Reflective terahertz imaging of porcine skin burns

Dynamic optical coherence elastography for skin burn assessment: A preliminary study on mice model

Skin burns that include tissue coagulation necrosis imply variations in stiffness. Dynamic phase-sensitive optical coherence elastography (OCE) is used to evaluate the stiffness of burned skin nondestructively in this paper. The homemade dynamic OCE was initially verified through tissue-mimicking phantom experiments regarding Rayleigh wave speed. After being burned with a series of temperatures and durations, the corresponding structure and stiffness variations of mice skin were demonstrated by histological images, optical coherence tomography B-scans, and OCE elastic wave speed maps. The results clearly displayed the variation in elastic properties and stiffness of the scab edge extending in the lateral direction. Statistical analysis revealed that murine skin burned at temperatures exceeding 100°C typically exhibited greater stiffness than skin burned at temperatures below 100°C. The dynamic OCE technique shows potential application for incorporating elasticity properties as a biomechanical extension module to diagnose skin burn injuries.

High-sensitivity THz-ATR imaging of cerebral ischemia in a rat model

The fast label-free detection of the extent and degree of cerebral ischemia has been the difficulty and hotspot for precise and accurate neurosurgery. We experimentally demonstrated that the fresh cerebral tissues at different ischemic stages within 24 hours can be well distinguished from the normal tissues using terahertz (THz) attenuated total reflection (ATR) imaging system. It was indicated that the total reflectivity of THz wave for ischemic cerebral tissues was lower than that for normal tissues. Especially, compared to the images stained with 2,3,5-triphenyl tetrazolium chloride (TTC), the ischemic tissues can be detected using THz wave with high sensitivity as early as the ischemic time of 2.5 hours, where THz images showed the ischemic areas became larger and diffused as the ischemic time increasing. Furthermore, the THz spectroscopy of cerebral ischemic tissues at different ischemic times was obtained in the range of 0.5-2.0 THz. The absorption coefficient of ischemic tissue increased with the increase of ischemic time, whereas the refractive index decreased with prolonging the ischemic time. Additionally, it was found from hematoxylin and eosin (H&E) staining microscopic images that, with the ischemic time increasing, the cell size and cell density of the ischemic tissues decreased, whereas the intercellular substance of the ischemic tissues increased. The result showed that THz recognition mechanism of the ischemia is mainly based on the increase of intercellular substance, especially water content, which has a stronger impact on absorption of THz wave than that of cell density. Thus, THz imaging has great potential for recognition of cerebral ischemia and it may become a new method for intraoperative real-time guidance, recognition in situ, and precise excision.

Characterization of human skin under tension using terahertz time domain spectroscopy

This paper introduces a spectral analysis method for monitoring the human skin in vivo based on a combination of terahertz time-domain spectroscopy (THz-TDS) and optical coherence tomography (OCT). The method can quantitatively measure the refractive index, thickness and transmission coefficient of epidermis, and the refractive index of dermis in natural, as well as the tension condition of the skin. An optically reflective model for the multilayer structure of the skin is first established. The initial thickness of the epidermis is then measured by OCT as a known quantity for the established model. By fitting the established model to the experimentally obtained THz-TDS signals, the above parameters of the skin can be calibrated. Furthermore, the dependence of these skin parameters on the tension status are investigated. This study provides a means for terahertz technology to measure the skin in vivo.

On-Chip Modification of Titanium Electrothermal Characteristics by Joule Heating: Application to Terahertz Microbolometer

This study demonstrates the conversion of metallic titanium (Ti) to titanium oxide just by conducting electrical current through Ti thin film in vacuum and increasing the temperature by Joule heating. This led to the improvement of electrical and thermal properties of a microbolometer. A microbolometer with an integrated Ti thermistor and heater width of 2.7 µm and a length of 50 µm was fabricated for the current study. Constant-voltage stresses were applied to the thermistor wire to observe the effect of the Joule heating on its properties. Thermistor resistance ~14 times the initial resistance was observed owing to the heating. A negative large temperature coefficient of resistance (TCR) of -0.32%/K was also observed owing to the treatment, leading to an improved responsivity of ~4.5 times from devices with untreated Ti thermistors. However, this does not improve the noise equivalent power (NEP), due to the increased flicker noise. Microstructural analyses with transmission electron microscopy (TEM), transmission electron diffraction (TED) and energy dispersive X-ray (EDX) confirm the formation of a titanium oxide (TiOx) semiconducting phase on the Ti phase (~85% purity) deposited initially, further to the heating. Formation of TiOx during annealing could minimize the narrow width effect, which we reported previously in thin metal wires, leading to enhancement of responsivity.

Temperature dependence of the dielectric function of dehydrated biological samples in the THz band

Terahertz technology has demonstrated enormous potential for the analysis of biological systems and the diagnosis of some medical conditions, given its high sensitivity to detect water content. In previously published papers, effective medium theories are used to extract the water content from the terahertz measurements. When the dielectric functions of water and dehydrated bio-material are well known, the volumetric fraction of water can be left as the only free parameter in those effective medium theory models. While water complex permittivity is very well known, the dielectric functions of dehydrated tissues are normally measured for each individual application. In previous studies, it has been traditionally assumed that, unlike water, the dielectric function of the dehydrated tissues is temperature independent, measuring it only at room temperature. Yet, this is an aspect that has not been discussed and that is relevant in order to get THz technology closer to clinical and in-the-field applications. In this work, we present the characterization of the complex permittivity of dehydrated tissues; each studied at temperatures ranging from 20°C to 36.5°C. We studied samples of different organism classifications to have a wider confirmation of the results. We find that, in each case, the dielectric function changes of dehydrated tissues caused by temperature are smaller than for water across the same temperature interval. Yet, the changes in the dielectric function of the dehydrated tissue are not negligible and should, in many cases, be taken into account for the processing of terahertz signals that interact with biological tissues. While this study gives a first introduction into the probable relevancy of temperature-dependent optical behavior of biological samples, this work only focuses on the experimental proof for this relationship and will, therefore, not give a deeper analysis of how the underlying models have to be modified.

