Whole-brain MR-registered cryo-imaging of a porcine-human glioma model to compare contrast agent biodistributions

As rapidly accelerating technology, fluorescence guided surgery (FGS) has the potential to place molecular information directly into the surgeon's field of view by imaging administered fluorescent contrast agents in real time, circumnavigating pre-operative MR registration challenges with brain deformation. The most successful implementation of FGS is 5-ALA-PpIX guided glioma resection which has been linked to improved patient outcomes. While FGS may offer direct in-field guidance, fluorescent contrast agent distributions are not as familiar to the surgical community as Gd-MRI uptake, and may provide discordant information from previous Gd-MRI guidance. Thus, a method to assess and validate consistency between fluorescence-labeled tumor regions and Gd-enhanced tumor regions could aid in understanding the correlation between optical agent fluorescence and Gd-enhancement. Herein, we present an approach for comparing whole-brain fluorescence biodistributions with Gd-enhancement patterns on a voxel-by-voxel basis using co-registered fluorescent cryo-volumes and Gd-MRI volumes. In this initial study, a porcine-human glioma xenograft model was administered 5-ALA-PpIX, imaged with MRI, and euthanized 22 hours following 5-ALA administration. Following euthanization, the extracted brain was imaged with the cryo-macrotome system. After image processing steps and non-rigid, point-based registration, the fluorescence cryo-volume and Gd-MRI volume were compared for similarity metrics including: image similarity, tumor shape similarity, and classification similarity. This study serves as a proof-of-principle in validating our screening approach for quantitatively comparing 3D biodistributions between optical agents and Gd-based agents.

Considerations for NIR-I and short-wave infrared (SWIR) fluorescence imaging within a clinical operating room

Short-wave infrared (SWIR/NIR-II) fluorescence imaging has received increased attention for use in fluorescence-guided surgery (FGS) due to the potential for higher resolution imaging of subsurface structures and reduced autofluorescence compared to conventional NIR-I imaging. As with any fluorescence imaging modality introduced in the operating room, an appropriate accounting of contaminating background signal from other light sources in the operating room is an important step. Herein, we report the background signals in the SWIR and NIR-I emitted from commonly-used equipment in the OR, such as ambient and operating lights, LCD screens and surgical guidance systems. These results can guide implementation of protocols to reduce background signal.

Suitability of poroelastic and viscoelastic mechanical models for high and low frequency MR elastography

PURPOSE

Descriptions of the structure of brain tissue as a porous cellular matrix support application of a poroelastic (PE) mechanical model which includes both solid and fluid phases. However, the majority of brain magnetic resonance elastography (MRE) studies use a single phase viscoelastic (VE) model to describe brain tissue behavior, in part due to availability of relatively simple direct inversion strategies for mechanical property estimation. A notable exception is low frequency intrinsic actuation MRE, where PE mechanical properties are imaged with a nonlinear inversion algorithm.

METHODS

This paper investigates the effect of model choice at each end of the spectrum of in vivo human brain actuation frequencies. Repeat MRE examinations of the brains of healthy volunteers were used to compare image quality and repeatability for each inversion model for both 50 Hz externally produced motion and ≈1 Hz intrinsic motions. Additionally, realistic simulated MRE data were generated with both VE and PE finite element solvers to investigate the effect of inappropriate model choice for ideal VE and PE materials.

RESULTS

In vivo, MRE data revealed that VE inversions appear more representative of anatomical structure and quantitatively repeatable for 50 Hz induced motions, whereas PE inversion produces better results at 1 Hz. Reasonable VE approximations of PE materials can be derived by equating the equivalent wave velocities for the two models, provided that the timescale of fluid equilibration is not similar to the period of actuation. An approximation of the equilibration time for human brain reveals that this condition is violated at 1 Hz but not at 50 Hz. Additionally, simulation experiments when using the "wrong" model for the inversion demonstrated reasonable shear modulus reconstructions at 50 Hz, whereas cross-model inversions at 1 Hz were poor quality. Attenuation parameters were sensitive to changes in the forward model at both frequencies, however, no spatial information was recovered because the mechanisms of VE and PE attenuation are different.

CONCLUSIONS

VE inversions are simpler with fewer unknown properties and may be sufficient to capture the mechanical behavior of PE brain tissue at higher actuation frequencies. However, accurate modeling of the fluid phase is required to produce useful mechanical property images at the lower frequencies of intrinsic brain motions.

3D parallel-detection microwave tomography for clinical breast imaging

A biomedical microwave tomography system with 3D-imaging capabilities has been constructed and translated to the clinic. Updates to the hardware and reconfiguration of the electronic-network layouts in a more compartmentalized construct have streamlined system packaging. Upgrades to the data acquisition and microwave components have increased data-acquisition speeds and improved system performance. By incorporating analog-to-digital boards that accommodate the linear amplification and dynamic-range coverage our system requires, a complete set of data (for a fixed array position at a single frequency) is now acquired in 5.8 s. Replacement of key components (e.g., switches and power dividers) by devices with improved operational bandwidths has enhanced system response over a wider frequency range. High-integrity, low-power signals are routinely measured down to -130 dBm for frequencies ranging from 500 to 2300 MHz. Adequate inter-channel isolation has been maintained, and a dynamic range >110 dB has been achieved for the full operating frequency range (500-2900 MHz). For our primary band of interest, the associated measurement deviations are less than 0.33% and 0.5° for signal amplitude and phase values, respectively. A modified monopole antenna array (composed of two interwoven eight-element sub-arrays), in conjunction with an updated motion-control system capable of independently moving the sub-arrays to various in-plane and cross-plane positions within the illumination chamber, has been configured in the new design for full volumetric data acquisition. Signal-to-noise ratios (SNRs) are more than adequate for all transmit/receive antenna pairs over the full frequency range and for the variety of in-plane and cross-plane configurations. For proximal receivers, in-plane SNRs greater than 80 dB are observed up to 2900 MHz, while cross-plane SNRs greater than 80 dB are seen for 6 cm sub-array spacing (for frequencies up to 1500 MHz). We demonstrate accurate recovery of 3D dielectric property distributions for breast-like phantoms with tumor inclusions utilizing both the in-plane and new cross-plane data.

Multiresolution MR elastography using nonlinear inversion

PURPOSE

Nonlinear inversion (NLI) in MR elastography requires discretization of the displacement field for a finite element (FE) solution of the "forward problem", and discretization of the unknown mechanical property field for the iterative solution of the "inverse problem". The resolution requirements for these two discretizations are different: the forward problem requires sufficient resolution of the displacement FE mesh to ensure convergence, whereas lowering the mechanical property resolution in the inverse problem stabilizes the mechanical property estimates in the presence of measurement noise. Previous NLI implementations use the same FE mesh to support the displacement and property fields, requiring a trade-off between the competing resolution requirements.

METHODS

This work implements and evaluates multiresolution FE meshes for NLI elastography, allowing independent discretizations of the displacements and each mechanical property parameter to be estimated. The displacement resolution can then be selected to ensure mesh convergence, and the resolution of the property meshes can be independently manipulated to control the stability of the inversion.

