Intrathecal drug delivery in the era of nanomedicine

Administration of substances directly into the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord is one approach that can circumvent the blood-brain barrier to enable drug delivery to the central nervous system (CNS). However, molecules that have been administered by intrathecal injection, which includes intraventricular, intracisternal, or lumbar locations, encounter new barriers within the subarachnoid space. These barriers include relatively high rates of turnover as CSF clears and potentially inadequate delivery to tissue or cellular targets. Nanomedicine could offer a solution. In contrast to the fate of freely administered drugs, nanomedicine systems can navigate the subarachnoid space to sustain delivery of therapeutic molecules, genes, and imaging agents within the CNS. Some evidence suggests that certain nanomedicine agents can reach the parenchyma following intrathecal administration. Here, we will address the preclinical and clinical use of intrathecal nanomedicine, including nanoparticles, microparticles, dendrimers, micelles, liposomes, polyplexes, and other colloidalal materials that function to alter the distribution of molecules in tissue. Our review forms a foundational understanding of drug delivery to the CSF that can be built upon to better engineer nanomedicine for intrathecal treatment of disease.

Lymphatic delivery of etanercept via nanotopography improves response to collagen-induced arthritis

Background

Evidence suggests lymphatic function mediates local rheumatoid arthritis (RA) flares. Yet biologics that target the immune system are dosed systemically via the subcutaneous (SC) administration route, thereby inefficiently reaching local lymphatic compartments. Nanotopography has previously been shown to disrupt tight cellular junctions, potentially enhancing local lymphatic delivery and potentially improving overall therapeutic efficacy.

Method

We first characterized nanotopography (SOFUSA™) delivery of an anti-TNF drug, etanercept, by comparing pharmacokinetic profiles to those obtained by conventional SC, intravenous (IV), and intradermal (ID) routes of administration, and assessed uptake of radiolabeled etanercept in draining lymph nodes (LNs) in single dosing studies. We then compared etanercept efficacy in a progressive rat model of collagen-induced arthritis (CIA), administered systemically via SC route of administration; via the regional lymphatics through ID delivery; or through a nanotopography (SOFUSA™) device at 10, 12, and 14 days post CIA induction. Measurements of hind limb swelling and near-infrared fluorescence (NIRF) imaging of afferent lymph pumping function and reflux were conducted on days 11, 13, and 18 post CIA induction and compared to untreated CIA animals. Univariate and multivariate analysis of variance were used to compare the group differences for percentage swelling and lymphatic contractile activity.

Results

Even though all three modes of administration delivered an equal amount of etanercept, SOFUSA™ delivery resulted in increased lymphatic pumping and significantly reduced swelling as compared to untreated, ID, and SC groups. Pharmacokinetic profiles in serum and LN uptake studies showed that using the nanotopography device resulted in the greatest uptake and retention in draining LNs.

Conclusions

Locoregional lymphatic delivery of biologics that target the immune system may have more favorable pharmacodynamics than SC or IV administration. Nanotopography may provide a more efficient method for delivery of anti-TNF drugs to reverse impairment of lymphatic function and reduce swelling associated with RA flares.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-017-1323-z) contains supplementary material, which is available to authorized users.

A novel mutation in CELSR1 is associated with hereditary lymphedema

BACKGROUND

Biological evidence reported in the literature supports the role of CELSR1 as being essential for valvular function in murine lymphatics. Yet thus far, there have been no variants in CELSR1 associated with lymphatic dysfunction in humans.

CASE PRESENTATION

In this report, a rare early inactivating mutation in CELSR1 is found to be causal for non-syndromic, lower extremity lymphedema in a family across three generations. Near-infrared fluorescence lymphatic imaging shows that instead of being propelled within the lumen of well-defined lymphatic vessels, lymph moved in regions of both legs in an unusual fashion and within sheet-like structures.

CONCLUSION

CELSRI may be responsible for primary, non-syndromic lymphedema in humans.

A review of performance of near-infrared fluorescence imaging devices used in clinical studies

Near-infrared fluorescence (NIRF) molecular imaging holds great promise as a new "point-of-care" medical imaging modality that can potentially provide the sensitivity of nuclear medicine techniques, but without the radioactivity that can otherwise place limitations of usage. Recently, NIRF imaging devices of a variety of designs have emerged in the market and in investigational clinical studies using indocyanine green (ICG) as a non-targeting NIRF contrast agent to demark the blood and lymphatic vasculatures both non-invasively and intraoperatively. Approved in the USA since 1956 for intravenous administration, ICG has been more recently used off label in intradermal or subcutaneous administrations for fluorescence imaging of the lymphatic vasculature and lymph nodes. Herein, we summarize the devices of a variety of designs, summarize their performance in lymphatic imaging in a tabular format and comment on necessary efforts to develop standards for device performance to compare and use these emerging devices in future, NIRF molecular imaging studies.