Investigating the Impact of Synchrotron THz Radiation on the Corneal Hydration Using Synchrotron THz-Far Infrared Beamline

Due to increasing interest in imaging, industrial, and the development of wireless communication operating at THz frequencies, it is crucial to ascertain possible health impacts arising from exposure to THz radiation. This paper reports on the pilot study of transmittance and absorbance spectra of the porcine cornea following THz frequency irradiation at a synchrotron THz/Far-IR beamline. The exposure period was 4 hours. One cornea was exposed to the radiation, with a second cornea acting as a control. An Attenuated Total Reflection (ATR) apparatus was used, and the frequency range of 2.4 to 8 THz was selected to evaluate any changes. It was found that the synchrotron THz radiation intensities are too low to produce induced corneal injury, but may lead to subtle changes in the state of water. Our results suggest that THz spectroscopy is a promising modality for corneal tissue hydration sensing.

Artificial Intelligence-Assisted Terahertz Imaging for Rapid and Label-Free Identification of Efficient Light Formula in Laser Therapy

Photodynamic therapy (PDT) is considered a promising noninvasive therapeutic strategy in biomedicine, especially by utilizing low-level laser therapy (LLLT) in visible and near-infrared spectra to trigger biological responses. The major challenge of PDT in applications is the complicated and time-consuming biological methodological measurements in identification of light formulas for different diseases. Here, we demonstrate a rapid and label-free identification method based on artificial intelligence (AI)-assisted terahertz imaging for efficient light formulas in LLLT of acute lung injury (ALI). The gray histogram of terahertz images is developed as the biophysical characteristics to identify the therapeutic effect. Label-free terahertz imaging is sequentially performed using rapid super-resolution imaging reconstruction and automatic identification algorithm based on a voting classifier. The results indicate that the therapeutic effect of LLLT with different light wavelengths and irradiation times for ALI can be identified using this method with a high accuracy of 91.22% in 33 s, which is more than 400 times faster than the biological methodology and more than 200 times faster than the scanning terahertz imaging technology. It may serve as a new tool for the development and application of PDT.

In Vivo Assessment and Monitoring of Burn Wounds Using a Handheld Terahertz Hyperspectral Scanner

The accuracy of clinical assessment techniques in diagnosing partial-thickness burn injuries has remained as low as 50-76%. Depending on the burn depth and environmental factors in the wound, such as reactive oxygen species, inflammation, and autophagy, partial-thickness burns can heal spontaneously or require surgical intervention. Herein, it is demonstrated that terahertz time-domain spectral imaging (THz-TDSI) is a promising tool for in vivo quantitative assessment and monitoring of partial-thickness burn injuries in large animals. We used a novel handheld THz-TDSI scanner to characterize burn injuries in a porcine scald model with histopathological controls. Statistical analysis (n= 40) indicates that the THz-TDSI modality can accurately differentiate between partial-thickness and full-thickness burn injuries (1-way ANOVA, p< 0.05). THz-TDSI has the potential to improve burn care outcomes by helping surgeons in making objective decisions for early excision of the wound.

Terahertz anisotropy in fascia and lean meat tissues

Terahertz (THz) spectroscopy provides multifaceted capabilities for observing low-energy responses of macromolecules, cells and tissues, understanding THz biophysical effects, and expecting to realize the application of THz technology in biomedicine. However, its high-frequency characteristics of limited penetration depth and strong absorption of water in the body comparable to microwaves are impeding the proliferation of THz spectroscopy. Here we show that THz spectroscopy makes possible the observation of THz anisotropy phenomena for the first time in fascia and lean tissue. Through optical microscopy, we infer that the microscopic mechanism of THz anisotropy comes from the periodic stripe structure of the biological tissue. The above related experimental findings may be expected to promote the application of THz technology in biomedicine.

Deep neural network classification of in vivo burn injuries with different etiologies using terahertz time-domain spectral imaging

Thermal injuries can occur due to direct exposure to hot objects or liquids, flames, electricity, solar energy and several other sources. If the resulting injury is a deep partial thickness burn, the accuracy of a physician's clinical assessment is as low as 50-76% in determining the healing outcome. In this study, we show that the Terahertz Portable Handheld Spectral Reflection (THz-PHASR) Scanner combined with a deep neural network classification algorithm can accurately differentiate between partial-, deep partial-, and full-thickness burns 1-hour post injury, regardless of the etiology, scanner geometry, or THz spectroscopy sampling method (ROC-AUC = 91%, 88%, and 86%, respectively). The neural network diagnostic method simplifies the classification process by directly using the pre-processed THz spectra and removing the need for any hyperspectral feature extraction. Our results show that deep learning methods based on THz time-domain spectroscopy (THz-TDS) measurements can be used to guide clinical treatment plans based on objective and accurate classification of burn injuries.

