the potential of tissue autofluorescence analysis and nonlinear microscopy in helping intraoperatively neurosurgeons to reach the actual boundaries of the tumor infiltration. Correspondence between H&E staining (top pictures) and the two-photon fluorescence imaging (bottom pictures).
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Affiliation(s)
| | | | - Pascale Varlet
- Neuropathology Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Fabrice Chretien
- Neuropathology Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Felipe Andreiuolo
- Neuropathology Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Mélanie Pages
- Neuropathology Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Ali Ibrahim
- IMNC Laboratory, UMR8165-CNRS, Orsay, France
| | - Johan Pallud
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Edouard Dezamis
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Georges Abi-Lahoud
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - François Nataf
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Baris Turak
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Bertrand Devaux
- Neurosurgery Department, Sainte-Anne Hospital, France
- Paris Descartes University, Paris, France
| | - Darine Abi Haidar
- IMNC Laboratory, UMR8165-CNRS, Orsay, France
- University Paris 7-Paris DIDEROT, F-75012, Paris, France
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10
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Vasefi F, MacKinnon N, Farkas DL, Kateb B. Review of the potential of optical technologies for cancer diagnosis in neurosurgery: a step toward intraoperative neurophotonics. NEUROPHOTONICS 2017; 4:011010. [PMID: 28042588 PMCID: PMC5184765 DOI: 10.1117/1.nph.4.1.011010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 11/07/2016] [Indexed: 05/06/2023]
Abstract
Advances in image-guided therapy enable physicians to obtain real-time information on neurological disorders such as brain tumors to improve resection accuracy. Image guidance data include the location, size, shape, type, and extent of tumors. Recent technological advances in neurophotonic engineering have enabled the development of techniques for minimally invasive neurosurgery. Incorporation of these methods in intraoperative imaging decreases surgical procedure time and allows neurosurgeons to find remaining or hidden tumor or epileptic lesions. This facilitates more complete resection and improved topology information for postsurgical therapy (i.e., radiation). We review the clinical application of recent advances in neurophotonic technologies including Raman spectroscopy, thermal imaging, optical coherence tomography, and fluorescence spectroscopy, highlighting the importance of these technologies in live intraoperative tissue mapping during neurosurgery. While these technologies need further validation in larger clinical trials, they show remarkable promise in their ability to help surgeons to better visualize the areas of abnormality and enable safe and successful removal of malignancies.
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Affiliation(s)
- Fartash Vasefi
- Spectral Molecular Imaging Inc., 13412 Ventura Boulevard, Suite 250, Sherman Oaks, California 91423, United States
- Brain Mapping Foundation, 8159 Santa Monica Boulevard, Suite 200, West Hollywood, California 90046, United States
- Society for Brain Mapping and Therapeutics (SBMT), 8159 Santa Monica Boulevard, Suite 200, West Hollywood, California 90046, United States
| | - Nicholas MacKinnon
- Spectral Molecular Imaging Inc., 13412 Ventura Boulevard, Suite 250, Sherman Oaks, California 91423, United States
| | - Daniel L. Farkas
- Spectral Molecular Imaging Inc., 13412 Ventura Boulevard, Suite 250, Sherman Oaks, California 91423, United States
- University of Southern California, Department of Biomedical Engineering, 1042 Downey Way, Los Angeles, California 90089, United States
| | - Babak Kateb
- Brain Mapping Foundation, 8159 Santa Monica Boulevard, Suite 200, West Hollywood, California 90046, United States
- Society for Brain Mapping and Therapeutics (SBMT), 8159 Santa Monica Boulevard, Suite 200, West Hollywood, California 90046, United States
- California Neurosurgical Institute, 25751 McBean Pkwy #305, Santa Clarita, California 91355, United States
- National Center for Nano-Bio-Electronics (NCNBE), NASA Research Park, P.O.Box 23, Moffett Field, California 94035, United States
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11
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Valdés PA, Roberts DW, Lu FK, Golby A. Optical technologies for intraoperative neurosurgical guidance. Neurosurg Focus 2016; 40:E8. [PMID: 26926066 DOI: 10.3171/2015.12.focus15550] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Biomedical optics is a broadly interdisciplinary field at the interface of optical engineering, biophysics, computer science, medicine, biology, and chemistry, helping us understand light-tissue interactions to create applications with diagnostic and therapeutic value in medicine. Implementation of biomedical optics tools and principles has had a notable scientific and clinical resurgence in recent years in the neurosurgical community. This is in great part due to work in fluorescence-guided surgery of brain tumors leading to reports of significant improvement in maximizing the rates of gross-total resection. Multiple additional optical technologies have been implemented clinically, including diffuse reflectance spectroscopy and imaging, optical coherence tomography, Raman spectroscopy and imaging, and advanced quantitative methods, including quantitative fluorescence and lifetime imaging. Here we present a clinically relevant and technologically informed overview and discussion of some of the major clinical implementations of optical technologies as intraoperative guidance tools in neurosurgery.
