Review of tissue simulating phantoms for optical spectroscopy, imaging and dosimetry

Absorption Coefficient Estimation of Pigmented Skin Phantoms Using Colorimetric Parameters

The increasing use of light-based treatments requires a better understanding of the light tissue interaction for pigmented skin. To enhance comprehension in this area, this study proposes the use of pigmented-mimicking skin phantoms to assess the optical properties based on their tone, represented by the Individual Typology Angle (ITA) color scale. In this study, an epoxy resin matrix alongside compact facial powder and titanium dioxide was used to mimic the absorption, scattering, and shade properties of human skins. Eight phantoms covering the skin tones, light (ITA = 45.2°), tan (ITA = 23.3°), brown (ITA = 6.9°, -5.7°, and -16.9°), and dark (ITA = -34.6°, -41.6°, and -48.6°), were crafted. The absorption and reduced scattering coefficients were obtained using integrating spheres and calibrated spectrometers in the 500-900 nm range, and tones were measured using a commercial colorimeter. The experimental fitting proposed in this study could estimate the optical properties as a function of the skin tones through ITA values, by using an exponential function with a second-order polynomial exponent. This investigation aligns with prior studies involving human skin samples, and these findings hold promise for future clinical and diagnostic applications, particularly in the realm of light-based treatments to individual dermatological corrections in pigmented skin.

Fabrication and Characterization of Brain Tissue Phantoms Using Agarose Gels for Ultraviolet Vision Systems

Recreating cerebral tissue using a tissue-mimicking phantom is valuable because it provides a tool for studying physiological and biological processes related to tissues without the necessity of performing the study directly in the tissue or even in a patient. The reproduction of the optical properties allows investigation in areas such as imaging, optics, and ultrasound, among others. This paper presents a methodology for manufacturing agarose-based phantoms that mimic the optical characteristics of brain tissue using scattering and absorbing agents and proposes combinations of these agents to recreate the healthy brain tissue optical coefficients within the wavelength range of 350 to 500 nm. The results of the characterization of the manufactured phantoms propose ideal combinations of the used materials for their use in controlled environment experiments in the UV range, following a cost-effective methodology.

Optical tuning of copolymer-in-oil tissue-mimicking materials for multispectral photoacoustic imaging

Objective. The availability of tissue-mimicking materials (TMMs) for manufacturing high-quality phantoms is crucial for standardization, evaluating novel quantitative approaches, and clinically translating new imaging modalities, such as photoacoustic imaging (PAI). Recently, a gel comprising the copolymer styrene-ethylene/butylene-styrene (SEBS) in mineral oil has shown significant potential as TMM due to its optical and acoustic properties akin to soft tissue. We propose using artists' oil-based inks dissolved and diluted in balsam turpentine to tune the optical properties.Approach. A TMM was fabricated by mixing a SEBS copolymer and mineral oil, supplemented with additives to tune its optical absorption and scattering properties independently. A systematic investigation of the tuning accuracies and relationships between concentrations of oil-based pigments and optical absorption properties of the TMM across visible and near-infrared wavelengths using collimated transmission spectroscopy was conducted. The photoacoustic spectrum of various oil-based inks was studied to analyze the effect of increasing concentration and depth.Main results. Artists' oil-based inks dissolved in turpentine proved effective as additives to tune the optical absorption properties of mineral oil SEBS-gel with high accuracy. The TMMs demonstrated long-term stability and suitability for producing phantoms with desired optical absorption properties for PAI studies.Significance. The findings, including tuning of optical absorption and spectral shape, suggest that this TMM facilitates the development of more sophisticated phantoms of arbitrary shapes. This approach holds promise for advancing the development of PAI, including investigation of the spectral coloring effect. In addition, it can potentially aid in the development and clinical translation of ultrasound optical tomography.

Using torsional wave elastography to evaluate spring pot parameters in skin tumor mimicking phantoms

Estimating the tissue parameters of skin tumors is crucial for diagnosis and effective therapy in dermatology and related fields. However, identifying the most sensitive biomarkers require an optimal rheological model for simulating skin behavior this remains an ongoing research endeavor. Additionally, the multi-layered structure of the skin introduces further complexity to this task. In order to surmount these challenges, an inverse problem methodology, in conjunction with signal analysis techniques, is being employed. In this study, a fractional rheological model is presented to enhance the precision of skin tissue parameter estimation from the acquired signal from torsional wave elastography technique (TWE) on skin tumor-mimicking phantoms for lab validation and the estimation of the thickness of the cancerous layer. An exhaustive analysis of the spring-pot model (SP) solved by the finite difference time domain (FDTD) is conducted. The results of experiments performed using a TWE probe designed and prototyped in the laboratory were validated against ultrafast imaging carried out by the Verasonics Research System. Twelve tissue-mimicking phantoms, which precisely simulated the characteristics of skin tissue, were prepared for our experimental setting. The experimental data from these bi-layer phantoms were measured using a TWE probe, and the parameters of the skin tissue were estimated using inverse problem-solving. The agreement between the two datasets was evaluated by comparing the experimental data obtained from the TWE technique with simulated data from the SP- FDTD model using Pearson correlation, dynamic time warping (DTW), and time-frequency representation. Our findings show that the SP-FDTD model and TWE are capable of determining the mechanical properties of both layers in a bilayer phantom, using a single signal and an inverse problem approach. The ultrafast imaging and the validation of TWE results further demonstrate the robustness and reliability of our technology for a realistic range of phantoms. This fusion of the SP-FDTD model and TWE, as well as inverse problem-solving methods has the potential to have a considerable impact on diagnoses and treatments in dermatology and related fields.

Poly(2-Hydroxyethyl Methacrylate) Hydrogel-Based Microneedles for Bioactive Release

Microneedle arrays are minimally invasive devices that have been extensively investigated for the transdermal/intradermal delivery of drugs/bioactives. Here, we demonstrate the release of bioactive molecules (estradiol, melatonin and meropenem) from poly(2-hydroxyethyl methacrylate), pHEMA, hydrogel-based microneedle patches in vitro. The pHEMA hydrogel microneedles had mechanical properties that were sufficiently robust to penetrate soft tissues (exemplified here by phantom tissues). The bioactive release from the pHEMA hydrogel-based microneedles was fitted to various models (e.g., zero order, first order, second order). Such pHEMA microneedles have potential application in the transdermal delivery of bioactives (exemplified here by estradiol, melatonin and meropenem) for the treatment of various conditions.

Optical-coherence-tomography-based deep-learning scatterer-density estimator using physically accurate noise model

We demonstrate a deep-learning-based scatterer density estimator (SDE) that processes local speckle patterns of optical coherence tomography (OCT) images and estimates the scatterer density behind each speckle pattern. The SDE is trained using large quantities of numerically simulated OCT images and their associated scatterer densities. The numerical simulation uses a noise model that incorporates the spatial properties of three types of noise, i.e., shot noise, relative-intensity noise, and non-optical noise. The SDE's performance was evaluated numerically and experimentally using two types of scattering phantom and in vitro tumor spheroids. The results confirmed that the SDE estimates scatterer densities accurately. The estimation accuracy improved significantly when compared with our previous deep-learning-based SDE, which was trained using numerical speckle patterns generated from a noise model that did not account for the spatial properties of noise.

Simultaneous reconstruction of 3D fluorescence distribution and object surface using structured light illumination and dual-camera detection

Fluorescence molecular tomography (FMT) serves as a noninvasive modality for visualizing volumetric fluorescence distribution within biological tissues, thereby proving to be an invaluable imaging tool for preclinical animal studies. The conventional FMT relies upon a point-by-point raster scan strategy, enhancing the dataset for subsequent reconstruction but concurrently elongating the data acquisition process. The resultant diminished temporal resolution has persistently posed a bottleneck, constraining its utility in dynamic imaging studies. We introduce a novel system capable of simultaneous FMT and surface extraction, which is attributed to the implementation of a rapid line scanning approach and dual-camera detection. The system performance was characterized through phantom experiments, while the influence of scanning line density on reconstruction outcomes has been systematically investigated via both simulation and experiments. In a proof-of-concept study, our approach successfully captures a moving fluorescence bolus in three dimensions with an elevated frame rate of approximately 2.5 seconds per frame, employing an optimized scan interval of 5 mm. The notable enhancement in the spatio-temporal resolution of FMT holds the potential to broaden its applications in dynamic imaging tasks, such as surgical navigation.