Terahertz imaging demonstrates its diagnostic potential and reveals a relationship between cutaneous dehydration and neuropathy for diabetic foot syndrome patients

Diabetic foot syndrome, a long term consequence of Diabetes Mellitus, is the most common cause of non-traumatic amputations. Around 8% of the world population suffers from diabetes, 15% of diabetic patients present a diabetic foot ulcer which leads to amputation in 2.5% of the cases. There is no objective method for the early diagnosis and prevention of the syndrome and its consequences. We test terahertz imaging, which is capable of mapping the cutaneous hydration, for the evaluation of the diabetic foot deterioration as an early diagnostic test as well as ulcers prevention and tracking tool. Furthermore, the analysis of our terahertz measurements combined with neurological and vascular assessment of the patients indicates that the dehydration is mainly related to the peripheral neuropathy without a significant vascular cause.

Application of contrast-enhanced ultrasound in the diagnosis of burn depth

Background

The diagnosis of burn depth often relies on the subjective judgment of plastic surgeons. Contrast-enhanced ultrasound (CEUS) can visualize the microcirculation well and has potential value in diagnosing the depth of burn wounds. We assessed the depth of the burn wounds by CEUS, and compared the results with histological examination.

Methods

Two rhesus monkeys were used, and multiple burn wounds with different depths were made on their backs. The echo of the dermis and subcutaneous tissue were observed for each wound, and the thickness of the dermis was measured. CEUS was performed to evaluate the depth of burn wounds and compared with pathological results.

Results

(I) After scalding, dermal tissue edema occurred, and the thickness of the dermis measured by a US tended to increase gradually, related to the time of scalding and the order of measurement. (II) With the prolongation of the burn time, the depth of filling by contrast agent gradually increased, from the superficial dermis to the deep dermis and subcutaneous tissue, indicating that the depth of tissue damage gradually increased. This was consistent with the pathological observation. The thickness of the healthy dermis was about 1.3-1.8 mm, and 2.7-4.1 mm after scalding. The depth of the burn wounds was 0.9-4.1 mm, accounting for 32-100% of the full skin thickness.

Conclusions

CEUS is a convenient and fast examination method that is consistent with pathological diagnosis of the depth of burn wounds and could prove valuable for the accurate assessment of burn injuries.

Terahertz scattering microscopy for dermatology diagnostics

We explore the possibility of detecting anomalous structures buried under the skin surface by studying the deviations from the ideal Airy pattern of the point-spread function (PSF) of a terahertz microscope that includes the skin as one of the reflecting surfaces of the optical system. Using a custom terahertz microscope with a monochromatic point source emitting at 0.611 THz, we record the PSF images with a microbolometer camera. Skin simulants based on collagen gel, with and without artificial buried structures, have been analyzed. The geometrical features characterizing the PSF deformations have been extracted automatically from the PSF images. A machine learning algorithm applied to these geometrical features produces a reliable classification of targets with or without buried structures with error below 5%. It can even classify targets with anisotropic buried structures according to their different orientation.

Spatial Domain Terahertz Image Reconstruction Based on Dual Sparsity Constraints

Terahertz time domain spectroscopy imaging systems suffer from the problems of long image acquisition time and massive data processing. Reducing the sampling rate will lead to the degradation of the imaging reconstruction quality. To solve this issue, a novel terahertz imaging model, named the dual sparsity constraints terahertz image reconstruction model (DSC-THz), is proposed in this paper. DSC-THz fuses the sparsity constraints of the terahertz image in wavelet and gradient domains into the terahertz image reconstruction model. Differing from the conventional wavelet transform, we introduce a non-linear exponentiation transform into the shift invariant wavelet coefficients, which can amplify the significant coefficients and suppress the small ones. Simultaneously, the sparsity of the terahertz image in gradient domain is used to enhance the sparsity of the image, which has the advantage of edge preserving property. The split Bregman iteration scheme is utilized to tackle the optimization problem. By using the idea of separation of variables, the optimization problem is decomposed into subproblems to solve. Compared with the conventional single sparsity constraint terahertz image reconstruction model, the experiments verified that the proposed approach can achieve higher terahertz image reconstruction quality at low sampling rates.

Differentiation of burn wounds in an in vivo porcine model using terahertz spectroscopy

The accuracy of current burn triage techniques has remained between 50-70%. Accordingly, there is a significant clinical need for the quantitative and accurate assessment of partial-thickness burn injuries. Porcine skin represents the closest animal model to human skin, and is often used in surgical skin grafting procedures. In this study, we used a standardized in vivo porcine burn model to obtain terahertz (THz) point-spectroscopy measurements from burns with various severities. We then extracted two reflection hyperspectral parameters, namely spectral area under the curve between approximately 0.1 and 0.9 THz (-10 dB bandwidth in each spectrum), and spectral slope, to characterize each burn. Using a linear combination of these two parameters, we accurately classified deep partial- and superficial partial-thickness burns (p = 0.0159), compared to vimentin immunohistochemistry as the gold standard for burn depth determination.