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Affiliation(s)
- Pablo A Valdés
- Departments of 1 Neurosurgery and.,Department of Neurosurgery, Harvard Medical School, Boston Children's Hospital, Boston
| | - David W Roberts
- Section of Neurosurgery, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Alexandra Golby
- Departments of 1 Neurosurgery and.,Radiology, and.,Dana Farber Cancer Institute, Harvard Medical School, Brigham and Women's Hospital
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12
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Real time optical Biopsy: Time-resolved Fluorescence Spectroscopy instrumentation and validation. Sci Rep 2016; 6:38190. [PMID: 27929039 PMCID: PMC5144092 DOI: 10.1038/srep38190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 10/26/2016] [Indexed: 11/08/2022] Open
Abstract
The Time-resolved fluorescence spectroscopy (TR-FS) has the potential to differentiate tumor and normal tissue in real time during surgical excision. In this manuscript, we describe the design of a novel TR-FS device, along with preliminary data on detection accuracy for fluorophores in a mixture. The instrument is capable of near real-time fluorescence lifetime acquisition in multiple spectral bands and analysis. It is also able to recover fluorescence lifetime with sub-20ps accuracy as validated with individual organic fluorescence dyes and dye mixtures yielding lifetime values for standard fluorescence dyes that closely match with published data. We also show that TR-FS is able to quantify the relative concentration of fluorescence dyes in a mixture by the unmixing of lifetime decays. We show that the TR-FS prototype is able to identify in near-real time the concentrations of dyes in a complex mixture based on previously trained data. As a result, we demonstrate that in complex mixtures of fluorophores, the relative concentration information is encoded in the fluorescence lifetime across multiple spectral bands. We show for the first time the temporal and spectral measurements of a mixture of fluorochromes and the ability to differentiate relative concentrations of each fluorochrome mixture in real time.
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13
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Ibrahim A, Poulon F, Melouki F, Zanello M, Varlet P, Habert R, Devaux B, Kudlinski A, Abi Haidar D. Spectral and fluorescence lifetime endoscopic system using a double-clad photonic crystal fiber. OPTICS LETTERS 2016; 41:5214-5217. [PMID: 27842096 DOI: 10.1364/ol.41.005214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a customized small-core double-clad photonic crystal fiber for spectral and fluorescence lifetime measurements of human samples. In this Letter, the new fiber has been characterized on different fluorophores and samples of human brain tumor; a comparison to a bi-fiber homemade system and a commercial fiber probe was made.
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14
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Blacker TS, Duchen MR. Investigating mitochondrial redox state using NADH and NADPH autofluorescence. Free Radic Biol Med 2016; 100:53-65. [PMID: 27519271 PMCID: PMC5145803 DOI: 10.1016/j.freeradbiomed.2016.08.010] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 11/27/2022]
Abstract
The redox states of the NAD and NADP pyridine nucleotide pools play critical roles in defining the activity of energy producing pathways, in driving oxidative stress and in maintaining antioxidant defences. Broadly speaking, NAD is primarily engaged in regulating energy-producing catabolic processes, whilst NADP may be involved in both antioxidant defence and free radical generation. Defects in the balance of these pathways are associated with numerous diseases, from diabetes and neurodegenerative disease to heart disease and cancer. As such, a method to assess the abundance and redox state of these separate pools in living tissues would provide invaluable insight into the underlying pathophysiology. Experimentally, the intrinsic fluorescence of the reduced forms of both redox cofactors, NADH and NADPH, has been used for this purpose since the mid-twentieth century. In this review, we outline the modern implementation of these techniques for studying mitochondrial redox state in complex tissue preparations. As the fluorescence spectra of NADH and NADPH are indistinguishable, interpreting the signals resulting from their combined fluorescence, often labelled NAD(P)H, can be complex. We therefore discuss recent studies using fluorescence lifetime imaging microscopy (FLIM) which offer the potential to discriminate between the two separate pools. This technique provides increased metabolic information from cellular autofluorescence in biomedical investigations, offering biochemical insights into the changes in time-resolved NAD(P)H fluorescence signals observed in diseased tissues.
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Affiliation(s)
- Thomas S Blacker
- Department of Cell and Developmental Biology, University College London, London WC1E 6BT, UK; Department of Physics and Astronomy, University College London, London WC1E 6BT, UK
| | - Michael R Duchen
- Department of Cell and Developmental Biology, University College London, London WC1E 6BT, UK
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15
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Li G, Wu B, Ward MG, Chong ACN, Mukherjee S, Chen S, Hao M. Multifunctional in vivo imaging of pancreatic islets during diabetes development. J Cell Sci 2016; 129:2865-75. [PMID: 27270669 DOI: 10.1242/jcs.190843] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/27/2016] [Indexed: 01/13/2023] Open
Abstract
Pancreatic islet dysfunction leading to insufficient glucose-stimulated insulin secretion triggers the clinical onset of diabetes. How islet dysfunction develops is not well understood at the cellular level, partly owing to the lack of approaches to study single islets longitudinally in vivo Here, we present a noninvasive, high-resolution system to quantitatively image real-time glucose metabolism from single islets in vivo, currently not available with any other method. In addition, this multifunctional system simultaneously reports islet function, proliferation, vasculature and macrophage infiltration in vivo from the same set of images. Applying our method to a longitudinal high-fat diet study revealed changes in islet function as well as alternations in islet microenvironment. More importantly, this label-free system enabled us to image real-time glucose metabolism directly from single human islets in vivo for the first time, opening the door to noninvasive longitudinal in vivo studies of healthy and diabetic human islets.
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Affiliation(s)
- Ge Li
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA
| | - Binlin Wu
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA
| | - Meliza G Ward
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA
| | - Angie C N Chong
- Department of Surgery, Weill Cornell Medical College, New York, NY 10065, USA
| | - Sushmita Mukherjee
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA
| | - Shuibing Chen
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA Department of Surgery, Weill Cornell Medical College, New York, NY 10065, USA
| | - Mingming Hao
- Department of Biochemistry, Weill Cornell Medical College, New York, NY 10065, USA
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16
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Dochow S, Ma D, Latka I, Bocklitz T, Hartl B, Bec J, Fatakdawala H, Marple E, Urmey K, Wachsmann-Hogiu S, Schmitt M, Marcu L, Popp J. Combined fiber probe for fluorescence lifetime and Raman spectroscopy. Anal Bioanal Chem 2015; 407:8291-301. [PMID: 26093843 PMCID: PMC4995092 DOI: 10.1007/s00216-015-8800-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 12/23/2022]
Abstract
In this contribution we present a dual modality fiber optic probe combining fluorescence lifetime imaging (FLIm) and Raman spectroscopy for in vivo endoscopic applications. The presented multi-spectroscopy probe enables efficient excitation and collection of fluorescence lifetime signals for FLIm in the UV/visible wavelength region, as well as of Raman spectra in the near-IR for simultaneous Raman/FLIm imaging. The probe was characterized in terms of its lateral resolution and distance dependency of the Raman and FLIm signals. In addition, the feasibility of the probe for in vivo FLIm and Raman spectral characterization of tissue was demonstrated. Graphical Abstract An image comparison between FLIm and Raman spectroscopy acquired with the bimodal probe onseveral tissue samples.
