Development of a multi-wavelength diffuse optical tomography system for early diagnosis of rheumatoid arthritis: simulation, phantoms and healthy human studies

Image Decomposition Technique Based on Near-Infrared Transmission

One way to diagnose a disease is to examine pictures of tissue thought to be affected by the disease. Near-infrared properties are subdivided into nonionizing, noninvasive, and nonradiative properties. Near-infrared also has selectivity properties for the objects it passes through. With this selectivity, the resulting attenuation coefficient value will differ depending on the type of material or wavelength. By measuring the output and input intensity values, as well as the attenuation coefficient, the thickness of a material can be measured. The thickness value can then be used to display a reconstructed image. In this study, the object studied was a phantom consisting of silicon rubber, margarine, and gelatin. The results showed that margarine materials could be decomposed from other ingredients with a wavelength of 980 nm.

Model-Based Optimization of Laser Excitation and Detection Improves Spectral Contrast in Noninvasive Diffuse Raman Spectroscopy

Spatially offset Raman spectroscopy (SORS) is a powerful technique for subsurface molecular analysis of optically turbid samples. Numerical modeling of light propagation has been used to investigate opportunities for improving spectral contrast and signal to noise ratio when imaging regions of interest located 0-4.5 mm below the surface in polymer bulk material. Two- and three-dimensional modeling results demonstrate that when analyzing a certain region of interest (ROI) of finite lateral dimensions below the sample surface, offsetting both the laser source and detector in opposite directions from the central point of the ROI can increase the spectral contrast as compared to conventional SORS approach where the detector or the laser source is maintained at the central point (centered SORS). The outlined modeling results have been validated experimentally using a bulk polymer sample with a trans-stilbene ROI (cylinder) below the sample surface. The results show that modeling of the spatial configurations of laser excitation and detection points can be used to optimize the instrument configuration to achieve significant improvements (up to 2.25-fold) in performance over the conventional centered SORS. Such optimal solutions can then be implemented, for example, using robust fiber optic probes, moveable optics, or flexible spatial light modulator instruments for specific applications.

Evaluation of SLE arthritis using frequency domain optical imaging

Objectives

Systemic lupus erythematosus (SLE) affects the joints in up to 95% of patients. The diagnosis and evaluation of SLE arthritis remain challenging in both practice and clinical trials. Frequency domain optical imaging (FDOI) has been previously used to assess joint involvement in inflammatory arthritis. The objective of this study was to evaluate FDOI in SLE arthritis.

Methods

Ninety-six proximal interphalangeal (PIP) joints from 16 patients with SLE arthritis and 60 PIP joints from 10 age-matched, gender-matched and race/ethnicity-matched controls were examined. A laser beam with a wavelength of 670 nm, 1 mm in diameter and intensity modulated at 300 MHz and 600 MHz was directed onto the dorsal surface of each joint, scanning across a sagittal plane. The transmitted light intensities and phase shifts were measured with an intensified charge-coupled device camera. The data were analysed using Discriminant Analysis and Support Vector Machine algorithms.

Results

The amplitude and phase of the transmitted light were significantly different between SLE and control PIPs (p<0.05). Receiver operating characteristic (ROC) analysis of cross-validated models showed an Area Under the ROC Curve (AUC)of 0.89 with corresponding sensitivity of 95%, specificity of 79%, and accuracy of 80%.

Conclusion

This study is the first evaluation of optical methods in the assessment of SLE arthritis; there was a statistically significant difference in the FDOI signals between patients with SLE and healthy volunteers. The results show that FDOI may have the potential to provide an objective, user-independent, evaluation of SLE PIP joints arthritis.

Flexible optical imaging band system for the assessment of arthritis in patients with systemic lupus erythematosus

We have developed a flexible optical imaging system (FOIS) to assess systemic lupus erythematosus (SLE) arthritis in the finger joints. While any part of the body can be affected, arthritis in the finger joints is one of the most common SLE manifestations. There is an unmet need for accurate, low-cost assessment of lupus arthritis that can be easily performed at every clinic visit. Current imaging methods are imprecise, expensive, and time consuming to allow for frequent monitoring. Our FOIS can be wrapped around joints, and multiple light sources and detectors gather reflected and transmitted light intensities. Using data from two SLE patients and two healthy volunteers, we demonstrate the potential of this FOIS for assessment of arthritis in SLE patients.

