Noninvasive diffuse optical measurement of blood flow and blood oxygenation for monitoring radiation therapy in patients with head and neck tumors: a pilot study.

This pilot study explores the potential of noninvasive diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) for monitoring early relative blood flow (rBF), tissue oxygen saturation (StO(2)), and total hemoglobin concentration (THC) responses to chemo-radiation therapy in patients with head and neck tumors. rBF, StO(2), and THC in superficial neck tumor nodes of eight patients are measured before and during the chemo-radiation therapy period. The weekly rBF, StO(2), and THC kinetics exhibit different patterns for different individuals, including significant early blood flow changes during the first two weeks. Averaged blood flow increases (52.7+/-9.7)% in the first week and decreases (42.4+/-7.0)% in the second week. Averaged StO(2) increases from (62.9+/-3.4)% baseline value to (70.4+/-3.2)% at the end of the second week, and averaged THC exhibits a continuous decrease from pretreatment value of (80.7+/-7.0) [microM] to (73.3+/-8.3) [microM] at the end of the second week and to (63.0+/-8.1) [microM] at the end of the fourth week of therapy. These preliminary results suggest daily diffuse-optics-based therapy monitoring is feasible during the first two weeks and may have clinical promise.

[1]  B. Chance,et al.  Spectroscopy and Imaging with Diffusing Light , 1995 .

[2]  M. Patterson,et al.  Improved solutions of the steady-state and the time-resolved diffusion equations for reflectance from a semi-infinite turbid medium. , 1997, Journal of the Optical Society of America. A, Optics, image science, and vision.

[3]  Tove Grönroos,et al.  Imaging perfusion and hypoxia with PET to predict radiotherapy response in head-and-neck cancer. , 2004, International Journal of Radiation Oncology, Biology, Physics.

[4]  Hanli Liu,et al.  Low-cost frequency-domain photon migration instrument for tissue spectroscopy, oximetry, and imaging , 1997 .

[5]  Albert Einstein,et al.  On the Motion of Small Particles Suspended in Liquids at Rest Required by the Molecular-Kinetic Theory of Heat ∗ , 2004 .

[6]  M. Huang,et al.  Utilizing optical tomography with ultrasound localization to image heterogeneous hemoglobin distribution in large breast cancers. , 2005, Neoplasia.

[7]  T. Foster,et al.  Oxygen consumption and diffusion effects in photodynamic therapy. , 1991, Radiation research.

[8]  G. Soelkner,et al.  Experimental and theoretical laser-Doppler frequency spectra of a tissuelike model of a human head with capillaries. , 1999, Applied optics.

[9]  Bruce J Tromberg,et al.  Combined diffuse optical spectroscopy and contrast-enhanced magnetic resonance imaging for monitoring breast cancer neoadjuvant chemotherapy: a case study. , 2005, Journal of biomedical optics.

[10]  D. Delpy,et al.  Absorption and scattering coefficient dependence of laser-Doppler flowmetry models for large tissue volumes , 2006, Physics in medicine and biology.

[11]  J. Shah,et al.  TNM Staging of Cancers of the Head and Neck: Striving for Uniformity Among Diversity , 2005, CA: a cancer journal for clinicians.

[12]  Turgut Durduran,et al.  Noninvasive measurements of tissue hemodynamics with hybrid diffuse optical methods , 2004 .

[13]  D. Voehringer,et al.  Biochemical modulation of radiation-induced apoptosis in murine lymphoma cells. , 1993, Radiation research.

[14]  N. Hayashi,et al.  Assessment of radiotherapeutic effect on brain tumors by dynamic susceptibility contrast MR imaging: a preliminary report. , 1999, Radiation medicine.

[15]  T L Phillips,et al.  Oxygen in human tumors: correlations between methods of measurement and response to therapy. Summary of a workshop held November 19-20, 1992, at the National Cancer Institute, Bethesda, Maryland. , 1993, Radiation research.

[16]  Arjun G. Yodh,et al.  Noninvasive Monitoring of Murine Tumor Blood Flow During and After Photodynamic Therapy Provides Early Assessment of Therapeutic Efficacy , 2005, Clinical Cancer Research.

[17]  E. Kochs,et al.  Tumor oxygenation in a transplanted rat rhabdomyosarcoma during fractionated irradiation. , 1995, International journal of radiation oncology, biology, physics.

[18]  D. Boas,et al.  Spatially varying dynamical properties of turbid media probed with diffusing temporal light correlation , 1997 .

[19]  Ricky T. Tong,et al.  Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer , 2004, Nature Medicine.

[20]  J. Webster,et al.  Changes in tumor oxygen tension during radiation therapy. , 1969, Acta radiologica: therapy, physics, biology.

[21]  Seth M Steinberg,et al.  A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. , 2003, The New England journal of medicine.