RESULTS

Phantom experiments indicate that eight nodes per wavelength (NPW) are sufficient for accurate mechanical property recovery, whereas mechanical property estimation from 50 Hz in vivo brain data stabilizes once the displacement resolution reaches 1.7 mm (approximately 19 NPW). Viscoelastic mechanical property estimates of in vivo brain tissue show that subsampling the loss modulus while holding the storage modulus resolution constant does not substantially alter the storage modulus images. Controlling the ratio of the number of measurements to unknown mechanical properties by subsampling the mechanical property distributions (relative to the data resolution) improves the repeatability of the property estimates, at a cost of modestly decreased spatial resolution.

CONCLUSIONS

Multiresolution NLI elastography provides a more flexible framework for mechanical property estimation compared to previous single mesh implementations.

A spectrally constrained dual-band normalization technique for protoporphyrin IX quantification in fluorescence-guided surgery

We report a dual-band normalization technique for in vivo quantification of the metabolic biomarker, protoporphyrin IX (PpIX), during brain tumor resection procedures. The accuracy of the approach was optimized in tissue simulating phantoms with varying absorption and scattering properties, validated with fluorimetric assessments on ex vivo brain tissue, and tested on human data acquired in vivo during fluorescence-guided surgery of brain tumors. The results demonstrate that the dual-band normalization technique allows PpIX concentrations to be accurately quantified by correction with reflectance data recorded and integrated within only two narrow wavelength intervals. The simplicity of the method lends itself to the enticing prospect that the method could be applicable to wide-field applications in quantitative fluorescence imaging and dosimetry in photodynamic therapy.

Analytic expression of fluorescence ratio detection correlates with depth in multi-spectral sub-surface imaging

Here we derived analytical solutions to diffuse light transport in biological tissue based on spectral deformation of diffused near-infrared measurements. These solutions provide a closed-form mathematical expression which predicts that the depth of a fluorescent molecule distribution is linearly related to the logarithm of the ratio of fluorescence at two different wavelengths. The slope and intercept values of the equation depend on the intrinsic values of absorption and reduced scattering of tissue. This linear behavior occurs if the following two conditions are satisfied: the depth is beyond a few millimeters and the tissue is relatively homogeneous. We present experimental measurements acquired with a broad-beam non-contact multi-spectral fluorescence imaging system using a hemoglobin-containing diffusive phantom. Preliminary results confirm that a significant correlation exists between the predicted depth of a distribution of protoporphyrin IX molecules and the measured ratio of fluorescence at two different wavelengths. These results suggest that depth assessment of fluorescence contrast can be achieved in fluorescence-guided surgery to allow improved intra-operative delineation of tumor margins.

Subzone based magnetic resonance elastography using a Rayleigh damped material model

PURPOSE

Recently, the attenuating behavior of soft tissue has been addressed in magnetic resonance elastography by the inclusion of a damping mechanism in the methods used to reconstruct the resulting mechanical property image. To date, this mechanism has been based on a viscoelastic model for material behavior. Rayleigh, or proportional, damping provides a more generalized model for elastic energy attenuation that uses two parameters to characterize contributions proportional to elastic and inertial forces. In the case of time-harmonic vibration, these two parameters lead to both the elastic modulus and the density being complex valued (as opposed to the case of pure viscoelasticity, where only the elastic modulus is complex valued).

METHODS

This article presents a description of Rayleigh damping in the time-harmonic case, discussing the differences between this model and the viscoelastic damping models. In addition, the results from a subzone based Rayleigh damped elastography study of gelatin and tofu phantoms are discussed, along with preliminary results from in vivo breast data.

RESULTS

Both the phantom and the tissue studies presented here indicate a change in the Rayleigh damping structure, described as Rayleigh composition, between different material types, with tofu and healthy tissue showing lower Rayleigh composition values than gelatin or cancerous tissue.

CONCLUSIONS

It is possible that Rayleigh damping elastography and the concomitant Rayleigh composition images provide a mechanism for differentiating tissue structure in addition to measuring elastic stiffness and attenuation. Such information could be valuable in the use of Rayleigh damped magnetic resonance elastography as a diagnostic imaging tool.

Optical breast shape capture and finite-element mesh generation for electrical impedance tomography

X-ray mammography is the standard for breast cancer screening. The development of alternative imaging modalities is desirable because mammograms expose patients to ionizing radiation. Electrical impedance tomography (EIT) may be used to determine tissue conductivity, a property which is an indicator of cancer presence. EIT is also a low-cost imaging solution and does not involve ionizing radiation. In breast EIT, impedance measurements are made using electrodes placed on the surface of the patient's breast. The complex conductivity of the volume of the breast is estimated by a reconstruction algorithm. EIT reconstruction is a severely ill-posed inverse problem. As a result, noisy instrumentation and incorrect modelling of the electrodes and domain shape produce significant image artefacts. In this paper, we propose a method that has the potential to reduce these errors by accurately modelling the patient breast shape. A 3D hand-held optical scanner is used to acquire the breast geometry and electrode positions. We develop methods for processing the data from the scanner and producing volume meshes accurately matching the breast surface and electrode locations, which can be used for image reconstruction. We demonstrate this method for a plaster breast phantom and a human subject. Using this approach will allow patient-specific finite-element meshes to be generated which has the potential to improve the clinical value of EIT for breast cancer diagnosis.

An octahedral shear strain-based measure of SNR for 3D MR elastography

A signal-to-noise ratio (SNR) measure based on the octahedral shear strain (the maximum shear strain in any plane for a 3D state of strain) is presented for magnetic resonance elastography (MRE), where motion-based SNR measures are commonly used. The shear strain, γ, is directly related to the shear modulus, μ, through the definition of shear stress, τ = μγ. Therefore, noise in the strain is the important factor in determining the quality of motion data, rather than the noise in the motion. Motion and strain SNR measures were found to be correlated for MRE of gelatin phantoms and the human breast. Analysis of the stiffness distributions of phantoms reconstructed from the measured motion data revealed a threshold for both strain and motion SNR where MRE stiffness estimates match independent mechanical testing. MRE of the feline brain showed significantly less correlation between the two SNR measures. The strain SNR measure had a threshold above which the reconstructed stiffness values were consistent between cases, whereas the motion SNR measure did not provide a useful threshold, primarily due to rigid body motion effects.

Effects of frequency- and direction-dependent elastic materials on linearly elastic MRE image reconstructions

The mechanical model commonly used in magnetic resonance elastography (MRE) is linear elasticity. However, soft tissue may exhibit frequency- and direction-dependent (FDD) shear moduli in response to an induced excitation causing a purely linear elastic model to provide an inaccurate image reconstruction of its mechanical properties. The goal of this study was to characterize the effects of reconstructing FDD data using a linear elastic inversion (LEI) algorithm. Linear and FDD phantoms were manufactured and LEI images were obtained from time-harmonic MRE acquisitions with variations in frequency and driving signal amplitude. LEI responses to artificially imposed uniform phase shifts in the displacement data from both purely linear elastic and FDD phantoms were also evaluated. Of the variety of FDD phantoms considered, LEI appeared to tolerate viscoelastic data-model mismatch better than deviations caused by poroelastic and anisotropic mechanical properties in terms of visual image contrast. However, the estimated shear modulus values were substantially incorrect relative to independent mechanical measurements even in the successful viscoelastic cases and the variations in mean values with changes in experimental conditions associated with uniform phase shifts, driving signal frequency and amplitude were unpredictable. Overall, use of LEI to reconstruct data acquired in phantoms with FDD material properties provided biased results under the best conditions and significant artifacts in the worst cases. These findings suggest that the success with which LEI is applied to MRE data in tissue will depend on the underlying mechanical characteristics of the tissues and/or organs systems of clinical interest.