Concentration of indocyanine green does not significantly influence lymphatic function as assessed by near-infrared imaging

BACKGROUND

Absorbance of near-infrared (600-800 nm) light by the tissue components water, melanin, and hemoglobin is minimal. This property allows the use of near-infrared-emitting fluorophores for noninvasive, in vivo, real-time imaging of tissue, without the interference of autofluorescence experienced with imaging in other wavelength ranges. Near-infrared (NIR) fluorescence imaging has been used to noninvasively image lymphatic architecture and pumping function in animals, as well as in humans. The effects of different doses of a NIR dye, indocyanine green (ICG), on lymphatic function have been questioned. This study aims to address these concerns in the context of a mouse inguinal-to-axillary lymphatic imaging model.

METHODS AND RESULTS

We measured lymph propulsive velocity and frequency using an imaging system composed of a laser diode for excitation of the dye, an image intensifier, and an intensified charge-coupled device (ICCD) camera to capture real-time images. At 0.32, 0.645, and 1.3 mM ICG, no significant differences in lymphatic propulsive velocity or frequency were observed. Additionally, the use of other NIR imaging agents did not result in significant differences.

CONCLUSIONS

The use of different concentrations of ICG and the use of other near-infrared fluorophores for optical imaging of lymphatics does not significantly affect lymphatic propulsive velocity or frequency.

Validating the Sensitivity and Performance of Near-Infrared Fluorescence Imaging and Tomography Devices Using a Novel Solid Phantom and Measurement Approach

With the aid of indocyanine green (ICG), lymphatic architecture and function in both mice and humans has been successfully imaged non-invasively using near-infrared (NIR) fluorescence imaging devices. Maximal measurement sensitivity of NIR fluorescence imaging devices is needed for “first-in-humans” molecularly targeting NIR fluorescence agents that are brighter than non-specific ICG. In this study, we developed a solid phantom and measurement approach for the quantification of excitation light leakage and measurement sensitivity of NIR fluorescence imaging devices. The constructed solid phantom, consisting of quantum dots impregnated onto specularly reflective surface, shows long-term stability and can be used as a traceable fluorescence standard. With the constructed solid phantom, the intensified CCD (ICCD)-based device demonstrated more than 300% higher measurement sensitivity compared to the Electron Multiplying CCD (EMCCD) based device when integration time was maintained less than 1.0 s.

P5-12-04: Genetic Linkage between Acquired and Primary Lymphedema Evaluated through Whole Exome Sequencing and NIR Fluorescence Lymphatic Imaging

Acquired lymphedema is thought to arise from the damage of the lymphatic vasculature that transports excess fluid and macromolecules away from tissues for return to the blood vasculature. The onset of the cancer acquired disease can occur months to years after lymph node dissection and manifests itself as an accumulation of fluid and macromolecules in tissues that leads to edema and irresolvable swelling. The rare disease of primary lymphedema is identical to cancer acquired lymphedema, with the exception that there is no trauma or cancer treatment that can be attributed as its cause. Primary lymphedema has been attributed to genetic causes since the late nineteenth century. Although there are five known genetic causes of hereditary or primary lymphedema, the majority of patients with lymphedema do not possess mutations in these genes. More recently, it has been proposed that a genetic link between cancer acquired and primary lymphedema exists. If a genetic susceptibility for cancer acquired lymphedema could be found, then we could predict which survivors will encounter the disease and could develop new therapies which are more effective than the current treatments that have remained unchanged for the past 80 years.

In an FDA approved investigational study, we used near-infrared (NIR) fluorescence imaging to phenotype the lymphatic architecture of subjects with both acquired and primary lymphedema, as well as their unaffected family members. We collected blood for DNA analyses. NIR fluorescence provided the phenotype of abnormal lymphatic function while whole exome sequencing provided the genotype. Bioinformatics analyses were then used to identify causative genes using cosegregation of familial genotypes using the phentotypes found through NIR fluorescence imaging.

The first family analyzed had members with primary and acquired lymphedema in which mutations encoding for proteins that participate in the HGF/c-MET and PI3K pathways could potentially explain the inheritance of lymphedema in this family. The father and affected daughters were heterozygous for a de novo SNP HGF in the kringle binding domain that interacts with tyrosine kinase receptor c-MET. The father had a normal lymphatic phenotype. On the other hand, the mother and daughters were heterozygous for the de novo mutation of INPPL1 (SHIP-2), adjacent to the SH2 domain of the protein that is known to bind to the multifunctional docking site of c-MET and associates with proteins in the Rho pathway for cytoskeletal reorganization. The daughters possessed both HGF and INPPL1 mutations and were diagnosed with primary lymphedema while the mother, who possessed the INPPL1 mutation, was diagnosed at the time of NIR imaging with acquired lymphedema. Analyses of remaining families as well as breast cancer related lymphedema patients are underway to confirm whether INPPL1 may be a candidate susceptibility gene for acquired lymphedema. Supported in parts by R01 HL092923 and CA128919, The Texas Star Award, and the Cullen Foundation.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-12-04.

Translation of near-infrared fluorescence imaging technologies: emerging clinical applications

Technical developments in near-infrared fluorescence (NIRF) imaging and tomography have enabled recent translation into investigational human studies. Noninvasive imaging of the lymphatic vasculature for diagnosis and assessment of function has been uniquely accomplished with NIR using indocyanine green (ICG), a nonspecific dye that has comparatively poor fluorescent properties compared to emerging dyes. Adjunct use of NIRF-ICG for (a) intraoperative sentinel lymph node mapping for cancer staging, (b) video-angiography during surgery, and (c) discrimination of malignant from benign breast lesions detected by mammography and ultrasongraphy also evidences the clinical utility of NIRF. Future NIRF imaging agents that consist of bright fluorescent dyes conjugated to disease-targeting moieties promise molecular imaging and image-guided surgery. In this review, emerging NIRF imaging is described within the context of nuclear imaging technologies that remain the "gold standard" of molecular imaging.

