Absorption spectroscopy in tissue-simulating materials: a theoretical and experimental study of photon paths

Spatial Sensitivity to Absorption Changes for Various Near-Infrared Spectroscopy Methods: A Compendium Review

This compendium review focuses on the spatial distribution of sensitivity to localized absorption changes in optically diffuse media, particularly for measurements relevant to near-infrared spectroscopy. The three temporal domains, continuous-wave, frequency-domain, and time-domain, each obtain different optical data-types whose changes may be related to effective homogeneous changes in the absorption coefficient. Sensitivity is the relationship between a localized perturbation and the recovered effective homogeneous absorption change. Therefore, spatial sensitivity maps representing the perturbation location can be generated for the numerous optical data-types in the three temporal domains. The review first presents a history of the past 30 years of work investigating this sensitivity in optically diffuse media. These works are experimental and theoretical, presenting 1-, 2-, and 3-dimensional sensitivity maps for different near-infrared spectroscopy methods, domains, and data-types. Following this history, we present a compendium of sensitivity maps organized by temporal domain and then data-type. This compendium provides a valuable tool to compare the spatial sensitivity of various measurement methods and parameters in one document. Methods for one to generate these maps are provided in the appendix, including code. This historical review and comprehensive sensitivity map compendium provides a single source researchers may use to visualize, investigate, compare, and generate sensitivity to localized absorption change maps.

Correlation of diabetic renal hypoperfusion with microvascular responses of the skeletal muscle: a rat model study using diffuse correlation spectroscopy

Using diffuse correlation spectroscopy, we assessed the renal blood flow and thigh muscle microvascular responses in a rat model of type 2 diabetes. The blood flow index at the renal surface decreased significantly with arterial clamping, cardiac extirpation, and the progression of diabetic endothelial dysfunction. Renal blood flow measured in diabetic and nondiabetic rats also showed a significant correlation with the reactive hyperemic response of the thigh muscle. These results suggest shared microcirculatory dysfunction in the kidney and skeletal muscle and support endothelial responses in the skeletal muscle as a potential noninvasive biomarker of renal hypoperfusion.

Differential changes in blood flow and oxygen utilization in active muscles between voluntary exercise and electrical muscle stimulation in young adults

The physiological effects on blood flow and oxygen utilization in active muscles during and after involuntary contraction triggered by electrical muscle stimulation (EMS) remain unclear, particularly compared with those elicited by voluntary (VOL) contractions. Therefore, we used diffuse correlation and near-infrared spectroscopy (DCS-NIRS) to compare changes in local muscle blood flow and oxygen consumption during and after these two types of muscle contractions in humans. Overall, 24 healthy young adults participated in the study, and data were successfully obtained from 17 of them. Intermittent (2-s contraction, 2-s relaxation) isometric ankle dorsiflexion with a target tension of 20% of maximal VOL contraction was performed by EMS or VOL for 2 min, followed by a 6-min recovery period. DCS-NIRS probes were placed on the tibialis anterior muscle, and relative changes in local tissue blood flow index (rBFI), oxygen extraction fraction (rOEF), and metabolic rate of oxygen (rMRO2) were continuously derived. EMS induced more significant increases in rOEF and rMRO2 than VOL exercise but a comparable increase in rBFI. After EMS, rBFI and rMRO2 decreased more slowly than after VOL and remained significantly higher until the end of the recovery period. We concluded that EMS augments oxygen consumption in contracting muscles by enhancing oxygen extraction while increasing oxygen delivery at a rate similar to the VOL exercise. Under the conditions examined in this study, EMS demonstrated a more pronounced and/or prolonged enhancement in local muscle perfusion and aerobic metabolism compared with VOL exercise in healthy participants.NEW & NOTEWORTHY This is the first study to visualize continuous changes in blood flow and oxygen utilization within contracted muscles during and after electrical muscle stimulation (EMS) using combined diffuse correlation and near-infrared spectroscopy. We found that initiating EMS increases blood flow at a rate comparable to that during voluntary (VOL) exercise but enhances oxygen extraction, resulting in higher oxygen consumption. Furthermore, EMS increased postexercise muscle perfusion and oxygen consumption compared with that after VOL exercise.

Skin microcirculatory responses: A potential marker for early diabetic neuropathy assessment using a low-cost portable diffuse optical spectrometry device

Diffuse optical measurement is an evolving optical modality providing a fast and portable solution for microcirculation assessment. Diffuse optics in static and dynamic modalities are combined here in a system to assess hemodynamics in skin tissues of control and diabetic subjects. The in-house developed system consists of a laser source, fiber optic probe, a low-cost avalanche photodiode, a finite element model (FEM) derived static optical property estimator, and a software correlator for continuous flow monitoring through microvasculature. The studies demonstrated that the system quantifies the changes in blood flow rate in the immediate skin subsurface. The system is calibrated with in vitro flow models and a proof-of-concept was demonstrated on a limited number of subjects in a clinical environment. The flow changes in response to vasoconstrictive and vasodilative stimuli were analyzed and used to classify different stages of diabetes, including diabetic neuropathy.

Pressure stimulus study on acupuncture points with multi-channel multimode-fiber diffuse speckle contrast analysis (MMF-DSCA)

A multi-channel multimode-fiber deep tissue flowmetry system has been constructed based on diffuse speckle contrast analysis (DSCA) for simultaneous blood flow measurements at different locations on the human body. This system has been utilized in an acupuncture study within the field of traditional Chinese medicine (TCM), primarily focusing on acupuncture points along the large intestine meridian. Deep tissue blood flow was monitored at four different acupuncture points (LI1, LI5, LI10, and ST25) with a sampling rate of 60 Hz while applying pressure stimulus on LI4 (hegu or hapgok). Although the blood flow index (BFI) and blood volume (BV) did not exhibit significant changes after the pressure stimulus, an increase in the amplitude and complexity of low-frequency oscillations (LFOs) in microcirculation was observed.

Deep-learning-based separation of shallow and deep layer blood flow rates in diffuse correlation spectroscopy

Diffuse correlation spectroscopy faces challenges concerning the contamination of cutaneous and deep tissue blood flow. We propose a long short-term memory network to directly quantify the flow rates of shallow and deep-layer tissues. By exploiting the different contributions of shallow and deep-layer flow rates to auto-correlation functions, we accurately predict the shallow and deep-layer flow rates (RMSE = 0.047 and 0.034 ml/min/100 g of simulated tissue, R2 = 0.99 and 0.99, respectively) in a two-layer flow phantom experiment. This approach is useful in evaluating the blood flow responses of active muscles, where both cutaneous and deep-muscle blood flow increase with exercise.