Quantitative prediction of AFB1 in various types of edible oil based on absorption, scattering and fluorescence signals at dual wavelengths

This study aims to address the challenge of matrix interference of various types of edible oils on intrinsic fluorescence of aflatoxin B1 (AFB1) by developing a novel solution. Considering the fluorescence internal filtering effect, the absorption (μa) and reduced scattering (μ's) coefficients at dual wavelengths (excitation: 375 nm, emission: 450 nm) were obtained by using integrating sphere technique, and were used to improve the quantitative prediction results for AFB1 contents in six different kinds of edible oils. A research process of "Monte Carlo (MC) simulation - phantom verification - actual sample validation" was conducted. The MC simulation was used to determine interference rule and correction parameters for fluorescence, the results indicated that the escaped fluorescence flux nonlinearly decreased with the μa, μ's at emission wavelength (μa,em, μ's,em) and μa at excitation wavelength (μa,ex), however increased with the μ's at excitation wavelength (μ's,ex). And the required optical parameters to eliminate the interference of matrix on fluorescence intensity are: effective attenuation coefficients at excitation and emission wavelengths (μeff,ex, μeff,em) and μ's,ex. Phantom verification was conducted to explore the feasibility of fluorescence correction based on the identified parameters by MC simulation, and determine the optimal machine learning method. The modelling results showed that least squares support vector regression (LSSVR) model could reach the best performance. Three kinds of edible oil (peanut, rapeseed, corn), each with two brands were used to prepare oil samples with different AFB1 contamination. The LSSVR model for AFB1 based on μeff,ex, μeff,em, μ's,ex and fluorescence intensity at 450 nm was calibrated, both correlation coefficients for calibration (Rc) and the validation (Rv) sets could reach 1.000, root mean square errors for calibration (RMSEC) and the validation (RMSEV) sets were as low as 0.038 and 0.099 respectively. This study proposed a novel method which is based solely on the absorption, scattering, and fluorescence characteristics at excitation and emission wavelengths to achieve accurate prediction of AFB1 content in different types of vegetable oils.

Engineering vascularized skin-mimetic phantom for non-invasive Raman spectroscopy

Recent advances in Raman spectroscopy have shown great potential for non-invasive analyte sensing, but the lack of a standardized optical phantom for these measurements has hindered further progress. While many research groups have developed optical phantoms that mimic bulk optical absorption and scattering, these materials typically have strong Raman scattering, making it difficult to distinguish metabolite signals. As a result, solid tissue phantoms for spectroscopy have been limited to highly scattering tissues such as bones and calcifications, and metabolite sensing has been primarily performed using liquid tissue phantoms. To address this issue, we have developed a layered skin-mimetic phantom that can support metabolite sensing through Raman spectroscopy. Our approach incorporates millifluidic vasculature that mimics blood vessels to allow for diffusion akin to metabolite diffusion in the skin. Furthermore, our skin phantoms are mechanically mimetic, providing an ideal model for development of minimally invasive optical techniques. By providing a standardized platform for measuring metabolites, our approach has the potential to facilitate critical developments in spectroscopic techniques and improve our understanding of metabolite dynamics in vivo.

Tissue mimicking materials and finger phantom design for pulse oximetry

Pulse oximetry represents a ubiquitous clinical application of optics in modern medicine. Recent studies have raised concerns regarding the potential impact of confounders, such as variable skin pigmentation and perfusion, on blood oxygen saturation measurement accuracy in pulse oximeters. Tissue-mimicking phantom testing offers a low-cost, well-controlled solution for characterizing device performance and studying potential error sources, which may thus reduce the need for costly in vivo trials. The purpose of this study was to develop realistic phantom-based test methods for pulse oximetry. Material optical and mechanical properties were reviewed, selected, and tuned for optimal biological relevance, e.g., oxygenated tissue absorption and scattering, strength, elasticity, hardness, and other parameters representing the human finger's geometry and composition, such as blood vessel size and distribution, and perfusion. Relevant anatomical and physiological properties are summarized and implemented toward the creation of a preliminary finger phantom. To create a preliminary finger phantom, we synthesized a high-compliance silicone matrix with scatterers for embedding flexible tubing and investigated the addition of these scatterers to novel 3D printing resins for optical property control without altering mechanical stability, streamlining the production of phantoms with biologically relevant characteristics. Phantom utility was demonstrated by applying dynamic, pressure waveforms to produce tube volume change and resultant photoplethysmography (PPG) signals. 3D printed phantoms achieved more biologically relevant conditions compared to molded phantoms. These preliminary results indicate that the phantoms show strong potential to be developed into tools for evaluating pulse oximetry performance. Gaps, recommendations, and strategies are presented for continued phantom development.

Interferometric near-infrared spectroscopy (iNIRS) reveals that blood flow index depends on wavelength

Blood flow index (BFI) is an optically accessible parameter, with unit distance-squared-over-time, that is widely used as a proxy for tissue perfusion. BFI is defined as the dynamic scattering probability (i.e. the ratio of dynamic to overall reduced scattering coefficients) times an effective Brownian diffusion coefficient that describes red blood cell (RBC) motion. Here, using a wavelength division multiplexed, time-of-flight- (TOF) - resolved iNIRS system, we obtain TOF-resolved field autocorrelations at 773 nm and 855 nm via the same source and collector. We measure the human forearm, comprising biological tissues with mixed static and dynamic scattering, as well as a purely dynamic scattering phantom. Our primary finding is that forearm BFI increases from 773 nm to 855 nm, though the magnitude of this increase varies across subjects (23% ± 19% for N = 3). However, BFI is wavelength-independent in the purely dynamic scattering phantom. From these data, we infer that the wavelength-dependence of BFI arises from the wavelength-dependence of the dynamic scattering probability. This inference is further supported by RBC scattering literature. Our secondary finding is that the higher-order cumulant terms of the mean squared displacement (MSD) of RBCs are significant, but decrease with wavelength. Thus, laser speckle and related modalities should exercise caution when interpreting field autocorrelations.

AAPM Task Group Report 311: Guidance for performance evaluation of fluorescence-guided surgery systems

The last decade has seen a large growth in fluorescence-guided surgery (FGS) imaging and interventions. With the increasing number of clinical specialties implementing FGS, the range of systems with radically different physical designs, image processing approaches, and performance requirements is expanding. This variety of systems makes it nearly impossible to specify uniform performance goals, yet at the same time, utilization of different devices in new clinical procedures and trials indicates some need for common knowledge bases and a quality assessment paradigm to ensure that effective translation and use occurs. It is feasible to identify key fundamental image quality characteristics and corresponding objective test methods that should be determined such that there are consistent conventions across a variety of FGS devices. This report outlines test methods, tissue simulating phantoms and suggested guidelines, as well as personnel needs and professional knowledge bases that can be established. This report frames the issues with guidance and feedback from related societies and agencies having vested interest in the outcome, coming from an independent scientific group formed from academics and international federal agencies for the establishment of these professional guidelines.

Investigations on correlations between changes of optical tissue properties and NMR relaxation times

BACKGROUND

Accurate light dosimetry is a complex remaining challenge in interstitial photodynamic therapy (iPDT) for malignant gliomas. The light dosimetry should ideally be based on the tissue morphology and the individual optical tissue properties of each tissue type in the target region. First investigations are reported on using NMR information to estimate changes of individual optical tissue properties.

METHODS

Porcine brain tissue and optical tissue phantoms were investigated. To the porcine brain, supplements were added to simulate an edema or high blood content. The tissue phantoms were based on agar, Lipoveneous, ink, blood and gadobutrol (Gd-based MRI contrast agent). The concentrations of phantom ingredients and tissue additives are varied to compare concentration-dependent effects on optical and NMR properties. A 3-tesla whole-body MRI system was used to determine T1 and T2 relaxation times. Optical tissue properties, i.e., the spectrally resolved absorption and reduced scattering coefficient, were obtained using a single integrating sphere setup. The observed changes of NMR and optical properties were compared to each other.