Noise pre-filtering techniques in fluorescence-enhanced optical tomography

In this contribution, different measurement noise pre-filtering techniques were developed using frequency-domain fluorescence measurements of homogeneous breast phantoms. We demonstrated that implementing noise pre-filtering, based on modulation depth and measurement error in amplitude, can improve model match between experimental and simulated data under varying experimental conditions (target depths, 1-3 cm and fluorescence optical contrast, 1:0 and 100:1). Noise pre-filtering also improves the qualitative estimation of target(s) location in reconstructed images in deep target(s) when there was fluorescence in the background. Interestingly, decreases in model mismatch did not necessarily correlate with increases in reconstructed target accuracy. In addition, it was observed that pre-filtering measurement noise using different criteria can help differentiate target(s) from artifacts, thus possibly minimizing the false-positive cases in a clinical environment.

Influence of excitation light rejection on forward model mismatch in optical tomography

Fluorescence enhanced tomography for molecular imaging requires low background for detection and accurate image reconstruction. In this contribution, we show that excitation light leakage is responsible for elevated background and can be minimized with the use of gradient index (GRIN) lenses when using fibre optics to collect propagated fluorescence light from tissue or other biological media. We show that the model mismatch between frequency-domain photon migration (FDPM) measurements and the diffusion approximation prediction is decreased when GRIN lenses are placed prior to the interference filters to provide efficient excitation light rejection. Furthermore, model mismatch is correlated to the degree of excitation light leakage. This work demonstrates the importance of proper light filtering when designing fluorescence optical imaging and tomography.

Tomographic fluorescence imaging in tissue phantoms: a novel reconstruction algorithm and imaging geometry

A novel image reconstruction algorithm has been developed and demonstrated for fluorescence-enhanced frequency-domain photon migration (FDPM) tomography from measurements of area illumination with modulated excitation light and area collection of emitted fluorescence light using a gain modulated image-intensified charge-coupled device (ICCD) camera. The image reconstruction problem was formulated as a nonlinear least-squares-type simple bounds constrained optimization problem based upon the penalty/modified barrier function (PMBF) method and the coupled diffusion equations. The simple bounds constraints are included in the objective function of the PMBF method and the gradient-based truncated Newton method with trust region is used to minimize the function for the large-scale problem (39919 unknowns, 2973 measurements). Three-dimensional (3-D) images of fluorescence absorption coefficients were reconstructed using the algorithm from experimental reflectance measurements under conditions of perfect and imperfect distribution of fluorophore within a single target. To our knowledge, this is the first time that targets have been reconstructed in three-dimensions from reflectance measurements with a clinically relevant phantom.

Impact of excipient particle size on measurement of active pharmaceutical ingredient absorbance in mixtures using frequency domain photon migration

A system of dual-component powder mixtures, varying in excipient particle size and concentration of active pharmaceutical ingredient (API), is analyzed using frequency domain photon migration (FDPM) techniques. The results show that the FDPM-measured absorption coefficient increases linearly with increasing API concentration whereas the isotropic scattering coefficient shows no sensitivity to changes in API concentration. It is further seen that the absorption coefficient of blends, owing to the API, is not only linearly dependent on its concentration, but that this relationship is furthermore related to the excipient particle size. Finally, a comparison between near-infrared absorbance and FDPM-measured isotropic scattering as a function of reciprocal particle size is made to highlight FDPM as a powerful particle sizing tool without need for calibration. Overall, this study presents FDPM as a comprehensive method for detection of API concentration independent of excipient particle size.

Diagnostic imaging of breast cancer using fluorescence-enhanced optical tomography: phantom studies

Molecular targeting with exogenous near-infrared excitable fluorescent agents using time-dependent imaging techniques may enable diagnostic imaging of breast cancer and prognostic imaging of sentinel lymph nodes within the breast. However, prior to the administration of unproven contrast agents, phantom studies on clinically relevant volumes are essential to assess the benefits of fluorescence-enhanced optical imaging in humans. Diagnostic 3-D fluorescence-enhanced optical tomography is demonstrated using 0.5 to 1 cm(3) single and multiple targets differentiated from their surroundings by indocyanine green (micromolar) in a breast-shaped phantom (10-cm diameter). Fluorescence measurements of referenced ac intensity and phase shift were acquired in response to point illumination measurement geometry using a homodyned intensified charge-coupled device system modulated at 100 MHz. Bayesian reconstructions show artifact-free 3-D images (3857 unknowns) from 3-D boundary surface measurements (126 to 439). In a reflectance geometry appropriate for prognostic imaging of lymph node involvement, fluorescence measurements were likewise acquired from the surface of a semi-infinite phantom (8x8x8 cm(3)) in response to area illumination (12 cm(2)) by excitation light. Tomographic 3-D reconstructions (24,123 unknowns) were recovered from 2-D boundary surface measurements (3194) using the modified truncated Newton's method. These studies represent the first 3-D tomographic images from physiologically relevant geometries for breast imaging.