Time-harmonic magnetic resonance elastography of the normal feline brain

Imaging of the mechanical properties of in vivo brain tissue could eventually lead to non-invasive diagnosis of hydrocephalus, Alzheimer's disease and other pathologies known to alter the intracranial environment. The purpose of this work is to (1) use time-harmonic magnetic resonance elastography (MRE) to estimate the mechanical property distribution of cerebral tissue in the normal feline brain and (2) compare the recovered properties of grey and white matter. Various in vivo and ex vivo brain tissue property measurement strategies have led to the highly variable results that have been reported in the literature. MR elastography is an imaging technique that can estimate mechanical properties of tissue non-invasively and in vivo. Data was acquired in 14 felines and elastic parameters were estimated using a globo-regional nonlinear image reconstruction algorithm. Results fell within the range of values reported in the literature and showed a mean shear modulus across the subject group of 7-8 kPa with all but one animal falling within 5-15 kPa. White matter was statistically stiffer (p<0.01) than grey matter by about 1 kPa on a per subject basis. To the best of our knowledge, the results reported represent the most extensive set of estimates in the in vivo brain which have been based on MRE acquisition of the three-dimensional displacement field coupled to volumetric shear modulus image reconstruction achieved through nonlinear parameter estimation. However, the inter-subject variation in mean shear modulus indicates the need for further study, including the possibility of applying more advanced models to estimate the relevant tissue mechanical properties from the data.

Electrical impedance tomography reconstruction for three-dimensional imaging of the prostate

Transrectal electrical impedance tomography (TREIT) has been proposed as an adjunct modality for enhancing standard clinical ultrasound (US) imaging of the prostate. The proposed TREIT probe has an array of electrodes adhered to the surface of a cylindrical US probe that is introduced inside of the imaging volume. Reconstructing TREIT images in the open-domain geometry established with this technique poses additional challenges to those encountered with closed-domain geometries, present in more conventional EIT systems, because of the rapidly decaying current densities at increasing distances from the probe surface. We developed a finite element method (FEM)-based dual-mesh reconstruction algorithm which employs an interpolation scheme for linking a fine forward mesh with a coarse grid of pixels, used for conductivity estimation. Simulation studies using the developed algorithm demonstrate the feasibility of imaging moderately contrasting inclusions at distances of three times the probe radius from the probe surface and at multiple angles about the probe's axis. The large, dense FEM meshes used here require significant computational effort. We have optimized our reconstruction algorithm with multi-core processing hardware and efficient parallelized computational software packages to achieve a speedup of 9.3 times when compared to a more traditional Matlab-based, single CPU solution. The simulation findings and computational optimization provide a state-of-the-art reconstruction platform for use in further evaluating transrectal electrical impedance tomography.

Monitoring of hemodynamic changes induced in the healthy breast through inspired gas stimuli with MR-guided diffuse optical imaging

PURPOSE

The modulation of tissue hemodynamics has important clinical value in medicine for both tumor diagnosis and therapy. As an oncological tool, increasing tissue oxygenation via modulation of inspired gas has been proposed as a method to improve cancer therapy and determine radiation sensitivity. As a radiological tool, inducing changes in tissue total hemoglobin may provide a means to detect and characterize malignant tumors by providing information about tissue vascular function. The ability to change and measure tissue hemoglobin and oxygenation concentrations in the healthy breast during administration of three different types of modulated gas stimuli (oxygen/ carbogen, air/carbogen, and air/oxygen) was investigated.

METHODS

Subjects breathed combinations of gases which were modulated in time. MR-guided diffuse optical tomography measured total hemoglobin and oxygen saturation in the breast every 30 s during the 16 min breathing stimulus. Metrics of maximum correlation and phase lag were calculated by cross correlating the measured hemodynamics with the stimulus. These results were compared to an air/air control to determine the hemodynamic changes compared to the baseline physiology.

RESULTS

This study demonstrated that a gas stimulus consisting of alternating oxygen/carbogen induced the largest and most robust hemodynamic response in healthy breast parenchyma relative to the changes that occurred during the breathing of room air. This stimulus caused increases in total hemoglobin and oxygen saturation during the carbogen phase of gas inhalation, and decreases during the oxygen phase. These findings are consistent with the theory that oxygen acts as a vasoconstrictor, while carbogen acts as a vasodilator. However, difficulties in inducing a consistent change in tissue hemoglobin and oxygenation were observed because of variability in intersubject physiology, especially during the air/oxygen or air/carbogen modulated breathing protocols.

CONCLUSIONS

MR-guided diffuse optical imaging is a unique tool that can measure tissue hemodynamics in the breast during modulated breathing. This technique may have utility in determining the therapeutic potential of pretreatment tissue oxygenation or in investigating vascular function. Future gas modulation studies in the breast should use a combination of oxygen and carbogen as the functional stimulus. Additionally, control measures of subject physiology during air breathing are critical for robust measurements.

Sensitivity study and optimization of a 3D electric impedance tomography prostate probe

In current clinical practice, the primary diagnostic method for testing for prostate cancer is ultrasound-guided biopsy. In this paper, we consider using a sonolucent array of electrodes, printed on a thin Kapton layer and positioned on the imaging window of a transrectal ultrasound probe, as a method for providing coregistered electrical and ultrasound imaging of the prostate. As the electrical properties of malignant tissues have been shown to differ significantly from benign tissues, the estimation of the electrical properties is expected to be helpful in distinguishing certain beginning pathologies from cancer and in improving the detection rate that current biopsy methods provide. One of the main difficulties in estimating electrical properties of tissues with this electrode configuration is the rapid decay of the sensitivity with distance from the sensing array. In order to partially overcome this difficulty, we propose to use prior information from the ultrasound (US). Specifically we intend to delineate the boundaries of the prostate from the US, to subdivide the organ into a small number of voxels and to estimate the conductivity as constant on each of these subvolumes. We use a 3D forward model based on the finite element method for studying the sensitivity of a simulated segmented prostate for three different electrode array designs. The three designs present different electrode areas and inter-electrode gaps. Larger electrodes are desirable as they present a better contact, but we show that as they result in smaller inter-electrode gaps, shunting currents can be significant and the sensitivity is reduced. Because our clinical measurement system employs a single current source, we consider tetrapolar measurement patterns for evaluating these electrode configurations. Optimal measurement patterns are well defined for adaptive systems, where multiple currents are injected at the same time. For the electrode array designs we consider, which are three dimensional, there are no established systematic methods for forming sets of linearly independent tetrapolar measurement patterns. We develop a novel method for automatically computing a full set of independent tetrapolar measurement patterns that maximizes the sensitivity in a region of interest (ROI). We use these patterns in the forward modeling and sensitivity studies. In addition to the electrode arrays on the probe, we study the use of a further configuration, where a distal electrode is positioned on the exterior of the body and used for current injection.