RESULTS

By adjusting the NMR relaxation times and optical tissue properties of the tissue phantoms to literature values, recipes for human brain tumor, white matter and grey matter tissue phantoms were obtained that mimic these brain tissues simultaneously in both properties. For porcine brain tissue, it was observed that with increasing water concentration in the tissue, both NMR-relaxation times increased, while µa decreased and µs' increased at 635 nm. The addition of blood to porcine brain samples showed a constant T1, while T2 shortened and the absorption coefficient at 635 nm increased.

CONCLUSIONS

In this investigation, by changing sample contents, notable changes of both NMR relaxation times and optical tissue properties have been observed and their relations examined. The developed dual NMR/optical tissue phantoms can be used in iPDT research, clinical training and demonstrations.

Development of a glass-based imaging phantom to model the optical properties of human tissue

The fabrication of a stable, reproducible optical imaging phantom is critical to the assessment and optimization of optical imaging systems. We demonstrate the use of an alternative material, glass, for the development of tissue-mimicking phantoms. The glass matrix was doped with nickel ions to approximate the absorption of hemoglobin. Scattering levels representative of human tissue were induced in the glass matrix through controlled crystallization at elevated temperatures. We show that this type of glass is a viable material for creating tissue-mimicking optical phantoms by providing controlled levels of scattering and absorption with excellent optical homogeneity, long-term stability and reproducibility.

Wavefront shaping improves the transparency of the scattering media: a review

Significance

Wavefront shaping (WFS) can compensate for distortions by optimizing the wavefront of the input light or reversing the transmission matrix of the media. It is a promising field of research. A thorough understanding of principles and developments of WFS is important for optical research.

Aim

To provide insight into WFS for researchers who deal with scattering in biomedicine, imaging, and optical communication, our study summarizes the basic principles and methods of WFS and reviews recent progress.

Approach

The basic principles, methods of WFS, and the latest applications of WFS in focusing, imaging, and multimode fiber (MMF) endoscopy are described. The practical challenges and prospects of future development are also discussed.

Results

Data-driven learning-based methods are opening up new possibilities for WFS. High-resolution imaging through MMFs can support small-diameter endoscopy in the future.

Conclusion

The rapid development of WFS over the past decade has shown that the best solution is not to avoid scattering but to find ways to correct it or even use it. WFS with faster speed, more optical modes, and more modulation degrees of freedom will continue to drive exciting developments in various fields.

Onward to Better Surgery - the Critical Need for Improved Ex Vivo Testing and Training Methods

Guided surgery has demonstrated significant improvements in patient outcomes in some disease processes. Interest in this field has led to substantial growth in the technologies under investigation. Most likely no single technology will prove to be "best," and combinations of macro- and microscale guidance-using radiological imaging navigation, probes (activatable, perfusion, and molecular-targeted; large- and small-molecule), autofluorescence, tissue intrinsic optical properties, bioimpedance, and other characteristics-will offer patients and surgeons the greatest opportunity for high-success/low-morbidity medical interventions. Problems are arising, however, from the lack of valid testing formats; surgical training simulators suffer the same problems. Small animal models do not accurately recreate human anatomy, especially in terms of tissue volume. Large animal models are expensive and have difficulty replicating many pathological states, particularly when molecular specificity for individual cancers is required. Furthermore, the sheer number of technologies and the potential for synergistic combination leads to exponential growth of testing requirements that is unrealistic for in vivo testing. Therefore, critical need exists to expand the ex vivo/in vitro testing platforms available to investigators and, once validated, a need to increase the acceptance of these methods for funding and regulatory endpoints. Herein is a review of the available ex vivo/in vitro testing formats for guided surgery, a review of their advantages/disadvantages, and consideration for how our field may safely and more swiftly move forward through stronger adoption of these testing and validation methods.

Agarose Gel Characterization for the Fabrication of Brain Tissue Phantoms for Infrared Multispectral Vision Systems

Synthetic phantoms that recreate the characteristics of biological tissues are valuable tools for systematically studying and comprehending physiologies, pathologies, and biological processes related to tissues. The reproduction of mechanical and optical properties allows for the development and evaluation of novel systems and applications in areas such as imaging, optics, ultrasound, or dosimetry, among others. This paper proposes a methodology for manufacturing agarose-based phantoms that mimics the optical properties of healthy brain tissue within the wavelength infrared range of 800 to 820 nm. The fabrication of such phantoms enables the possibility of testing and experimentation in controlled and safe environments toward the design of new near-infrared multispectral imaging systems in neurosurgery. The results of an experimental optical characterization study indicate the validity and reliability of the proposed method for fabricating brain tissue phantoms in a cost-effective and straightforward fashion.

Focusing Coherent Light through Volume Scattering Phantoms via Wavefront Shaping

Manipulating the wavefront of coherent light incident on scattering media to enhance the imaging depth, sensitivity, and resolution is a common technique in biomedical applications. Local phase variations cause changes in the interference and can be used to create a focus inside or behind a scattering medium. We use wavefront shaping (WFS) to force constructive interference at an arbitrary location. The amount of light transmitted into a given region strongly depends on the scattering and absorption characteristics. These are described by their respective coefficients μs and μa and the scattering phase function. Controlling the scattering and absorption coefficients, we study the behavior of wavefront shaping and the achievable intensity enhancement behind volume scattering media with well-defined optical properties. The phantoms designed in this publication are made of epoxy resin. Into these epoxy matrices, specific amounts of scattering and absorbing particles, such as titanium dioxide pigments and molecular dyes, are mixed. The mixture obtained is filled into 3D-printed frames of various thicknesses. After a precise fabrication procedure, an integrating sphere-based setup characterizes the phantoms experimentally. It detects the total hemispherical transmission and reflection. Further theoretical characterization is performed with a newly developed hybrid PN method. This method senses the flux of light into a particular angular range at the lower boundary of a slab. The calculations are performed without suffering from ringing and fulfill the exact boundary conditions there. A decoupled two-path detection system allows for fast optimization as well as sensitive detection. The measurements yield results that agree well with the theoretically expected behavior.

Fabrication and characterization of multi-biomarker optimized tissue-mimicking phantoms for multi-modal optical spectroscopy

Rapid advancement of novel optical spectroscopy and imaging systems relies on the availability of well-characterised and reproducible protocols for phantoms as a standard for the validation of the technique. The tissue-mimicking phantoms are also used to investigate photon transport in biological samples before clinical trials that require well-characterized phantoms with known optical properties (reduced scattering (μ's) and absorption (μa) coefficients). However, at present, there is limited literature available providing well-characterized phantom recipes considering various biomarkers and tested over a wide range of optical properties covering most of the human organs and applicable to multimodal optical spectroscopy. In this study, gelatin-based phantoms were designed to simulate tissue optical properties where India ink and Intralipid were used as absorbing and scattering agents, respectively. Multiple biomarkers were simulated by varying the gelatin concentration to mimic the change in tissue hydration and hydroxyapatite concentration to mimic bone signature. The recipe along with biomarkers were optimized and characterised over a wide range of optical properties (μa from 0.1 to 0.5 cm-1; μ's from 5 to 15 cm-1) relevant to human tissue using a broadband time-domain diffuse optical spectrometer. The data collected showed a linear relationship between the concentration of ink/lipids and μa/μ's values with negligible coupling between μa and μ's values. While being stored in a refrigerator post-fabrication, the μa and μ's did not change significantly (<4% coefficient of variation, 'CV') over three weeks. The reproducibility in three different sets was validated experimentally and found to be strong with a variation of ≤6% CV in μa and ≤9% CV in μ's. From the 3 × 3 data of μa and μ's matrices, one can deduce the recipe for any target absorption or reduced scattering coefficient. The applicability of the phantoms was tested using diffuse reflectance and Raman spectrometers. A use case application was demonstrated for Raman spectroscopy where hydration and hydroxyapatite phantoms were designed to characterize the Raman instrument. The Raman instrument could detect the change in 1% of HA and 5% of hydration. This study presents a first-of-its-kind robust, well-characterized, multi-biomarker phantom recipe for calibration and benchmarking of multimodal spectroscopy devices assisting in their clinical translation.