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Affiliation(s)
- Sebastian Dochow
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
| | - Dinglong Ma
- Department of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA
| | - Ines Latka
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
| | - Thomas Bocklitz
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
| | - Brad Hartl
- Department of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA
| | - Julien Bec
- Department of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA
| | - Hussain Fatakdawala
- Department of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA
| | - Eric Marple
- EmVision LCC, 1471 F Road, Loxahatchee, FL, 33470, USA
| | - Kirk Urmey
- EmVision LCC, 1471 F Road, Loxahatchee, FL, 33470, USA
| | - Sebastian Wachsmann-Hogiu
- Department of Pathology and Laboratory Medicine and Center for Biophotonics, University of California, Davis, 2700 Stockton Blvd., Sacramento, CA, 95817, USA
| | - Michael Schmitt
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
| | - Laura Marcu
- Department of Biomedical Engineering, University of California, Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA.
| | - Jürgen Popp
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany.
- Leibniz Institute of Photonic Technology Jena e.V., Albert-Einstein-Str. 9, 07745, Jena, Germany.
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17
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Patil R, Koronyo Y, Ljubimov AV, Salumbides B, Mamelak A, Gangalum PR, Ding H, Portilla-Arias J, Holler E, Butte P, Koronyo-Hamaoui M, Ljubimova JY, Black KL. Advances in Imaging: Brain Tumors to Alzheimer's Disease. THE BANGKOK MEDICAL JOURNAL 2015; 10:83-97. [PMID: 29142857 PMCID: PMC5683733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Professor Black and colleagues have been working to improve the quality and sensitivity of imaging in the early detection of conditions from brain tumors to Alzheimer's disease to enhance treatment protocols and patient management. Professor Black et al introduced nanoparticles to improve MRI imaging. These nanoparticles consist of poly (b-L- malic acid (PMLA)) conjugates with monoclonal antibodies ((mAbs)) and Gd-DOTA. These are known as MRI nano-imaging agents (NIA). Most importantly, they can penetrate the endothelial blood-brain barrier (BBB) to reach brain tumors (primary or metastasis). This is effective in cases of brain tumors or breast cancer or other cancers such as lung cancer and gastric cancer having HER2 and/or EGFR positive crossing BBB. By the covalent conjugation of MR contrast (NIA), the MRI virtual biopsy can differentiate brain tumors from infections or other brain pathological conditions. The brain's intrinsic natural fluorescence such as NADH, FAD, lipopigments and porphyrin in the brain tissue can be identified by using time resolved fluorescence spectroscopy (TRFS) which is operated through the use of ultra-short laser. TRFS produces various color bands to differentiate the tumor from normal brain tissue in real time and registers the data on a 3D map. This is significant, as this will provide a greatly improved assessment methodology of tissue type. Consequently, this will potentially result in shorter operation times as well as more satisfactory tumor removal. In the detection of Alzheimer disease, amyloid plaque is deposited in retina tissue (including the RGC, RNFL and inner plexiform layer) which can produce a fluorescence effect by using curcumin as a contrast. This is then shown by human retina amyloid imaging device. Immunotherapies with glatiramer acetate (GA) have been shown to reduce amyloid deposits in brain and retinal AB deposits in mice. The study of advanced imaging technology and techniques including NIA, TRFS and the detection of amyloid plaque in Alzheimer disease are very important approaches to create a new era for diagnostic and therapeutic management of brain tumors and other cancers (HER2 and/or EGFR positive). This pioneering work by Professor Black, and colleagues, gives rise to a new hope for cancer patients for targeted therapy and for immunotherapies in Alzheimer's disease.
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Affiliation(s)
- Rameshwar Patil
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Alexander V. Ljubimov
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Brenda Salumbides
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Adam Mamelak
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Pallavi R. Gangalum
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Hui Ding
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jose Portilla-Arias
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eggehard Holler
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Pramod Butte
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Julia Y. Ljubimova
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Keith L. Black
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
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18
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Pires L, Nogueira MS, Pratavieira S, Moriyama LT, Kurachi C. Time-resolved fluorescence lifetime for cutaneous melanoma detection. BIOMEDICAL OPTICS EXPRESS 2014; 5:3080-9. [PMID: 25401022 PMCID: PMC4230861 DOI: 10.1364/boe.5.003080] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/08/2014] [Accepted: 08/10/2014] [Indexed: 05/04/2023]
Abstract
Melanoma is the most aggressive skin cancer type. It is characterized by pigmented lesions with high tissue invasion and metastatic potential. The early detection of melanoma is extremely important to improve patient prognosis and survival rate, since it can progress to the deadly metastatic stage. Presently, the melanoma diagnosis is based on the clinical analysis of the macroscopic lesion characteristics such as shape, color, borders following the ABCD rules. The aim of this study is to evaluate the time-resolved fluorescence lifetime of NADH and FAD molecules to detect cutaneous melanoma in an experimental in vivo model. Forty-two lesions were analyzed and the data was classified using linear discriminant analysis, a sensitivity of 99.4%, specificity of 97.4% and accuracy of 98.4% were achieved. These results show the potential of this fluorescence spectroscopy for melanoma detection.