Imaging forearm blood flow with pulse-ox gated electrical impedance tomography

Assessing peripheral vasculature health has the potential to impact clinical decision making in terms of treating patients with cardiovascular disease. The electrical conductivity of certain tissue regions within the forearm change as blood vessels undergo pulsatile dilation in synchrony with the beating of the heart. We use dynamic electrical impedance tomography (EIT) gated to the peak of a pulse oxymetry plethysmography waveform to image this temporally varying spatial conductivity. A phantom imaging experiment is presented showing that small conductivity changes of less than 1 mm are detectable using the developed dynamic EIT system. This system is used to image a volunteer's forearm during resting cardiovascular activity. Similar structures are observed in the plethysmography trace and the temporally varying conductivity. Spectral analysis shows that the maximum amplitude is occurring at frequencies of 1.19 Hz and 1.21 Hz for the plethysmography trace and conductivity trace, respectively. This preliminary data suggests that EIT may be sensitive enough to visualize cardiac-based pulsatility in the peripheral vessels of the forearm.

Comparison of fibroglandular tissue distributions for microwave tomographic breast images with complementary MR T2 weighted images

We have recently demonstrated good correlation between the recovered permittivity from microwave imaging (MIS) and the recovered water content from near infrared imaging (NIR) for a common set of normal patients undergoing associated breast examinations. We have subsequently conducted a small sample of comparison breast examinations between microwave imaging and MR to assess possible correlation between the location and extent of the fibroglandular as seen on MR images with increased permittivity zones of the microwave images. From various physiological and MR breast studies, it has been shown that the fibroglandular regions are generally comprised of significantly higher levels of water than the more dominant adipose tissue. The initial results of this study are quite encouraging and demonstrate obvious correlations between the permittivity and MR-recovered fibroglandular regions for a set of patients with widely varying tissue type variations. In addition, they illustrate the value of extracting diagnostic information from multiple modalities especially where the amount of direct in vivo property measurements is limited or nonexistent.

Microwave thermal imaging: initial in vivo experience with a single heating zone

The deployment of hyperthermia as a routine adjuvant to radiation or chemotherapy is limited largely by the inability to devise treatment plans which can be monitored through temperature distribution feedback during therapy. A non-invasive microwave tomographic thermal imaging system is currently being developed which has previously exhibited excellent correlation between the recovered electrical conductivity of a heated zone and its actual temperature change during phantom studies. To extend the validation of this approach in vivo, the imaging system has been re-configured for small animal experiments to operate within the bore of a CT scanner for anatomical and thermometry registration. A series of 5-7 day old pigs have been imaged during hyperthermia with a monopole antenna array submerged in a saline tank where a small plastic tube surgically inserted the length of the abdomen has been used to create a zone of heated saline at pre-selected temperatures. Tomographic microwave data over the frequency range of 300-1000 MHz of the pig abdomen in the plane perpendicular to the torso is collected at regular intervals after the tube saline temperatures have settled to the desired settings. Images are reconstructed over a range of operating frequencies. The tube location is clearly visible and the recovered saline conductivity varies linearly with the controlled temperature values. Difference images utilizing the baseline state prior to heating reinforces the linear relationship between temperature and imaged saline conductivity. Demonstration of in vivo temperature recovery and correlation with an independent monitoring device is an important milestone prior to clinical integration of this non-invasive imaging system with a thermal therapy device.

Image accuracy improvements in microwave tomographic thermometry: phantom experience

Evaluation of a laboratory-scale microwave imaging system for non-invasive temperature monitoring has previously been reported with good results in terms of both spatial and temperature resolution. However, a new formulation of the reconstruction algorithm in terms of the log-magnitude and phase of the electric fields has dramatically improved the ability of the system to track the temperature-dependent electrical conductivity distribution. This algorithmic enhancement was originally implemented as a way of improving overall imaging capability in cases of large, high contrast permittivity scatterers, but has also proved to be sensitive to subtle conductivity changes as required in thermal imaging. Additional refinements in the regularization procedure have strengthened the reliability and robustness of image convergence. Imaging experiments were performed for a single heated target consisting of a 5.1 cm diameter PVC tube located within 15 and 25 cm diameter monopole antenna arrays, respectively. The performance of both log-magnitude/phase and complex-valued reconstructions when subjected to four different regularization schemes has been compared based on this experimental data. The results demonstrate a significant accuracy improvement (to 0.2 degrees C as compared with 1.6 degrees C for the previously published approach) in tracking thermal changes in phantoms where electrical properties vary linearly with temperature over a range relevant to hyperthermia cancer therapy.

A two-stage microwave image reconstruction procedure for improved internal feature extraction

We have developed a two-stage Gauss-Newton reconstruction process with an automatic procedure for determining the regularization parameter. The combination is utilized by our microwave imaging system and has facilitated recovery of quantitatively improved images. The first stage employs a Levenberg-Marquardt regularization along with a spatial filtering technique for a few iterations to produce an intermediate image. In effect, the first set of iterative image reconstruction steps synthesizes a priori information from the measurement data versus actually requiring physical prior information on the interrogated object. Because of the interaction of the Levenberg-Marquardt regularization and spatial filtering at each iteration, the intermediate image produced from the first reconstruction stage represents an improvement in terms of the least squared error over the initial uniform guess; however, it has not completely converged in a least squared sense. The second stage involves using this distribution as a priori information in an iteratively regularized Gauss-Newton reconstruction with a weighted Euclidean distance penalty term. The penalized term restricts the final image to a vicinity (determined by the scale of the weighting parameter) about the intermediate image while allowing more flexibility in extracting internal object structures. The second stage makes use of an empirical Bayesian/random effects model that enables an optimal determination of the weighting parameter of the penalized term. The new approach demonstrates quantifiably improved images in simulation, phantom and in vivo experiments with particularly striking improvements with respect to the recovery of heterogeneities internal to large, high contrast scatterers such as encountered when imaging the human breast in a water-coupled configuration.

Absorbance of opaque microstructures in optically diffuse media

In this study experimental measurements are used to determine that the observed absorbance of opaque microstructures in optically diffuse media correlates with the total surface area rather than the attenuation as calculated in a nonscattering environment. The data suggest that it may be possible to use remote measurements of optical diffuse transmission to quantify surface areas of microcapillaries that are highly absorbing or larger blood vessels that can have high intrinsic attenuation because of hematocrit alone. Results obtained in a transmission geometry are insensitive to the position of the microstructure along the line between source and detector, whereas those collected in a remission geometry are highly sensitive to the depth at which the structure is located. These types of measurement involving microscopic structures embedded in diffuse media have potential application in quantifying blood vessel surface areas that contain contrast agents or other microparticles within tissue.