Durable 3D murine ex vivo retina glaucoma models for optical coherence tomography

Durable and standardized phantoms with optical properties similar to native healthy and disease-like biological tissues are essential tools for the development, performance testing, calibration and comparison of label-free high-resolution optical coherence tomography (HR-OCT) systems. Available phantoms are based on artificial materials and reflect thus only partially ocular properties. To address this limitation, we have performed investigations on the establishment of durable tissue phantoms from ex vivo mouse retina for enhanced reproduction of in vivo structure and complexity. In a proof-of-concept study, we explored the establishment of durable 3D models from dissected mouse eyes that reproduce the properties of normal retina structures and tissue with glaucoma-like layer thickness alterations. We explored different sectioning and preparation procedures for embedding normal and N-methyl-D-aspartate (NMDA)-treated mouse retina in transparent gel matrices and epoxy resins, to generate durable three-dimensional tissue models. Sample quality and reproducibility were quantified by thickness determination of the generated layered structures utilizing computer-assisted segmentation of OCT B-scans that were acquired with a commercial HR-OCT system at a central wavelength of 905 nm and analyzed with custom build software. Our results show that the generated 3D models feature thin biological layers close to current OCT resolution limits and glaucoma-like tissue alterations that are suitable for reliable HR-OCT performance characterization. The comparison of data from resin-embedded tissue with native murine retina in gels demonstrates that by utilization of appropriate preparation protocols, highly stable samples with layered structures equivalent to native tissues can be fabricated. The experimental data demonstrate our concept as a promising approach toward the fabrication of durable biological 3D models suitable for high-resolution OCT system performance characterization supporting the development of optimized instruments for ophthalmology applications.

Intraoperative identification of functional brain areas with RGB imaging using statistical parametric mapping: Simulation and clinical studies

Complementary technique to preoperative fMRI and electrical brain stimulation (EBS) for glioma resection could improve dramatically the surgical procedure and patient care. Intraoperative RGB optical imaging is a technique for localizing functional areas of the human cerebral cortex that can be used during neurosurgical procedures. However, it still lacks robustness to be used with neurosurgical microscopes as a clinical standard. In particular, a robust quantification of biomarkers of brain functionality is needed to assist neurosurgeons. We propose a methodology to evaluate and optimize intraoperative identification of brain functional areas by RGB imaging. This consist in a numerical 3D brain model based on Monte Carlo simulations to evaluate intraoperative optical setups for identifying functional brain areas. We also adapted fMRI Statistical Parametric Mapping technique to identify functional brain areas in RGB videos acquired for 12 patients. Simulation and experimental results were consistent and showed that the intraoperative identification of functional brain areas is possible with RGB imaging using deoxygenated hemoglobin contrast. Optical functional identifications were consistent with those provided by EBS and preoperative fMRI. We also demonstrated that a halogen lighting may be particularity adapted for functional optical imaging. We showed that an RGB camera combined with a quantitative modeling of brain hemodynamics biomarkers can evaluate in a robust way the functional areas during neurosurgery and serve as a tool of choice to complement EBS and fMRI.

Development of a morphologically realistic mouse phantom for pre-clinical photoacoustic imaging

BACKGROUND

Characterizations based on anatomically realistic phantoms are highly effective to perform accurate technical validation of imaging systems. Specifically for photoacoustic imaging (PAI), although a variety of phantom models with simplified geometries are reported, an unmet need still exists to establish morphologically realistic heterogeneous pre-clinical phantoms. So the development of a mouse-mimicking phantom can reduce the use of animals for the validation and standardization studies of pre-clinical PAI systems and thus eventually translate the PAI technology to clinical research.

PURPOSE

Here we designed, developed, and fabricated a stable phantom that mimics the detailed morphology of a mouse, to be used as a realistic tool for PAI.

METHODS

The mouse phantom, has been designed by using a combination of image modeling and 3D-printing techniques. As a tissue-mimicking material, we have used copolymer-in-oil-based material that was recently proposed by the International Photoacoustic Standardization Consortium (IPASC). In particular, the anatomically realistic phantom has been modeled by using the real atlas of a mouse as a reference. The mouse phantom includes a 3D-printed skeleton and the main abdominal organs such as the liver, spleen, and kidneys obtained by using doped copolymer-in-oil material with 3D-printed molds. In addition, the acoustic and optical properties of the tissue-mimicking material and the long-term stability have been broadly characterized.

RESULTS

Furthermore, our studies showed that the phantom is durable and stable for more than 200 days, under normal storage and repeated use. Fabrication protocol is easy to reproduce. As a result, the proposed morphologically realistic mouse phantom offers durability, material compatibility, and an unprecedented realistic resemblance to the actual rodents' anatomy in PAI.

CONCLUSION

This durable morphologically realistic mouse phantom would minimize the animal experiments in compliance with the 3R principle of Replacement, Reduction, and Refinement. To our knowledge, this is the first time an anatomically realistic heterogeneous mouse phantom has been proposed for PAI in pre-clinical animal imaging and tested its durability over 200 days.

Design and characterization of color printed polyurethane films as biomedical phantom layers

We propose a new, user-friendly and accessible approach for fabricating thin phantoms with controllable absorption properties in magnitude, spectral shape, and spatial distribution. We utilize a standard office laser color printer to print on polyurethane thin films (40 - 60 μm), commonly available as medical film dressings and ultrasound probe covers. We demonstrate that the optical attenuation and absorption of the printed films correlate linearly with the printer input settings (opacity), which facilitates a systematic phantom design. The optical and acoustic properties of these polyurethane films are similar to biological tissue. We argue that these thin phantoms are applicable to a wide range of biomedical applications. Here, we introduce two potential applications: (1) homogeneous epidermal melanin phantoms and (2) spatially resolved absorbers for photoacoustic imaging. We characterize the thin phantoms in terms of optical properties, thickness, microscopic structure, and reproducibility of the printing process.

Assessment of open-field fluorescence guided surgery systems: implementing a standardized method for characterization and comparison

Significance

Fluorescence guided surgery (FGS) has demonstrated improvements in decision making and patient outcomes for a wide range of surgical procedures. Not only can FGS systems provide a higher level of structural perfusion accuracy in tissue reconstruction cases but they can also serve for real-time functional characterization. Multiple FGS devices have been Food and Drug administration (FDA) cleared for use in open and laparoscopic surgery. Despite the rapid growth of the field, there has been a lack standardization methods.

Aim

This work overviews commonalities inherent to optical imaging methods that can be exploited to produce such a standardization procedure. Furthermore, a system evaluation pipeline is proposed and executed through the use of photo-stable indocyanine green fluorescence phantoms. Five different FDA-approved open-field FGS systems are used and evaluated with the proposed method.

Approach

The proposed pipeline encompasses the following characterization: (1) imaging spatial resolution and sharpness, (2) sensitivity and linearity, (3) imaging depth into tissue, (4) imaging system DOF, (5) uniformity of illumination, (6) spatial distortion, (7) signal to background ratio, (8) excitation bands, and (9) illumination wavelength and power.

Results

The results highlight how such a standardization approach can be successfully implemented for inter-system comparisons as well as how to better understand essential features within each FGS setup.

Conclusions

Despite clinical use being the end goal, a robust yet simple standardization pipeline before clinical trials, such as the one presented herein, should benefit regulatory agencies, manufacturers, and end-users to better assess basic performance and improvements to be made in next generation FGS systems.

Near-infrared phototheranostics of tumors with protoporphyrin IX and chlorin e6 photosensitizers

BACKGROUND

The study aims to develop a method for phototheranostics of tumors in the near-infrared (NIR) range using protoporphyrin IX (PpIX) and chlorin e6 (Ce6) photosensitizers (PSs) MATERIALS AND METHODS: Phototheranostics includes spectral fluorescence diagnostics of PS distribution and photodynamic therapy (PDT) using a single laser in the red spectral range. PpIX and Ce6 fluorescence were registered in the NIR range. PpIX and Ce6 photobleaching was determined during PDT by the change in PS fluorescence. NIR phototheranostics with PpIX and Ce6 were performed on optical phantoms and tumors of patients with oral leukoplakia and basal cell carcinoma.