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19
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Blacker TS, Mann ZF, Gale JE, Ziegler M, Bain AJ, Szabadkai G, Duchen MR. Separating NADH and NADPH fluorescence in live cells and tissues using FLIM. Nat Commun 2014; 5:3936. [PMID: 24874098 PMCID: PMC4046109 DOI: 10.1038/ncomms4936] [Citation(s) in RCA: 348] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/23/2014] [Indexed: 02/07/2023] Open
Abstract
NAD is a key determinant of cellular energy metabolism. In contrast, its phosphorylated form, NADP, plays a central role in biosynthetic pathways and antioxidant defence. The reduced forms of both pyridine nucleotides are fluorescent in living cells but they cannot be distinguished, as they are spectrally identical. Here, using genetic and pharmacological approaches to perturb NAD(P)H metabolism, we find that fluorescence lifetime imaging (FLIM) differentiates quantitatively between the two cofactors. Systematic manipulations to change the balance between oxidative and glycolytic metabolism suggest that these states do not directly impact NAD(P)H fluorescence decay rates. The lifetime changes observed in cancers thus likely reflect shifts in the NADPH/NADH balance. Using a mathematical model, we use these experimental data to quantify the relative levels of NADH and NADPH in different cell types of a complex tissue, the mammalian cochlea. This reveals NADPH-enriched populations of cells, raising questions about their distinct metabolic roles. NAD and NADP play fundamentally different roles in cellular metabolism, and yet these pyridine nucleotides cannot be distinguished spectroscopically in living cells. Blacker et al. demonstrate that fluorescence lifetime imaging can be used to quantify NADPH/NADH balance in cultured cells and in the mammalian cochlea.
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Affiliation(s)
- Thomas S Blacker
- 1] Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London WC1E 6BT, UK [2] Research Department of Cell & Developmental Biology, University College London, London WC1E 6BT, UK [3] Department of Physics and Astronomy, University College London, London WC1E 6BT, UK
| | - Zoe F Mann
- 1] Research Department of Cell & Developmental Biology, University College London, London WC1E 6BT, UK [2] UCL Ear Institute, University College London, London WC1X 8EE, UK
| | - Jonathan E Gale
- 1] Research Department of Cell & Developmental Biology, University College London, London WC1E 6BT, UK [2] UCL Ear Institute, University College London, London WC1X 8EE, UK
| | - Mathias Ziegler
- Department of Molecular Biology, University of Bergen, N-5008 Bergen, Norway
| | - Angus J Bain
- Department of Physics and Astronomy, University College London, London WC1E 6BT, UK
| | - Gyorgy Szabadkai
- 1] Research Department of Cell & Developmental Biology, University College London, London WC1E 6BT, UK [2] Department of Biomedical Sciences, University of Padua and CNR Neuroscience Institute, Padua 35121, Italy [3]
| | - Michael R Duchen
- 1] Research Department of Cell & Developmental Biology, University College London, London WC1E 6BT, UK [2]
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20
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Klatt J, Gerich CE, Gröbe A, Opitz J, Schreiber J, Hanken H, Salomon G, Heiland M, Kluwe L, Blessmann M. Fractal dimension of time-resolved autofluorescence discriminates tumour from healthy tissues in the oral cavity. J Craniomaxillofac Surg 2013; 42:852-4. [PMID: 24444757 DOI: 10.1016/j.jcms.2013.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/12/2013] [Accepted: 12/17/2013] [Indexed: 11/15/2022] Open
Abstract
Early detection and complete resection of oral carcinomas is of crucial importance for patient survival. This could be significantly improved by developing a non-invasive, sensitive and real-time detection technique. Time-resolved autofluorescence measurement is state-of-the-art technology originally developed for non-destructive inspection of material. In this study, we measured time-resolved autofluorescence in tumours and healthy tissues of the oral cavity ex vivo and calculated the corresponding fractal dimension which was significantly higher in tumours than in healthy tissues (1.8 vs. 1.6, P < 0.001, unpaired t-test) with non-overlapping 95% confidential intervals 1.88-1.84 and 1.57-1.69, respectively. Very high specificity (86%) could be reached at 100% sensitivity. The area under the curve was 99%, further suggesting the superior prediction potential of fractal dimension based on time-resolved autofluorescence spectra.
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Affiliation(s)
- Jan Klatt
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola E Gerich
- Fraunhofer Institute for Non-Destructive Testing, Laboratory of Optical Diagnostics, Dresden, Germany
| | - Alexander Gröbe
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jörg Opitz
- Fraunhofer Institute for Non-Destructive Testing, Laboratory of Optical Diagnostics, Dresden, Germany
| | - Jürgen Schreiber
- Fraunhofer Institute for Non-Destructive Testing, Laboratory of Optical Diagnostics, Dresden, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georg Salomon
- Martiniclinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lan Kluwe
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marco Blessmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Li Y, Rey-Dios R, Roberts DW, Valdés PA, Cohen-Gadol AA. Intraoperative fluorescence-guided resection of high-grade gliomas: a comparison of the present techniques and evolution of future strategies. World Neurosurg 2013; 82:175-85. [PMID: 23851210 DOI: 10.1016/j.wneu.2013.06.014] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 04/15/2013] [Accepted: 06/29/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Fluorescence guidance has a demonstrated potential in maximizing the extent of high-grade glioma resection. Different fluorophores (fluorescent biomarkers), including 5-aminolevulinic acid (5-ALA) and fluorescein, have been examined with the use of several imaging techniques. Our goal was to review the state of this technology and discuss strategies for more widespread adoption. METHODS We performed a Medline search using the key words "fluorescence," "intraoperative fluorescence-guided resection," "intraoperative image-guided resection," and "brain glioma" for articles from 1960 until the present. This initial search revealed 267 articles. Each abstract and article was reviewed and the reference lists from select articles were further evaluated for relevance. A total of 64 articles included information about the role of fluorescence in resection of high-grade gliomas and therefore were selectively included for our analysis. RESULTS 5-ALA and fluorescein sodium have shown promise as fluorescent markers in detecting residual tumor intraoperatively. These techniques have demonstrated a significant increase in the extent of tumor resection. Regulatory barriers have limited the use of 5-ALA and technological challenges have restricted the use of fluorescein and its derivatives in the United States. Limitations to this technology currently exist, such as the fact that fluorescence at tumor margins is not always reliable for identification of tumor-brain interface. CONCLUSIONS These techniques are safe and effective for increasing gross total resection. The development of more tumor-specific fluorophores is needed to resolve problems with subjective interpretation of fluorescent signal at tumor margins. Techniques such as quantum dots and polymer or iron oxide-based nanoparticles have shown promise as potential future tools.
