Effects of optical clearing agents on noninvasive blood glucose monitoring with optical coherence tomography: a pilot study

Optical attenuation coefficient of skin under low compression

In various biomedical optics therapies, knowledge of how light is absorbed or scattered by tissues is crucial. Currently, it is suspected that a low compression applied to the skin surface may improve light delivery into tissue. However, the minimum pressure needed to be applied to significantly increase the light penetration into the skin has not been determined. In this study, we used optical coherence tomography (OCT) to measure the optical attenuation coefficient of the human forearm dermis in a low compression regime (<8k P a). Our results show low pressures such as 4 kPa to 8 kPa are sufficient to significantly increase light penetration by decreasing the attenuation coefficient by at least 1.0m m ^-1.

Penetration-enhanced optical coherence tomography angiography with optical clearing agent for clinical evaluation of human skin

BACKGROUND

Optical coherence tomography angiography (OCTA) is an emerging imaging technique which shows its advantages over visualizing microcirculation with free label. However, its shortcomings in imaging depth limit its development in dermatological field. Nowadays, the newly optical clearing agent (OCA) designed for skin optical imaging demonstrates its potential. In our study, whether this OCA can improve the imaging ability of OCTA in healthy human skin and whether the combination of them is beneficial to compare the lesions and the contralateral normal skins in the patients with port wine stains (PWS) have been investigated.

METHODS

Five healthy volunteers and 3 PWS patients were recruited in this study. In terms of healthy people, the opisthenar area which has same structure information as facial skin was taken for investigating the OCA's ability of enhancing OCTA imaging depth on healthy human skin, besides, in order to verifying whether the exists of skin corneum interfere OCA's function, we compared the effect of only using OCA with that of comprehensive using pre-processing skin and OCA. There are one physical removing corneum method by using medical tape to strip opisthenar skin for over 20-time and one chemical way through applying exfoliating cream. For PWS patient, the combining using OCA and OCTA was applied at the lesion area and the contralateral normal area for the purpose of verifying their ability to provide the information of vessels.

RESULTS

This novel OCA had excellent efficacy to increase the penetration depth of human opisthenar skin for the OCTA imaging by approximately 0.16 ± 0.03 mm. Pre-processing of stratum corneum with an exfoliating cream or medical tape stripping did not further benefit the penetrating efficacy of the OCA. Moreover, according to a comprehensive analysis of the OCTA images enhanced by the OCA, the PWS lesions usually have larger density and diameter of the vessels which located in deep layers (beyond 0.21 mm) than the contralateral normal skin.

CONCLUSIONS

The OCTA imaging depth and contrast were significantly improved by the OCA. The OCA application is a simple and efficient clinical procedure for OCTA enhancement. Moreover, it demonstrated great clinical value to compare the normal skin and the PWS lesions in the patients by the enhanced OCTA imaging.

A useful way to develop effective in vivo skin optical clearing agents

Skin optical clearing has shown tremendous potential in improving various optical imaging performances, but there is some certain blindness in screening out high-efficiency in vivo optical clearing methods. In this work, three optical clearing agents: sucrose (Suc), fructose (Fruc) and PEG-400 (PEG), and two chemical penetration enhancers: propylene glycol (PG) and thiazone (Thiaz) were used. PEG was firstly mixed with the two penetration enhancers, respectively, and then mixed with Fruc and Suc, respectively, to obtain six kinds of skin optical clearing agents (SOCAs). Optical coherence tomography angiography was applied to monitor SOCAs-induced changes in imaging performances, skin optical properties, refractive index mismatching extent, and permeability rate. Experimental results demonstrated that PEG+Thiaz+Suc has the optimal capacity in enhancing the imaging performances, decreasing the scattering and the refractive index mismatching since Thiaz is superior to PG, and Suc is superior to Fruc. This study indicates that the optimal SOCA can be obtained directly by means of additionally adding or replacing the similar category substance in preexisting SOCAs with some more effective reagents. It not only provides an optimal SOCA, but also provides a useful way to develop more effective SOCAs. Cross-section skin structural texture (a), reconstructed blood flow distribution information (b), before or after treated with different SOCAs.