Imaging Dynamics Beneath Turbid Media via Parallelized Single-Photon Detection

Noninvasive optical imaging through dynamic scattering media has numerous important biomedical applications but still remains a challenging task. While standard diffuse imaging methods measure optical absorption or fluorescent emission, it is also well-established that the temporal correlation of scattered coherent light diffuses through tissue much like optical intensity. Few works to date, however, have aimed to experimentally measure and process such temporal correlation data to demonstrate deep-tissue video reconstruction of decorrelation dynamics. In this work, a single-photon avalanche diode array camera is utilized to simultaneously monitor the temporal dynamics of speckle fluctuations at the single-photon level from 12 different phantom tissue surface locations delivered via a customized fiber bundle array. Then a deep neural network is applied to convert the acquired single-photon measurements into video of scattering dynamics beneath rapidly decorrelating tissue phantoms. The ability to reconstruct images of transient (0.1-0.4 s) dynamic events occurring up to 8 mm beneath a decorrelating tissue phantom with millimeter-scale resolution is demonstrated, and it is highlighted how the model can flexibly extend to monitor flow speed within buried phantom vessels.

Cortical Spreading Depolarization, Blood Flow, and Cognitive Outcomes in a Closed Head Injury Mouse Model of Traumatic Brain Injury

BACKGROUND

Cortical spreading depolarizations (CSDs) are associated with worse outcomes in many forms of acute brain injury, including traumatic brain injury (TBI). Animal models could be helpful in developing new therapies or biomarkers to improve outcomes in survivors of TBI. Recently, investigators have observed CSDs in murine models of mild closed head injury (CHI). We designed the currently study to determine additional experimental conditions under which CSDs can be observed, from mild to relatively more severe TBI.

METHODS

Adult male C57Bl/6J mice (8-14 weeks old) were anesthetized with isoflurane and subjected to CHI with an 81-g weight drop from 152 or 183 cm. CSDs were detected with minimally invasive visible light optical intrinsic signal imaging. Cerebral blood flow index (CBFi) was measured in the 152-cm drop height cohort using diffuse correlation spectroscopy at baseline before and 4 min after CHI. Cognitive outcomes were assessed at 152- and 183-cm drop heights for the Morris water maze hidden platform, probe, and visible platform tests.

RESULTS

CSDs occurred in 43% (n = 12 of 28) of 152-cm and 58% (n = 15 of 26) of 183-cm drop height CHI mice (p = 0.28). A lower baseline preinjury CBFi was associated with development of CSDs in CHI mice (1.50 ± 0.07 × 10-7 CHI without CSD [CSD-] vs. 1.17 ± 0.04 × 10-7 CHI with CSD [CSD+], p = 0.0001). Furthermore, in CHI mice that developed CSDs, the ratio of post-CHI to pre-CHI CBFi was lower in the hemisphere ipsilateral to a CSD compared with non-CSD hemispheres (0.19 ± 0.07 less in the CSD hemisphere, p = 0.028). At a 152-cm drop height, there were no detectable differences between sham injured (n = 10), CHI CSD+ (n = 12), and CHI CSD- (n = 16) mice on Morris water maze testing at 4 weeks. At a 183-cm drop height, CHI CSD+ mice had worse performance on the hidden platform test at 1-2 weeks versus sham mice (n = 15 CHI CSD+, n = 9 sham, p = 0.045), but there was no appreciable differences compared with CHI CSD- mice (n = 11 CHI CSD-).

CONCLUSIONS

The data suggest that a lower baseline cerebral blood flow prior to injury may contribute to the occurrence of a CSD. Furthermore, a CSD at the time of injury can be associated with worse cognitive outcome under the appropriate experimental conditions in a mouse CHI model of TBI.

Evaluation of Local Skeletal Muscle Blood Flow in Manipulative Therapy by Diffuse Correlation Spectroscopy

Manipulative therapy (MT) is applied to motor organs through a therapist’s hands. Although MT has been utilized in various medical treatments based on its potential role for increasing the blood flow to the local muscle, a quantitative validation of local muscle blood flow in MT remains challenging due to the lack of appropriate bedside evaluation techniques. Therefore, we investigated changes in the local blood flow to the muscle undergoing MT by employing diffuse correlation spectroscopy, a portable and emerging optical measurement technology that non-invasively measures blood flow in deep tissues. This study investigated the changes in blood flow, heart rate, blood pressure, and autonomic nervous activity in the trapezius muscle through MT application in 30 volunteers without neck and shoulder injury. Five minutes of MT significantly increased the median local blood flow relative to that of the pre-MT period (p < 0.05). The post-MT local blood flow increase was significantly higher in the MT condition than in the control condition, where participants remained still without receiving MT for the same time (p < 0.05). However, MT did not affect the heart rate, blood pressure, or cardiac autonomic nervous activity. The post-MT increase in muscle blood flow was significantly higher in the participants with muscle stiffness in the neck and shoulder regions than in those without (p < 0.05). These results suggest that MT could increase the local blood flow to the target skeletal muscle, with minimal effects on systemic circulatory function.

A novel spatially resolved interactance spectroscopy system to estimate degree of red coloration in red-fleshed apple

Reliable information about degree of red coloration in fruit flesh is essential for grading and sorting of red-fleshed apples. We propose a spatially resolved interactance spectroscopy approach as a new rapid and non-destructive technique to estimate degree of red coloration in the flesh of a red-fleshed apple cultivar 'Kurenainoyume'. A novel measurement system was developed to obtain spatially resolved interactance spectra (190-1070 nm) for apple fruits at eight different light source-detector separation (SDS) distances on fruit surface. Anthocyanins in apple were extracted using a solvent extraction technique, and their contents were quantified with a spectrophotometer. Partial least squares (PLS) regression analyses were performed to develop estimation models for anthocyanin content from spatially resolved interactance spectra. Results showed that the PLS models based on interactance spectra obtained at different SDS distances achieved different predictive accuracy. Further, the system demonstrated the possibility to detect the degree of red coloration in the flesh at specific depths by identifying an optimal SDS distance. This might contribute to provide a detailed profile of the red coloration (anthocyanins) that is unevenly distributed among different depths of the flesh. This new approach may be potentially applied to grading and sorting systems for red-fleshed apples in fruit industry.