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Affiliation(s)
- Yiping Li
- Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Roberto Rey-Dios
- Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - David W Roberts
- Section of Neurosurgery, Department of Surgery, Dartmouth Medical School, Lebanon, New Hampshire, USA; Dartmouth Medical School, Hanover, New Hampshire, USA
| | - Pablo A Valdés
- Section of Neurosurgery, Department of Surgery, Dartmouth Medical School, Lebanon, New Hampshire, USA; Dartmouth Medical School, Hanover, New Hampshire, USA
| | - Aaron A Cohen-Gadol
- Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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22
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Marcu L, Hartl BA. Fluorescence Lifetime Spectroscopy and Imaging in Neurosurgery. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS : A PUBLICATION OF THE IEEE LASERS AND ELECTRO-OPTICS SOCIETY 2012; 18:1465-1477. [PMID: 28053498 PMCID: PMC5205025 DOI: 10.1109/jstqe.2012.2185823] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Clinical outcome of patients diagnosed with primary brain tumor has been correlated with the extent of surgical resection. In treating this disease, the neurosurgeon must balance between an aggressive, radical resection and minimizing the loss of healthy, functionally significant brain tissue. Numerous intra-operative methodologies and technological approaches have been explored as a means to improve the accuracy of surgical resection. This paper presents an overview of current conventional techniques and new emerging technologies with potential to impact the area of image-guided surgery of brain tumors. Emphasis is placed on techniques based on endogenous fluorescence lifetime contrast and their potential for intraoperative diagnosis of brain tumors.
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Affiliation(s)
- Laura Marcu
- University of California, Davis, Davis, CA 95616 USA
| | - Brad A Hartl
- University of California, Davis, Davis, CA 95616 USA
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23
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Thompson AJ, Coda S, Sørensen MB, Kennedy G, Patalay R, Waitong-Brämming U, De Beule PAA, Neil MAA, Andersson-Engels S, Bendsøe N, French PMW, Svanberg K, Dunsby C. In vivo measurements of diffuse reflectance and time-resolved autofluorescence emission spectra of basal cell carcinomas. JOURNAL OF BIOPHOTONICS 2012; 5:240-54. [PMID: 22308093 DOI: 10.1002/jbio.201100126] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 12/23/2011] [Accepted: 01/12/2012] [Indexed: 05/20/2023]
Abstract
We present a clinical investigation of diffuse reflectance and time-resolved autofluorescence spectra of skin cancer with an emphasis on basal cell carcinoma. A total of 25 patients were measured using a compact steady-state diffuse reflectance/fluorescence spectrometer and a fibre-optic-coupled multispectral time-resolved spectrofluorometer. Measurements were performed in vivo prior to surgical excision of the investigated region. Singular value decomposition was used to reduce the dimensionality of steady state diffuse reflectance and fluorescence spectra. Linear discriminant analysis was then applied to the measurements of basal cell carcinomas (BCCs) and used to predict the tissue disease state with a leave-one-out methodology. This approach was able to correctly diagnose 87% of the BCCs. With 445 nm excitation a decrease in the spectrally averaged fluorescence lifetime was observed between normal tissue and BCC lesions with a mean value of 886 ps. Furthermore, the fluorescence lifetime for BCCs was lower than that of the surrounding healthy tissue in all cases and statistical analysis of the data revealed that this decrease was significant (p = 0.002).
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Affiliation(s)
- Alex J Thompson
- Photonics Group, Department of Physics, Imperial College, Prince Consort Road, London, UK.
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Valdés PA, Kim A, Leblond F, Conde OM, Harris BT, Paulsen KD, Wilson BC, Roberts DW. Combined fluorescence and reflectance spectroscopy for in vivo quantification of cancer biomarkers in low- and high-grade glioma surgery. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:116007. [PMID: 22112112 PMCID: PMC3221714 DOI: 10.1117/1.3646916] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 09/12/2011] [Accepted: 09/16/2011] [Indexed: 05/19/2023]
Abstract
Biomarkers are indicators of biological processes and hold promise for the diagnosis and treatment of disease. Gliomas represent a heterogeneous group of brain tumors with marked intra- and inter-tumor variability. The extent of surgical resection is a significant factor influencing post-surgical recurrence and prognosis. Here, we used fluorescence and reflectance spectral signatures for in vivo quantification of multiple biomarkers during glioma surgery, with fluorescence contrast provided by exogenously-induced protoporphyrin IX (PpIX) following administration of 5-aminolevulinic acid. We performed light-transport modeling to quantify multiple biomarkers indicative of tumor biological processes, including the local concentration of PpIX and associated photoproducts, total hemoglobin concentration, oxygen saturation, and optical scattering parameters. We developed a diagnostic algorithm for intra-operative tissue delineation that accounts for the combined tumor-specific predictive capabilities of these quantitative biomarkers. Tumor tissue delineation achieved accuracies of up to 94% (specificity = 94%, sensitivity = 94%) across a range of glioma histologies beyond current state-of-the-art optical approaches, including state-of-the-art fluorescence image guidance. This multiple biomarker strategy opens the door to optical methods for surgical guidance that use quantification of well-established neoplastic processes. Future work would seek to validate the predictive power of this proof-of-concept study in a separate larger cohort of patients.
