Optical clearing of melanoma in vivo: characterization by diffuse reflectance spectroscopy and optical coherence tomography

Conditions of acceleration and deceleration of the cancer cell growth under osmotic pressure

In this paper, we study a pattern formation in the epidermal layer of skin during tumor development and appearance of a binary surface consisting of healthy and cancer cells forming Turing patterns under external osmotic pressure. The basic methodology of introducing the external influences, for example, time-targeted drug therapy or radiation exposure, influence of electromagnetic fields, laser radiation or other tumor-targeting physical influences act differently in different phases of the cell cycle. In some cases, this can lead to a slowdown in the growth of cancer cells, and sometimes vice versa. Therefore, it is of particular interest to choose the right parameters such as starting time of external pressure, its magnitude and duration depending on the cell cycle of developing cancer cells. We propose a biologically inspired model that allows us to simulate the growth of cancer cells under conditions of osmotic pressure. We divide this growth into two phases. The first is characterized by active cell division, and the second by their growth. In this article, we introduce two types of pressure: short-term and long-term, and looked at what this leads to in different phases. We have found an interesting result, that there are some resonant points in time both in the first and second phases, when the introduction of additional pressure leads to the most significant slowdown in the growth of cancer cells.

Photometric and Monte-Carlo modeling unified approach for the calculation of spatially-resolved correction coefficients linking simulated and experimental diffuse reflectance spectra

The estimation of skin optical properties by means of inverse problem solving from spatially resolved diffuse reflectance (SR-DR) spectra is one way to exploit the acquired clinical signals. This method requires the comparison between the experimental spectra collected with a medical device, and spectra generated by the photons transport numerical simulations. This comparison is usually limited to spectral shape due to the absence of intensity standardization of the experimental DR spectra. This study proposes to theoretically (using photometric calculation) and experimentally (from experimental spectra acquired on optical phantom) establish a corrective factor to obtain common intensity unit for experimental and simulated signals.

Binary dose level classification of tumour microvascular response to radiotherapy using artificial intelligence analysis of optical coherence tomography images

The dominant consequence of irradiating biological systems is cellular damage, yet microvascular damage begins to assume an increasingly important role as the radiation dose levels increase. This is currently becoming more relevant in radiation medicine with its pivot towards higher-dose-per-fraction/fewer fractions treatment paradigm (e.g., stereotactic body radiotherapy (SBRT)). We have thus developed a 3D preclinical imaging platform based on speckle-variance optical coherence tomography (svOCT) for longitudinal monitoring of tumour microvascular radiation responses in vivo. Here we present an artificial intelligence (AI) approach to analyze the resultant microvascular data. In this initial study, we show that AI can successfully classify SBRT-relevant clinical radiation dose levels at multiple timepoints (t = 2–4 weeks) following irradiation (10 Gy and 30 Gy cohorts) based on induced changes in the detected microvascular networks. Practicality of the obtained results, challenges associated with modest number of animals, their successful mitigation via augmented data approaches, and advantages of using 3D deep learning methodologies, are discussed. Extension of this encouraging initial study to longitudinal AI-based time-series analysis for treatment outcome predictions at finer dose level gradations is envisioned.

A 3D Analysis of Cleared Human Melanoma

Cutaneous melanoma is one of the most aggressive and deadliest cancers in human beings due to its invasiveness and other factors. Histopathological analysis is crucial for a proper diagnosis. Optical tissue clearing is a novel field that allows 3D image acquisition of large-scale biological tissues. Optical clearing and immunolabeling for 3D fluorescence imaging has yet to be extensively applied to melanoma. In the present manuscript, we establish, for the first time, an optical clearing and immunostaining procedure for human melanoma and human cell line-derived melanoma xenograft models using the CUBIC (clear, unobstructed brain imaging cocktails) technique. We have successfully cleared the samples and achieved 3D volumetric visualization of the tumor microenvironment, vasculature, and cell populations.