Biophotonics methods for functional monitoring of complications of diabetes mellitus

The prevalence of diabetes complications is a significant public health problem with a considerable economic cost. Thus, the timely diagnosis of complications and prevention of their development will contribute to increasing the length and quality of patient life, and reducing the economic costs of their treatment. This article aims to review the current state-of-the-art biophotonics technologies used to identify the complications of diabetes mellitus and assess the quality of their treatment. Additionally, these technologies assess the structural and functional properties of biological tissues, and they include capillaroscopy, laser Doppler flowmetry and hyperspectral imaging, laser speckle contrast imaging, diffuse reflectance spectroscopy and imaging, fluorescence spectroscopy and imaging, optical coherence tomography, optoacoustic imaging and confocal microscopy. Recent advances in the field of optical noninvasive diagnosis suggest a wider introduction of biophotonics technologies into clinical practice and, in particular, in diabetes care units.

Continuous-wave terahertz reflective ptychography by oblique illumination

Massive usage scenarios prompt the prosperity of terahertz (THz) reflective imaging methods. In this Letter, we apply ptychography to continuous-wave THz reflective imaging. Our scheme has a compact lensless layout and uses a full-field oblique-illumination recording mode. Diffraction patterns are corrected through tilted plane correction. This method can be used to retrieve the complex-valued object function and to suppress the negative effect of non-uniform illumination. The feasibility is investigated using two metal samples.

Broadband Terahertz Near-Perfect Absorbers

Broadband terahertz (THz) absorbers are highly desired in detection, modulation, receiving, and imaging devices. We report the design and successful implementation of a novel broadband THz metasurface with a near-perfect absorption. Different from the traditional metal/dielectric/metal three-layer structures, the as-designed THz absorber has one more metal layer and a dielectric spacer on top, both of which are 200 nm thick. Although the total thickness increased by ∼7%, the near-perfect THz absorption band significantly broadened by 4×, achieving a broadband absorption of 270 GHz. Broadband, polarization-insensitive, and near-perfect THz absorptions were also observed over wide incident angles in these meta-absorbers, where the electric field and power loss were mainly concentrated in the additional thin dielectric layer. Such a broadband THz absorption was achieved through electromagnetic coupling between the top and middle metal layers and the resultant overlapping of the resonance frequencies. This strategy can be adapted to other spectrum-shaping devices.

Horizontal-scanning attenuated total reflection terahertz imaging for biological tissues

Significance: Terahertz wave is a potential tool for biological tissues due to its noninvasiveness and high sensitivity to water. Attenuated total reflection (ATR) with the characteristics of high sensitivity and nondestruction has been applied for THz imaging. Aim: We aim to develop an imaging methodology to facilitate practical application of THz ATR imaging. Approach: We have demonstrated a horizontally scanning THz continuous wave ATR imaging system. The effective imaging area was as large as the prism imaging surface by optimizing the ATR prism, and the influence of secondary reflection can be well avoided. By taking the image resolution and stability of this system into consideration, the incident angle α to the prism bottom was chosen to be 30 deg. Results: The image resolution of this system can be up to 400 and 450    μ m in horizontal and vertical directions, respectively. Furthermore, U87-glioma regions of mice brain tissues with different sizes and C6-glioma regions of rat brain tissues with relatively large size can be differentiated clearly from normal brain tissues by this imaging system. The volume and location of the tumor region shown in the THz images are similar to those visualized macroscopically in the corresponding visual and H&E-stained images. Conclusion: We indicate terahertz horizontal-scanning ATR imaging technique with large effective imaging area, and high resolution could be used as an alternative method for label-free and high-sensitivity imaging of biological tissues.

Terahertz spectroscopy of human skin tissue models with different melanin content

Terahertz imaging has been proposed for burns and skin cancer identification. However, the role of melanocytes, melanosomes, melanin content and distribution in determining the terahertz optical properties of human skin has not been investigated. We use terahertz time domain spectroscopy to measure the optical properties of in vitro pigmented human skin tissue models from Asian, Black, and Caucasian donors. Spectra were collected at various time intervals and used to extract the absorption coefficient and index of refraction at terahertz frequencies. Our results indicate that the degree of cell differentiation and type of donor both contribute to the measured terahertz optical properties.

Terahertz Spectroscopy and Imaging: A Cutting-Edge Method for Diagnosing Digestive Cancers

The Terahertz's wavelength is located between the microwave and the infrared region of the electromagnetic spectrum. Because it is non-ionizing and non-invasive, Terahertz (THz)-based detection represents a very attractive tool for repeated assessments, patient monitoring, and follow-up. Cancer acts as the second leading cause of death in many regions, and current predictions estimate a continuous increasing trend. Of all types of tumors, digestive cancers represent an important percentage and their incidence is expected to increase more rapidly than other tumor types due to unhealthy lifestyle habits. Because it can precisely differentiate between different types of molecules, depending on water content, the information obtained through THz-based scanning could have several uses in the management of cancer patients and, more importantly, in the early detection of different solid tumors. The purpose of this manuscript is to offer a comprehensive overview of current data available on THz-based detection for digestive cancers. It summarizes the characteristics of THz waves and their interaction with tissues and subsequently presents available THz-based technologies (THz spectroscopy, THz-tomography, and THZ-endoscope) and their potential for future clinical use. The third part of the review is focused on highlighting current in vitro and in vivo research progress in the field, for identifying specific digestive cancers known as oral, esophageal, gastric, colonic, hepatic, and pancreatic tumors.