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Affiliation(s)
- Pablo A Valdés
- Dartmouth College, Thayer School of Engineering, Hanover, New Hampshire 03755, USA.
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25
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Butte PV, Mamelak AN, Nuno M, Bannykh SI, Black KL, Marcu L. Fluorescence lifetime spectroscopy for guided therapy of brain tumors. Neuroimage 2011; 54 Suppl 1:S125-35. [PMID: 21055475 PMCID: PMC3335732 DOI: 10.1016/j.neuroimage.2010.11.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 10/27/2010] [Accepted: 11/01/2010] [Indexed: 11/30/2022] Open
Abstract
This study evaluates the potential of time-resolved laser induced fluorescence spectroscopy (TR-LIFS) as intra-operative tool for the delineation of brain tumor from normal brain. Forty two patients undergoing glioma (WHO grade I-IV) surgery were enrolled in this study. A TR-LIFS prototype apparatus (gated detection, fast digitizer) was used to induce in-vivo fluorescence using a pulsed N2 laser (337 nm excitation, 0.7 ns pulse width) and to record the time-resolved spectrum (360-550 nm range, 10 nm interval). The sites of TR-LIFS measurement were validated by conventional histopathology (H&E staining). Parameters derived from the TR-LIFS data including intensity values and time-resolved intensity decay features (average fluorescence lifetime and Laguerre coefficients values) were used for tissue characterization and classification. 71 areas of tumor and normal brain were analyzed. Several parameters allowed for the differentiation of distinct tissue types. For example, normal cortex (N=35) and normal white matter (N=12) exhibit a longer-lasting fluorescence emission at 390 nm (τ390=2.12±0.10 ns) when compared with 460 nm (τ460=1.16±0.08 ns). High grade glioma (grades III and IV) samples (N=17) demonstrate emission peaks at 460 nm, with large variation at 390 nm while low grade glioma (I and II) samples (N=7) demonstrated a peak fluorescence emission at 460 nm. A linear discriminant algorithm allowed for the classification of low-grade gliomas with 100% sensitivity and 98% specificity. High-grade glioma demonstrated a high degree of heterogeneity thus reducing the discrimination accuracy of these tumors to 47% sensitivity and 94% specificity. Current findings demonstrate that TR-LIFS holds the potential to diagnose brain tumors intra-operatively and to provide a valuable tool for aiding the neurosurgeon-neuropathologist team in to rapidly distinguish between tumor and normal brain during surgery.
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Affiliation(s)
- Pramod V. Butte
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA – 90048
| | - Adam N. Mamelak
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA – 90048
| | - Miriam Nuno
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA – 90048
| | - Serguei I. Bannykh
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA – 90048
| | - Keith L. Black
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA – 90048
| | - Laura Marcu
- Biomedical Engineering, University of California, Davis, CA – 95616
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Butte PV, Fang Q, Jo JA, Yong WH, Pikul BK, Black KL, Marcu L. Intraoperative delineation of primary brain tumors using time-resolved fluorescence spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:027008. [PMID: 20459282 PMCID: PMC4171753 DOI: 10.1117/1.3374049] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 01/18/2010] [Accepted: 02/09/2010] [Indexed: 05/20/2023]
Abstract
The goal of this study is to determine the potential of time-resolved laser-induced fluorescence spectroscopy (TR-LIFS) as an adjunctive tool for delineation of brain tumor from surrounding normal tissue in order to assist the neurosurgeon in near-complete tumor excision. A time-domain TR-LIFS prototype apparatus (gated photomultiplier detection, fast digitizer) was used for recording tissue autofluorescence in normal cortex (NC), normal white matter (NWM), and various grades of gliomas intraoperatively. Tissue fluorescence was induced with a pulsed nitrogen laser (337 nm, 700 ps), and the intensity decay profiles were recorded in the 360- to 550-nm spectral range (10-nm interval). Histopathological analysis (hematoxylin & eosin) of the biopsy samples taken from the site of TR-LIFS measurements was used for validation of spectroscopic results. Preliminary results on 17 patients demonstrate that normal cortex (N=16) and normal white matter (N=3) show two peaks of fluorescence emission at 390 nm (lifetime=1.8+/-0.3 ns) and 460 nm (lifetime=0.8+/-0.1 ns). The 390-nm emission peak is absent in low-grade glioma (N=5; lifetime=1.1 ns) and reduced in high-grade glioma (N=9; lifetime=1.7+/-0.4 ns). The emission characteristics at 460 nm in all tissues correlated with the nicotinamide adenine dinucleotide fluorescence (peak: 440 to 460 nm; lifetime: 0.8 to 1.0 ns). These findings demonstrate the potential of using TR-LIFS as a tool for enhanced delineation of brain tumors during surgery. In addition, this study evaluates similarities and differences between TR-LIFS signatures of brain tumors obtained in vivo and those previously reported in ex vivo brain tumor specimens.