Spatial and temporal patterns in dynamic-contrast enhanced intraoperative fluorescence imaging enable classification of bone perfusion in patients undergoing leg amputation

Dynamic contrast-enhanced fluorescence imaging (DCE-FI) classification of tissue viability in twelve adult patients undergoing below knee leg amputation is presented. During amputation and with the distal bone exposed, indocyanine green contrast-enhanced images were acquired sequentially during baseline, following transverse osteotomy and following periosteal stripping, offering a uniquely well-controlled fluorescence dataset. An unsupervised classification machine leveraging 21 different spatiotemporal features was trained and evaluated by cross-validation in 3.5 million regions-of-interest obtained from 9 patients, demonstrating accurate stratification into normal, suspicious, and compromised regions. The machine learning (ML) approach also outperformed the standard method of using fluorescence intensity only to evaluate tissue perfusion by a two-fold increase in accuracy. The generalizability of the machine was evaluated in image series acquired in an additional three patients, confirming the stability of the model and ability to sort future patient image-sets into viability categories.

Examination of Subungual Hematomas and Subungual Melanocytic Lesions by Using Optical Coherence Tomography and Dermoscopy

INTRODUCTION

Examination of subungual pigmented lesions is sometimes a diagnostic challenge for clinicians.

OBJECTIVES

The study was aimed to investigate characteristic patterns in optical coherence tomography (OCT) of subungual hematomas and determine distinctive features that can differentiate them from subungual melanocytic lesions.

METHODS

VivoSight® (Michelson Diagnostics, Maidstone, UK) was used to examine 71 subungual hematomas and 11 subungual melanocytic lesions in 69 patients (18 female and 51 male patients).

RESULTS

On OCT, bleeding was related to sharply defined black sickle-shaped (p < 0.001) or globular regions (not significant [ns]) with a hyperreflective margin (0.002), a grey center (0.013), hyperreflective lines in the area (ns) or periphery (p = 0.031), peripheral fading (p = 0.029), and red dots in the area (p = 0.001). In the 1 case of melanoma in situ examined, we found curved vessels with irregular sizes and distribution on the dermis of the nailbed, while subungual hematomas and subungual benign nevi presented as clustered red dots and/or regularly distributed curved vessels.

CONCLUSION

Our findings indicate that the use of OCT in addition to dermoscopy provides high-resolution optical imaging information for the diagnosis of subungual hematoma and facilitates the differential diagnosis of subungual hematomas and subungual melanocytic lesions.

Improving SERS bioimaging of subcutaneous phantom in vivo with optical clearing

Surface-enhanced Raman scattering (SERS) has proven to be a promising technique for different types of imaging including preoperative and intraoperative in vivo tumor visualization. However, the strong scattering of the turbid tissue limits its use in subcutaneous areas. In this article, we used an optical clearing technique to improve the SERS signal from a subcutaneous tumor phantom. The phantom is a 2 mm sphere of calcium alginate with incorporated petal-like gap-enhanced Raman tags. The use of optical clearing increases the SERS signal target-to-background ratio for 5 times and allow to decrease the total imaging time for at least 10 times. In addition, SERS imaging assisted with optical clearing made it possible to more precisely determine the shape and boundaries of the implanted phantom. The combination of optical clearing and SERS is a promising strategy for the clinical imaging of subcutaneous objects that are usually shielded by dermal tissue.

TISSUE CLEARING

Tissue clearing of gross anatomical samples was first described over a century ago and has only recently found widespread use in the field of microscopy. This renaissance has been driven by the application of modern knowledge of optical physics and chemical engineering to the development of robust and reproducible clearing techniques, the arrival of new microscopes that can image large samples at cellular resolution and computing infrastructure able to store and analyze large data volumes. Many biological relationships between structure and function require investigation in three dimensions and tissue clearing therefore has the potential to enable broad discoveries in the biological sciences. Unfortunately, the current literature is complex and could confuse researchers looking to begin a clearing project. The goal of this Primer is to outline a modular approach to tissue clearing that allows a novice researcher to develop a customized clearing pipeline tailored to their tissue of interest. Further, the Primer outlines the required imaging and computational infrastructure needed to perform tissue clearing at scale, gives an overview of current applications, discusses limitations and provides an outlook on future advances in the field.

