Fiber-optic pulseoximeter for local oxygen saturation determination using a Monte Carlo multi-layer model for calibration

BACKGROUND AND OBJECTIVE Local tissue oxygenation determines the relationship between the supply and the demand for oxygen by the tissue and it is an important indicator of the physiological or pathological condition of the tissue. Moreover, some therapeutic methods strongly depend on the oxygen content of the tissue. In photodynamic therapy, when molecular oxygen is present, the irradiation of the photosensitizer with light triggers the generation of reactive oxygen species that kill the target diseased cells within the treated tissue. To ensure the best possible therapy response, the tissue must be well oxygenated; hence, oxygen concentration measurement becomes a decisive factor. In this work, the design, construction and calibration of a module to locally measure the blood oxygen saturation in tissue is presented. METHODS The system is built using a red (660-nm) and an infrared (940-nm) light emitting diodes as light sources, a photodiode as a detector, and a homemade handheld fiber optic-based reflectance pulse oximetry sensor. In addition, the developed sensor was modeled by means of multilayered Monte Carlo simulations, to study its behavior when used in different thickness and melanin content skin. RESULTS From the simulation reflectance values, the oxygen saturation calibration curves considering different melanin concentrations and skin thicknesses were obtained for two different skin models, one comprising three skin layers and the second, assuming seven different layers for the skin. A comparison of the performances of the developed pulse oximeter sensor with a commercial one is also presented. CONCLUSIONS A new pulseoximeter for the measurement of local oxygenation in tissue was developed. Its calibration strongly depends on the site of measurement due to the influence of tissue thickness, vascularization, and melanin content. A three-layer skin model is proved to be suitable for the calibration of the pulseoximeter in thin and medium thickness skin.

[1]  Gerald B. Kasting,et al.  Visualization of the lipid barrier and measurement of lipid pathlength in human stratum corneum , 2001, AAPS PharmSci.

[2]  Edik U Rafailov,et al.  Multimodal optical measurement for study of lower limb tissue viability in patients with diabetes mellitus. , 2017, Journal of biomedical optics.

[3]  Miroslav Stojanović,et al.  Diagnostic importance of pulse oximetry in the determination of the stage of chronic arterial insufficiency of lower extremities. , 2010, Srpski arhiv za celokupno lekarstvo.

[4]  Howard M Kimmel,et al.  The Presence of Oxygen in Wound Healing. , 2016, Wounds : a compendium of clinical research and practice.

[5]  M. Wukitsch,et al.  Pulse oximetry: Analysis of theory, technology, and practice , 1988, Journal of Clinical Monitoring.

[6]  Dmitry Yudovsky,et al.  Rapid and accurate estimation of blood saturation, melanin content, and epidermis thickness from spectral diffuse reflectance. , 2010, Applied optics.

[7]  Johannes Swartling,et al.  Online dosimetry for temoporfin-mediated interstitial photodynamic therapy using the canine prostate as model , 2016, Journal of biomedical optics.

[8]  Valery V. Tuchin,et al.  Monte Carlo study of skin optical clearing to enhance light penetration in the tissue: implications for photodynamic therapy of acne vulgaris , 2007, Advanced Laser Technologies.

[9]  Michele M. Kim,et al.  Explicit dosimetry for 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a-mediated photodynamic therapy: macroscopic singlet oxygen modeling , 2015, Journal of biomedical optics.

[10]  A. N. Bashkatov,et al.  Optical properties of human skin, subcutaneous and mucous tissues in the wavelength range from 400 to 2000 nm , 2005 .

[11]  D. Giavarina.  Understanding Bland Altman analysis , 2015, Biochemia medica.

[12]  S. J. Matcher,et al.  Computer simulation of the skin reflectance spectra , 2003, Comput. Methods Programs Biomed..

[13]  B. Wilson,et al.  The physics, biophysics and technology of photodynamic therapy , 2008, Physics in medicine and biology.

[14]  Igor V Meglinski,et al.  Influence of probe pressure on diffuse reflectance spectra of human skin measured in vivo. , 2017, Journal of biomedical optics.

[15]  S L Jacques,et al.  CONV--convolution for responses to a finite diameter photon beam incident on multi-layered tissues. , 1997, Computer methods and programs in biomedicine.

[16]  Jianlin Shi,et al.  Chemical Design and Synthesis of Functionalized Probes for Imaging and Treating Tumor Hypoxia. , 2017, Chemical reviews.

[17]  T. Gambichler,et al.  In vivo data of epidermal thickness evaluated by optical coherence tomography: effects of age, gender, skin type, and anatomic site. , 2006, Journal of dermatological science.