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Affiliation(s)
- Pramod V Butte
- Cedars-Sinai Medical Center, Department of Neurosurgery, 8631 West 3rd Street, Suite 800E, Los Angeles, California 90048, USA
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Farwell DG, Meier JD, Park J, Sun Y, Coffman H, Poirier B, Phipps J, Tinling S, Enepekides DJ, Marcu L. Time-resolved fluorescence spectroscopy as a diagnostic technique of oral carcinoma: Validation in the hamster buccal pouch model. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 2010; 136:126-33. [PMID: 20157056 PMCID: PMC4128623 DOI: 10.1001/archoto.2009.216] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To investigate the benefit of using time-resolved, laser-induced fluorescence spectroscopy for diagnosing malignant and premalignant lesions of the oral cavity. DESIGN The carcinogen 7,12-dimethylbenz[a]anthracene (DMBA) was applied to 1 cheek pouch of 19 hamsters. The contralateral pouch and the cheek pouches of 3 hamsters without DMBA exposure served as controls. SETTING University of California, Davis. PARTICIPANTS Twenty-two golden/Syrian hamsters. INTERVENTION A nitrogen pulse laser was used to induce tissue autofluorescence between the wavelengths of 360 and 650 nm. MAIN OUTCOME MEASURES Spectral intensities and time-domain measurements were obtained and compared with the histopathologic findings at each corresponding site. RESULTS Spectral intensities and lifetime values at 3 spectral bands (SBs; SB1 = 380 +/- 10 nm; SB2 = 460 +/- 10 nm, and SB3 = 635 +/- 10 nm) allowed for discrimination among healthy epithelium, dysplasia, carcinoma in situ, and invasive carcinoma. The lifetime values at SB2 were the most important when distinguishing the lesions using only time-resolved parameters. An algorithm combining spectral fluorescence parameters derived from both spectral and time-domain parameters (peak intensities, average fluorescence lifetimes, and the Laguerre coefficient [zero-order]) for healthy epithelium, dysplasia, carcinoma in situ, and invasive carcinoma provided the best diagnostic discrimination, with 100%, 100%, 69.2%, and 76.5% sensitivity and 100%, 92.2%, 97.1%, and 96.2% specificity, respectively. CONCLUSIONS The addition of time-resolved fluorescence-derived parameters significantly improves the capability of fluorescence spectroscopy-based diagnostics in the hamster buccal pouch. This technique provides a potential noninvasive diagnostic instrument for head and neck cancer.
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Affiliation(s)
- D Gregory Farwell
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
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Marcu L. Fluorescence lifetime in cardiovascular diagnostics. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:011106. [PMID: 20210432 PMCID: PMC2847934 DOI: 10.1117/1.3327279] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 12/16/2009] [Indexed: 05/20/2023]
Abstract
We review fluorescence lifetime techniques including time-resolved laser-induced fluorescence spectroscopy (TR-LIFS) and fluorescence lifetime imaging microscopy (FLIM) instrumentation and associated methodologies that allow for characterization and diagnosis of atherosclerotic plaques. Emphasis is placed on the translational research potential of TR-LIFS and FLIM and on determining whether intrinsic fluorescence signals can be used to provide useful contrast for the diagnosis of high-risk atherosclerotic plaque. Our results demonstrate that these techniques allow for the discrimination of important biochemical features involved in atherosclerotic plaque instability and rupture and show their potential for future intravascular applications.
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Affiliation(s)
- Laura Marcu
- University of California, Davis, Department of Biomedical Engineering, Davis, California 95616, USA.
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Canpolat M, Akyüz M, Gökhan GA, Gürer EI, Tuncer R. Intra-operative brain tumor detection using elastic light single-scattering spectroscopy: a feasibility study. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:054021. [PMID: 19895123 DOI: 10.1117/1.3247151] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We have investigated the potential application of elastic light single-scattering spectroscopy (ELSSS) as an adjunctive tool for intraoperative rapid detection of brain tumors and demarcation of the tumor from the surrounding normal tissue. Measurements were performed on 29 excised tumor specimens from 29 patients. There were 21 instances of low-grade tumors and eight instances of high-grade tumors. Normal gray matter and white matter brain tissue specimens of four epilepsy patients were used as a control group. One low-grade and one high-grade tumor were misclassified as normal brain tissue. Of the low- and high-grade tumors, 20 out of 21 and 7 out of 8 were correctly classified by the ELSSS system, respectively. One normal white matter tissue margin was detected in a high-grade tumor, and three normal tissue margins were detected in three low-grade tumors using spectroscopic data analysis and confirmed by histopathology. The spectral slopes were shown to be positive for normal white matter brain tissue and negative for normal gray matter and tumor tissues. Our results indicate that signs of spectral slopes may enable the discrimination of brain tumors from surrounding normal white matter brain tissue with a sensitivity of 93% and specificity of 100%.
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Affiliation(s)
- Murat Canpolat
- Akdeniz University, School of Medicine, Department of Biophysics, Antalya, 07059, Turkey.
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Sun Y, Phipps J, Elson DS, Stoy H, Tinling S, Meier J, Poirier B, Chuang FS, Farwell DG, Marcu L. Fluorescence lifetime imaging microscopy: in vivo application to diagnosis of oral carcinoma. OPTICS LETTERS 2009; 34:2081-3. [PMID: 19572006 PMCID: PMC4083182 DOI: 10.1364/ol.34.002081] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A compact clinically compatible fluorescence lifetime imaging microscopy (FLIM) system was designed and built for intraoperative disease diagnosis and validated in vivo in a hamster oral carcinogenesis model. This apparatus allows for the remote image collection via a flexible imaging probe consisting of a gradient index objective lens and a fiber bundle. Tissue autofluorescence (337 nm excitation) was imaged using an intensified CCD with a gate width down to 0.2 ns. We demonstrate a significant contrast in fluorescence lifetime between tumor (1.77+/-0.26 ns) and normal (2.50+/-0.36 ns) tissues at 450 nm and an over 80% intensity decrease at 390 nm emission in tumor versus normal areas. The time-resolved images were minimally affected by tissue morphology, endogenous absorbers, and illumination. These results demonstrate the potential of FLIM as an intraoperative diagnostic technique.