The Case for Measuring Long Bone Hemodynamics With Near-Infrared Spectroscopy

Diseases and associated fragility of bone is an important medical issue. There is increasing evidence that bone health is related to blood flow and oxygen delivery. The development of non-invasive methods to evaluate bone blood flow and oxygen delivery promise to improve the detection and treatment of bone health in human. Near-infrared spectroscopy (NIRS) has been used to evaluate oxygen levels, blood flow, and metabolism in skeletal muscle and brain. While the limited penetration depth of NIRS restricts its application, NIRS studies have been performed on the medial aspect of the tibia and some other prominent bone sites. Two approaches using NIRS to evaluate bone health are discussed: (1) the rate of re-oxygenation of bone after a short bout of ischemia, and (2) the dynamics of oxygen levels during an intervention such as resistance exercise. Early studies have shown these approaches to have the potential to evaluate bone vascular health as well as the predicted efficacy of an intervention before changes in bone composition are detectable. Future studies are needed to fully develop and exploit the use of NIRS technology for the study of bone health.

Non-invasive optical neuromonitoring of the temperature-dependence of cerebral oxygen metabolism during deep hypothermic cardiopulmonary bypass in neonatal swine

Management of deep hypothermic (DH) cardiopulmonary bypass (CPB), a critical neuroprotective strategy, currently relies on non-invasive temperature to guide cerebral metabolic suppression during complex cardiac surgery in neonates. Considerable inter-subject variability in temperature response and residual metabolism may contribute to the persisting risk for postoperative neurological injury. To characterize and mitigate this variability, we assess the sufficiency of conventional nasopharyngeal temperature (NPT) guidance, and in the process, validate combined non-invasive frequency-domain diffuse optical spectroscopy (FD-DOS) and diffuse correlation spectroscopy (DCS) for direct measurement of cerebral metabolic rate of oxygen (CMRO₂). During CPB, n = 8 neonatal swine underwent cooling from normothermia to 18℃, sustained DH perfusion for 40 min, and then rewarming to simulate cardiac surgery. Continuous non-invasive and invasive measurements of intracranial temperature (ICT) and CMRO₂ were acquired. Significant hysteresis (p < 0.001) between cooling and rewarming periods in the NPT versus ICT and NPT versus CMRO₂ relationships were found. Resolution of this hysteresis in the ICT versus CMRO₂ relationship identified a crucial insufficiency of conventional NPT guidance. Non-invasive CMRO₂ temperature coefficients with respect to NPT (Q₁₀ = 2.0) and ICT (Q₁₀ = 2.5) are consistent with previous reports and provide further validation of FD-DOS/DCS CMRO₂ monitoring during DH CPB to optimize management.

Topological complexity of photons' paths in biological tissues

In the present contribution, three means of measuring the geometrical and topological complexity of photons' paths in random media are proposed. This is realized by investigating the behavior of the average crossing number, the mean writhe, and the minimal crossing number of photons' paths generated by Monte Carlo (MC) simulations, for different sets of optical parameters. It is observed that the complexity of the photons' paths increases for increasing light source/detector spacing, and that highly "knotted" paths are formed. Due to the particular rules utilized to generate the MC photons' paths, the present results may have an interest not only for the biomedical optics community, but also from a pure mathematical point of view.

Method to improve the depth sensitivity of diffuse reflectance measurements to absorption changes in optically turbid medium

We have studied the spatial distributions of the sensitivity of time-resolved near-infrared diffuse reflectance measurement. Sensitivity factors representing a change of parameters of a measured optical signal induced by absorption perturbation in a certain voxel of the medium were simulated using the diffusion equation solution. The parameters were statistical moments of measured distributions of time of flight of photons (DTOFs) i.e., the total number of photons, mean time of flight and variance. The distributions of the sensitivity of statistical moments of DTOFs to a change in absorption were generated for various source-detector separations and various optical properties of the medium. Furthermore, differential sensitivity distributions for two different source-detector separations were calculated. A measurement geometry, in which two detection spots, separated by 5 mm, in combination with two sources was proposed. For this setup differences between the signals obtained for both detectors were calculated independently for both sources and afterward summed up for both source positions. Obtained differences in moments of DTOFs assessed at two source-detector separations and summed up for different positioning of the sources allowed to shape up the sensitivity profiles. Calculated sensitivity profiles show that positive sensitivities of the mean time of flight of photons and variance of the DTOF can be obtained. These positive sensitivity areas are located just between both detection spots and cover the compartment located deeply in the medium. The sensitivity in superficial compartments of the medium is negative and much smaller in amplitude. The proposed technique can be used for improved discrimination of optical signals related to the intracerebral change in absorption which remains a serious obstacle in the application of the NIRS technique in the assessment of brain oxygenation or perfusion.

Optical sampling depth in the spatial frequency domain

We present a Monte Carlo (MC) method to determine depth-dependent probability distributions of photon visitation and detection for optical reflectance measurements performed in the spatial frequency domain (SFD). These distributions are formed using an MC simulation for radiative transport that utilizes a photon packet weighting procedure consistent with the two-dimensional spatial Fourier transform of the radiative transport equation. This method enables the development of quantitative metrics for SFD optical sampling depth in layered tissue and its dependence on both tissue optical properties and spatial frequency. We validate the computed depth-dependent probability distributions using SFD measurements in a layered phantom system with a highly scattering top layer of variable thickness supported by a highly absorbing base layer. We utilize our method to establish the spatial frequency-dependent optical sampling depth for a number of tissue types and also provide a general tool to determine such depths for tissues of arbitrary optical properties.

Time-Domain Near-Infrared Spectroscopy and Imaging: A Review

This article reviews the past and current statuses of time-domain near-infrared spectroscopy (TD-NIRS) and imaging. Although time-domain technology is not yet widely employed due to its drawbacks of being cumbersome, bulky, and very expensive compared to commercial continuous wave (CW) and frequency-domain (FD) fNIRS systems, TD-NIRS has great advantages over CW and FD systems because time-resolved data measured by TD systems contain the richest information about optical properties inside measured objects. This article focuses on reviewing the theoretical background, advanced theories and methods, instruments, and studies on clinical applications for TD-NIRS including some clinical studies which used TD-NIRS systems. Major events in the development of TD-NIRS and imaging are identified and summarized in chronological tables and figures. Finally, prospects for TD-NIRS in the near future are briefly described.