Automatic evaluation of traumatic brain injury based on terahertz imaging with machine learning

The imaging diagnosis and prognostication of different degrees of traumatic brain injury (TBI) is very important for early care and clinical treatment. Especially, the exact recognition of mild TBI is the bottleneck for current label-free imaging technologies in neurosurgery. Here, we report an automatic evaluation method for TBI recognition with terahertz (THz) continuous-wave (CW) transmission imaging based on machine learning (ML). We propose a new feature extraction method for biological THz images combined with the transmittance distribution features in spatial domain and statistical distribution features in normalized gray histogram. Based on the extracted feature database, ML algorithms are performed for the classification of different degrees of TBI by feature selection and parameter optimization. The highest classification accuracy is up to 87.5%. The area under the curve (AUC) scores of the receiver operating characteristics (ROC) curve are all higher than 0.9, which shows this evaluation method has a good generalization ability. Furthermore, the excellent performance of the proposed system in the recognition of mild TBI is analyzed by different methodological parameters and diagnostic criteria. The system can be extensible to various diseases and will be a powerful tool in automatic biomedical diagnostics.

In vivo terahertz reflection imaging of human scars during and after the healing process

We use terahertz imaging to measure four human skin scars in vivo. Clear contrast between the refractive index of the scar and surrounding tissue was observed for all of the scars, despite some being difficult to see with the naked eye. Additionally, we monitored the healing process of a hypertrophic scar. We found that the contrast in the absorption coefficient became less prominent after a few months post-injury, but that the contrast in the refractive index was still significant even months post-injury. Our results demonstrate the capability of terahertz imaging to quantitatively measure subtle changes in skin properties and this may be useful for improving scar treatment and management.

Thermal injury of skin and subcutaneous tissues: A review of experimental approaches and numerical models

Thermal injury to skin and subcutaneous tissue is common in both civilian and combat scenarios. Understanding the change in tissue morphologies and properties and the underlying mechanisms of thermal injury are of vital importance to clinical determination of the degree of burn and treatment approach. This review aims at summarizing the research involving experimental and numerical studies of skin and subcutaneous tissue subjected to thermal injury. The review consists of two parts. The first part deals with experimental studies including burn protocols and prevailing imaging approaches. The second part deals with existing numerical models for burns of tissue and related computational simulations. Based on this review, we conclude that though there is literature contributing to the knowledge of the pathology and pathogenesis of tissue burn, there is scant quantitative information regarding changes in tissue properties including mechanical, thermal, electrical and optical properties as a result of burns that are linked to altered tissue morphology.

Observation of dehydration dynamics in biological tissues with terahertz digital holography [Invited]

A terahertz (THz) digital holographic imaging system is utilized to investigate natural dehydration processes in three types of biological tissues, including cattle, mutton, and pork. An image reconstruction algorithm is applied to remove the diffraction influence of THz waves and further improve clarity of THz images. From THz images of different biological specimens, distinctive water content as well as dehydration features of adipose and muscle tissues are precisely distinguished. By analyzing THz absorption spectra of these samples, temporal evolution characteristics of the absorbances for adipose and muscle tissues are described and compared in detail. Discrepancies between water retention ability of different animal tissues are also discussed. The imaging technique provides a valuable measurement platform for biological sensing.

Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept

Most people with diabetes suffer some deterioration of the feet. Diabetic foot syndrome causes ulceration in about 15% of cases and such deterioration leads to amputation in about 2.5% of diabetic patients, diminishing their quality of life and generating extraordinary costs for patients and public health systems. Currently, there is no objective method for the detection of diabetic foot syndrome in its early stages. We propose terahertz imaging as a method for the evaluation of such deterioration. This screening method could aid the prevention and medical treatment of this condition in the future.

THz Imaging of Skin Burn: Seeing the Unseen-An Overview

Significance: This review article puts together all the studies performed so far in realizing terahertz (THz) spectra as a probing mechanism for burn evaluation, summarizing their experimental conditions, observations, outcomes, merits, and demerits, along with a comparative discussion of other currently used technologies to present the state of art in a condensed manner. The key features of this noncontact investigation technique like its precise burn depth analysis and the approaches it follows to convert the probed data into a quantitative measure have also been discussed in this article. Recent Advances: The current research developments in THz regime observed in device design technologies (like THz time domain spectrometer, quantum cascade THz lasers, THz single-photon detectors, etc.) and in understanding its unique properties (like nonionizing nature, penetrability through dry dielectrics, etc.) have motivated the research world to realize THz window as a potential candidate for burn detection. Critical Issues: Application of appropriate medical measure for burn injury is primarily subjective to proper estimation of burn depth. Tool modality distinguishing between partial and full-thickness burn contributing toward correct medical care is indeed awaited. Future Directions: The overview of THz imaging as a burn assessment tool as provided in this article will certainly help in further nurturing of this emerging diagnostic technique particularly in improving its detection and accompanied image processing methods so that the minute nuances captured by the THz beam can be correlated with the physiological-anatomical changes in skin structures, caused by burn, for better sensitivity, resolution, and quantitative analysis.