RESULTS

NIR spectral fluorescence diagnostics of optical phantoms with PpIX or Ce6 is possible when fluorescence is excited by 635 or 660 nm lasers. Fluorescence intensity of PpIX and Ce6 was measured in the range of 725-780 nm. The highest values of signal-to-noise in the case of phantoms with PpIX were observed at λ_exc=635 nm, and for phantoms with Ce6 at λ_exc=660 nm. NIR phototheranostics provides the detection of tumor tissues with PpIX or Ce6 accumulation. The PSs photobleaching in the tumor during PDT occurs according to a bi-exponential law.

CONCLUSION

Phototheranostics of tumors containing PpIX or Ce6 allows fluorescent monitoring of PS distribution in the NIR range and measuring PSs photobleaching during light exposure that provides personalization of the photodynamic exposure duration to deeper tumors. Using a single laser for fluorescence diagnostics and PDT reduces patient treatment time.

Stable tissue-mimicking phantoms for longitudinal multimodality imaging studies that incorporate optical, CT, and MRI contrast

Significance

Tissue phantoms that mimic the optical and radiologic properties of human or animal tissue play an important role in the development, characterization, and evaluation of imaging systems. Phantoms that are easily produced and stable for longitudinal studies are highly desirable.

Aim

A new type of long-lasting phantom was developed with commercially available materials and was assessed for fabrication ease, stability, and optical property control. Magnetic resonance imaging (MRI) and x-ray computed tomography (CT) contrast properties were also evaluated.

Approach

A systematic investigation of relationships between concentrations of skin-like pigments and composite optical properties was conducted to realize optical property phantoms in the red and near-infrared (NIR) wavelength range that also offered contrast for CT and MRI.

Results

Phantom fabrication time was < 1    h and did not involve any heating or cooling processes. Changes in optical properties were < 2 % over a 12-month period. Phantom optical and spectral features were similar to human soft tissue over the red to NIR wavelength ranges. Pigments used in the study also had CT and MRI contrasts for multimodality imaging studies.

Conclusions

The phantoms described here mimic optical properties of soft tissue and are suitable for multimodality imaging studies involving CT or MRI without adding secondary contrast agents.

Emerging Technology for Intraoperative Margin and Assisting in Post-Surgery tissue diagnostic for Future Breast-Conserving

INTRODUCTION

Tissue-preserving surgery is utilized progressively in cancer therapy, where a clear surgical margin is critical to avoid cancer recurrence, specifically in breast cancer (BC) surgery. The Intraoperative pathologic approaches that rely on tissue segmenting and staining have been recognized as the ground truth for BC diagnosis. Nevertheless, these methods are constrained by its complication and timewasting for tissue preparation.

OBJECTIVE

We present a non-invasive optical imaging system incorporating a hyperspectral (HS) camera to discriminate between cancerous and non-cancerous tissues in ex-vivo breast specimens, which could be an intraoperative diagnostic technique to aid surgeons during surgery and later a valuable tool to assist pathologists.

METHODS

We have established a hyperspectral Imaging (HSI) system comprising a push-broom HS camera at wavelength 380∼1050 nm with source light 390∼980 nm. We have measured the investigated samples' diffuse reflectance (R_d), fixed on slides from 30 distinct patients incorporating mutually normal and ductal carcinoma tissue. The samples were divided into two groups, stained tissues during the surgery (control group) and unstained samples (test group), both captured with the HSI system in the visible and near-infrared (VIS-NIR) range. Then, to address the problem of the spectral nonuniformity of the illumination device and the influence of the dark current, the radiance data were normalized to yield the radiance of the specimen and neutralize the intensity effect to focus on the spectral reflectance shift for each tissue. The selection of the threshold window from the measured R_d is carried out by exploiting the statistical analysis by calculating each region's mean and standard deviation. Afterward, we selected the optimum spectral images from the HS data cube to apply a custom K-means algorithm and contour delineation to identify the regular districts from the BC regions.

RESULTS

We noticed that the measured spectral R_d for the malignant tissues of the investigated case studies versus the reference source light varies regarding the cancer stage, as sometimes the R_d is higher for the tumor or vice versa for the normal tissue. Later, from the analysis of the whole samples, we found that the most appropriate wavelength for the BC tissues was 447 nm, which was highly reflected versus the normal tissue. However, the most convenient one for the normal tissue was at 545 nm with high reflection versus the BC tissue. Finally, we implement a moving average filter for noise reduction and a custom K-means clustering algorithm on the selected two spectral images (447, 551 nm) to identify the various regions and effectively-identified spectral tissue variations with a sensitivity of 98.95%, and specificity of 98.44%. A pathologist later confirmed these outcomes as the ground truth for the tissue sample investigations.

CONCLUSIONS

The proposed system could help the surgeon and the pathologist identify the cancerous tissue margins from the non-cancerous tissue with a non-invasive, rapid, and minimum time method achieving high sensitivity up to 98.95%.

Challenges in, and recommendations for, hyperspectral imaging in ex vivo malignant glioma biopsy measurements

The visualization of protoporphyrin IX (PPIX) fluorescence with the help of surgical microscopes during 5-aminolevulinic acid-mediated fluorescence-guided resection (FGR) of gliomas is still limited at the tumor margins. Hyperspectral imaging (HI) detects PPIX more sensitively but is not yet ready for intraoperative use. We illustrate the current status with three experiments and summarize our own experience using HI: (1) assessment of HI analysis algorithm using pig brain tissue, (2) a partially retrospective evaluation of our experience from HI projects, and (3) device comparison of surgical microscopy and HI. In (1), we address the problem that current algorithms for evaluating HI data are based on calibration with liquid phantoms, which have limitations. Their pH is low compared to glioma tissue; they provide only one PPIX photo state and only PPIX as fluorophore. Testing the HI algorithm with brain homogenates, we found proper correction for optical properties but not pH. Considerably more PPIX was measured at pH 9 than at pH 5. In (2), we indicate pitfalls and guide HI application. In (3), we found HI superior to the microscope for biopsy diagnosis (AUC = 0.845 ± 0.024 (cut-off 0.75 µg PPIX/ml) vs. 0.710 ± 0.035). HI thus offers potential for improved FGR.

Solid optical tissue phantom tools based on upconverting nanoparticles for biomedical applications

SIGNIFICANCE

Phantoms play a critical role in the development of biophotonics techniques. There is a lack of novel phantom tools in the emerging field of upconverting nanoparticles (UCNPs) for biophotonics application. This work provides a range of UCNP-based phantom tools and a manufacturing recipe to bridge the gap and accelerate the development of UCNP-based biophotonics applications.

AIM

The study aims to provide a well-characterized UCNP-based solid phantom recipe and set of phantom tools to address a wide range of UCNP-based biophotonics applications.

APPROACH

A solid phantom recipe based on silicone matrix was developed to manufacture UCNP-based phantoms. A lab built UCNP imaging system was used to characterize upconverted fluorescence emission of phantoms for linearity, homogeneity, and long-term stability. A photon time-of-flight spectroscopy technique was used to characterize the optical properties of the phantoms.

RESULTS

In total, 24 phantoms classified into 4 types, namely homogeneous, multilayer, inclusion, and base phantoms, were manufactured. The phantoms exhibit linear behavior over the dosage range of UCNPs. The phantoms were found to be stable over a limited observed period of 4 months with a coefficient of variation of < 4 % . The deep tissue imaging case showed that increasing the thickness of tissue reduced the UCNP emission.

CONCLUSIONS

A first-of-its-kind UCNP-based solid phantom recipe was developed, and four types of UCNP phantom tools to explore biophotonics applications were presented. The UCNP phantoms exhibited a linear behavior with dosage and were stable over time. An example case showed the potential use of the phantom for deep tissue imaging applications. With recent advance in the use of UCNPs for biophotonics, we believe our recipe and tools will play a pivotal role in the growth of the UCNPs for biophotonics applications.

Fluorescence guidance improves the accuracy of radiological imaging-guided surgical navigation

BACKGROUND

Imaging-based navigation technologies require static referencing between the target anatomy and the optical sensors. Imaging-based navigation is therefore well suited to operations involving bony anatomy; however, these technologies have not translated to soft-tissue surgery. We sought to determine if fluorescence imaging complement conventional, radiological imaging-based navigation to guide the dissection of soft-tissue phantom tumors.

METHODS

Using a human tissue-simulating model, we created tumor phantoms with physiologically accurate optical density and contrast concentrations. Phantoms were dissected using all possible combinations of computed tomography (CT), magnetic resonance, and fluorescence imaging; controls were included. The data were margin accuracy, margin status, tumor spatial alignment, and dissection duration.