Low cerebral blood flow is a non-invasive biomarker of neuroinflammation after repetitive mild traumatic brain injury

Previous work has shown that non-invasive optical measurement of low cerebral blood flow (CBF) is an acute biomarker of poor long-term cognitive outcome after repetitive mild traumatic brain injury (rmTBI). Herein, we explore the relationship between acute cerebral blood flow and underlying neuroinflammation. Specifically, because neuroinflammation is a driver of secondary injury after TBI, we hypothesized that both glial activation and inflammatory signaling are associated with acute CBF and, by extension, with long-term cognitive outcome after rmTBI. To test this hypothesis, cortical CBF was non-invasively measured in anesthetized mice 4 h after 3 repetitive closed head injuries spaced once-daily, at which time brains were collected. Right hemispheres were fixed for immunohistochemical staining for glial activation markers Iba1 and GFAP while left hemispheres were used to quantify Iba1 and GFAP expression via Western blot as well as 32 cytokines and 21 phospho-proteins in the MAPK, PI3K/Akt, and NF-κB pathways using a Luminex multiplexed immunoassay. N = 8/7 injured/sham C57/black-6 adult male mice were studied. Within the injured group, CBF inversely correlated with Iba1 expression (R = -0.86, p < .01). Further, partial least squares regression analysis revealed significant correlations between CBF and expression of multiple pro-inflammatory cytokines, including RANTES and IL-17. Finally, within the injured group, phosphorylation of specific signals in the MAPK and NF-κB intracellular signaling pathways (e.g., p38 MAPK and NF-κB) were significantly positively correlated with Iba1. In total, our data indicate that acute cerebral blood flow after rmTBI is a biomarker of underlying neuroinflammatory pathology.

Muscular blood flow responses as an early predictor of the severity of diabetic neuropathy at a later stage in streptozotocin-induced type I diabetic rats: a diffuse correlation spectroscopy study

We propose a novel application of diffuse correlation spectroscopy to evaluate microvascular malfunctions of muscle tissue affected by hyperglycemia and determine their correlation with the severity of diabetic neuropathy at a later stage. Microvascular responses of the thigh muscle and the mechanical pain threshold of the hind paw of streptozotocin-induced type I diabetic rats were continuously monitored once per week for 70 days. Significantly decreased baseline blood flow and reactive hyperemia responses were observed as early as 1 week after hyperglycemia induction. The reactive hyperemia response at 2 weeks of hyperglycemia was highly correlated with the mechanical pain threshold at 8 weeks, at which time a decreased pain threshold was statistically confirmed in hyperglycemic rats relative to controls.

Real time evaluation of tissue optical properties during thermal ablation of ex vivo liver tissues

Complete ablation of liver tumors is vital for minimizing the risk of local tumor recurrence. Accurately identifying the hallmarks of tissue necrosis during thermal ablative therapies may significantly increase the efficacy of ablation, while minimizing unnecessary damage to the surrounding normal tissues or critical structures. Light propagation in biological tissues is sensitive to the tissue microstructure and chromophore concentrations. In our previous studies, we found that the wavelength (λ) averaged liver tissue absorption coefficient (µ_a) and reduced scattering coefficient (µ_s') change significantly upon heating which may be used for assessment of tissue damage during thermal ablation of solid tumors. Here, we seek to demonstrate the use of an integrated fiber-optic probe for continuous monitoring of the local tissue temperature (T), µ_a(λ) and µ_s'(λ) during thermal ablation of ex vivo porcine livers. The wavelength-averaged (435-630 nm) tissue absorption and scattering (µ_a and µ_s' ) increased rapidly at 45 °C and plateaued at 67 °C. The mean µ_a and µ_s' for liver tissue at 37 °C (n = 10) were 8.5 ± 3.7 and 2.8 ± 1.1 cm^-1, respectively. The relative changes in µ_a and µ_s' at 37, 55, and 65 °C were significantly different (p < .02) from each other. A relationship between the relative changes in µ_a and µ_s' and the degree of tissue damage estimated using the temperature-based Arrhenius model for porcine liver tissues was established and studied.

Sympathoexcitation constrains vasodilation in the human skeletal muscle microvasculature during postocclusive reactive hyperemia

We used diffuse correlation spectroscopy to investigate sympathetic vasoconstriction, local vasodilation, and integration of these two responses in the skeletal muscle microvasculature of 20 healthy volunteers. Diffuse correlation spectroscopy probes were placed on the flexor carpi radialis muscle or vastus lateralis muscle, and a blood flow index was derived continuously. We measured hemodynamic responses during sympathoexcitation induced by forehead cooling, after which the effects of the increased sympathetic tone on vasodilatory responses during postocclusive reactive hyperemia (PORH) were examined. PORH was induced by releasing arterial occlusion (3 min) in an arm or leg. To increase sympathetic tone during PORH, forehead cooling was begun 60 s before the occlusion release and ended 60 s after the release. During forehead cooling, mean arterial pressure rose significantly and was sustained at an elevated level. Significant vasoconstriction and decreases in blood flow index followed by gradual blunting of the vasoconstriction also occurred. The time course of these responses is in good agreement with previous observations in animals. The acute sympathoexcitation diminished the peak vasodilation during PORH only in the vastus lateralis muscle, but it hastened the decline in vasodilation after the peak in both the flexor carpi radialis muscle and vastus lateralis muscle. Consequently, the total vasodilatory response assessed as the area of the vascular conductance during the first minute of PORH was significantly diminished in both regions. We conclude that, in humans, the integrated effects of sympathetic vasoconstriction and local vasodilation have an important role in vascular regulation and control of perfusion in the skeletal muscle microcirculation.

NEW & NOTEWORTHY We used diffuse correlation spectroscopy to demonstrate that acute sympathoexcitation constrains local vasodilation in the human skeletal muscle microvasculature during postocclusive reactive hyperemia. This finding indicates that integration of sympathetic vasoconstriction and local vasodilation is importantly involved in vascular regulation and the control of perfusion of the skeletal muscle microcirculation in humans.