Fluorescence-enhanced optical imaging of large phantoms using single and simultaneous dual point illumination geometries

Fluorescence-enhanced optical tomography is typically performed using single point illumination and multiple point collection measurement geometry. Single point illumination is often insufficient to illuminate greater volumes of large phantoms and results in an inadequate fluorescent signal to noise ratio (SNR) for the majority of measurements. In this work, the use of simultaneous multiple point illumination geometry is proposed for acquiring a large number of fluorescent measurements with a sufficiently high SNR. As a feasibility study, dual point excitation sources, which are in-phase, were used in order to acquire surface measurements and perform three-dimensional reconstructions on phantoms of large volume and/or significant penetration depth. Measurements were acquired in the frequency-domain using a modulated intensified CCD imaging system under different experimental conditions of target depth (1.4-2.8 cm deep) with a perfect uptake optical contrast. Three-dimensional reconstructions of the fluorescence absorption from the dual point illumination geometry compare well with the reconstructions from the single point illumination geometry. Targets located up to 2 cm deep were located successfully, establishing the feasibility of reconstructions from simultaneous multiple point excitation sources. With improved excitation light rejection, multiple point illumination geometry may prove useful in reconstructing more challenging domains containing deeply embedded targets. Image quality assessment tools are required to determine the optimal measurement geometry for the largest set off imaging tasks.

A comparison of exact and approximate adjoint sensitivities in fluorescence tomography

Many approaches to fluorescence tomography utilize some form of regularized nonlinear least-squares algorithm for data inversion, thus requiring repeated computation of the Jacobian sensitivity matrix relating changes in observable quantities, such as emission fluence, to changes in underlying optical parameters, such as fluorescence absorption. An exact adjoint formulation of these sensitivities comprises three terms, reflecting the individual contributions of 1) sensitivities of diffusion and decay coefficients at the emission wavelength, 2) sensitivities of diffusion and decay coefficients at the excitation wavelength, and 3) sensitivity of the emission source term. Simplifying linearity assumptions are computationally attractive in that they cause the first and second terms to drop out of the formulation. The relative importance of the three terms is thus explored in order to determine the extent to which these approximations introduce error. Computational experiments show that, while the third term of the sensitivity matrix has the largest magnitude, the second term becomes increasingly significant as target fluorophore concentration or volume increases. Image reconstructions from experimental data confirm that neglecting the second term results in overestimation of sensitivities and consequently overestimation of the value and volume of the fluorescent target, whereas contributions of the first term are so low that they are probably not worth the additional computational costs.

Assessment of Small-Angle and Angle-Averaged Structure Factor for Monitoring Electrostatic Colloidal Interactions Using Multiply Scattered Light

The isotropic scattering coefficients of 143-nm diameter polystyrene latex suspensions were measured using frequency-domain photon migration (FDPM) at 687 and 828 nm as a function of volume fraction (0.05-0.3) and ionic strength (1.0 to 120 mM NaCl equivalents) in order to derive the angle-integrated structure factor, S(q), and structure factor at zero wave vector, S(0). The effective surface charges of the dispersions were estimated by fitting the measured isotropic scattering coefficients at each wavelength as a function of volume fraction to the solution of the Orstein-Zernike integral equation using the hard sphere Yukawa potential model and mean spherical approximation as a closure relation. The estimates of surface charges were comparable at both wavelengths, but decreased with ionic strength. At 120 mM NaCl equivalents, the values of S(0) obtained from FDPM matched those predicted by the Percus-Yevick model, and decreased with volume fraction, consistent with prediction by the Carnahan-Starling equation.

Error consideration in contrast-enhanced three-dimensional optical tomography

We present three-dimensional tomographic images of the absorption coefficient that is due to the presence of a fluorophore reconstructed from frequency domain fluence measurements of a tissue phantom containing a single, fluorescence contrast-enhanced inclusion. We show that such a reconstruction may be improved when the importance of measurement error correlations between relative phase shift and amplitude is assessed and when measurements are preprocessed to reduce the magnitude and the bias of system error.

Three-dimensional unconstrained and constrained image-reconstruction techniques applied to fluorescence, frequency-domain photon migration

The development of near-infrared (NIR) optical imaging for biomedical optical imaging is hampered by the computational intensiveness of large-scale three-dimensional (3-D) image reconstruction and the potential lack of endogenous contrast for detection of relevant tissue features. In this contribution the inverse optical imaging problem is formulated in three dimensions in a noncompressive geometry as a simple-bound constrained minimization problem in order to recover the interior fluorescence properties of exogenous contrast agent from frequency-domain photon migration measurements at the boundary. The solution of the forward optical diffusion problem for the frustum shape containing fluorescence inclusions of 10:1 contrast is accomplished by use of the Galerkin finite-element formulation. The inverse approach employs the truncated Newton method with trust region and a modification of automatic reverse differentiation to speed the computation of the optimization problem. The image-reconstruction results confirm that the constrained minimization may offer a more logical approach for the 3-D optical imaging problem than unconstrained optimization.