Magnetic resonance elastography using 3D gradient echo measurements of steady-state motion

Magnetic resonance elastography (MRE) is an important new method used to measure the elasticity or stiffness of tissues in vivo. While there are many possible applications of MRE, breast cancer detection and classification is currently the most common. Several groups have been developing methods based on MR and ultrasound (US). MR or US is used to estimate the displacements produced by either quasi-static compression or dynamic vibration of the tissue. An important advantage of MRE is the possibility of measuring displacements accurately in all three directions. The central problem in most versions of MRE is recovering elasticity information from the measured displacements. In previous work, we have presented simulation results in two and three dimensions that were promising. In this article, accurate reconstructions of elasticity images from 3D, steady-state experimental data are reported. These results are significant because they demonstrate that the process is truly three-dimensional even for relatively simple geometries and phantoms. Further, they show that the integration of displacement data acquisition and elastic property reconstruction has been successfully achieved in the experimental setting. This process involves acquiring volumetric MR phase images with prescribed phase offsets between the induced mechanical motion and the motion-encoding gradients, converting this information into a corresponding 3D displacement field and estimating the concomitant 3D elastic property distribution through model-based image reconstruction. Fully 3D displacement fields and resulting elasticity images are presented for single and multiple inclusion gel phantoms.

Modeling of retraction and resection for intraoperative updating of images

OBJECTIVE

Intraoperative tissue deformation that occurs during the course of neurosurgical procedures may compromise patient-to-image registration, which is essential for image guidance. A new approach to account for brain shift, using computational methods driven by sparsely available operating room (OR) data, has been augmented with techniques for modeling tissue retraction and resection.

METHODS

Modeling strategies to arbitrarily place and move an intracranial retractor and to excise designated tissue volumes have been implemented within a computationally tractable framework. To illustrate these developments, a surgical case example, which uses OR data and the preoperative neuroanatomic image volume of the patient to generate a highly resolved, heterogeneous, finite-element model, is presented. Surgical procedures involving the retraction of tissue and the resection of a left frontoparietal tumor were simulated computationally, and the simulations were used to update the preoperative image volume to represent the dynamic OR environment.

RESULTS

Retraction and resection techniques are demonstrated to accurately reflect intraoperative events, thus providing an approach for near-real-time image-updating in the OR. Information regarding subsurface deformation and, in particular, changing tumor margins is presented. Some of the current limitations of the model, with respect to specific tissue mechanical responses, are highlighted.

CONCLUSION

The results presented demonstrate that complex surgical events such as tissue retraction and resection can be incorporated intraoperatively into the model-updating process for brain shift compensation in high-resolution preoperative images.

Initial studies of in vivo absorbing and scattering heterogeneity in near-infrared tomographic breast imaging

Simultaneously recovered absorption and scattering images that separate these optical property features within the female breast are demonstrated from frequency-domain measurements. A study of known absorbing and scattering objects is presented as a foundation for interpreting these in vivo images once the contrast space has been fully characterized. No measurable influence of absorbing-object contrast appears in the scattering images, whereas localized scattering contrast enhances the corresponding region within the absorption image by approximately 30% (e.g., a 2:1 scatterer also reconstructs as an approximately 1.3:1 absorber). Scattering and absorption images of a female volunteer with a 3.4-cm fibroadenoma show a clear 2:1 localized increase in absorption coefficient with little or no evidence of scattering enhancement in the lesion.

Three-dimensional subzone-based reconstruction algorithm for MR elastography

Accurate characterization of harmonic tissue motion for realistic tissue geometries and property distributions requires knowledge of the full three-dimensional displacement field because of the asymmetric nature of both the boundaries of the tissue domain and the location of internal mechanical heterogeneities. The implications of this for magnetic resonance elastography (MRE) are twofold. First, for MRE methods which require the measurement of a harmonic displacement field within the tissue region of interest, the presence of 3D motion effects reduces or eliminates the possibility that simpler, lower-dimensional motion field images will capture the true dynamics of the entire stimulated tissue. Second, MRE techniques that exploit model-based elastic property reconstruction methods will not be able to accurately match the observed displacements unless they are capable of accounting for 3D motion effects. These two factors are of key importance for MRE techniques based on linear elasticity models to reconstruct mechanical tissue property distributions in biological samples. This article demonstrates that 3D motion effects are present even in regular, symmetric phantom geometries and presents the development of a 3D reconstruction algorithm capable of discerning elastic property distributions in the presence of such effects. The algorithm allows for the accurate determination of tissue mechanical properties at resolutions equal to that of the MR displacement image in complex, asymmetric biological tissue geometries. Simulation studies in a realistic 3D breast geometry indicate that the process can accurately detect 1-cm diameter hard inclusions with 2.5x elasticity contrast to the surrounding tissue.

Microwave image reconstruction utilizing log-magnitude and unwrapped phase to improve high-contrast object recovery

Reconstructing images of large high-contrast objects with microwave methods has proved difficult. Successful images have generally been obtained by using a priori information to constrain the image reconstruction to recover the correct electromagnetic property distribution. In these situations, the measured electric field phases as a function of receiver position around the periphery of the imaging field-of-view vary rapidly often undergoing changes of greater than pi radians especially when the object contrast and illumination frequency increase. In this paper, we introduce a modified form of a Maxwell equation model-based image reconstruction algorithm which directly incorporates log-magnitude and phase of the measured electric field data. By doing so, measured phase variation can be unwrapped and distributed over more than one Rieman sheet in the complex plane. Simulation studies and microwave imaging experiments demonstrate that significant image quality enhancements occur with this approach for large high-contrast objects. Simple strategies for visualizing and unwrapping phase values as a function of the transmitter and receiver positions within our microwave imaging array are described. Metrics of the degree of phase variation expressed in terms of the amount and extent of phase wrapping are defined and found to be figures-of-merit which estimate when it is critical to deploy the new image reconstruction approach. In these cases, the new algorithm recovers high-quality images without resorting to the use of a priori information on object contrast and/or size as previously required.

Dartmouth's next generation EIS system: preliminary hardware considerations

Our previous system covered the frequency range of 0 to 1 MHz. In this new design we propose to cover the range from 0 to 10 MHz. The higher frequencies have forced us to reconsider several design decisions in view of both the physics of the problem and the performance of available electronic components. In this presentation we examine in detail the constraints faced by the designer, starting from wiring consideration to measurement techniques. We will also present the solutions we selected to overcome the limitations we discovered. The problems include phase detection, amplitude measurements, system organization and layout and finally system calibration.

Three-dimensional simulation of near-infrared diffusion in tissue: boundary condition and geometry analysis for finite-element image reconstruction

Imaging of tissue with near-infrared spectral tomography is emerging as a practicable method to map hemoglobin concentrations within tissue. However, the accurate recovery of images by using modeling methods requires a good match between experiments and the model prediction of light transport in tissue. We illustrate the potential for a match between (i) three-dimensional (3-D) frequency-domain diffusion theory, (ii) two-dimensional diffusion theory, (iii) Monte Carlo simulations, and (iv) experimental data from tissue-simulating phantoms. Robin-type boundary conditions are imposed in the 3-D model, which can be implemented with a scalar coupling coefficient relating the flux through the surface to the diffuse fluence rate at the same location. A comparison of 3-D mesh geometries for breast imaging indicates that relative measurements are sufficiently similar when calculated on either cylindrical or female breast shapes, suggesting that accurate reconstruction may be achieved with the simpler cylindrical mesh. Simulation studies directly assess the effects from objects extending out of the image plane, with results suggesting that spherically shaped objects reconstruct at lower contrast when their diameters are less than 15-20 mm. The algorithm presented here illustrates that a 3-D forward diffusion model can be used with circular tomographic measurements to reconstruct two-dimensional images of the interior absorption coefficient.