Optical clearing of tissues: Issues of antimicrobial phototherapy and drug delivery

This review presents principles and novelties in the field of tissue optical clearing (TOC) technology, as well as application for optical monitoring of drug delivery and effective antimicrobial phototherapy. TOC is based on altering the optical properties of tissue through the introduction of immersion optical cleaning agents (OCA), which impregnate the tissue of interest. We also analyze various methods and kinetics of delivery of photodynamic agents, nanoantibiotics and their mixtures with OCAs into the tissue depth in the context of antimicrobial and antifungal phototherapy. In vitro and in vivo studies of antimicrobial phototherapies, such as photodynamic, photothermal plasmonic and photocatalytic, are summarized, and the prospects of a new TOC technology for effective killing of pathogens are discussed.

Proposal for a Skin Layer-Wise Decomposition Model of Spatially-Resolved Diffuse Reflectance Spectra Based on Maximum Depth Photon Distributions: A Numerical Study

In the context of cutaneous carcinoma diagnosis based on in vivo optical biopsy, Diffuse Reflectance (DR) spectra, acquired using a Spatially Resolved (SR) sensor configuration, can be analyzed to distinguish healthy from pathological tissues. The present contribution aims at studying the depth distribution of SR-DR-detected photons in skin from the perspective of analyzing how these photons contribute to acquired spectra carrying local physiological and morphological information. Simulations based on modified Cuda Monte Carlo Modeling of Light transport were performed on a five-layer human skin optical model with epidermal thickness, phototype and dermal blood content as variable parameters using (i) wavelength-resolved scattering and absorption properties and (ii) the geometrical configuration of a multi-optical fiber probe implemented on an SR-DR spectroscopic device currently used in clinics. Through histograms of the maximum probed depth and their exploitation, we provide numerical evidence linking the characteristic penetration depth of the detected photons to their wavelengths and four source–sensor distances, which made it possible to propose a decomposition of the DR signals related to skin layer contributions.

Tissue optical clearing for 3D visualization of vascular networks: A review

Reconstruction of the vasculature of intact tissues/organs down to the capillary level is essential for understanding the development and remodeling of vascular networks under physiological and pathological conditions. Optical imaging techniques can provide sufficient resolution to distinguish small vessels with several microns, but the imaging depth is somewhat limited due to the high light scattering of opaque tissue. Recently, various tissue optical clearing methods have been developed to overcome light attenuation and improve the imaging depth both for ex-vivo and in-vivo visualizations. Tissue clearing combined with vessel labeling techniques and advanced optical tomography enables successful mapping of the vasculature of different tissues/organs, as well as dynamically monitoring vessel function under normal and pathological conditions. Here, we briefly introduce the commonly-used labeling strategies for entire vascular networks, the current tissue optical clearing techniques available for various tissues, as well as the advanced optical imaging techniques for fast, high-resolution structural and functional imaging for blood vessels. We also discuss the applications of these techniques in the 3D visualization of vascular networks in normal tissues, and the vascular remodeling in several typical pathological models in clinical research. This review is expected to provide valuable insights for researchers to study the potential mechanisms of various vessel-associated diseases using tissue optical clearing pipeline.

3D models of the dynamics of cancer cells under external pressure

Skin cancer is one of the most frequent cancers worldwide. Recently, it has been shown that the tumor proliferation rate in skin and its dynamics can be changed by an osmotic pressure. However, these findings are rather unstructured. A weak pressure can slow down the tumor growth, while a very high pressure can, on the contrary, lead to accelerated growth and metastases. The magnitude and spatial distribution of osmotic pressures in tumors at present cannot be measured experimentally. Therefore, it is of particular interest to find appropriate models that would simulate the effects of additional osmotic pressures in skin and assess the features of its implementation. In this paper, we suggest an improved model based on the principles of the conventional hydrodynamic model for macrophase separations, which allows one to include not only the properties of healthy and cancer cells but also the microenvironment. We study and analyze the proliferation of cancer cells in 3D models of the epidermal layer of skin under an osmotic pressure. There are two suggested 3D models that are based on the same principles: (1) cellular cubic lattice and (2) cell spheroid. This allows expanding the application of the model depending on a given task. Here, we are focused on the study of melanoma at an early stage when there are not many cancer cells. Additional compressive and expansive pressures are added to the central part of the system. Both systems demonstrate similar results in slowing down the rate of tumor growth with a small pressure.