Three-dimensional Bayesian optical image reconstruction with domain decomposition

Most current efforts in near-infrared optical tomography are effectively limited to two-dimensional reconstructions due to the computationally intensive nature of full three-dimensional (3-D) data inversion. Previously, we described a new computationally efficient and statistically powerful inversion method APPRIZE (automatic progressive parameter-reducing inverse zonation and estimation). The APPRIZE method computes minimum-variance estimates of parameter values (here, spatially variant absorption due to a fluorescent contrast agent) and covariance, while simultaneously estimating the number of parameters needed as well as the size, shape, and location of the spatial regions that correspond to those parameters. Estimates of measurement and model error are explicitly incorporated into the procedure and implicitly regularize the inversion in a physically based manner. The optimal estimation of parameters is bounds-constrained, precluding infeasible values. In this paper, the APPRIZE method for optical imaging is extended for application to arbitrarily large 3-D domains through the use of domain decomposition. The effect of subdomain size on the performance of the method is examined by assessing the sensitivity for identifying 112 randomly located single-voxel heterogeneities in 58 3-D domains. Also investigated are the effects of unmodeled heterogeneity in background optical properties. The method is tested on simulated frequency-domain photon migration measurements at 100 MHz in order to recover absorption maps owing to fluorescent contrast agent. This study provides a new approach for computationally tractable 3-D optical tomography.

Developments toward diagnostic breast cancer imaging using near-infrared optical measurements and fluorescent contrast agents

The use of near-infrared (NIR) light to interrogate deep tissues has enormous potential for molecular-based imaging when coupled with NIR excitable dyes. More than a decade has now passed since the initial proposals for NIR optical tomography for breast cancer screening using time-dependent measurements of light propagation in the breast. Much accomplishment in the development of optical mammography has been demonstrated, most recently in the application of time-domain, frequency-domain, and continuous-wave measurements that depend on endogenous contrast owing to angiogenesis and increased hemoglobin absorbance for contrast. Although exciting and promising, the necessity of angiogenesis-mediated absorption contrast for diagnostic optical mammography minimizes the potential for using NIR techniques to assess sentinel lymph node staging, metastatic spread, and multifocality of breast disease, among other applications. In this review, we summarize the progress made in the development of optical mammography, and focus on the emerging work underway in the use of diagnostic contrast agents for the molecular-based, diagnostic imaging of breast.

Active constrained truncated Newton method for simple-bound optical tomography

In the past, nonlinear unconstrained optimization of the optical imaging problem has focused on Newton-Raphson techniques. Besides requiring expensive computation of the Jacobian, the unconstrained minimization with Tikhonov regularization can pose significant storage problems for large-scale reconstructions, involving a large number of unknowns necessary for realization of optical imaging. We formulate the inverse optical imaging problem as both simple-bound constrained and unconstrained minimization problems in order to illustrate the reduction in computational time and storage associated with constrained image reconstructions. The forward simulator of excitation and generated fluorescence, consisting of the Galerkin finite-element formulation, is used in an inverse algorithm to find the spatial distribution of absorption and lifetime that minimizes the difference between predicted and synthetic frequency-domain measurements. The inverse approach employs the truncated Newton method with trust region and a modification of automatic reverse differentiation to speed the computation of the optimization problem. The reconstruction results confirm that the physically based, constrained minimization with efficient optimization schemes may offer a more logical approach to the large-scale optical imaging problem than unconstrained minimization with regularization.

Pharmacokinetics of ICG and HPPH-car for the detection of normal and tumor tissue using fluorescence, near-infrared reflectance imaging: a case study

We present in vivo fluorescent, near-infrared (NIR), reflectance images of indocyanine green (ICG) and carotene-conjugated 2-devinyl-2-(1-hexyloxyethyl) pyropheophorbide (HPPH-car) to discriminate spontaneous canine adenocarcinoma from normal mammary tissue. Following intravenous administration of 1.0 mg kg-1 ICG or 0.3 mg kg-1 HPPH-car into the canine, a 25 mW, 778 nm or 70 mW, 660 nm laser diode beam, expanded by a diverging lens to approximately 4 cm in diameter, illuminated the surface of the mammary tissue. Successfully propagating to the tissue surface, ICG or HPPH-car fluorescence generated from within the tissue was collected by an image-intensified, charge-coupled device camera fitted with an 830 or 710 nm bandpass interference filter. Upon collecting time-dependent fluorescence images at the tissue surface overlying both normal and diseased tissue volumes, and fitting these images to a pharmacokinetic model describing the uptake (wash-in) and release (wash-out) of fluorescent dye, the pharmacokinetics of fluorescent dye was spatially determined. Mapping the fluorescence intensity owing to ICG indicates that the dye acts as a blood pool or blood persistent agent, for the model parameters show no difference in the ICG uptake rates between normal and diseased tissue regions. The wash-out of ICG was delayed for up to 72 h after intravenous injection in tissue volumes associated with disease, because ICG fluorescence was still detected in the diseased tissue 72 h after injection. In contrast, HPPH-car pharmacokinetics illustrated active uptake into diseased tissues, perhaps owing to the overexpression of LDL receptors associated with the malignant cells. HPPH-car fluorescence was not discernable after 24 h. This work illustrates the ability to monitor the pharmacokinetic delivery of NIR fluorescent dyes within tissue volumes as great as 0.5-1 cm from the tissue surface in order to differentiate normal from diseased tissue volumes on the basis of parameters obtained from the pharmacokinetic models.