Broadband time-resolved multi-channel functional near-infrared spectroscopy system to monitor in vivo physiological changes of human brain activity

We have developed a broadband time-resolved multi-channel near-infrared spectroscopy system that can monitor the physiological responses of the adult human brain. This system is composed of a supercontinuum laser for the source part and of an intensified charge-coupled device camera coupled with an imaging spectrometer for the detection part. It allows the detection of the spectral, from 600 to 900 nm, and spatial dimensions as well as the arrival time of photon information simultaneously. We describe the setup and its characterization in terms of temporal instrument response function, wavelength sensitivity, and stability. The ability of the system to detect the hemodynamic response is then demonstrated. First, an in vivo experiment on an adult volunteer was performed to monitor the response in the arm during a cuff occlusion. Second, the response in the brain during a cognitive task was monitored on a group of five healthy volunteers. Moreover, looking at the response at different time windows, we could monitor the hemodynamic response in depth, enhancing the detection of the cortical activation. Those first results demonstrate the ability of our system to discriminate between the responses of superficial and deep tissues, addressing an important issue in functional near-infrared spectroscopy.

Concurrent measurement of cerebral hemodynamics and electroencephalography during transcranial direct current stimulation

Transcranial direct current stimulation (tDCS) is currently being used for research and treatment of some neurological and neuropsychiatric disorders, as well as for improvement of cognitive functions. In order to better understand cerebral response to the stimulation and to redefine protocols and dosage, its effects must be monitored. To this end, we have used functional diffuse correlation spectroscopy (fDCS) and time-resolved functional near-infrared spectroscopy (TR-fNIRS) together with electroencephalography (EEG) during and after stimulation of the frontal cortex. Twenty subjects participated in two sessions of stimulation with two different polarity montages and twelve also underwent a sham session. Cerebral blood flow and oxyhemoglobin concentration increased during and after active stimulation in the region under the stimulation electrode while deoxyhemoglobin concentration decreased. The EEG spectrum displayed statistically significant power changes across different stimulation sessions in delta (2 to 4 Hz), theta (4 to 8 Hz), and beta (12 to 18 Hz) bands. Results suggest that fDCS and TR-fNIRS can be employed as neuromonitors of the effects of transcranial electrical stimulation and can be used together with EEG.

Angle-selective optical filter for highly sensitive reflection photoplethysmogram

We report an angle-selective optical filter (ASOF) for highly sensitive reflection photoplethysmography (PPG) sensors. The ASOF features slanted aluminum (Al) micromirror arrays embedded in transparent polymer resin, which effectively block scattered light under human tissue. The device microfabrication was done by using geometry-guided resist reflow of polymer micropatterns, polydimethylsiloxane replica molding, and oblique angle deposition of thin Al film. The angular transmittance through the ASOF is precisely controlled by the angle of micromirrors. For the mirror angle of 30 degrees, the ASOF accepts an incident light between - 90 to + 50 degrees and the maximum transmittance at - 55 degrees. The ASOF exhibits the substantial reduction of both the in-band noise of PPG signals over a factor of two and the low-frequency noise by three times. Consequently, this filter allows distinguishing the diastolic peak that allows miscellaneous parameters with diverse vascular information. This optical filter provides a new opportunity for highly sensitive PPG monitoring or miscellaneous optical tomography.

Depth sensitivity of frequency domain optical measurements in diffusive media

The depth sensitivity functions for AC amplitude, phase (PH) and DC intensity signals have been obtained in the frequency domain (where the source amplitude is modulated at radio-frequencies) by making use of analytical solutions of the photon diffusion equation in an infinite slab geometry. Furthermore, solutions for the relative contrast of AC, PH and DC signals when a totally absorbing plane is placed at a fixed depth of the slab have also been obtained. The solutions have been validated by comparisons with gold standard Monte Carlo simulations. The obtained results show that the AC signal, for modulation frequencies < 200 MHz, has a depth sensitivity with similar characteristics to that of the continuous-wave (CW) domain (source modulation frequency of zero). Thus, the depth probed by such a signal can be estimated by using the formula of penetration depth for the CW domain (Sci. Rep.6, 27057 (2016)). However, the PH signal has a different behavior compared to the CW domain, showing a larger depth sensitivity at shallow depths and a less steep relative contrast as a function of depth. These results mark a clear difference in term of depth sensitivity between AC and PH signals, and highlight the complexity of the estimation of the actual depth probed in tissue spectroscopy.

Non-invasive, multimodal analysis of cortical activity, blood volume and neurovascular coupling in infantile spasms using EEG-fNIRS monitoring

Although infantile spasms can be caused by a variety of etiologies, the clinical features are stereotypical. The neuronal and vascular mechanisms that contribute to the emergence of infantile spasms are not well understood. We performed a multimodal study by simultaneously recording electroencephalogram and functional Near-infrared spectroscopy in an intentionally heterogeneous population of six children with spasms in clusters. Regardless of the etiology, spasms were accompanied by two phases of hemodynamic changes; an initial change in the cerebral blood volume (simultaneously with each spasm) followed by a neurovascular coupling in all children except for the one with a large porencephalic cyst. Changes in cerebral blood volume, like the neurovascular coupling, occurred over frontal areas in all patients regardless of any brain damage suggesting a diffuse hemodynamic cortical response. The simultaneous motor activation and changes in cerebral blood volume might result from the involvement of the brainstem. The inconstant neurovascular coupling phase suggests a diffuse activation of the brain likely resulting too from the brainstem involvement that might trigger diffuse changes in cortical excitability.

Endoscopic optical coherence tomography: technologies and clinical applications [Invited]

In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.

Quantifying the effect of adipose tissue in muscle oximetry by near infrared spectroscopy

Change of muscle tissue oxygen saturation (StO2), due to exercise, measured by near infrared spectroscopy (NIRS) is known to be lower for subjects with higher adipose tissue thickness. This is most likely not physiological but caused by the superficial fat and adipose tissue. In this paper we assessed, in vitro, the influence of adipose tissue thickness on muscle StO2, measured by NIRS oximeters. We measured StO2 of a liquid phantom by 3 continuous wave (CW) oximeters (Sensmart Model X-100 Universal Oximetry System, INVOS 5100C, and OxyPrem v1.3), as well as a frequency-domain oximeter, OxiplexTS, through superficial layers with 4 different thicknesses. Later, we employed the results to calibrate OxyPrem v1.3 for adipose tissue thickness in-vivo.

There's plenty of light at the bottom: statistics of photon penetration depth in random media

We propose a comprehensive statistical approach describing the penetration depth of light in random media. The presented theory exploits the concept of probability density function f(z|ρ, t) for the maximum depth reached by the photons that are eventually re-emitted from the surface of the medium at distance ρ and time t. Analytical formulas for f, for the mean maximum depth 〈zmax〉 and for the mean average depth reached by the detected photons at the surface of a diffusive slab are derived within the framework of the diffusion approximation to the radiative transfer equation, both in the time domain and the continuous wave domain. Validation of the theory by means of comparisons with Monte Carlo simulations is also presented. The results are of interest for many research fields such as biomedical optics, advanced microscopy and disordered photonics.