[22]  K. T. Moesta,et al.  Time-domain scanning optical mammography: II. Optical properties and tissue parameters of 87 carcinomas , 2005, Physics in medicine and biology.

[23]  T. Powles,et al.  Reduction in angiogenesis after neoadjuvant chemoendocrine therapy in patients with operable breast carcinoma , 1999, Cancer.

[24]  A. Yodh,et al.  Diffuse optical correlation tomography of cerebral blood flow during cortical spreading depression in rat brain. , 2006, Optics express.

[25]  H Lyng,et al.  Changes in oxygen tension during radiotherapy of head and neck tumours. , 1999, Acta oncologica.

[26]  R. Pecora.  Dynamic Light Scattering , 1985 .

[27]  B. Tromberg,et al.  Monitoring neoadjuvant chemotherapy in breast cancer using quantitative diffuse optical spectroscopy: a case study. , 2004, Journal of biomedical optics.

[28]  P. Okunieff,et al.  Blood flow, oxygen and nutrient supply, and metabolic microenvironment of human tumors: a review. , 1989, Cancer research.

[29]  M. Dewhirst,et al.  Tumor hypoxia adversely affects the prognosis of carcinoma of the head and neck. , 1997, International journal of radiation oncology, biology, physics.

[30]  R. Bahado-Singh,et al.  Effects of external radiotherapy on uterine blood flow in patients with advanced cervical carcinoma assessed by Color Doppler ultrasonography , 1995, Cancer.

[31]  Roger Maynard,et al.  Imaging of dynamic heterogeneities in multiple-scattering media , 1997 .

[32]  T. Feyerabend,et al.  Tumor oxygenation after radiotherapy, chemotherapy, and/or hyperthermia predicts tumor free survival. , 2001, International journal of radiation oncology, biology, physics.

[33]  David M Jablons,et al.  Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[34]  A. Yodh,et al.  Diffuse Optical Tomography of Cerebral Blood Flow, Oxygenation, and Metabolism in Rat during Focal Ischemia , 2003, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[35]  Jürgen Griebel,et al.  Tumor microcirculation and diffusion predict therapy outcome for primary rectal carcinoma. , 2003, International journal of radiation oncology, biology, physics.

[36]  A. Einstein.  Über die von der molekularkinetischen Theorie der Wärme geforderte Bewegung von in ruhenden Flüssigkeiten suspendierten Teilchen [AdP 17, 549 (1905)] , 2005, Annalen der Physik.

[37]  A L Baert,et al.  Non-invasive tumour perfusion measurement by dynamic CT: preliminary results. , 1997, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[38]  A. Padhani,et al.  The RECIST criteria: implications for diagnostic radiologists , 2001 .

[39]  J. Hecht,et al.  Addition of bevacizumab to bolus fluorouracil and leucovorin in first-line metastatic colorectal cancer: results of a randomized phase II trial. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[40]  J. Detre,et al.  Diffuse optical measurement of blood flow, blood oxygenation, and metabolism in a human brain during sensorimotor cortex activation. , 2004, Optics letters.

[41]  J. Folkman.  Angiogenesis in cancer, vascular, rheumatoid and other disease , 1995, Nature Medicine.

[42]  Validation of Diffuse Correlation Spectroscopy for Muscle Blood Flow with Concurrent Arterial-Spin-Labeling Perfusion MRI: 2245 , 2007 .

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

[44]  D. Weitz,et al.  Diffusing wave spectroscopy. , 1988, Physical review letters.

[45]  Beth Felinski-Semler,et al.  NRC restrictions on the packaging of radioactive material should be expressed more explicitly than simply in terms of "activity". Against the proposition. , 2004, Medical physics.

[46]  G Brix,et al.  Tumor microcirculation evaluated by dynamic magnetic resonance imaging predicts therapy outcome for primary rectal carcinoma. , 2001, Cancer research.

[47]  A. Yodh,et al.  Frequency-domain multiplexing system for in vivo diffuse light measurements of rapid cerebral hemodynamics. , 2003, Applied optics.

[48]  T. Floyd,et al.  Validation of diffuse correlation spectroscopy for muscle blood flow with concurrent arterial spin labeled perfusion MRI. , 2007, Optics express.

[49]  B. Chance,et al.  Time-dependent blood flow and oxygenation in human skeletal muscles measured with noninvasive near-infrared diffuse optical spectroscopies. , 2005, Journal of biomedical optics.

[50]  Jun Li,et al.  Noninvasive detection of functional brain activity with near-infrared diffusing-wave spectroscopy. , 2005, Journal of biomedical optics.

[51]  D. Delpy,et al.  Quantification in tissue near–infrared spectroscopy , 1997 .

[52]  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.

[53]  Michael Stumm,et al.  STI571 enhances the therapeutic index of epothilone B by a tumor-selective increase of drug uptake. , 2003, Clinical cancer research : an official journal of the American Association for Cancer Research.