Pharmacokinetics of ICG and HPPH-car for the detection of normal and tumor tissue using fluorescence, near-infrared reflectance imaging: a case study

We present in vivo fluorescent, near-infrared (NIR), reflectance images of indocyanine green (ICG) and carotene-conjugated 2-devinyl-2-(1-hexyloxyethyl) pyropheophorbide (HPPH-car) to discriminate spontaneous canine adenocarcinoma from normal mammary tissue. Following intravenous administration of 1.0 mg kg-1 ICG or 0.3 mg kg-1 HPPH-car into the canine, a 25 mW, 778 nm or 70 mW, 660 nm laser diode beam, expanded by a diverging lens to approximately 4 cm in diameter, illuminated the surface of the mammary tissue. Successfully propagating to the tissue surface, ICG or HPPH-car fluorescence generated from within the tissue was collected by an image-intensified, charge-coupled device camera fitted with an 830 or 710 nm bandpass interference filter. Upon collecting time-dependent fluorescence images at the tissue surface overlying both normal and diseased tissue volumes, and fitting these images to a pharmacokinetic model describing the uptake (wash-in) and release (wash-out) of fluorescent dye, the pharmacokinetics of fluorescent dye was spatially determined. Mapping the fluorescence intensity owing to ICG indicates that the dye acts as a blood pool or blood persistent agent, for the model parameters show no difference in the ICG uptake rates between normal and diseased tissue regions. The wash-out of ICG was delayed for up to 72 h after intravenous injection in tissue volumes associated with disease, because ICG fluorescence was still detected in the diseased tissue 72 h after injection. In contrast, HPPH-car pharmacokinetics illustrated active uptake into diseased tissues, perhaps owing to the overexpression of LDL receptors associated with the malignant cells. HPPH-car fluorescence was not discernable after 24 h. This work illustrates the ability to monitor the pharmacokinetic delivery of NIR fluorescent dyes within tissue volumes as great as 0.5-1 cm from the tissue surface in order to differentiate normal from diseased tissue volumes on the basis of parameters obtained from the pharmacokinetic models.

Measurements of multiply scattered light for on-line monitoring of changes in size distribution of cell debris suspension

Dual wavelength frequency-domain measurements of photon migration (FDPM) are conducted on filtrate samples obtained from an industrial centrifugation process designed to separate Escherichia coli cell debris from the inclusion bodies. FDPM measurements consist of detecting phase delay of intensity-modulated light at 670 and 820 (or 830) nm. Optical properties of isotropic scattering and absorption are obtained from the regression of phase delay data to the optical diffusion equation. We show that the corresponding intensity-based measurements alone cannot provide accurate and independent estimates for these optical properties. However, FDPM-derived scattering coefficients of filtrate solutions (primarily consisting of 0.1-0.2 micrometer E. coli cell debris) are sensitive to approximately 1 vol % of added inclusion bodies (of 1-2 micrometer size). The technique, theory, and future adaptation of FDPM as an on-line monitor to detect the loss of inclusion bodies in centrifugation following homogenization are presented and contrasted to conventional, intensity-based measurements.

Frequency-domain photon migration measurements for quantitative assessment of powder absorbance: A novel sensor of blend homogeneity

The measurement and analysis of frequency-domain photon migration (FDPM) measurements of powder absorbance in pharmaceutical powders is described in the context of other optical techniques. FDPM consists of launching intensity-modulated light into a powder and detecting the phase delay and amplitude modulation of the re-emitted light as a function of the modulation frequency. From analysis of the data using the diffusion approximation to the radiative transport equation, the absorption coefficient can be obtained. Absorption coefficient measurements of riboflavin in lactose mixtures are presented at concentrations of 0.1 to 1% (w/w) at near-infrared wavelengths where solution absorption cross sections are difficult to accurately measure using traditional transmission measurements in nonscattering solutions. FDPM measurements in powders enabled determinations of absorption coefficients that increase linearly with concentration (w/w) according to Beer-Lambert relationship. The extension of FDPM for monitoring absorbance of low-dose and ultralow-dose powder blending operations is presented.

Measurement of the fluorescence lifetime in scattering media by frequency-domain photon migration

A method is presented to determine fluorescence decay lifetimes within tissuelike scattering media. Fluorescence lifetimes are determined for micromolar concentrations of the dyes 3,3'-Diethylthiatricarbocyanine Iodide and Indocyanine Green by frequency-domain investigations of light propagating in turbid media. Dual-wavelength photon-migration measurements that use intensity-modulated sources at excitation and emission wavelengths of the fluorophores provide optical parameters of the media as well as fluorescence properties of the dyes. The deduction of fluorescence lifetimes requires no calibration with reference fluorophores, and the results are shown to be independent of dye concentration.