[18]  Jane Ward,et al.  Oxygen delivery and demand , 2006 .

[19]  Vladislav V. Yakovlev,et al.  Human tissue color as viewed in high dynamic range optical spectral transmission measurements , 2012, Biomedical optics express.

[20]  J B Harness,et al.  Skin photoplethysmography--a review. , 1989, Computer methods and programs in biomedicine.

[21]  I. Amelio,et al.  The hypoxic tumour microenvironment , 2018, Oncogenesis.

[22]  J. L. Reuss,et al.  The pulse in reflectance pulse oximetry: Modeling and experimental studies , 2004, Journal of Clinical Monitoring and Computing.

[23]  Valery V. Tuchin,et al.  OPTICAL PROPERTIES OF SKIN, SUBCUTANEOUS, AND MUSCLE TISSUES: A REVIEW , 2011 .

[24]  Stefan Andersson-Engels,et al.  Clinical system for interstitial photodynamic therapy with combined on-line dosimetry measurements. , 2005, Applied optics.

[25]  Luke Howard,et al.  Key Points Educational Aims , 2022 .

[26]  C. Schaller,et al.  Distributions of local oxygen saturation and its response to changes of mean arterial blood pressure in the cerebral cortex adjacent to arteriovenous malformations. , 1999, Stroke.

[27]  Saeed Setayeshi,et al.  Modeling of diffuse reflectance of light in heterogeneous biological tissue to analysis of the effects of multiple scattering on reflectance pulse oximetry , 2017, Journal of biomedical optics.

[28]  Michelle Hickey,et al.  Investigation of photoplethysmographic signals and blood oxygen saturation values obtained from human splanchnic organs using a fiber optic sensor , 2011, Journal of Clinical Monitoring and Computing.

[29]  Panayiotis A. Kyriacou,et al.  Investigation of photoplethysmographic signals and blood oxygen saturation values on healthy volunteers during cuff-induced hypoperfusion using a multimode PPG/SpO2 sensor , 2012, Medical & Biological Engineering & Computing.

[30]  I. Meglinski,et al.  Assessment of the calibration curve for transmittance pulse-oximetry , 2011 .

[31]  Panayiotis A. Kyriacou,et al.  A new fibre optic pulse oximeter probe for monitoring splanchnic organ arterial blood oxygen saturation , 2012, Comput. Methods Programs Biomed..

[32]  Igor Kozlov,et al.  The influence of local pressure on evaluation parameters of skin blood perfusion and fluorescence , 2017, Saratov Fall Meeting.

[33]  Valerii V. Shupletsov,et al.  Optical probe pressure effects on cutaneous blood flow. , 2018, Clinical hemorheology and microcirculation.

[34]  H. Mcintosh,et al.  Pulse oximetry index: a simple arterial assessment for patients with venous disease. , 2008, Journal of wound care.

[35]  Tom Lister,et al.  Optical properties of human skin , 2012, Journal of biomedical optics.

[36]  M. Rollins,et al.  Accuracy of Carboxyhemoglobin Detection by Pulse CO-Oximetry During Hypoxemia , 2013, Anesthesia and analgesia.

[37]  Dean E. Myers,et al.  Noninvasive method for measuring local hemoglobin oxygen saturation in tissue using wide gap second derivative near-infrared spectroscopy. , 2005, Journal of biomedical optics.

[38]  L. Lilge,et al.  Implicit and explicit dosimetry in photodynamic therapy: a New paradigm , 1997, Lasers in Medical Science.

[39]  S. Barker,et al.  Measurement of Carboxyhemoglobin and Methemoglobin by Pulse Oximetry: A Human Volunteer Study , 2006, Anesthesiology.

[40]  A. Hasan.  The Non-Invasive Monitoring of Blood Oxygen and Carbon Dioxide Levels , 2013 .

[41]  L Wang,et al.  MCML--Monte Carlo modeling of light transport in multi-layered tissues. , 1995, Computer methods and programs in biomedicine.

[42]  H. Wulf,et al.  Epidermal thickness at different body sites: relationship to age, gender, pigmentation, blood content, skin type and smoking habits. , 2003, Acta dermato-venereologica.

[43]  C. Kieda,et al.  Why is the partial oxygen pressure of human tissues a crucial parameter? Small molecules and hypoxia , 2011, Journal of cellular and molecular medicine.

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

[45]  Shuliang Jiao,et al.  Accuracy of retinal oximetry: a Monte Carlo investigation , 2013, Journal of biomedical optics.