RESULTS

Margin accuracy was higher for combined navigation modalities compared to individual navigation modalities, and accuracy was highest with combined CT and fluorescence navigation (p = 0.045). Margin status improved with combined CT and fluorescence imaging.

CONCLUSIONS

At present, imaging-based navigation has limited application in guiding soft-tissue tumor operations due to its inability to compensate for positional changes during surgery. This study indicates that fluorescence guidance enhances the accuracy of imaging-based navigation and may be best viewed as a synergistic technology, rather than a competing one.

Development of a platform for broadband, spectra-fitted, tissue optical phantoms

SIGNIFICANCE

Current methods of producing optical phantoms are incapable of accurately capturing the wavelength-dependent properties of tissue critical for many optical modalities.

AIM

We aim to introduce a method of producing solid, inorganic phantoms whose wavelength-dependent optical properties can be matched to those of tissue over the wavelength range of 370 to 950 nm.

APPROACH

The concentration-dependent optical properties of 20 pigments were characterized and used to determine combinations that result in optimal fits compared to the target properties over the full spectrum. Phantoms matching the optical properties of muscle and nerve, the diffuse reflectance of pale and melanistic skin, and the chromophore concentrations of a computational skin model with varying oxygen saturation ( StO 2 ) were made with this method.

RESULTS

Both optical property phantoms were found to accurately mimic their respective tissues' absorption and scattering properties across the entire spectrum. The diffuse reflectance phantoms were able to closely approximate skin reflectance regardless of skin type. All three computational skin phantoms were found to have emulated chromophore concentrations close to the model, with an average percent error for the StO 2 of 4.31%.

CONCLUSIONS

This multipigment phantom platform represents a powerful tool for creating spectrally accurate tissue phantoms, which should increase the availability of standards for many optical techniques.

Diffuse reflectance spectroscopy of the spine: improved breach detection with angulated fibers

Accuracy in spinal fusion varies greatly depending on the experience of the physician. Real-time tissue feedback with diffuse reflectance spectroscopy has been shown to provide cortical breach detection using a conventional probe with two parallel fibers. In this study, Monte Carlo simulations and optical phantom experiments were conducted to investigate how angulation of the emitting fiber affects the probed volume to allow for the detection of acute breaches. Difference in intensity magnitude between cancellous and cortical spectra increased with the fiber angle, suggesting that outward angulated fibers are beneficial in acute breach scenarios. Proximity to the cortical bone could be detected best with fibers angulated at θ f = 45 ∘ for impending breaches between θ p = 0 ∘ and θ p = 45 ∘ . An orthopedic surgical device comprising a third fiber perpendicular to the device axis could thus cover the full impending breach range from θ p = 0 ∘ to θ p = 90 ∘ .

Current and Future Applications of Fluorescence Guidance in Orthopaedic Surgery

Fluorescence-guided surgery (FGS) is an evolving field that seeks to identify important anatomic structures or physiologic phenomena with helpful relevance to the execution of surgical procedures. Fluorescence labeling occurs generally via the administration of fluorescent reporters that may be molecularly targeted, enzyme-activated, or untargeted, vascular probes. Fluorescence guidance has substantially changed care strategies in numerous surgical fields; however, investigation and adoption in orthopaedic surgery have lagged. FGS shows the potential for improving patient care in orthopaedics via several applications including disease diagnosis, perfusion-based tissue healing capacity assessment, infection/tumor eradication, and anatomic structure identification. This review highlights current and future applications of fluorescence guidance in orthopaedics and identifies key challenges to translation and potential solutions.

Optical Tissue Phantoms for Quantitative Evaluation of Surgical Imaging Devices

Optical tissue phantoms (OTPs) have been extensively applied to the evaluation of imaging systems and surgical training. Due to their human tissue-mimicking characteristics, OTPs can provide accurate optical feedback on the performance of image-guided surgical instruments, simulating the biological sizes and shapes of human organs, and preserving similar haptic responses of original tissues. This review summarizes the essential components of OTPs (i.e., matrix, scattering and absorbing agents, and fluorophores) and the various manufacturing methods currently used to create suitable tissue-mimicking phantoms. As photobleaching is a major challenge in OTP fabrication and its feedback accuracy, phantom photostability and how the photobleaching phenomenon can affect their optical properties are discussed. Consequently, the need for novel photostable OTPs for the quantitative evaluation of surgical imaging devices is emphasized.

Optical Epidermal Mimicry from Ultraviolet to Infrared Wavelengths

Optical tissue phantoms present substantial value for medical imaging and therapeutic applications. We have developed an epidermal tissue phantom to mimic the optical properties of human skin from the ultraviolet to the infrared region, exceeding the breadth of existing studies. An epoxy matrix is combined with melanin-mimicking polydopamine via a cost-effective fabrication strategy. Reflectance and transmittance measurements enable calculation of the wavelength-dependent complex refractive index and absorption coefficient. Results are compared with literature data to establish agreement with a real human epidermis. By analyzing emissive power at a typical skin temperature, the epidermal tissue phantom is shown to accurately mimic the radiative properties of human skin. This simple, multifunctional material represents a promising substitute for human tissue for a variety of medical and bioengineering applications.

Gold Nanoparticles-Mediated Photothermal Therapy of Pancreas Using GATE: A New Simulation Platform

This work presents the first investigation of gold nanorods (GNRs)-based photothermal therapy of the pancreas tumor using the Monte Carlo-based code implemented with Geant4 Application for Emission Tomography (GATE). The model of a human pancreas was obtained by segmenting an abdominal computed tomography (CT) scan, and its physical and chemical properties, were obtained from experimental and theoretical data. In GATE, GNRs-mediated hyperthermal therapy, simple heat diffusion as well as interstitial laser ablation were then modeled in the pancreas tumor by defining the optical parameters of this tissue when it is loaded with GNRs. Two different experimental setups on ex vivo pancreas tissue and GNRs-embedded water were devised to benchmark the developed Monte Carlo-based model for the hyperthermia in the pancreas alone and with GNRs, respectively. The influence of GNRs on heat distribution and temperature increase within the pancreas tumor was compared for two different power values (1.2 W and 2.1 W) when the tumor was exposed to 808 nm laser irradiation and with two different laser applicator diameters. Benchmark tests demonstrated the possibility of the accurate simulating of NPs-assisted thermal therapy and reproducing the experimental data with GATE software. Then, the output of the simulated GNR-mediated hyperthermia emphasized the importance of the precise evaluation of all of the parameters for optimizing the preplanning of cancer thermal therapy. Simulation results on temperature distribution in the pancreas tumor showed that the temperature enhancement caused by raising the power was increased with time in both the tumor with and without GNRs, but it was higher for the GNR-load tumor compared to tumor alone.

Two-layer analytical model for estimation of layer thickness and flow using Diffuse Correlation Spectroscopy

Diffuse correlation spectroscopy (DCS) has been widely explored for its ability to measure cerebral blood flow (CBF), however, mostly under the assumption that the human head is homogenous. In addition to CBF, knowledge of extracerebral layers, such as skull thickness, can be informative and crucial for patient with brain complications such as traumatic brain injuries. To bridge the gap, this study explored the feasibility of simultaneously extracting skull thickness and flow in the cortex layer using DCS. We validated a two-layer analytical model that assumed the skull as top layer with a finite thickness and the brain cortex as bottom layer with semi-infinite geometry. The model fitted for thickness of the top layer and flow of the bottom layer, while assumed other parameters as constant. The accuracy of the two-layer model was tested against the conventional single-layer model using measurements from custom made two-layer phantoms mimicking skull and brain. We found that the fitted top layer thickness at each source detector (SD) distance is correlated with the expected thickness. For the fitted bottom layer flow, the two-layer model fits relatively consistent flow across all top layer thicknesses. In comparison, the conventional one-layer model increasingly underestimates the bottom layer flow as top layer thickness increases. The overall accuracy of estimating first layer thickness and flow depends on the SD distance in relationship to first layer thickness. Lastly, we quantified the influence of uncertainties in the optical properties of each layer. We found that uncertainties in the optical properties only mildly influence the fitted thickness and flow. In this work we demonstrate the feasibility of simultaneously extracting of layer thickness and flow using a two-layer DCS model. Findings from this work may introduce a robust and cost-effective approach towards simultaneous bedside assessment of skull thickness and cerebral blood flow.