Imaging of spontaneous canine mammary tumors using fluorescent contrast agents

We present near-infrared frequency-domain photon migration imaging for the lifetime sensitive detection and localization of exogenous fluorescent contrast agents within tissue-simulating phantoms and actual tissues. We employ intensity-modulated excitation light that is expanded and delivered to the surface of a tissue or tissue-simulating phantom. The intensity-modulated fluorescence generated from within the volume propagates to the surface and is collected using a gain-modulated image-intensified charge-coupled device camera. From the spatial values of modulation amplitude and phase of the detected fluorescent light, micromolar volumes of diethylthiatricarbocyanine iodide (tau = 1.17 ns) and indocyanine green (ICG) (tau = 0.58 ns) embedded 1.0 cm deep in a tissue phantom are localized and discriminated on the basis of their lifetime differences. To demonstrate the utility of frequency-domain fluorescent measurements for imaging disease, we image the fluorescence emitted from the surface of in vivo and ex vivo canine mammary gland tissues containing lesions with preferential uptake of ICG. Pathology confirms the ability to detect spontaneous mammary tumors and regional lymph nodes amidst normal mammary tissue and fat as deep as 1.5 cm from the tissue surface.

Biomedical optical tomography using dynamic parameterization and bayesian conditioning on photon migration measurements

Stochastic reconstruction techniques are developed for mapping the interior optical properties of tissues from exterior frequency-domain photon migration measurements at the air-tissue interface. Parameter fields of absorption cross section, fluorescence lifetime, and quantum efficiency are accurately reconstructed from simulated noisy measurements of phase shift and amplitude modulation by use of a recursive, Bayesian, minimum-variance estimator known as the approximate extended Kalman filter. Parameter field updates are followed by data-driven zonation to improve the accuracy, stability, and computational efficiency of the method by moving the system from an underdetermined toward an overdetermined set of equations. These methods were originally developed by Eppstein and Dougherty [Water Resources Res. 32, 3321 (1996)] for applications in geohydrology. Estimates are constrained to within feasible ranges by modeling of parameters as beta-distributed random variables. No arbitrary smoothing, regularization, or interpolation is required. Results are compared with those determined by use of Newton-Raphson-based inversions. The speed and accuracy of these preliminary Bayesian reconstructions suggest the near-future application of this inversion technology to three-dimensional biomedical imaging with frequency-domain photon migration.

Probing Static Structure of Colloid-Polymer Suspensions with Multiply Scattered Light

Time-dependent measurements of light propagation were conducted in aqueous dispersions of 523 nm diameter polystyrene at concentrations between 0.1 and 0.4 solids volume fraction in order to assess how particle correlation is influenced by depletion interactions arising from the addition of soluble polyethyleneoxide (PEO). In the absence of polymer, the transport scattering length can be predicted from Mie scattering theory and the Percus-Yevick (P-Y) model for static structure of a dense hard-sphere colloidal solution. Depletion forces arising from the addition of PEO of varying molecular weights influenced the spatial ordering of the dispersion and caused a further increase in the transport scattering length beyond that predicted by hard-sphere static structure factor but similar to that predicted by the mean sphere approximation (MSA) to the P-Y model described by Ye et al. (1996). Onset of flocculation occurred with increased PEO addition and correlated with PEO molecular weight. Phase separation was noted by no further change in the transport scattering length, except when flocculation was induced by the highest molecular weight PEO. The use of time-dependent measurements of light propagation in dense systems provides an alternative to small-angle light, neutron, and X-ray scattering characterization of interaction potentials in dense, multiply scattering samples and promises further fruitful investigation of colloidal particle interactions in suspensions. Copyright 1999 Academic Press.

Fluorescence lifetime spectroscopic imaging with measurements of photon migration

Frequency-domain measurements of photon migration are coupled with a model of fluorescence generation and propagation in order to develop a method for reconstructing maps of fluorescent properties within interior tissue volumes from exterior measurements at the air-tissue interface. Simulation results confirm the feasibility of optical imaging through the use of exogenously administered contrast agents on the basis of fluorophore decay kinetics and yield. Experimental measurements using single-pixel and multipixel devices illustrate that the contrast owing to exogenous fluorescence exceeds that owing to absorption or scattering caused by endogenous chromophores or tissue structure and owing to absorption caused by exogenous contrast agents.

Role of higher-order scattering in solutions to the forward and inverse optical-imaging problems in random media

From analytical and numerical solutions that predict the scattering of diffuse photon density waves and from experimental measurements of changes in phase shift theta and ac amplitude demodulation M caused by the presence of single and double cylindrical heterogeneities, we show that second- and higher-order perturbations can affect the prediction of the propagation characteristics of diffuse photon density waves. Our experimental results for perfect absorbers in a lossless medium suggest that the performance of fast inverse-imaging algorithms that use first-order Born or Rytov approximations might have inherent limitations compared with inverse solutions that use iterative solutions of a linear perturbation equation or numerical solutions of the diffusion equation.