An improved data acquisition method for electrical impedance tomography

Isaacson, Cheney and Seager have demonstrated that simultaneously applying trigonometric patterns of current to a circular electrode array optimizes the sensitivity of EIT to inner structure. We have found that it is less desirable to measure voltage at an electrode that also applies a current due to variable contact impedance. In order to preserve the optimum sensitivity while minimizing the effect of electrode artefacts, we have devised an approach where we sequentially apply a current between each individual electrode and a separate, fixed ground while measuring voltages at all other electrodes for each consecutive current impulse. By adding weighted sums of both the applied currents and corresponding measured voltages from individual passes, we can synthesize trigonometric patterns of any spatial frequency. Since only one of the electrodes in any given acquired data set is used as a source, this approach significantly dilutes the effect of contact impedance on the resulting voltage measurements. We present simulated data showing the equivalency between the synthesized and actual trigonometric excitation patterns. In addition, we report experimental data, both in vitro and in vivo, that show improved results using this data acquisition technique.

Quantitative hemoglobin tomography with diffuse near-infrared spectroscopy: pilot results in the breast

The authors describe what is, to the best of their knowledge, the first quantitative hemoglobin concentration images of the female breast that were formed with model-based reconstruction of near-infrared intensity-modulated tomographic data. The results in 11 patients, including two with breast tumors with pathologic correlation, are summarized. Hemoglobin concentration appears to correlate with tumor vascularity without the need for exogenous contrast material and thereby has intrinsic diagnostic value.

Estimation of oxygen distribution in RIF-1 tumors by diffusion model-based interpretation of pimonidazole hypoxia and eppendorf measurements

Numerical simulations of oxygen diffusion from the capillaries in tumor tissue were used to predict the capillary oxygen supply within and near hypoxic regions of the RIF-1 tumor. A finite element method to simulate the oxygen distribution from a histology section is presented, along with a method to iteratively estimate capillary oxygen concentrations. Pathological structural data for these simulations came from sections of the tumor stained with hematoxylin and eosin and were used to define the capillary positions and shapes, while overlapping regions of low oxygen concentration were defined by the hypoxia marker pimonidazole. These simulations were used to calculate spatial maps of the oxygen concentration and were tested for their ability to reproduce Eppendorf pO(2) histograms from the same tumor line. This simulation study predicted that capillary oxygen concentrations ranged from zero to above 20 microM, with a dominant peak in the hypoxic regions showing 78% of capillaries with less than 1 microM oxygen concentration, compared to only 12% in the non-hypoxic regions. The results were not highly sensitive to the metabolic oxygen consumption rate, within the range of 2 to 16 microM/s. This numerical method for oxygen capillary simulation is readily adaptable to histology sections and provides a method to examine the heterogeneity of oxygen within the capillaries and throughout the tumor tissue section being examined.

Contrast-detail analysis for detection and characterization with near-infrared diffuse tomography

Near-infrared (NIR) diffuse tomography is emerging as a medical imaging modality for obtaining information related to tissue hemoglobin concentration and oxygen saturation and may be used for characterizing diseased tissues such as breast cancer. The optimal methodology for NIR image reconstruction remains an ongoing research problem with several new approaches being demonstrated in recent years. However, a comparison of reconstruction methods is problematic because tools for the objective assessment of image quality have yet to be clearly defined for this type of nonlinear reconstruction problem. Contrast-detail analysis has become an accepted assessment tool to quantify x-ray mammography image quality, and in this study it has been applied to a prototype NIR diffuse tomography system that is being evaluated for breast cancer characterization. The minimum detectable levels of contrast have been defined for different sizes of objects, and the minimum contrasts which can be accurately reconstructed have also been determined for the same object sizes. In general, objects 8 mm and larger in diameter can be accurately reconstructed and detected for most absorption contrasts which are observed in human tissues (i.e., greater than 1% contrast in absorption). Objects as small as 2 mm can be detected with high contrast (i.e., near 100%), but cannot be accurately reconstructed. Within the size range of 2 mm to 8 mm, there is an inverse correlation between contrast and detail size which is characteristic of the total noise in the system. This analysis provides an objective method for assessing detection and characterization limits and can be applied to future improvements in hardware system architecture as well as reconstruction algorithms.

Coregistered ultrasound as a neurosurgical guide

INTRODUCTION

The dynamic nature and three dimensionality of ultrasound data can be utilized to enhance the capabilities of image guidance systems.

METHODS

Coregistration of ultrasound data was done using an electromagnetic digitizer, and subsequent ultrasound images were correlated with preoperative MRI studies. Thirty-two patients undergoing craniotomy were investigated in this manner.

RESULTS

Phantom testing done with a rigid stylus and 3D ultrasound tracker demonstrated an accuracy of 1.36 +/- 1.67 mm in determining the location of a point. Thirty-two clinical cases were coregistered without difficulty.

CONCLUSION

Coregistered ultrasound is a useful methodology that can aid in neuronavigation.

Updated neuroimaging using intraoperative brain modeling and sparse data

A strategy to update preoperative imaging for image-guided surgery using readily available intraoperative information has been developed and implemented. A patient-specific three-dimensional finite element model of the brain is generated from preoperative MRI and used to simulate deformation resulting from multiple surgical processes. Intraoperatively obtained sparse imaging data, such as from digital cameras or ultrasonography, is then used to prescribe the displacement of selected points within the model. Interpolation to the resolution of preoperative imaging may then be performed based upon the model. The algorithms for generation of the finite element model and for its subsequent deformation have been successfully validated using a pig brain model, and preliminary clinical application in the operating room has demonstrated feasibility.

In vivo modeling of interstitial pressure in the brain under surgical load using finite elements

Current brain deformation models have predominantly reflected solid constitutive relationships generated from empirical ex vivo data and have largely overlooked interstitial hydrodynamic effects. In the context of a technique to update images intraoperatively for image-guided neuronavigation, we have developed and quantified the deformation characteristics of a three-dimensional porous media finite element model of brain deformation in vivo. Results have demonstrated at least 75-85 percent predictive capability, but have also indicated that interstitial hydrodynamics are important. In this paper we investigate interstitial pressure transient behavior in brain tissue when subjected to an acute surgical load consistent with neurosurgical events. Data are presented from three in vivo porcine experiments where subsurface tissue deformation and interhemispheric pressure gradients were measured under conditions of an applied mechanical deformation and then compared to calculations with our three-dimensional brain model. Results demonstrate that porous-media consolidation captures the hydraulic behavior of brain tissue subjected to comparable surgical loads and that the experimental protocol causes minimal trauma to porcine brain tissue. Working values for hydraulic conductivity of white and gray matter are also reported and an assessment of transient pressure gradient effects with respect to deformation is provided.