Quantification of joint blood flow by dynamic contrast-enhanced near-infrared spectroscopy: application to monitoring disease activity in a rat model of rheumatoid arthritis

Significance

Current guidelines for rheumatoid arthritis (RA) management recommend early treatment with disease modifying antirheumatic drugs (DMARDs). However, DMARD treatment fails in 30% of patients and current monitoring methods can only detect failure after 3 to 6 months of therapy.

Aim

We investigated whether joint blood flow (BF), quantified using dynamic contrast-enhanced time-resolved near-infrared spectroscopy, can monitor disease activity and treatment response in a rat model of RA.

Approach

Ankle joint BF was measured every 5 days in eight rats with adjuvant-induced arthritis (AIA) and four healthy controls. Arthritis was allowed to progress for 20 days before rats with AIA were treated with a DMARD once every 5 days until day 40.

Results

Time and group had separate significant main effects on joint BF; however, there was no significant interaction between time and group despite a notable difference in average joint BF on day 5. Comparison of individual blood flow measures between rats with AIA and control group animals did not reveal a clear response to treatment.

Conclusions

Joint BF time courses could not distinguish between rats with AIA and study controls. Heterogeneous disease response and low temporal frequency of BF measurements may have been important study limitations.

Non-contact dynamic diffuse optical tomography imaging system for evaluating lower extremity vasculature

A novel multi-view non-contact dynamic diffuse optical tomographic imaging system for the clinical evaluation of vasculature in the lower extremities is presented. The system design and implementation are described in detail, including methods for simultaneously obtaining and reconstructing diffusely reflected and transmitted light using a system of mirrors and a single CCD camera. The system and its performance using numeric simulations and optical phantoms. Measurements of a healthy foot in vivo demonstrates the potential of the system in assessing perfusion within the foot.

L1-norm based nonlinear reconstruction improves quantitative accuracy of spectral diffuse optical tomography

Spectrally constrained diffuse optical tomography (SCDOT) is known to improve reconstruction in diffuse optical imaging; constraining the reconstruction by coupling the optical properties across multiple wavelengths suppresses artefacts in the resulting reconstructed images. In other work, L1-norm regularization has been shown to improve certain types of image reconstruction problems as its sparsity-promoting properties render it robust against noise and enable the preservation of edges in images, but because the L1-norm is non-differentiable, it is not always simple to implement. In this work, we show how to incorporate L1 regularization into SCDOT. Three popular algorithms for L1 regularization are assessed for application in SCDOT: iteratively reweighted least square algorithm (IRLS), alternating directional method of multipliers (ADMM), and fast iterative shrinkage-thresholding algorithm (FISTA). We introduce an objective procedure for determining the regularization parameter in these algorithms and compare their performance in simulated experiments, and in real data acquired from a tissue phantom. Our results show that L1 regularization consistently outperforms Tikhonov regularization in this application, particularly in the presence of noise.

Multispectral, non-contact diffuse optical tomography of healthy human finger joints

Rheumatoid arthritis (RA) is an inflammatory joint disease often affecting the hands, which if untreated causes disability. Diffuse optical tomography (DOT) provides information about the underlying functional properties of biological tissue. To detect pathophysiological changes in inflamed RA joints, a good understanding of the baseline values for healthy subjects is first required. Finger joints from healthy subjects were imaged using a non-contact, multispectral, continuous wave DOT system, recovering physiological parameters of oxygen saturation, total haemoglobin, water concentration and scatter amplitude. Reconstructed values across the cohort demonstrated good consistency between finger joints from the same participant, with greater variation seen between subjects.

Diffuse optical tomography reconstruction method using ultrasound images as prior for regularization matrix

Ultrasound-guided diffuse optical tomography (DOT) is a promising imaging technique that maps hemoglobin concentrations of breast lesions to assist ultrasound (US) for cancer diagnosis and treatment monitoring. The accurate recovery of breast lesion optical properties requires an effective image reconstruction method. We introduce a reconstruction approach in which US images are encoded as prior information for regularization of the inversion matrix. The framework of this approach is based on image reconstruction package “NIRFAST.” We compare this approach to the US-guided dual-zone mesh reconstruction method, which is based on Born approximation and conjugate gradient optimization developed in our laboratory. Results were evaluated using phantoms and clinical data. This method improves classification of malignant and benign lesions by increasing malignant to benign lesion absorption contrast. The results also show improvements in reconstructed lesion shapes and the spatial distribution of absorption maps.