Volumetric tumor delineation and assessment of its early response to radiotherapy with optical coherence tomography

Texture analyses of optical coherence tomography (OCT) images have shown initial promise for differentiation of normal and tumor tissues. This work develops a fully automatic volumetric tumor delineation technique employing quantitative OCT image speckle analysis based on Gamma distribution fits. We test its performance in-vivo using immunodeficient mice with dorsal skin window chambers and subcutaneously grown tumor models. Tumor boundaries detection is confirmed using epi-fluorescence microscopy, combined photoacoustic-ultrasound imaging, and histology. Pilot animal study of tumor response to radiotherapy demonstrates high accuracy, objective nature, novelty of the proposed method in the volumetric separation of tumor and normal tissues, and the sensitivity of the fitting parameters to radiation-induced tissue changes. Overall, the developed methodology enables hitherto impossible longitudinal studies for detecting subtle tissue alterations stemming from therapeutic insult.

Optical clearing agent increases effectiveness of photodynamic therapy in a mouse model of cutaneous melanoma: an analysis by Raman microspectroscopy

Melanoma is the most aggressive type of skin cancer and a relevant health problem due to its poor treatment response with high morbidity and mortality rates. This study, aimed to investigate the tissue changes of an improved photodynamic therapy (PDT) response when combined with optical clearing agent (OCA) in the treatment of cutaneous melanoma in mice. Photodithazine (PDZ) was administered intraperitoneally and a solution of OCA was topically applied before PDT irradiation. Due to a resultant refractive index matching, OCA-treated tumors are more optically homogenous, improving the PDT response. Raman analysis revealed, when combined with OCA, the PDT response was more homogenous down to 725 µm-depth in thickness.

Biomedical Applications of Tissue Clearing and Three-Dimensional Imaging in Health and Disease

Three-dimensional (3D) optical imaging techniques can expand our knowledge about physiological and pathological processes that cannot be fully understood with 2D approaches. Standard diagnostic tests frequently are not sufficient to unequivocally determine the presence of a pathological condition. Whole-organ optical imaging requires tissue transparency, which can be achieved by using tissue clearing procedures enabling deeper image acquisition and therefore making possible the analysis of large-scale biological tissue samples. Here, we review currently available clearing agents, methods, and their application in imaging of physiological or pathological conditions in different animal and human organs. We also compare different optical tissue clearing methods discussing their advantages and disadvantages and review the use of different 3D imaging techniques for the visualization and image acquisition of cleared tissues. The use of optical tissue clearing resources for large-scale biological tissues 3D imaging paves the way for future applications in translational and clinical research.

Dual-Agent Photodynamic Therapy with Optical Clearing Eradicates Pigmented Melanoma in Preclinical Tumor Models

Treatment using light-activated photosensitizers (photodynamic therapy, PDT) has shown limited efficacy in pigmented melanoma, mainly due to the poor penetration of light in this tissue. Here, an optical clearing agent (OCA) was applied topically to a cutaneous melanoma model in mice shortly before PDT to increase the effective treatment depth by reducing the light scattering. This was used together with cellular and vascular-PDT, or a combination of both. The effect on tumor growth was measured by longitudinal ultrasound/photoacoustic imaging in vivo and by immunohistology after sacrifice. In a separate dorsal window chamber tumor model, angiographic optical coherence tomography (OCT) generated 3D tissue microvascular images, enabling direct in vivo assessment of treatment response. The optical clearing had minimal therapeutic effect on the in control, non-pigmented cutaneous melanomas but a statistically significant effect (p < 0.05) in pigmented lesions for both single- and dual-photosensitizer treatment regimes. The latter enabled full-depth eradication of tumor tissue, demonstrated by the absence of S100 and Ki67 immunostaining. These studies are the first to demonstrate complete melanoma response to PDT in an immunocompromised model in vivo, with quantitative assessment of tumor volume and thickness, confirmed by (immuno) histological analyses, and with non-pigmented melanomas used as controls to clarify the critical role of melanin in the PDT response. The results indicate the potential of OCA-enhanced PDT for the treatment of pigmented lesions, including melanoma.

[Dynamic imaging of melanoma development in nude mice using high-frequency ultrasound and optical coherence tomography]

OBJECTIVE

To investigate the application of high-frequency ultrasound (HFUS) and optical coherence tomography (OCT) for monitoring the progression of cutaneous melanoma (CM) in nude mice.