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Affiliation(s)
- Yinghua Sun
- Department of Biomedical Engineering, University of California-Davis, Davis, California 95616, USA
- NSF Center for Biophotonics Science and Technology, University of California-Davis, Sacramento, California 95817, USA
| | - Jennifer Phipps
- Department of Biomedical Engineering, University of California-Davis, Davis, California 95616, USA
| | - Daniel S. Elson
- Institute of Biomedical Engineering, Imperial College London, London SW7 2AZ, UK
| | - Heather Stoy
- Department of Otolaryngology, University of California-Davis, Sacramento, California 95817, USA
| | - Steven Tinling
- Department of Otolaryngology, University of California-Davis, Sacramento, California 95817, USA
| | - Jeremy Meier
- Department of Otolaryngology, University of California-Davis, Sacramento, California 95817, USA
| | - Brian Poirier
- Department of Pathology, University of California-Davis, Sacramento, California 95817, USA
| | - Frank S. Chuang
- NSF Center for Biophotonics Science and Technology, University of California-Davis, Sacramento, California 95817, USA
| | - D. Gregory Farwell
- Department of Otolaryngology, University of California-Davis, Sacramento, California 95817, USA
| | - Laura Marcu
- Department of Biomedical Engineering, University of California-Davis, Davis, California 95616, USA
- NSF Center for Biophotonics Science and Technology, University of California-Davis, Sacramento, California 95817, USA
- Corresponding author:
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Dabir AS, Trivedi CA, Ryu Y, Pande P, Jo JA. Fully automated deconvolution method for on-line analysis of time-resolved fluorescence spectroscopy data based on an iterative Laguerre expansion technique. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:024030. [PMID: 19405759 DOI: 10.1117/1.3103342] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Time-resolved fluorescence spectroscopy (TRFS) is a powerful analytical tool for quantifying the biochemical composition of organic and inorganic materials. The potential of TRFS for tissue diagnosis has been recently demonstrated. To facilitate the translation of TRFS to the clinical arena, algorithms for online TRFS data analysis are essential. A fast model-free TRFS deconvolution algorithm based on the Laguerre expansion method has previously been introduced. One limitation of this method, however, is the need to heuristically select two parameters that are crucial for the accurate estimation of the fluorescence decay: the Laguerre parameter alpha and the expansion order. Here, a new implementation of the Laguerre deconvolution method is introduced, in which a nonlinear least-square optimization of the Laguerre parameter alpha is performed, and the optimal expansion order is selected based on a minimum description length criterion (MDL). In addition, estimation of the zero-time delay between the recorded instrument response and fluorescence decay is also performed based on normalized mean square error criterion (NMSE). The method is validated on experimental data from fluorescence lifetime standards, endogenous tissue fluorophores, and human tissue. The proposed automated Laguerre deconvolution method will facilitate online applications of TRFS, such as real-time clinical tissue diagnosis.
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Affiliation(s)
- Aditi S Dabir
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas 77843, USA
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Lo J, Chen SJ, Fang Q, Papaioannou T, Kim ES, Gundersen M, Marcu L. Performance of a diaphragmed microlens for a packaged microspectrometer. SENSORS (BASEL, SWITZERLAND) 2009; 9:859-68. [PMID: 22399943 PMCID: PMC3280835 DOI: 10.3390/s90200859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 01/09/2009] [Accepted: 02/04/2009] [Indexed: 05/31/2023]
Abstract
This paper describes the design, fabrication, packaging and testing of a microlens integrated in a multi-layered MEMS microspectrometer. The microlens was fabricated using modified PDMS molding to form a suspended lens diaphragm. Gaussian beam propagation model was used to measure the focal length and quantify M(2) value of the microlens. A tunable calibration source was set up to measure the response of the packaged device. Dual wavelength separation by the packaged device was demonstrated by CCD imaging and beam profiling of the spectroscopic output. We demonstrated specific techniques to measure critical parameters of microoptics systems for future optimization of spectroscopic devices.
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Affiliation(s)
- Joe Lo
- Biomedical Engineering, University of Southern California, Los Angeles, CA, USA; E-Mail:
| | - Shih-Jui Chen
- Electrical Engineering and Electrophysics, University of Southern California, Los Angeles, CA USA; E-Mails: ; ;
| | - Qiyin Fang
- Cedars Sinai Medical Center, Los Angeles, CA, USA; E-Mail:
- Engineering Physics, McMaster University, Hamilton, Ontario, Canada; E-Mail:
| | | | - Eun-Sok Kim
- Electrical Engineering and Electrophysics, University of Southern California, Los Angeles, CA USA; E-Mails: ; ;
| | - Martin Gundersen
- Electrical Engineering and Electrophysics, University of Southern California, Los Angeles, CA USA; E-Mails: ; ;
| | - Laura Marcu
- Biomedical Engineering, University of California at Davis, USA
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Galletly N, McGinty J, Dunsby C, Teixeira F, Requejo-Isidro J, Munro I, Elson D, Neil M, Chu A, French P, Stamp G. Fluorescence lifetime imaging distinguishes basal cell carcinoma from surrounding uninvolved skin. Br J Dermatol 2008; 159:152-61. [DOI: 10.1111/j.1365-2133.2008.08577.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Meningiomas are mostly benign tumours originating from the arachnoid cap cells, represent 13-26% of all intracranial tumours. They are more common in older age and in females. Deletion in NF2 gene and exposure to ionizing radiation are established risk factors, while the role of sex hormones is yet not clarified. Five-year survival for typical meningiomas exceeds 80%, but is poorer (5-year survival <60%) in malignant and atypical meningiomas. Papillary and haemangiopericytic morphology, large tumour size, high mitotic index, absence of progesterone receptors, deletions and loss of heterozygosity are poor prognostic factors. Complete surgical excision is the standard treatment. Radiotherapy is currently used in the clinical practice in atypical, malignant or recurrent meningioma at a total dose of 45-60Gy. However, the role of adjuvant irradiation is still controversial and has to be compared in a randomised prospective setting with a policy of watchful waiting. Radiosurgery has gained more and more importance in the management of meningiomas, especially in meningiomas that cannot be completely resected as for many skull base meningiomas. Medical therapy for patients with recurrent, progressive and symptomatic disease after repeated surgery, radiosurgery and radiotherapy is investigational. Hormonal therapy with progesterone antagonists has shown modest results, while chemotherapy with hydroxyurea appears moderately active.
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