Calibration of near-infrared frequency-domain tissue spectroscopy for absolute absorption coefficient quantitation in neonatal head-simulating phantoms

Frequency-domain tissue spectroscopy is a method to measure the absolute absorption coefficient of bulk tissues, assuming that a representative model can be found to recover the optical properties from measurements. While reliable methods exist to calculate absorption coefficients from source-detector measurements less than a few centimeters apart along a flat tissue volume, it is less obvious what methods can be used for transmittance through the larger tissue volumes typically associated with neonatal cerebral monitoring. In this study we compare the use of multiple distance frequency-domain measurements processed with (i) a modified Beer-Lambert law method, (ii) an analytic infinite-medium diffusion theory expression, and (iii) a numerical finite element solution of the diffusion equation, with the goal of recovering the absolute absorption coefficient of the medium. Based upon our observations, the modified Beer-Lambert method provides accurate absolute changes in the absorption coefficient, while analytic infinite-medium diffusion theory solutions or finite element-based numerical solutions can be used to calculate the absolute absorption coefficient, assuming that the data can be measured at multiple source-detector distances. We recommend that the infinite-medium multi-distance method or the finite element method be used across large tissue regions for calculation of the absolute absorption coefficient using frequency-domain near-infrared measurements at multiple positions along the head.

Electrical impedance imaging at multiple frequencies in phantoms

We have recently built and tested a 32 channel, multi-frequency (1 kHz to 1 MHz) voltage mode system to investigate electrical impedance spectroscopy (EIS) imaging. We completed a series of phantom experiments to define the baseline imaging performance of our system. Our phantom consisted of a plastic circular tank (20 cm diameter) filled with 0.9% aqueous NaCl solution. Conductors and nonconductors of decreasing width (W5: 3.4 cm, W4: 2.54 cm, W3: 0.95 cm, W2: 0.64 cm and WI: 0.32 cm) were positioned at various distances from the tank edge (1 cm, 2 cm, 4 cm and 8 cm). The results suggest that the detection of objects less than 1 cm in width is limited to the first 1 to 2 cm from the tank edge for absolute images, but this depth can extend to 8 cm in difference images. Larger 3.4 cm wide objects can be detected in absolute images at depths up to 8 cm from the tank edge. Generally, conductor images were clearer than their nonconductor counterparts. Not only did electrode artefacts lessen as the frequency increased, but the system's maximum resolution was attained at the highest operating frequencies. Although the system recovered the value of the electrical conductivity at the correct order of magnitude, it tended to smooth out large property discontinuities. The calculated electrical permittivity in these phantom studies was inconclusive due to the presence of electrode artefacts.

In vivo quantification of a homogeneous brain deformation model for updating preoperative images during surgery

Clinicians using image-guidance for neurosurgical procedures have recently recognized that intraoperative deformation from surgical loading can compromise the accuracy of patient registration in the operating room. While whole brain intraoperative imaging is conceptually appealing it presents significant practical limitations. Alternatively, a promising approach may be to combine incomplete intraoperatively acquired data with a computational model of brain deformation to update high resolution preoperative images during surgery. The success of such an approach is critically dependent on identifying a valid model of brain deformation physics. Towards this end, we evaluate a three-dimensional finite element consolidation theory model for predicting brain deformation in vivo through a series of controlled repeat-experiments. This database is used to construct an interstitial pressure boundary condition calibration curve which is prospectively tested in a fourth validation experiment. The computational model is found to recover 75%-85% of brain motion occurring under loads comparable to clinical conditions. Additionally, the updating of preoperative images using the model calculations is presented and demonstrates that model-updated image-guided neurosurgery may be a viable option for addressing registration errors related to intraoperative tissue motion.

Multifrequency electrical impedance imaging: preliminary in vivo experience in breast

We have deployed a recently completed spectroscopic electrical impedance tomography (EITS) imaging system in a small series of women (13 participants accrued to date) in order to investigate the feasibility of delivering EITS breast examinations on a routine basis. Hardware is driven with sinusoidally varying spatial patterns of applied voltage delivered to 16 electrodes over the 10 kHz to 1 MHz spectral range using a radially translating interface which couples the electrodes to the breast through direct contact. Imaging examinations have consisted of the acquisition of multi-channel measurements at ten frequencies on both breasts. Participants lie prone on an examination table with the breast to be imaged pendant in the electrode array that is located below the table. Examinations were comfortable and easy to deliver (about 10 minutes per breast including electrode-positioning time). Although localized near-surface electrode artefacts are evident in the acquired images, several findings have emerged. Permittivity images have generally been more informative than their conductivity counterparts, except in the case of fluid-filled cysts. Specifically, the mammographically normal breast appears to have characteristic absolute EITS permittivity and conductivity images that emerge across subjects. Structural features in the EITS images have correlated with limited clinical information available on participants with benign and malignant abnormality, cysts and scarring from previous lumpectomy and follow-up radiation therapy. Several cases from this preliminary experience are described.

A multichannel continuously selectable multifrequency electrical impedance spectroscopy measurement system

There is increasing evidence that alterations in the electrical property spectrum of tissues below 10 MHz is diagnostic for tissue pathology and/or pathophysiology. Yet, the complexity associated with constructing a high-fidelity multichannel, multifrequency data acquisition instrument has limited widespread development of spectroscopic electrical impedance imaging concepts. To contribute to the relatively sparse experience with multichannel spectroscopy systems this paper reports on the design, realization and evaluation of a prototype 32-channel instrument. The salient features of the system include a continuously selectable driving frequency up to 1 MHz, either voltage or current source modes of operation and simultaneous measurement of both voltage and current on each channel in either of these driving configurations. Comparisons of performance with recently reported fixed-frequency systems is favorable. Volts dc (VDC) signal-to-noise ratios of 75-80 dB are achieved and the noise floor for ac signals is near 100 dB below the signal strength of interest at 10 kHz and 60 dB down at 1 MHz. The added benefit of being able to record multispectral information on source and sense signal amplitudes and phases has also been realized. Phase-sensitive detection schemes and multiperiod undersampling techniques have been deployed to ensure measurement fidelity over the full bandwidth of system operation.

Elasticity reconstruction from experimental MR displacement data: initial experience with an overlapping subzone finite element inversion process

The determination of the elastic property distribution in heterogeneous gel samples with a finite element based reconstruction scheme is considered. The algorithm operates on small overlapping subzones of the total field to allow for a high degree of spatial discretization while maintaining computational tractability. By including a Maxwellian-type viscoelastic property in the model physics and optimizing the spatial distribution of this property in the same manner as elasticity, a Young's modulus image is obtained which reasonably reflects the true distribution within the gel. However, the image lacks the clarity and accuracy expected based on simulation experience. Preliminary investigations suggest that transient effects in the data are the cause of a significant mismatch between the inversion model, which assumes steady-state conditions, and the actual displacements as measured by a phase contrast MR technique.