Imaging Techniques for Clinical Burn Assessment with a Focus on Multispectral Imaging

Significance: Burn assessments, including extent and severity, are some of the most critical diagnoses in burn care, and many recently developed imaging techniques may have the potential to improve the accuracy of these evaluations. Recent Advances: Optical devices, telemedicine, and high-frequency ultrasound are among the highlights in recent burn imaging advancements. We present another promising technology, multispectral imaging (MSI), which also has the potential to impact current medical practice in burn care, among a variety of other specialties. Critical Issues: At this time, it is still a matter of debate as to why there is no consensus on the use of technology to assist burn assessments in the United States. Fortunately, the availability of techniques does not appear to be a limitation. However, the selection of appropriate imaging technology to augment the provision of burn care can be difficult for clinicians to navigate. There are many technologies available, but a comprehensive review summarizing the tissue characteristics measured by each technology in light of aiding clinicians in selecting the proper device is missing. This would be especially valuable for the nonburn specialists who encounter burn injuries. Future Directions: The questions of when burn assessment devices are useful to the burn team, how the various imaging devices work, and where the various burn imaging technologies fit into the spectrum of burn care will continue to be addressed. Technologies that can image a large surface area quickly, such as thermography or laser speckle imaging, may be suitable for initial burn assessment and triage. In the setting of presurgical planning, ultrasound or optical microscopy techniques, including optical coherence tomography, may prove useful. MSI, which actually has origins in burn care, may ultimately meet a high number of requirements for burn assessment in routine clinical use.

THz and mm-Wave Sensing of Corneal Tissue Water Content: In Vivo Sensing and Imaging Results

A pulsed terahertz (THz) imaging system and millimeter-wave reflectometer were used to acquire images and point measurements, respectively, of five rabbit cornea in vivo. These imaging results are the first ever produced of in vivo cornea. A modified version of a standard protocol using a gentle stream of air and a Mylar window was employed to slightly dehydrate healthy cornea. The sensor data and companion central corneal thickness (CCT) measurements were acquired every 10-15 min over the course of two hours using ultrasound pachymmetry.. Statistically significant positive correlations were established between CCT measurements and millimeter wave reflectivity. Local shifts in reflectivity contrast were observed in the THz imagery; however, the THz reflectivity did not display a significant correlation with thickness in the region probed by the 100 GHz and CCT measurements. This is explained in part by a thickness sensitivity at least 10× higher in the mm-wave than the THz systems. Stratified media and effective media modeling suggest that the protocol perturbed the thickness and not the corneal tissue water content (CTWC). To further explore possible etalon effects, an additional rabbit was euthanized and millimeter wave measurements were obtained during death induced edema. These observations represent the first time that the uncoupled sensing of CTWC and CCT have been achieved in vivo.

THz and mm-Wave Sensing of Corneal Tissue Water Content: Electromagnetic Modeling and Analysis

Terahertz (THz) spectral properties of human cornea are explored as a function of central corneal thickness (CCT) and corneal water content, and the clinical utility of THz-based corneal water content sensing is discussed. Three candidate corneal tissue water content (CTWC) perturbations, based on corneal physiology, are investigated that affect the axial water distribution and total thickness. The THz frequency reflectivity properties of the three CTWC perturbations were simulated and explored with varying system center frequency and bandwidths (Q-factors). The modeling showed that at effective optical path lengths on the order of a wavelength the cornea presents a lossy etalon bordered by air at the anterior and the aqueous humor at the posterior. The simulated standing wave peak-to-valley ratio is pronounced at lower frequencies and its effect on acquired data can be modulated by adjusting the bandwidth of the sensing system. These observations are supported with experimental spectroscopic data. The results suggest that a priori knowledge of corneal thickness can be utilized for accurate assessments of corneal tissue water content. The physiologic variation of corneal thickness with respect to the wavelengths spanned by the THz band is extremely limited compared to all other structures in the body making CTWC sensing unique amongst all proposed applications of THz medical imaging.

Terahertz time-domain spectroscopy of human blood

In the continuing development of terahertz technology to enable the determination of tissue pathologies in real-time during surgical procedures, it is important to distinguish the measured terahertz signal from biomaterials and fluids, such as blood, which may mask the signal from tissues of interest. In this paper, we present the frequency-dependent absorption coefficients, refractive indices, and Debye relaxation times of whole blood, red blood cells, plasma, and a thrombus.

Detection of terahertz radiation from 2.52 THz CO2 laser using a 320 × 240 vanadium oxide microbolometer focal plane array

Real-time, continuous-wave THz detection and imaging were demonstrated with a 320 × 240 VO_x FPA detector with a nanostructured Ti thin film absorber.

Discrimination of moldy wheat using terahertz imaging combined with multivariate classification

Terahertz (THz) imaging was employed to develop a novel method for discriminating wheat of varying states of moldiness.

High-contrast coherent terahertz imaging of porcine tissue via swept-frequency feedback interferometry

There is considerable interest in the interrogation of biological tissue at terahertz (THz) frequencies, largely due to the contrast in the optical properties of different biological tissues which occur in this electro-magnetic radiation band. Of particular interest are THz biomedical images, which have the potential to highlight different information than those acquired in other frequency bands, thereby providing an augmented picture of biological structures. In this work, we demonstrate the feasibility of an interferometric biological imaging technique using a THz quantum cascade laser (QCL) operating at 2.59 THz to perform coherent imaging of porcine tissue samples. We show the potential of this new THz biomedical imaging technique for in vivo studies, by virtue of its reflection geometry and useful tissue penetration depth enabled by the large THz powers emitted by the quantum cascade laser used in this work. The observed clustering of interferometric tissue signatures opens a pathway towards automatic techniques for the discrimination of healthy tissue types for the study of normal physiology and possible therapeutic approaches.