METHODS

Twenty 4-week-old nude mice were randomly divided into CM group (n=16) and control group (n=4). In CM group, A375 cell suspension were injected subcutaneously on the back of the nude mice, and only culture medium was injected in the control group. The tumor growth was monitored by gross observation and with HFUS and OCT on a daily basis. The tumor formation rate, time, and size were recorded and melanoma visibility was assessed quantitatively using the contrast- to-background-noise ratio (CNR). Twentyfour days after cell implantation, the tumors were dissected for pathological examination.

RESULTS

The tumor formation rate was 87.5% in CM group. OCT detected tumor formation at an earlier time than HFUS. With the growth of the tumor, HFUS detected spots or bands of strong echoes, and flattening of the upper dermis could be observed in OCT; the of HFUS and OCT were obviously enhanced over time (P &lt; 0.05). The tumor growth curve showed that OCT was more sensitive for measurement of the tumor thickness than HFUS. The length, depth and volume of the tumors measured by HFUS were significantly greater than those measured by OCT (P &lt; 0.05).

CONCLUSIONS

HFUS and OCT can monitor the dynamic development of cutaneous melanoma in nude mice, and their imaging performance differs in different stages of tumor development.

Source separation approach for the analysis of spatially resolved multiply excited autofluorescence spectra during optical clearing of ex vivo skin

Spatially resolved multiply excited autofluorescence spectroscopy is a valuable optical biopsy technique to investigate skin UV-visible optical properties in vivo in clinics. However, it provides bulk fluorescence signals from which the individual endogenous fluorophore contributions need to be disentangled. Skin optical clearing allows for increasing tissue transparency, thus providing access to more accurate in-depth information. The aim of the present contribution was to study the time changes in skin spatially resolved and multiply excited autofluorescence spectra during skin optical clearing. The latter spectra were acquired on an ex vivo human skin strip lying on a fluorescent gel substrate during 37 minutes of the optical clearing process of a topically applied sucrose-based solution. A Non Negative Matrix Factorization-based blind source separation approach was proposed to unmix skin tissue intrinsic fluorophore contributions and to analyze the time evolution of this mixing throughout the optical clearing process. This spectral unmixing exploited the multidimensionality of the acquired data, i.e., spectra resolved in five excitation wavelengths, four source-to-detector separations, and eight measurement times. Best fitting results between experimental and estimated spectra were obtained for optimal numbers of 3 and 4 sources. These estimated spectral sources exhibited common identifiable shapes of fluorescence emission spectra related to the fluorescent gel substrate and to known skin intrinsic fluorophores matching namely dermis collagen/elastin and epidermis flavins. The time analysis of the fluorophore contributions allowed us to highlight how the clearing process towards the deepest skin layers impacts skin autofluorescence through time, namely with a strongest contribution to the bulk autofluorescence signal of dermis collagen (respectively epidermis flavins) fluorescence at shortest (respectively longest) excitation wavelengths and longest (respectively shortest) source-to-detector separations.

Hydrogen bound water profiles in the skin influenced by optical clearing molecular agents-Quantitative analysis using confocal Raman microscopy

Confocal Raman microscopy has been used to measure depth-dependent profiles of porcine skin ex vivo in the high wavenumber region after application of molecular optical clearing agents (OCAs). Glycerol (70%) and iohexol (100% Omnipaque [300]) water solutions were used as OCAs and topically applied to porcine ear skin for 30 and 60 minutes. Using Gaussian function-based deconvolution, the changes of hydrogen bound water molecule types have been microscopically analyzed down to the depth of 200 μm. Results show that both OCAs induced skin dehydration (reduction of total water), which is 51.3% for glycerol (60 minutes), 33.1% for glycerol (30 minutes), 8.3% for Omnipaque (60 minutes) and 4.4% for Omnipaque (30 minutes), on average for the 40 to 200 μm depths. Among the water types in the skin, the following reduction was observed in concentration of weakly bound (51.1%, 33.2%, 7.5% and 4.6%), strongly bound (50.4%, 33.0%, 7.9% and 3.4%), tightly bound (63.6%, 42.3%, 26.1% and 12.9%) and unbound (55.4%, 28.7%, 10.1% and 5.9%) water types on average for the 40 to 200 μm depths, post application of glycerol (60 minutes), glycerol (30 minutes), Omnipaque (60 minutes) and Omnipaque (30 minutes), respectively. As most concentrated in the skin, weakly and strongly bound water types are preferentially involved in the OCA-induced water flux in the skin, and thus, are responsible for optical clearing efficiency.