Confidence maps and confidence intervals for near infrared images in breast cancer

This paper extends basic concepts of statistical hypothesis testing and confidence intervals to images generated by a new procedure for near infrared spectroscopic tomography being developed for use in breast cancer diagnosis. By estimating the covariance matrix of the pixels of an image from data used in the image reconstruction process, confidence maps for statistical tests on individual pixels and confidence intervals for entire images are displayed as an aid to research and clinical personnel interpreting possibly noisy images. The methods are applied to simulated and phantom-based images.

Intraoperatively updated neuroimaging using brain modeling and sparse data

OBJECTIVE

Image-guided neurosurgery incorporating preoperatively obtained imaging information is subject to spatial error resulting from intraoperative brain displacement and deformation. A strategy to update preoperative imaging using readily available intraoperative information has been developed and implemented.

METHODS

Preoperative magnetic resonance imaging is used to generate a patient-specific three-dimensional finite element model of the brain by which deformation resulting from multiple surgical processes may be simulated. Sparse imaging data obtained subsequently, such as from digital cameras or ultrasound, are then used to prescribe the displacement of selected points within the model. Based on the model, interpolation to the resolution of preoperative imaging may then be performed.

RESULTS

The algorithms for generation of the finite element model and for its subsequent deformation were successfully validated using a pig brain model. In these experiments, the method recovered 84% of the intraoperative shift resulting from surgically induced tissue motion. Preliminary clinical application in the operating room has demonstrated feasibility.

CONCLUSION

A strategy by which intraoperative brain deformation may be accounted for has been developed, validated in an animal model, and demonstrated clinically.

An overlapping subzone technique for MR-based elastic property reconstruction

A finite element-based nonlinear inversion scheme for magnetic resonance (MR) elastography is detailed. The algorithm operates on small overlapping subzones of the total region of interest, processed in a hierarchical order as determined by progressive error minimization. This zoned approach allows for a high degree of spatial discretization, taking advantage of the data-rich environment afforded by the MR. The inversion technique is tested in simulation under high-noise conditions (15% random noise applied to the displacement data) with both complicated user-defined stiffness distributions and realistic tissue geometries obtained by thresholding MR image slices. In both cases the process has proved successful and has been capable of discerning small inclusions near 4 mm in diameter. Magn Reson Med 42:779-786, 1999.

Model-updated image guidance: initial clinical experiences with gravity-induced brain deformation

Image-guided neurosurgery relies on accurate registration of the patient, the preoperative image series, and the surgical instruments in the same coordinate space. Recent clinical reports have documented the magnitude of gravity-induced brain deformation in the operating room and suggest these levels of tissue motion may compromise the integrity of such systems. We are investigating a model-based strategy which exploits the wealth of readily-available preoperative information in conjunction with intraoperatively acquired data to construct and drive a three dimensional (3-D) computational model which estimates volumetric displacements in order to update the neuronavigational image set. Using model calculations, the preoperative image database can be deformed to generate a more accurate representation of the surgical focus during an operation. In this paper, we present a preliminary study of four patients that experienced substantial brain deformation from gravity and correlate cortical shift measurements with model predictions. Additionally, we illustrate our image deforming algorithm and demonstrate that preoperative image resolution is maintained. Results over the four cases show that the brain shifted, on average, 5.7 mm in the direction of gravity and that model predictions could reduce this misregistration error to an average of 1.2 mm.

Spectroscopic diffuse optical tomography for the quantitative assessment of hemoglobin concentration and oxygen saturation in breast tissue

Near-infrared (NIR) spectroscopic diffuse tomography has been used to map the hemoglobin concentration and the hemoglobin oxygen saturation quantitatively in tissuelike phantoms and to determine average values in vivo. A series of phantom calibrations were performed to achieve quantitatively accurate images of the absorption and the reduced scattering coefficients at multiple optical wavelengths. A least-squares fit was applied to absorption-coefficient images at multiple NIR wavelengths to obtain hemoglobin images of the concentration and the hemoglobin oxygen saturation. Objects of varying hemoglobin concentration and oxygen saturation within highly scattering media were localized and imaged to within 15% of their actual values. The average hemoglobin concentration and oxygen saturation of breast tissue was measured in vivo for two women volunteers. The potential application for the diagnosis of breast tumors is discussed.

In vivo electrical impedance spectroscopic monitoring of the progression of radiation-induced tissue injury

This study evaluates the potential of electrical impedance spectroscopy (EIS) as a noninvasive technique for tracking the progression of radiation-induced damage in normal muscle tissue. Male Sprague-Dawley rats were irradiated locally to the gastrocnemius and biceps femoris muscle. Single doses were administered using a procedure that spares skin and bone. Complex impedance spectral measurements (taken at 50 frequency points between 1 kHz and 1 MHz) were made at monthly intervals using recessed disk electrodes applied to the skin. A histological scoring scheme was developed for evaluation of injury. A strong dose-dependent progression of injury evident in both spectral measurements and histological scoring has been observed. Latent time also appears to be dependent on dose with changes induced by 70 Gy evident by 2 months, changes induced by 90 Gy observed by 1 month, and dramatic changes found within 3 weeks at 150 Gy. Injury was morphologically comparable to the type of damage that occurs in response to small, fractionated doses, but on a much shorter time scale. Increased spectral shift was a consistent indicator of the extent of tissue injury at the time of measurement. The use of a large single dose resulted in an excellent model in terms of inducing a significant progression in tissue injury over a short post-treatment follow-up period in the muscle mass while also providing a consistent location for in vivo electrical impedance measurements. The results show that EIS can follow radiation-induced tissue change, suggesting that EIS has the potential to monitor the types of injury observed in late radiation damage of muscle tissue noninvasively.

Nonactive antenna compensation for fixed-array microwave imaging: Part II--Imaging results

Model-based imaging techniques utilizing microwave signal illumination rely heavily on the ability to accurately represent the wave propagation with a suitable numerical model. To date, the highest quality images from our prototype system have been achieved utilizing a single transmitter/single receiver measurement system where both antennas are manually repositioned to facilitate multiple illuminations of the imaging region, thus requiring long data acquisition times. In an effort to develop a system that can acquire data in a real time manner, a 32-channel network has been fabricated with all ports capable of being electronically selected for either transmit or receive mode. The presence of a complete array of antenna elements at data collection time perturbs the field distributions being measured, which can subsequently degrade the image reconstruction due to increased data-model mismatch. Incorporating the nonactive antenna-compensation model from Part I of this paper into our hybrid element near field image reconstruction algorithm is shown to restore image quality when fixed antenna-array data acquisition is used. Improvements are most dramatic for inclusions located in near proximity to the antenna array itself, although cases of improvement in the recovery of centered heterogeneities are also illustrated. Increases in the frequency of illumination are found to warrant an increased need for nonactive antenna compensation. Quantitative measures of recovered inclusion shape and position reveal a systematic improvement in image reconstruction quality when the nonactive antenna-compensation model is employed. Improvements in electrical property value recovery of localized heterogeneities are also observed. Image reconstructions in freshly excised breast tissue illustrate the applicability of the approach when used with our two-dimensional microwave imaging system.