Monitoring of tissue optical properties during thermal coagulation of ex vivo tissues

BACKGROUND AND OBJECTIVE

Real-time monitoring of tissue status during thermal ablation of tumors is critical to ensure complete destruction of tumor mass, while avoiding tissue charring and excessive damage to normal tissues. Currently, magnetic resonance thermometry (MRT), along with magnetic resonance imaging (MRI), is the most commonly used technique for monitoring and assessing thermal ablation process in soft tissues. MRT/MRI is very expensive, bulky, and often subject to motion artifacts. On the other hand, light propagation within tissue is sensitive to changes in tissue microstructure and physiology which could be used to directly quantify the extent of tissue damage. Furthermore, optical monitoring can be a portable, and cost-effective alternative for monitoring a thermal ablation process. The main objective of this study, is to establish a correlation between changes in tissue optical properties and the status of tissue coagulation/damage during heating of ex vivo tissues.

MATERIALS AND METHODS

A portable diffuse reflectance spectroscopy system and a side-firing fiber-optic probe were developed to study the absorption (μa (λ)), and reduced scattering coefficients (μ's (λ)) of native and coagulated ex vivo porcine, and chicken breast tissues. In the first experiment, both porcine and chicken breast tissues were heated at discrete temperature points between 24 and 140°C for 2 minutes. Diffuse reflectance spectra (430-630 nm) of native and coagulated tissues were recorded prior to, and post heating. In a second experiment, porcine tissue samples were heated at 70°C and diffuse reflectance spectra were recorded continuously during heating. The μa (λ) and μ's (λ) of the tissues were extracted from the measured diffuse reflectance spectra using an inverse Monte-Carlo model of diffuse reflectance. Tissue heating was stopped when the wavelength-averaged scattering plateaued.

RESULTS

The wavelength-averaged optical properties, <μ's (λ)> and <μa (λ)>, for native porcine tissues (n = 66) at room temperature, were 5.4 ± 0.3 cm(-1) and 0.780 ± 0.008 cm(-1) (SD), respectively. The <μ's (λ)> and <μa (λ)> for native chicken breast tissues (n = 66) at room temperature, were 2.69 ± 0.08 cm(-1) and 0.29 ± 0.01 cm(-1) (SD), respectively. In the first experiment, the <μ's (λ)> of coagulated porcine and chicken breast tissue rose to 56.4 ± 3.6 cm(-1) at 68.7 ± 1.7°C (SD), and 52.8 ± 1 cm(-1) at 57.1 ± 1.5°C (SD), respectively. Correspondingly, the <μa (λ)> of coagulated porcine (140.6°C), and chicken breast tissues (130°C) were 0.75 ± 0.05 cm(-1) and 0.263 ± 0.004 cm(-1) (SD). For both tissues, charring was observed at temperatures above 80°C. During continuous monitoring of porcine tissue (with connective tissues) heating, the <μ's (λ)> started to rise rapidly from 13.7 ± 1.5 minutes and plateaued at 19 ± 2.5 (SD) minutes. The <μ's (λ)> plateaued at 11.7 ± 3 (SD) minutes for porcine tissue devoid of connective tissue between probe and tissue surface. No charring was observed during continuous monitoring of thermal ablation process.

CONCLUSION

The changes in optical absorption and scattering properties can be continuously quantified, which could be used as a diagnostic biomarker for assessing tissue coagulation/damage during thermal ablation. Lasers Surg. Med. 48:686-694, 2016. © 2016 Wiley Periodicals, Inc.

Decreased microvascular cerebral blood flow assessed by diffuse correlation spectroscopy after repetitive concussions in mice

Repetitive concussions are associated with long-term cognitive dysfunction that can be attenuated by increasing the time intervals between concussions; however, biomarkers of the safest rest interval between injuries remain undefined. We hypothesize that deranged cerebral blood flow (CBF) is a candidate biomarker for vulnerability to repetitive concussions. Using a mouse model of human concussion, we examined the effect of single and repetitive concussions on cognition and on an index of CBF (CBFi) measured with diffuse correlation spectroscopy. After a single mild concussion, CBFi was reduced by 35±4% at 4 hours (P<0.01 versus baseline) and returned to preinjury levels by 24 hours. After five concussions spaced 1 day apart, CBFi was also reduced from preinjury levels 4 hours after each concussion but had returned to preinjury levels by 72 hours after the final concussion. Interestingly, in this repetitive concussion model, lower CBFi values measured both preinjury and 4 hours after the third concussion were associated with worse performance on the Morris water maze assessed 72 hours after the final concussion. We conclude that low CBFi measured either before or early on in the evolution of injury caused by repetitive concussions could be a useful predictor of cognitive outcome.

Fiber-optic Monitoring of Spinal Cord Hemodynamics in Experimental Aortic Occlusion

BACKGROUND

Spinal cord ischemia occurs frequently during thoracic aneurysm repair. Current methods based on electrophysiology techniques to detect ischemia are indirect, non-specific, and temporally slow. In this article, the authors report the testing of a spinal cord blood flow and oxygenation monitor, based on diffuse correlation and optical spectroscopies, during aortic occlusion in a sheep model.

METHODS

Testing was carried out in 16 Dorset sheep. Sensitivity in detecting spinal cord blood flow and oxygenation changes during aortic occlusion, pharmacologically induced hypotension and hypertension, and physiologically induced hypoxia/hypercarbia was assessed. Accuracy of the diffuse correlation spectroscopy measurements was determined via comparison with microsphere blood flow measurements. Precision was assessed through repeated measurements in response to pharmacologic interventions.

RESULTS

The fiber-optic probe can be placed percutaneously and is capable of continuously measuring spinal cord blood flow and oxygenation preoperatively, intraoperatively, and postoperatively. The device is sensitive to spinal cord blood flow and oxygenation changes associated with aortic occlusion, immediately detecting a decrease in blood flow (-65 ± 32%; n = 32) and blood oxygenation (-17 ± 13%, n = 11) in 100% of trials. Comparison of spinal cord blood flow measurements by the device with microsphere measurements led to a correlation of R = 0.49, P < 0.01, and the within-sheep coefficient of variation was 9.69%. Finally, diffuse correlation spectroscopy is temporally more sensitive to ischemic interventions than motor-evoked potentials.