Preclinical quantitative in-vivo assessment of skin tissue vascularity in radiation-induced fibrosis with optical coherence tomography

Radiation therapy (RT) is widely and effectively used for cancer treatment but can also cause deleterious side effects, such as a late-toxicity complication called radiation-induced fibrosis (RIF). Accurate diagnosis of RIF requires analysis of histological sections to assess extracellular matrix infiltration. This is invasive, prone to sampling limitations, and thus rarely used; instead, current practice relies on subjective clinical surrogates, including visual observation, palpation, and patient symptomatology questionnaires. This preclinical study demonstrates that functional optical coherence tomography (OCT) is a useful tool for objective noninvasive in-vivo assessment and quantification of fibrosis-associated microvascular changes in tissue. Data were collected from murine hind limbs 6 months after 40-Gy single-dose irradiation and compared with nonirradiated contralateral tissues of the same animals. OCT-derived vascular density and average vessel diameter metrics were compared to quantitative vascular analysis of stained histological slides. Results indicate that RIF manifests significant microvascular changes at this time point posttreatment. Abnormal microvascular changes visualized by OCT in this preclinical setting suggest the potential of this label-free high-resolution noninvasive functional imaging methodology for RIF diagnosis and assessment in the context of clinical RT.

Upconversion in photodynamic therapy: plumbing the depths

Photodynamic therapy (PDT) involves the combination of non-toxic dyes called photosensitizers (PS) and harmless visible light that interact with ambient oxygen to give reactive oxygen species (ROS) that can damage biomolecules and kill cells. PDT has mostly been developed as a cancer therapy but can also be used as an antimicrobial approach against localized infections. However even the longest wavelength used for exciting PS (in the 700 nm region) has relatively poor tissue penetration, and many PS are much better excited by blue and green light. Therefore upconversion nanoparticles (UCNPs) have been investigated in order to allow deeper-penetrating near-infrared light (980 nm or 810 nm) to be used for PDT. NaYF4 nanoparticles doped with Yb3+ and Er3+ or with Tm3+ and Er3+ have been attached to PS either by covalent conjugation, or by absorption to the coating or shell (used to render the UCNPs biocompatible). Forster resonance energy transfer to the PS then allows NIR light energy to be transduced into ROS leading to cell killing and tumor regression. Some studies have experimentally demonstrated the deep tissue advantage of UCNP-PDT. Recent advances have included dye-sensitized UCNPs and UCNPs coupled to PS, and other potentially synergistic drug molecules or techniques. A variety of bioimaging modalities have also been combined with upconversion PDT. Further studies are necessary to optimize the drug-delivery abilities of the UCNPs, improve the quantum yields, allow intravenous injection and tumor targeting, and ensure lack of toxicity at the required doses before potential clinical applications.

Recent progress in tissue optical clearing for spectroscopic application

This paper aims to review recent progress in optical clearing of the skin and over naturally turbid biological tissues and blood using this technique in vivo and in vitro with multiphoton microscopy, confocal Raman microscopy, confocal microscopy, NIR spectroscopy, optical coherence tomography, and laser speckle contrast imaging. Basic principles of the technique, its safety, advantages and limitations are discussed. The application of optical clearing agent on a tissue allows for controlling the optical properties of tissue. Optical clearing-induced reduction of tissue scattering significantly facilitates the observation of deep-located tissue regions, at the same time improving the resolution and image contrast for a variety of optical imaging methods suitable for clinical applications, such as diagnostics and laser treatment of skin diseases, mucosal tumor imaging, laser disruption of pathological abnormalities, etc.

Enhancement of short coherence digital holographic microscopy by optical clearing

In this work, we used a short coherence digital holographic microscopy system to demonstrate cross-talk noise suppression and imaging performance enhancement by optical clearing. Performance of the system on both phantom and in vitro porcine skin tissues before and after the treatment of 70% v./v. glycerol-saline solution was investigated. Our results showed that optical clearing effectively inhibits the cross-talk noise and improves the image quality in the deep of the in vitro porcine skin tissues. The imaging depth was increased by about 30% after topical application of the glycerol-saline solution for 30 min.