Preclinical and clinical validation of a novel oxygenation imaging system

Introduction: Two major disadvantages of currently available oxygenation probes are the need for contact with the skin and long measurement stabilization times. A novel oxygenation imaging device based on spatial frequency domain and spectral principles has been designed, validated preclinically on pigs, and validated clinically on humans. Importantly, this imaging system has been designed to operate under the rigorous conditions of an operating room. Materials and Methods: Optical properties reconstruction and wavelength selection have been optimized to allow fast and reliable oxyhemoglobin and deoxyhemoglobin imaging under realistic conditions. In vivo preclinical validation against commercially available contact oxygenation probes was performed on pigs undergoing arterial and venous occlusions. Finally, the device was used clinically to image skin flap oxygenation during a pilot study on women undergoing breast reconstruction after mastectomy. Results: A novel illumination head containing a spatial light modulator (SLM) and a novel fiber-coupled high power light source were constructed. Preclinical experiments showed similar values between local probes and the oxygenation imaging system, with measurement times of the new system being < 500 msec. During pilot clinical studies, the imaging system was able to provide near real-time oxyHb, deoxyHb, and saturation measurements over large fields of view (> 300 cm2). Conclusion: A novel optical-based oxygenation imaging system has the potential to replace contact probes during human surgery and to provide quantitative, wide-field measurements in near real-time.

[1]  B. Wilson,et al.  A diffusion theory model of spatially resolved, steady-state diffuse reflectance for the noninvasive determination of tissue optical properties in vivo. , 1992, Medical physics.

[2]  David Abookasis,et al.  Imaging cortical absorption, scattering, and hemodynamic response during ischemic stroke using spatially modulated near-infrared illumination. , 2009, Journal of biomedical optics.

[3]  Y. Mendelson Pulse oximetry: theory and applications for noninvasive monitoring. , 1992, Clinical chemistry.

[4]  G. Wagnières,et al.  Determination of tissue optical properties by steady-state spatial frequency-domain reflectometry , 1998, Lasers in Medical Science.

[5]  L. Ngo,et al.  The FLARE™ Intraoperative Near-Infrared Fluorescence Imaging System: A First-in-Human Clinical Trial in Breast Cancer Sentinel Lymph Node Mapping , 2009, Annals of Surgical Oncology.

[6]  J. Severinghaus,et al.  History and recent developments in pulse oximetry. , 1993, Scandinavian journal of clinical and laboratory investigation. Supplementum.

[7]  Anthony J. Durkin,et al.  Modulated imaging: quantitative analysis and tomography of turbid media in the spatial-frequency domain. , 2005, Optics letters.

[8]  Rinaldo Cubeddu,et al.  Detection of inhomogeneities in diffusive media using spatially modulated light. , 2009, Optics letters.

[9]  Anthony J. Durkin,et al.  Quantitation and mapping of tissue optical properties using modulated imaging. , 2009, Journal of biomedical optics.

[10]  Sylvain Gioux,et al.  Wavelength optimization for rapid chromophore mapping using spatial frequency domain imaging. , 2010, Journal of biomedical optics.

[11]  R. Doornbos,et al.  The determination of in vivo human tissue optical properties and absolute chromophore concentrations using spatially resolved steady-state diffuse reflectance spectroscopy. , 1999, Physics in medicine and biology.

[12]  E R Anderson,et al.  Frequency-domain photon migration measurements of normal and malignant tissue optical properties in a human subject. , 1997, Applied optics.

[13]  Sylvain Gioux,et al.  Structured illumination enhances resolution and contrast in thick tissue fluorescence imaging. , 2010, Journal of biomedical optics.

[14]  Xavier Intes,et al.  Real-time diffuse optical tomography based on structured illumination. , 2010, Journal of biomedical optics.

[15]  Andrea Bassi,et al.  Fast 3D optical reconstruction in turbid media using spatially modulated light , 2010, Biomedical optics express.

[16]  L. Svaasand,et al.  Non-invasive in vivo characterization of breast tumors using photon migration spectroscopy. , 2000, Neoplasia.

[17]  F. Jöbsis Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. , 1977, Science.

[18]  Anthony J. Durkin,et al.  Spatial shift of spatially modulated light projected on turbid media. , 2008, Journal of the Optical Society of America. A, Optics, image science, and vision.

[19]  Anthony J. Durkin,et al.  Quantitative optical tomography of sub-surface heterogeneities using spatially modulated structured light. , 2009, Optics express.

[20]  Sylvain Gioux,et al.  Three-dimensional surface profile intensity correction for spatially modulated imaging. , 2009, Journal of biomedical optics.

[21]  Alex Keller,et al.  A New Diagnostic Algorithm for Early Prediction of Vascular Compromise in 208 Microsurgical Flaps Using Tissue Oxygen Saturation Measurements , 2009, Annals of plastic surgery.

[22]  Anthony J. Durkin,et al.  Lookup-table method for imaging optical properties with structured illumination beyond the diffusion theory regime. , 2010, Journal of biomedical optics.

[23]  Alex Keller,et al.  Noninvasive tissue oximetry for flap monitoring: an initial study. , 2007, Journal of reconstructive microsurgery.

[24]  Sylvain Gioux,et al.  High-Power, Computer-Controlled, Light-Emitting Diode–Based Light Sources for Fluorescence Imaging and Image-Guided Surgery , 2009, Molecular imaging.