Optical coherence tomography angiography offers comprehensive evaluation of skin optical clearing in vivo by quantifying optical properties and blood flow imaging simultaneously

Tissue optical clearing (TOC) is helpful for reducing scattering and enhancing the penetration depth of light, and shows promising potential in optimizing optical imaging performances. A mixture of fructose with PEG-400 and thiazone (FPT) is used as an optical clearing agent in mouse dorsal skin and evaluated with OCT angiography (Angio-OCT) by quantifying optical properties and blood flow imaging simultaneously. It is observed that FPT leads to an improved imaging performance for the deeper tissues. The imaging performance improvement is most likely caused by the FPT-induced dehydration of skin, and the reduction of scattering coefficient (more than ∼ 40.5%) and refractive-index mismatching (more than ∼ 25.3%) in the superficial (epidermal, dermal, and hypodermal) layers. A high correlation (up to ∼ 90%) between the relative changes in refractive-index mismatching and Angio-OCT signal strength is measured. The optical clearing rate is ∼ 5.83 × 10(-5) cm/s. In addition, Angio-OCT demonstrates enhanced performance in imaging cutaneous hemodynamics with satisfactory spatiotemporal resolution and contrast when combined with TOC, which exhibits a powerful practical application in studying microcirculation.

Ex vivo optical measurements of glucose diffusion kinetics in native and diabetic mouse skin

The aim of this study was to estimate the glucose diffusion coefficients ex vivo in skin of mice with diabetes induced in vivo by alloxan in comparison to non-diabetic mice. The temporal dependences of collimated transmittance of tissue samples immersed in glucose solutions were measured in the VIS-NIR spectral range to quantify the glucose diffusion/permeability coefficients and optical clearing efficiency of mouse skin. The average thickness of intact healthy and diabetic skin was 0.023 ± 0.006 cm and 0.019 ± 0.005 cm, respectively. Considerable differences in optical and kinetic properties of diabetic and non-diabetic skin were found: clearing efficiency was 1.5-fold better and glucose diffusivity was 2-fold slower for diabetic skin. Experimental Setup for measuring collimated transmittance spectra of mouse skin samples.

Measurements of the thermal coefficient of optical attenuation at different depth regions of in vivo human skins using optical coherence tomography: a pilot study

We present detailed measurement results of optical attenuation's thermal coefficients (referenced to the temperature of the skin surface) in different depth regions of in vivo human forearm skins using optical coherence tomography (OCT). We first design a temperature control module with an integrated optical probe to precisely control the surface temperature of a section of human skin. We propose a method of using the correlation map to identify regions in the skin having strong correlations with the surface temperature of the skin and find that the attenuation coefficient in these regions closely follows the variation of the surface temperature without any hysteresis. We observe a negative thermal coefficient of attenuation in the epidermis. While in dermis, the slope signs of the thermal coefficient of attenuation are different at different depth regions for a particular subject, however, the depth regions with a positive (or negative) slope are different in different subjects. We further find that the magnitude of the thermal coefficient of attenuation coefficient is greater in epidermis than in dermis. We believe the knowledge of such thermal properties of skins is important for several noninvasive diagnostic applications, such as OCT glucose monitoring, and the method demonstrated in this paper is effective in studying the optical and biological properties in different regions of skin.

Influence of nanoparticles accumulation on optical properties of human normal and cancerous liver tissue in vitro estimated by OCT

In this work, the potential use of nanoparticles as contrast agents by using spectral domain optical coherence tomography (SD-OCT) in liver tissue was demonstrated. Gold nanoparticles (average size of 25 and 70 nm), were studied in human normal and cancerous liver tissues in vitro, respectively. Each sample was monitored with SD-OCT functional imaging for 240 min. Continuous OCT monitoring showed that, after application of gold nanoparticles, the OCT signal intensities of normal liver and cancerous liver tissue both increase with time, and the larger nanoparticles tend to produce a greater signal enhancement in the same type of tissue. The results show that the values of attenuation coefficients have significant differences between normal liver tissue and cancerous liver tissue. In addition, 25 nm gold nanoparticles allow higher penetration depth than 70 nm gold nanoparticles in liver tissues.

Continuous noninvasive monitoring of changes in human skin optical properties during oral intake of different sugars with optical coherence tomography

The objective of this study was to evaluate the effects of blood glucose concentration (BGC) on in vivo human skin optical properties after oral intake of different sugars. In vivo optical properties of human skin were measured with a spectral domain optical coherence tomography (SD-OCT). Experimental results show that increase of BGC causes a decrease in the skin attenuation coefficient. And the maximum decrements in mean attenuation coefficient of skin tissue after drinking glucose, sucrose and fructose solution are 47.0%, 36.4% and 16.5% compared with that after drinking water, respectively (p < 0.05). The results also show that blood glucose levels of the forearm skin tissue are delayed compared with finger-stick blood glucose, and there are significant differences in the time delays after oral intake of different sugars. The time delay between mean attenuation coefficient and BGC after drinking glucose solution is evidently larger than that after drinking sucrose solution, and that after drinking sucrose solution is larger than that after drinking fructose solution. Our pilot studies indicate that OCT technique is capable of non-invasive, real-time, and sensitive monitoring of skin optical properties in human subjects during oral intake of different sugars.