Observation of hydrofluoric acid burns on osseous tissues by means of terahertz spectroscopic imaging

Terahertz technologies have gained great amount of attention for biomedical imaging and tissue analysis. In this study, we utilize terahertz imaging to study the effects of hydrofluoric acid on both compact bone tissue and cartilage. We compare the differences observed in the exposure for formalin fixed and raw, dried, tissue as well as those resulting from a change in hydrofluoric (HF) concentration. Measurements are performed with THz-TDS, and a variety of spectroscopic-based image reconstruction techniques are utilized to develop contrast in the features of interest.

Reflective terahertz imaging with the TEM01 mode laser beam

Reflective terahertz imaging with a first-order Hermite-Gaussian laser beam was experimentally investigated. High spatial resolution targets prepared by direct laser microprocessing were used to evaluate the performance. The reflection imaging system at 2.524 THz frequency demonstrated up to diffraction limited resolution using the single focusing mirror with the numerical aperture not smaller than 0.6. The TEM(01) mode laser beam was also applied for practical samples such as silicon solar cell terahertz (THz) imaging. It is shown that usage of appropriate optics enables us to obtain high-quality THz images with the multimode laser beam.

Terahertz time-domain spectroscopy of human blood

In the continuing development of terahertz technology to enable the determination of tissue pathologies in real-time during surgical procedures, it is important to distinguish the measured terahertz signal from biomaterials and fluids, such as blood, which may mask the signal from tissues of interest. In this paper, we present the frequency-dependent absorption coefficients, refractive indices, and Debye relaxation times of whole blood, red blood cells, plasma, and a thrombus.

Bi-material terahertz sensors using metamaterial structures

In this paper we report on the design, fabrication and characterization of terahertz (THz) bi-material sensors with metamaterial absorbers. MEMS fabrication-friendly SiOx and Al are used to maximize the bimetallic effect and metamaterial absorption at 3.8 THz, the frequency of a quantum cascade laser illumination source. Sensors with different configurations were fabricated and the measured absorption is near 100% and responsivity is around 1.2 deg/μW, which agree well with finite element simulations. The results indicate the potential of using these detectors to fabricate focal plane arrays for real time THz imaging.

Modeling the interaction of DNA with alternating fields

We study the influence of a terahertz field on thermal properties of DNA molecules. A Peyrard-Bishop-Dauxois model with the inclusion of a solvent interaction term is considered. The terahertz field is included as a sinusoidal driven force in the equation of motion. We show how under certain field and system parameters, the melting transition and bubble formation are modified.

Assessment of corneal hydration sensing in the terahertz band: in vivo results at 100 GHz

Terahertz corneal hydration sensing has shown promise in ophthalmology applications and was recently shown to be capable of detecting water concentration changes of about two parts in a thousand in ex vivo corneal tissues. This technology may be effective in patient monitoring during refractive surgery and for early diagnosis and treatment monitoring in diseases of the cornea. In this work, Fuchs dystrophy, cornea transplant rejection, and keratoconus are discussed, and a hydration sensitivity of about one part in a hundred is predicted to be needed to successfully distinguish between diseased and healthy tissues in these applications. Stratified models of corneal tissue reflectivity are developed and validated using ex vivo spectroscopy of harvested porcine corneas that are hydrated using polyethylene glycol solutions. Simulation of the cornea's depth-dependent hydration profile, from 0.01 to 100 THz, identifies a peak in intrinsic reflectivity contrast for sensing at 100 GHz. A 100 GHz hydration sensing system is evaluated alongside the current standard ultrasound pachymetry technique to measure corneal hydration in vivo in four rabbits. A hydration sensitivity, of three parts per thousand or better, was measured in all four rabbits under study. This work presents the first in vivo demonstration of remote corneal hydration sensing.

In vivo terahertz imaging of rat skin burns

A reflective, pulsed terahertz (THz) imaging system was used to acquire high-resolution (d(10-90)/λ~1.925) images of deep, partial thickness burns in a live rat. The rat's abdomen was burned with a brass brand heated to ~220°C and pressed against the skin with contact pressure for ~10 sec. The burn injury was imaged beneath a Mylar window every 15 to 30 min for up to 7 h. Initial images display an increase in local water concentration of the burned skin as evidenced by a marked increase in THz reflectivity, and this likely correlates to the post-injury inflammatory response. After ~1 h the area of increased reflectivity consolidated to the region of skin that had direct contact with the brand. Additionally, a low reflecting ring of tissue could be observed surrounding the highly reflective burned tissue. We hypothesize that these regions of increased and decreased reflectivity correlate to the zones of coagulation and stasis that are the classic foundation of burn wound histopathology. While further investigations are necessary to confirm this hypothesis, if true, it likely represents the first in vivo THz images of these pathologic zones and may represent a significant step forward in clinical application of THz technology.

Continuous-wave terahertz phase imaging using a far-infrared laser interferometer

Terahertz phase imaging can reveal the depth information of an optically opaque object and provide much better contrast for weak-absorption materials. We demonstrate a continuous-wave terahertz interferometric imaging method in which a far-infrared laser interferometer is used to measure the phase distribution with diffraction-limited lateral resolution and subwavelength axial resolution. An improved four-step phase-shifting algorithm is introduced to retrieve the phase map with very high accuracy and low distortion. The relative depth profiles of two transparent samples are successfully extracted by using this method. Experimental results verify that terahertz interferometric imaging in combination with the phase-shifting technique enables effective reconstruction of the phase image of the object under test.