Modeling photoacoustic pressure generation in colloidal suspensions at different volume fractions based on a multi-scale approach

Further development of quantitative photoacoustic tomography requires understanding the photoacoustic pressure generation by modeling the generation process. This study modeled the initial photoacoustic pressure in colloidal suspensions, used as tissue phantoms, at different volume fractions on a multi-scale approach. We modeled the thermodynamic and light scattering properties on a microscopic scale with/without treating the hard-sphere interaction between colloidal particles. Meanwhile, we did the light energy density on a macroscopic scale. We showed that the hard-sphere interaction significantly influences the initial pressure and related quantities at a high volume fraction except for the thermodynamic properties. We also showed the initial pressure at the absorber inside the medium logarithmically decreases with increasing the volume fractions. This result is mainly due to the decay of the light energy density with light scattering. Our numerical results suggest that modeling light scattering and propagation is crucial over modeling thermal expansion.

Development of Tough Hydrogel Phantoms to Mimic Fibrous Tissue for Focused Ultrasound Therapies

Tissue-mimicking gels provide a cost-effective medium to optimize histotripsy treatment parameters with immediate feedback. Agarose and polyacrylamide gels are often used to evaluate treatment outcomes as they mimic the acoustic properties and stiffness of a variety of soft tissues, but they do not exhibit high toughness, a characteristic of fibrous connective tissue. To mimic pathologic fibrous tissue found in benign prostate hyperplasia (BPH) and other diseases that are potentially treatable with histotripsy, an optically transparent hydrogel with high toughness was developed that is a hybrid of polyacrylamide and alginate. The stiffness was established using shear wave elastography (SWE) and indentometry techniques and was found to be representative of human BPH ex vivo prostate tissue. Different phantom compositions and excised ex vivo BPH tissue samples were treated with a 700-kHz histotripsy transducer at different pulse repetition frequencies. Post-treatment, the hybrid gels and the tissue samples exhibited differential reduction in stiffness as measured by SWE. On B-mode ultrasound, partially treated areas were present as hyperechoic zones and fully liquified areas as hypoechoic zones. Phase contrast microscopy of the gel samples revealed liquefaction in regions consistent with the target lesion dimensions and correlated to findings identified in tissue samples via histology. The dose required to achieve liquefaction in the hybrid gel was similar to what has been observed in ex vivo tissue and greater than that of agarose of comparable or higher Young's modulus by a factor >10. These results indicate that the developed hydrogels closely mimic elasticities found in BPH prostate ex vivo tissue and have a similar response to histotripsy treatment, thus making them a useful cost-effective alternative for developing and evaluating different treatment protocols.

Model-based characterization platform of fiber optic extended-wavelength diffuse reflectance spectroscopy for identification of neurovascular bundles

SIGNIFICANCE

Fiber-optic extended-wavelength diffuse reflectance spectroscopy (EWDRS) using both visible/near-infrared and shortwave-infrared detectors enables improved detection of spectral absorbances arising from lipids, water, and collagen and has demonstrated promise in a variety of applications, including detection of nerves and neurovascular bundles (NVB). Development of future applications of EWDRS for nerve detection could benefit from the use of model-based analyses including Monte Carlo (MC) simulations and evaluation of agreement between model systems and empirical measurements.

AIM

The aim of this work is to characterize agreement between EWDRS measurements and simulations and inform future applications of model-based studies of nerve-detecting applications.

APPROACH

A model-based platform consisting of an ex vivo microsurgical nerve dissection model, unique two-layer optical phantoms, and MC model simulations of fiber-optic EWDRS spectroscopic measurements were used to characterize EWDRS and compare agreement across models. In addition, MC simulations of an EWDRS measurement scenario are performed to provide a representative example of future analyses.

RESULTS

EWDRS studies performed in the common chicken thigh femoral nerve microsurgical dissection model indicate similar spectral features for classification of NVB versus adjacent tissues as reported in porcine models and human subjects. A comparison of measurements from unique EWDRS issue mimicking optical phantoms and MC simulations indicates high agreement between the two in homogeneous and two-layer optical phantoms, as well as in dissected tissues. Finally, MC simulations of measurement over a simulated NVB indicate the potential of future applications for measurement of nerve plexus.

CONCLUSIONS

Characterization of agreement between fiber-optic EWDRS measurements and MC simulations demonstrates strong agreement across a variety of tissues and optical phantoms, offering promise for further use to guide the continued development of EWDRS for translational applications.

Non-invasive monitoring of blood oxygenation in human placentas via concurrent diffuse optical spectroscopy and ultrasound imaging

Direct assessment of blood oxygenation in the human placenta can provide information about placental function. However, the monitoring of placental oxygenation involves invasive sampling or imaging techniques that are poorly suited for bedside use. Here we show that placental oxygen haemodynamics can be non-invasively probed in real time and up to 4.2 cm below the body surface via concurrent frequency-domain diffuse optical spectroscopy and ultrasound imaging. We developed a multimodal instrument to facilitate the assessment of the properties of the anterior placenta by leveraging image-reconstruction algorithms that integrate ultrasound information about the morphology of tissue layers with optical information on haemodynamics. In a pilot investigation involving placentas with normal function (15 women) or abnormal function (9 women) from pregnancies in the third trimester, we found no significant differences in baseline haemoglobin properties, but statistically significant differences in the haemodynamic responses to maternal hyperoxia. Our findings suggest that the non-invasive monitoring of placental oxygenation may aid the early detection of placenta-related adverse pregnancy outcomes and maternal vascular malperfusion.

Validation of a surgical training model containing indocyanine green for near-infrared fluorescence imaging

Objective

To determine the efficacy of a surgical training model for fluorescence-guided cancer surgery and validate its utility to detect any residual tumors after tumor resection using electrocautery.

Methods

We developed surgical training models containing indocyanine green (ICG) for near-infrared (NIR) fluorescence imaging using a root vegetable organic material (konjac). After the fluorescence assessment for the models, the surgical simulation for fluorescence-guided cancer surgery using electrocautery was performed. ICG-containing tumors were divided into two surgical groups: "Enucleation" (removal of the entire visible tumor) and "Complete resection" (removal of the tumor with an appropriate 5-mm surgical margin).

Results

All 12 ICG-containing tumors were clearly visible from the normal view but not from the flipped view. The tumor resection time was significantly longer in the "Complete resection" group than in the "Enucleation" group (p < .001). The ICG-containing tumors showed a high tumor-to background ratio from the normal (average = 45.8) and flipped (average = 19.2) views, indicating that the models including ICG-containing tumors were useful for a surgical simulation in fluorescence-guided surgery. The average mean fluorescence intensity of the wound bed was significantly higher in the "Enucleation" group than in the "Complete resection" group (p < .01). No decrease in fluorescence signal was found in the wound bed even at 2 days postresection.

Conclusion

Our surgical training model containing a fluorescent agent is safe, inexpensive, not harmful for humans, and easy to dispose after use. Our model would be beneficial for surgeons to learn NIR fluorescence imaging and to accelerate fluorescence-guided cancer surgery into clinical application.

Anthropomorphic Polydimethylsiloxane silicone-based phantom for Diffuse Optical Imaging

This work presents a method for constructing phantoms suitable for diffuse optical mammography. They are based on Polydimethylsiloxane silicones, with the characteristic of being anthropomorphic, and having similar mechanical and optical properties as a real breast. These phantoms are useful for testing the performance of diffuse optical imaging devices in the near infrared, both in transmittance and reflectance geometries, since they can be constructed containing inclusions, to simulate breast tumors. An alternative component to be used as scattering agent, that is easier to handle than traditional scattering agents, is also studied.

The optical properties of the phantoms were tested varying the concentration of scattering and absorbing agents, while their mechanical properties were modified by adding a silicone fluid to the basic mixture.

Finally, the phantoms were tested by Diffuse Optical Imaging experiments, and these images were compared to the ones obtained by conventional ultrasound techniques.