CONCLUSION

The first-generation spinal fiber-optic monitoring device offers a novel and potentially important step forward in the monitoring of spinal cord ischemia.

Model-based analysis on the influence of spatial frequency selection in spatial frequency domain imaging

Frequency variation in spatial frequency domain imaging is a powerful tool for adjusting the penetration depth of the imaging signal and the parameter sensitivity toward absorption and diffusive and subdiffusive scattering. Through our computational analysis, using an analytical solution of the radiative transfer equation, we add quantitation to this tool by linking the different spatial frequency regimes to their relative information content and to their absolute depth sensitivity. Special focus is placed on high spatial frequencies by analysis of the phase function parameter γ and its significance and ambiguity in describing subdiffusive scattering.

Simulation-based optimization of a near-infrared spectroscopic subcutaneous fat thickness measuring device

Using Monte Carlo simulations we optimized the wavelength and source-detector distance (SDD) of a reflectance-based spectroscopic device used for measuring subcutaneous fat thickness. As the optical properties of muscle, fat and dermis are wavelength dependent, it is necessary to choose a wavelength that is highly sensitive to fat but insensitive to water and melanin. The SDD is important since it determines average photon penetration depth. With a tissue optics plug-in for the GEANT4/GAMOS system and published ex vivo tissue optical properties we were able to predict the behavior of different device configurations when used with varying thicknesses of fat, melanin concentrations or hydration levels. Our results indicate that the ideal wavelengths for fat measurement are 630-650 nm with an SDD of 2.6-29 cm. We also examined the potential of using near infrared (NIR) spectroscopy to determine tissue hydration levels, but concluded that this wavelength range was not ideal.

Calibration of diffuse correlation spectroscopy blood flow index with venous-occlusion diffuse optical spectroscopy in skeletal muscle

We investigate and assess the utility of a simple scheme for continuous absolute blood flow monitoring based on diffuse correlation spectroscopy (DCS). The scheme calibrates DCS using venous-occlusion diffuse optical spectroscopy (VO-DOS) measurements of arm muscle tissue at a single time-point. A calibration coefficient (γ) for the arm is determined, permitting conversion of DCS blood flow indices to absolute blood flow units, and a study of healthy adults (N=10) is carried out to ascertain the variability of γ. The average DCS calibration coefficient for the right (i.e., dominant) arm was γ=(1.24±0.15)×10(8) (mL·100  mL(−1)·min(−1))/(cm(2)/s). However, variability can be significant and is apparent in our site-to-site and day-to-day repeated measurements. The peak hyperemic blood flow overshoot relative to baseline resting flow was also studied following arm-cuff ischemia; excellent agreement between VO-DOS and DCS was found (R(2)=0.95, slope=0.94±0.07, mean difference=−0.10±0.45). Finally, we show that incorporation of subject-specific absolute optical properties significantly improves blood flow calibration accuracy.

Depth-dependent cerebral hemodynamic responses following direct cortical electrical stimulation (DCES) revealed by in vivo dual-optical imaging techniques

We studied depth-dependent cerebral hemodynamic responses of rat brain following direct cortical electrical stimulation (DCES) in vivo with optical recording of intrinsic signal (ORIS) and near-infrared spectroscopy (NIRS). ORIS is used to visualize the immediate hemodynamic changes in cortical areas following the stimulation, whereas NIRS measures the hemodynamic changes originating from subcortical areas. We found strong hemodynamic changes in relation to DCES both in ORIS and NIRS data. In particular, the signals originating from cortical areas exhibited a tri-phasic response, whereas those originating from subcortical regions exhibited multi-phasic responses. In addition, NIRS signals from two different sets of source-detector separation were compared and analyzed to investigate the causality of perfusion, which demonstrated downstream propagation, indicating that the upper brain region reacted faster than the deep region.

Direct measurement of tissue blood flow and metabolism with diffuse optics

Diffuse optics has proven useful for quantitative assessment of tissue oxy- and deoxyhaemoglobin concentrations and, more recently, for measurement of microvascular blood flow. In this paper, we focus on the flow monitoring technique: diffuse correlation spectroscopy (DCS). Representative clinical and pre-clinical studies from our laboratory illustrate the potential of DCS. Validation of DCS blood flow indices in human brain and muscle is presented. Comparison of DCS with arterial spin-labelled MRI, xenon-CT and Doppler ultrasound shows good agreement (0.50<r<0.95) over a wide range of tissue types and source detector distances, corroborating the potential of the method to measure perfusion non-invasively and in vivo at the microvasculature level. All-optical measurements of cerebral oxygen metabolism in both rat brain, following middle cerebral artery occlusion, and human brain, during functional activation, are also described. In both situations, the use of combined DCS and diffuse optical spectroscopy/near-infrared spectroscopy to monitor changes in oxygen consumption by the tissue is demonstrated. Finally, recent results spanning from gene expression-induced angiogenic response to stroke care and cancer treatment monitoring are discussed. Collectively, the research illustrates the capability of DCS to quantitatively monitor perfusion from bench to bedside, providing results that match up both with literature findings and with similar experiments performed with other techniques.

Effects of probe geometry on transscleral diffuse optical spectroscopy

The purpose of this study was to investigate how the geometry of a fiber optic probe affects the transmission and reflection of light through the scleral eye wall. Two geometrical parameters of the fiber probe were investigated: the source-detector distance and the fiber protrusion, i.e. the length of the fiber extending from the flat surface of the fiber probe. For optimization of the fiber optic probe geometry, fluorescence stained choroidal tumor phantoms in ex vivo porcine eyes were measured with both diffuse reflectance- and laser-induced fluorescence spectroscopy. The strength of the fluorescence signal compared to the excitation signal was used as a measure for optimization. Intraocular pressure (IOP) and temperature were monitored to assess the impact of the probe on the eye. For visualizing any possible damage caused by the probe, the scleral surface was imaged with scanning electron microscopy after completion of the spectroscopic measurements. A source-detector distance of 5 mm with zero fiber protrusion was considered optimal in terms of spectroscopic contrast, however, a slight fiber protrusion of 0.5 mm is argued to be advantageous for clinical measurements. The study further indicates that transscleral spectroscopy can be safely performed in human eyes under in vivo conditions, without leading to an unacceptable IOP elevation, a significant rise in tissue temperature, or any visible damage to the scleral surface.