THz Medical Imaging: in vivo Hydration Sensing

The application of THz to medical imaging is experiencing a surge in both interest and federal funding. A brief overview of the field is provided along with promising and emerging applications and ongoing research. THz imaging phenomenology is discussed and tradeoffs are identified. A THz medical imaging system, operating at ~525 GHz center frequency with ~125 GHz of response normalized bandwidth is introduced and details regarding principles of operation are provided. Two promising medical applications of THz imaging are presented: skin burns and cornea. For burns, images of second degree, partial thickness burns were obtained in rat models in vivo over an 8 hour period. These images clearly show the formation and progression of edema in and around the burn wound area. For cornea, experimental data measuring the hydration of ex vivo porcine cornea under drying is presented demonstrating utility in ophthalmologic applications.

Terahertz reflectometry of burn wounds in a rat model

We present sub-millimeter wave reflectometry of an experimental rat skin burn model obtained by the Terahertz Time-Domain Spectroscopy (THz-TDS) technique. Full thickness burns, as confirmed by histology, were created on rats (n = 4) euthanized immediately prior to the experiments. Statistical analysis shows that the burned tissue exhibits higher reflectivity compared to normal skin over a frequency range between 0.5 and 0.7 THz (p < 0.05), likely due to post-burn formation of interstitial edema. Furthermore, we demonstrate that a double Debye dielectric relaxation model can be used to explain the terahertz response of both normal and less severely burned rat skin. Finally, our data suggest that the degree of conformation between the experimental burn measurements and the model for normal skin can potentially be used to infer the extent of burn severity.

Terahertz-wave water concentration and distribution measurement in thin biotissue based on a novel sample preparation

The measurement of water concentration and distribution in thin biotissues with terahertz (THz)-wave has been proposed. In this paper, a novel sample preparation approach was introduced to effectively preserve tissue freshness at room temperature. Excellent stability of this method was demonstrated by measuring the transmittance spectroscopy and imaging many times within a certain time. Moreover, the reliability of water volume concentration measurement with THz-wave was evaluated. Measurement results using THz-wave were in good agreement with volume concentration measurement results based on other quantitative methods. The results suggest that water concentration and distribution measurement in thin biotissues using THz-wave will be a potential modality for medical and biological diagnosis.

Terahertz sensing in corneal tissues

This work introduces the potential application of terahertz (THz) sensing to the field of ophthalmology, where it is uniquely suited due to its nonionizing photon energy and high sensitivity to water content. Reflective THz imaging and spectrometry data are reported on ex-vivo porcine corneas prepared with uniform water concentrations using polyethylene glycol (PEG) solutions. At 79% water concentration by mass, the measured reflectivity of the cornea was 20.4%, 14.7%, 11.7%, 9.6%, and 7.4% at 0.2, 0.4, 0.6, 0.8, and 1 THz, respectively. Comparison of nine corneas hydrated from 79.1% to 91.5% concentration by mass demonstrated an approximately linear relationship between THz reflectivity and water concentration, with a monotonically decreasing slope as the frequency increases. The THz-corneal tissue interaction is simulated with a Bruggeman model with excellent agreement. THz applications to corneal dystrophy, graft rejection, and refractive surgery are examined from the context of these measurements.

Development of a compact terahertz time-domain spectrometer for the measurement of the optical properties of biological tissues

Terahertz spectrometers and imaging systems are currently being evaluated as biomedical tools for skin burn assessment. These systems show promise, but due to their size and weight, they have restricted portability, and are impractical for military and battlefield settings where space is limited. In this study, we developed and tested the performance of a compact, light, and portable THz time-domain spectroscopy (THz-TDS) device. Optical properties were collected with this system from 0.1 to 1.6 THz for water, ethanol, and several ex vivo porcine tissues (muscle, adipose, skin). For all samples tested, we found that the index of refraction (n) decreases with frequency, while the absorption coefficient (μ(a)) increases with frequency. Muscle, adipose, and frozen/thawed skin samples exhibited comparable n values ranging between 2.5 and 2.0, whereas the n values for freshly harvested skin were roughly 40% lower. Additionally, we found that the freshly harvested samples exhibited higher μ(a) values than the frozen/thawed skin samples. Overall, for all liquids and tissues tested, we found that our system measured optical property values that were consistent with those reported in the literature. These results suggest that our compact THz spectrometer performed comparable to its larger counterparts, and therefore may be a useful and practical tool for skin health assessment.

Terahertz sensing of corneal hydration

An indicator of ocular health is the hydrodyanmics of the cornea. Many corneal disorders deteriorate sight as they upset the normal hydrodynamics of the cornea. The mechanisms include the loss of endothelial pump function of corneal dystophies, swelling and immune response of corneal graft rejection, and inflammation and edema, which accompany trauma, burn, and irritation events. Due to high sensitivity to changes of water content in materials, a reflective terahertz (300 GHz and 3 THz) imaging system could be an ideal tool to measure the hydration level of the cornea. This paper presents the application of THz technology to visualize the hydration content across ex vivo porcine corneas. The corneas, with a thickness variation from 470 - 940 µm, were successfully imaged using a reflective pulsed THz imaging system, with a maximum SNR of 50 dB. To our knowledge, no prior studies have reported on the use of THz in measuring hydration in corneal tissues or other ocular tissues. These preliminary findings indicate that THz can be used to accurately sense hydration levels in the cornea using a pulsed, reflective THz imaging system.