Results show that the constructed anthropomorphic phantoms properly reproduce the optical and mechanical characteristics of human breasts, and are suitable to be used in Diffuse Optical Imaging.

•

We constructed anthropomorphic phantoms for Diffuse Optical Imaging.

•

They simulate the optical and mechanical characteristics of a human breast.

•

A new scattering agent was successfully introduced.

•

Results of Diffuse Optical images are compared to Ultrasound images.

3D Ultrasound-Guided Photoacoustic Imaging to Monitor the Effects of Suboptimal Tyrosine Kinase Inhibitor Therapy in Pancreatic Tumors

Pancreatic cancer is a disease with an incredibly poor survival rate. As only about 20% of patients are eligible for surgical resection, neoadjuvant treatments that can relieve symptoms and shrink tumors for surgical resection become critical. Many forms of treatments rely on increased vulnerability of cancerous cells, but tumors or regions within the tumors that may be hypoxic could be drug resistant. Particularly for neoadjuvant therapies such as the tyrosine kinase inhibitors utilized to shrink tumors, it is critical to monitor changes in vascular function and hypoxia to predict treatment efficacy. Current clinical imaging modalities used to obtain structural and functional information regarding hypoxia or oxygen saturation (StO2) do not provide sufficient depth penetration or require the use of exogenous contrast agents. Recently, ultrasound-guided photoacoustic imaging (US-PAI) has garnered significant popularity, as it can noninvasively provide multiparametric information on tumor vasculature and function without the need for contrast agents. Here, we built upon existing literature on US-PAI and demonstrate the importance of changes in StO2 values to predict treatment response, particularly tumor growth rate, when the outcomes are suboptimal. Specifically, we image xenograft mouse models of pancreatic adenocarcinoma treated with suboptimal doses of a tyrosine kinase inhibitor cabozantinib. We utilize the US-PAI data to develop a multivariate regression model that demonstrates that a therapy-induced reduction in tumor growth rate can be predicted with 100% positive predictive power and a moderate (58.33%) negative predictive power when a combination of pretreatment tumor volume and changes in StO2 values pretreatment and immediately posttreatment was employed. Overall, our study indicates that US-PAI has the potential to provide label-free surrogate imaging biomarkers that can predict tumor growth rate in suboptimal therapy.

Mechanical Testing of Artificial Vessels and Tissues for Photoplethysmography Phantoms

Various studies have looked at the efficiency of artificial vessel and tissue networks in the study of photoplethysmography (PPG) in an effort to better understand the origin of various morphological features present in the signal. Whilst there are all reasonable attempts made to replicate geometrical features such as vessel depth, vessel wall thickness and diameter etc., not many studies have attempted to replicate the mechanical properties such as vessel elasticity and tissue compressibility. This study reports two methods for tissue mechanical testing for the analysis of vessel elasticity and tissue compressibility. A two-part polydimethylsiloxane (PDMS) was used as a base material for both tissue and vessel construction, and the properties altered by changing the curing component ratio. Tissue compression properties were investigated using an industrially calibrated materials testing device using the protocol from the ASTM 0575-91 testing method. Vessel elasticity was investigated using a custom method and apparatus to report vessel diameter and length change simultaneously. Tissue compressive properties proved reasonably easy to replicate through catalyst alteration, however the vessel elasticity properties were found to be higher than expected at all reasonable catalyst ratios. The property of hyper-elasticity was observed in the artificial vessels though, leading to the conclusion that alternative material recipes or construction methods may be needed to correctly replicate the expected mechanical characteristics. Clinical Relevance- The latest generation of health monitoring devices, especially those that are wearable and used widely by individuals wishing to monitor their health daily are becoming smarter and more sophisticated in their functionality. The majority of such devices use photoplethysmography (PPG) as their primary monitoring technique. Being able to replicate the PPG in a phantom allows the continued study and development of devices, and to improve their functionality without the continued need for extensive user-testing.

Development of a microstructured tissue phantom with adaptable optical properties for use with microscopes and fluorescence lifetime imaging systems

OBJECTIVES

For the development and validation of diagnostic procedures based on microscopic methods, knowledge about the imaging depth and achievable resolution in tissue is crucial. This poses the challenge to develop a microscopic artificial phantom focused on the microscopic instead of the macroscopic optical tissue characteristics.

METHODS

As existing artificial tissue phantoms designed for image forming systems are primarily targeted at wide field applications, they are unsuited for reaching the formulated objective. Therefore, a microscopy- and microendoscopy-suited artificial tissue phantom was developed and characterized. It is based on a microstructured glass surface coated with fluorescent beads at known depths covered by a scattering agent with modifiable optical properties. The phantom was examined with different kinds of microscopy systems in order to characterize its quality and stability and to demonstrate its usefulness for instrument comparison, for example, regarding structural as well as fluorescence lifetime analysis.

RESULTS

The analysis of the manufactured microstructured glass surfaces showed high regularity in their physical dimensions in accordance with the specifications. Measurements of the optical parameters of the scattering medium were consistent with simulations. The fluorescent beads coating proved to be stable for a respectable period of time (about a week). The developed artificial tissue phantom was successfully used to detect differences in image quality between a research microscope and an endoscopy based system. Plausible causes for the observed differences could be derived based on the well known microstructure of the phantom.

CONCLUSIONS

The artificial tissue phantom is well suited for the intended use with microscopic and microendoscopic systems. Due to its configurable design, it can be adapted to a wide range of applications. It is especially targeted at the characterization and calibration of clinical imaging systems that often lack extensive positioning capabilities such as an intrinsic z-stage.

The Effects of Silicone Enclosure Colour on the Function of Optical Sensors

Simple Summary

Implantable optical sensing is a rapidly growing field that allows for continuous monitoring of internal organs’ physiological states. Near-infrared spectroscopy is an optical sensing technology allowing for low-cost, non-invasive, high-sensitivity measurement of tissue oxygenation and haemodynamic parameters. The colour of an optical sensor’s enclosure affects the sensor’s sensitivity, function, and ability to detect tissue vital signs. This study compared the optical properties of coloured silicone materials and related these properties to the function of silicone enclosed implantable near-infrared spectroscopy sensors. We demonstrated that sensor enclosures highly reflective to red and near-infrared light facilitated light propagation to the photodetector and increased the ability to detect the effects of cardiac pulsation and respiratory rhythm on tissue haemodynamics. In contrast, highly absorptive sensor enclosures resulted in better detection and monitoring of tissue oxygenation.

Abstract

The colour of the silicone enclosure of an implantable reflectance-based optical probe plays a critical role in sensor performance. Red-coloured probes that are highly reflective to near-infrared light have been found to increase photodetector power by a factor of 6 for wavelengths between 660 and 950 nm and triple the magnitude of measured cardiac pulsations compared to traditional black probes. The increase in photodetector power and cardiac pulsation magnitude is presumably due to increased spatial range resulting from a higher magnitude of superficial tissue scattering. Conversely, probes with highly absorbent colours such as black and blue result in more stable signals and are expected to have higher spatial resolution and depth of penetration.

Near-Infrared Spectroscopy as a Potential COVID-19 Early Detection Method: A Review and Future Perspective

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide health anxiety. The rapid dispersion of the infection globally results in unparalleled economic, social, and health impacts. The pathogen that causes COVID-19 is known as a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A fast and low-cost diagnosis method for COVID-19 disease can play an important role in controlling its proliferation. Near-infrared spectroscopy (NIRS) is a quick, non-destructive, non-invasive, and inexpensive technique for profiling the chemical and physical structures of a wide range of samples. Furthermore, the NIRS has the advantage of incorporating the internet of things (IoT) application for the effective control and treatment of the disease. In recent years, a significant advancement in instrumentation and spectral analysis methods has resulted in a remarkable impact on the NIRS applications, especially in the medical discipline. To date, NIRS has been applied as a technique for detecting various viruses including zika (ZIKV), chikungunya (CHIKV), influenza, hepatitis C, dengue (DENV), and human immunodeficiency (HIV). This review aims to outline some historical and contemporary applications of NIRS in virology and its merit as a novel diagnostic technique for SARS-CoV-2.

Special Section Guest Editorial: Tissue Phantoms to Advance Biomedical Optical Systems

The editorial introduces the JBO Special Section on Tissue Phantoms to Advance Biomedical Optical Systems.