Physical interpretation of the phase function related parameter γ studied with a fractal distribution of spherical scatterers

The optical properties within limited volumes of diffusive media can be probed by carrying spatially-resolved measurements of diffused light at short source-detector separation (typically one scattering mean free path). At such distance, analytical models only relying on the absorption and reduced scattering coefficients fail at correctly predicting reflectance and it was demonstrated that adding a third optical coefficient γ improves the description of light propagation conditions near the source. In an attempt to relate the γ coefficient to physical properties of turbid media, this paper uses a fractal distribution law for modeling scatterers' sizes distributions and investigates numerically and experimentally how γ is related to the fractal power α. The results indicate that within the range of γ typically encountered in biological samples, this coefficient is approximately linearly correlated with α.

A new method based on ICBM152 head surface for probe placement in multichannel fNIRS

We propose a new probe placement method for multichannel functional Near Infrared Spectroscopy (fNIRS) based on the ICBM152 template, the most commonly used reference brain for neuroimaging. Our method is based on the use of a physical model of the ICBM152 head surface as reference scalp and its validity is supported by previous investigations of cranio-cerebral correlation. The method, intended for fNIRS group studies, dispenses with the use of individual MRI scan and digitizing procedure for each participant. The present approach offers a fast, simple, reproducible and straightforward method to place the probes on the head surface according to the MNI coordinates of the regions of interest with an average measurement error similar to those of previous methods. This ensures that fNIRS results can be readily compared within the neuroimaging community, both across studies and techniques.

Diffuse Optics for Tissue Monitoring and Tomography

This review describes the diffusion model for light transport in tissues and the medical applications of diffuse light. Diffuse optics is particularly useful for measurement of tissue hemodynamics, wherein quantitative assessment of oxy- and deoxy-hemoglobin concentrations and blood flow are desired. The theoretical basis for near-infrared or diffuse optical spectroscopy (NIRS or DOS, respectively) is developed, and the basic elements of diffuse optical tomography (DOT) are outlined. We also discuss diffuse correlation spectroscopy (DCS), a technique whereby temporal correlation functions of diffusing light are transported through tissue and are used to measure blood flow. Essential instrumentation is described, and representative brain and breast functional imaging and monitoring results illustrate the workings of these new tissue diagnostics.

Intracranial microprobe for evaluating neuro-hemodynamic coupling in unanesthetized human neocortex

Measurement of the blood-oxygen-level dependent (BOLD) response with fMRI has revolutionized cognitive neuroscience and is increasingly important in clinical care. The BOLD response reflects changes in deoxy-hemoglobin concentration, blood volume, and blood flow. These hemodynamic changes ultimately result from neuronal firing and synaptic activity, but the linkage between these domains is complex, poorly understood, and may differ across species, cortical areas, diseases, and cognitive states. We describe here a technique that can measure neural and hemodynamic changes simultaneously from cortical microdomains in waking humans. We utilize a "laminar optode," a linear array of microelectrodes for electrophysiological measures paired with a micro-optical device for hemodynamic measurements. Optical measurements include laser Doppler to estimate cerebral blood flow as well as point spectroscopy to estimate oxy- and deoxy-hemoglobin concentrations. The microelectrode array records local field potential gradients (PG) and multi-unit activity (MUA) at 24 locations spanning the cortical depth, permitting estimation of population trans-membrane current flows (Current Source Density, CSD) and population cell firing in each cortical lamina. Comparison of the laminar CSD/MUA profile with the origins and terminations of cortical circuits allows activity in specific neuronal circuits to be inferred and then directly compared to hemodynamics. Access is obtained in epileptic patients during diagnostic evaluation for surgical therapy. Validation tests with relatively well-understood manipulations (EKG, breath-holding, cortical electrical stimulation) demonstrate the expected responses. This device can provide a new and robust means for obtaining detailed, quantitative data for defining neurovascular coupling in awake humans.

Coupled oxygenation oscillation measured by NIRS and intermittent cerebral activation on EEG in premature infants

Electroencephalography of premature neonates shows a physiological discontinuity of electrical activity during quiet sleep. Near infrared spectroscopy (NIRS) shows spontaneous oscillations of hemoglobin oxygenation and volume. Similar oscillations are visible in term neonates and adults, with NIRS and other functional imaging techniques (fMRI, Doppler, etc.), but are generally thought to result from vasomotion and to be a physiological artifact of limited interest. The origin and possible relationship to neuronal activity of the baseline changes in the NIRS signal have not been established. We carried out simultaneous EEG-NIRS recordings on six healthy premature neonates and four premature neonates presenting neurological distress, to determine whether changes in the concentration of cerebral oxy- and deoxy- and total hemoglobin were related to the occurrence of spontaneous bursts of cerebral electric activity. Bursts of electroencephalographic activity in neonates during quiet sleep were found to be coupled to a transient stereotyped hemodynamic response involving a decrease in oxy-hemoglobin concentration, sometimes beginning a few seconds before the onset of electroencephalographic activity, followed by an increase, and then a return to baseline. This pattern could be either part of the baseline oscillations or superimposed changes to this baseline, influencing its shape and phase. The temporal patterns of NIRS parameters present an unique configuration, and tend to be different between our healthy and pathological subjects. Studies of physiological activities and of the effects of intrinsic regulation on the NIRS signal should increase our understanding of these patterns and EEG-NIRS studies should facilitate the integration of NIRS into the set of clinical tools used in neurology.

Spatially resolved reflectance spectroscopy for diagnosis of cervical precancer: Monte Carlo modeling and comparison to clinical measurements

We present Monte Carlo modeling studies to provide a quantitative understanding of contrast observed in spatially resolved reflectance spectra of normal and highly dysplastic cervical tissue. Simulations have been carried out to analyze the sensitivity of spectral measurements to a range of changes in epithelial and stromal optical properties that are reported to occur as dysplasia develops and to predict reflectance spectra of normal and highly dysplastic tissue at six different source-detector separations. Simulation results provide important insights into specific contributions of different optical parameters to the overall spectral response. Predictions from simulations agree well with in vivo measurements from cervical tissue and successfully describe spectral differences observed in reflectance measurements from normal and precancerous tissue sites. Penetration depth statistics of photons detected at the six source-detector separations are also presented to reveal the sampling depth profile of the fiber-optic probe geometry simulated. The modeling studies presented provide a framework to meaningfully interpret optical signals obtained from epithelial tissues and to optimize design of optical sensors for in vivo reflectance measurements for precancer detection. Results from this study can facilitate development of analytical photon propagation models that enable inverse estimation of diagnostically relevant optical parameters from in vivo reflectance measurements.