Multipixel techniques for frequency-domain photon migration imaging

The ability to map interior optical properties of a highly scattering medium from exterior measurements of light propagation is afforded by optical tomography. In this communication, we describe the problem of optical tomography, the techniques of photon migration measurements necessary to accomplish it, and the development of multipixel measurements for rapid collection of optical signals. These multipixel measurements are shown to provide detection of contrast owing to the optical properties of absorption and fluorescence associated with dye-laden heterogeneities embedded in a tissue-like scattering medium. From these rapid measurements, successful reconstruction of an interior optical property map may now be possible with clinically realistic data acquisition times. Applications for the technology arise for biomedical optical imaging for the in vivo detection of disease and the diagnosis of tissue (bio-) chemistry.

Fluorescence and absorption contrast mechanisms for biomedical optical imaging using frequency-domain techniques

The ability to optically image or detect diseased tissue volumes located deep within tissues depends upon the degree of contrast provided by differences in local optical properties. In this report, we show that the exogenous contrast offered by fluorescent compounds is superior to that provided by nonfluorescing, light-absorbing compounds when time-dependent measurements are employed. In addition, we show that the induced contrast is not only moderated by the preferential uptake of fluorescent agents into diseased tissue volumes of interest but also by the fluorescent optical properties and the fluorescence dynamics in the specific tissue volume. Using tissue phantom studies, we demonstrated experimentally that near-infrared-absorbing and fluorescent dyes such as indocyanine green can provide detection of diseased tissue volumes from fluorescence measurements made at the periphery of tissue when there is perfect, 100-fold and 10-fold partitioning in diseased tissues over that in surrounding normal tissues. Experimental results of common laser dyes show the contrast is also mediated by the quantum yield and lifetime parameters that may be dependent upon the local tissue environment.

Imaging of fluorescent yield and lifetime from multiply scattered light reemitted from random media

The feasibility of employing fluorescent contrast agents to perform optical imaging in tissues and other scattering media has been examined through computational studies. Fluorescence lifetime and yield can give crucial information about local metabolite concentrations or environmental conditions within tissues. This information can be employed toward disease detection, diagnosis, and treatment if noninvasively quantitated from reemitted optical signals. However, the problem of inverse image reconstruction of fluorescence yield and lifetime is complicated because of the highly scattering nature of the tissue. Here a light propagation model employing the diffusion equation is used to account for the scattering of both the excitation and fluorescent light. Simulated measurements of frequency-domain parameters of fluorescent modulated ac amplitude and phase lag are used as inputs to an inverse image-reconstruction algorithm, which employs the diffusion model to predict frequency-domain measurements resulting from a modulated input at the phantom periphery. In the inverse image-reconstruction algorithm, a Newton-Raphson technique combined with a Marquardt algorithm is employed to converge on the fluorescent properties within the medium. The successful reconstruction of both the fluorescence yield and lifetime in the case of a heterogeneous fluorophore distribution within a scattering medium has been demonstrated without a priori information or without the necessity of obtaining absence images.

Fluorescence-lifetime determination in tissues or other scattering media from measurement of excitation and emission kinetics

Measurements of nanosecond and subnanosecond fluorescence lifetimes are restricted to dilute, nonscattering systems since excitation and emission photon times of flight significantly affect measured fluorescent decay kinetics. We provide the theoretical rationale for frequency-domain measurements of phase-shift and amplitude demodulation made at excitation and emission wavelengths for direct determination of lifetimes in tissues and other scattering media. We confirm our analytical expressions using standard laser dyes such as 3,3'-diethylthiatricarbocyanine iodide, IR- 125, and IR- 140 in polystyrene suspensions with similar scattering properties as tissues. Our results have significant implication for lifetime-based spectroscopy in tissues and other scattering media.

Fluorescence lifetime-based sensing in tissues: a computational study

We have numerically solved the photon diffusion equation to predict the distribution of light in a tissue model system with a uniform concentration of fluorophore. Our results show that time-dependent measurements of light propagation can be used to monitor the fluorescent lifetimes of a uniformly distributed fluorophore in tissues. With proper referencing, frequency-domain measurements of phase-shift, theta, may allow quantitation of fluorescent lifetimes, tau, independent of changes in the local absorption and scattering properties. These results point to a new approach for noninvasive diagnostic monitoring through quantitation of fluorescent lifetime, tau, when the lifetime of the fluorophore is comparable with photon migration times.

Origin of phosphorescence signals reemitted from tissues

We investigate the origin of fluorescent or phosphorescent signals reemitted from highly scattering media (such as tissues), using diffusion theory and probability analysis. Results show that the lifetime of a uniformly distributed phosphorescent or fluorescent optical probe will profoundly affect the volume interrogated by noninvasive reflectance measurements. When the lifetime is greater than photon migration times, the origin of the reemitted signal is confined closest to the surface. Our computations suggest that noninvasive measurements of tissue oxygen concentration may not necessarily interrogate deep tissues when systemically administered phosphorescent dyes are used.

Computations of time-dependent photon migration for biomedical optical imaging

In summary, Table II is a listing of the pitfalls and advantages of using Monte Carlo simulations and numerical solution of the diffusion equation to describe photon migration in tissues. Judicious use of these techniques to describe the solution to the forward imaging problem may allow determination of the best theoretical resolution and the smallest detectable volume for the range of optical property differences expected in situ or imposed by contrast agent administration. Furthermore, an understanding of the forward imaging problem through these numerical techniques also contributes to our understanding of the most efficient solution to the inverse imaging problem.