[54]  Hsing-Wen Wang,et al.  Noninvasive monitoring hemodynamic responses in RIF tumors during and after PDT , 2003, SPIE BiOS.

[55]  V. Ntziachristos,et al.  Concurrent MRI and diffuse optical tomography of breast after indocyanine green enhancement. , 2000, Proceedings of the National Academy of Sciences of the United States of America.

[56]  Tobias Sjöblom,et al.  Inhibition of PDGF receptor signaling in tumor stroma enhances antitumor effect of chemotherapy. , 2002, Cancer research.

[57]  Yasser M Kadah,et al.  Determination of the optical properties of a two-layer tissue model by detecting photons migrating at progressively increasing depths. , 2003, Applied optics.

[58]  Peter Schmitt,et al.  Quantitative tissue perfusion measurements in head and neck carcinoma patients before and during radiation therapy with a non-invasive MR imaging spin-labeling technique. , 2003, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[59]  Dai Fukumura,et al.  Dissecting tumour pathophysiology using intravital microscopy , 2002, Nature Reviews Cancer.

[60]  J. Mourant,et al.  Predictions and measurements of scattering and absorption over broad wavelength ranges in tissue phantoms. , 1997, Applied optics.

[61]  W Van den Bogaert,et al.  Tumoural perfusion as measured by dynamic computed tomography in head and neck carcinoma. , 1999, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[62]  J C Ehrhardt,et al.  Tumor perfusion studies using fast magnetic resonance imaging technique in advanced cervical cancer: a new noninvasive predictive assay. , 1996, International journal of radiation oncology, biology, physics.

[63]  Sandra K. Soho,et al.  Characterization of hemoglobin, water, and NIR scattering in breast tissue: analysis of intersubject variability and menstrual cycle changes. , 2004, Journal of biomedical optics.

[64]  A. Fyles,et al.  The relationship between elevated interstitial fluid pressure and blood flow in tumors: a bioengineering analysis. , 1999, International journal of radiation oncology, biology, physics.

[65]  H Lyng,et al.  Changes in tumor oxygen tension during radiotherapy of uterine cervical cancer: relationships to changes in vascular density, cell density, and frequency of mitosis and apoptosis. , 2000, International journal of radiation oncology, biology, physics.

[66]  P. Vaupel,et al.  Blood flow and oxygenation status of human tumors , 1999, Strahlentherapie und Onkologie.

[67]  R K Jain,et al.  Taxane-induced apoptosis decompresses blood vessels and lowers interstitial fluid pressure in solid tumors: clinical implications. , 1999, Cancer research.

[68]  Bruce J. Tromberg,et al.  The Role of Diffuse Optical Spectroscopy in the Clinical Management of Breast Cancer , 2004, Disease markers.

[69]  E Gratton,et al.  Measurements of scattering and absorption changes in muscle and brain. , 1997, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[70]  Alessandro Torricelli,et al.  Effects of the Menstrual Cycle on the Red and Near-infrared Optical Properties of the Human Breast¶ , 2000, Photochemistry and photobiology.

[71]  Jean-Luc Balligand,et al.  Irradiation-induced angiogenesis through the up-regulation of the nitric oxide pathway: implications for tumor radiotherapy. , 2003, Cancer research.

[72]  S K Libutti,et al.  Measuring tumor blood flow with H(2)(15)O: practical considerations. , 2000, Nuclear medicine and biology.

[73]  Brian W. Pogue,et al.  Interpreting hemoglobin and water concentration, oxygen saturation, and scattering measured in vivo by near-infrared breast tomography , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[74]  A. Yodh,et al.  In vivo cerebrovascular measurement combining diffuse near-infrared absorption and correlation spectroscopies. , 2001, Physics in medicine and biology.

[75]  G. Maret,et al.  Multiple light scattering from disordered media. The effect of brownian motion of scatterers , 1987 .

[76]  Peter Vaupel,et al.  Blood Perfusion and Microenvironment of Human Tumors , 2000 .

[77]  M. Schweiger,et al.  Diffuse optical tomography with spectral constraints and wavelength optimization. , 2005, Applied optics.

[78]  A. Yodh,et al.  Diffuse optical measurement of blood flow in breast tumors. , 2006, Optics letters.

[79]  D. Hanahan,et al.  The Hallmarks of Cancer , 2000, Cell.

[80]  B Chance,et al.  Near‐Infrared Images Using Continuous, Phase‐Modulated, and Pulsed Light with Quantitation of Blood and Blood Oxygenation a , 1998, Annals of the New York Academy of Sciences.

[81]  E M Lord,et al.  Effects of Radiation on Tumor Intravascular Oxygenation, Vascular Configuration, Development of Hypoxia, and Clonogenic Survival , 2001, Radiation research.

[82]  Campbell,et al.  Scattering and Imaging with Diffusing Temporal Field Correlations. , 1995, Physical review letters.

[83]  B. Wilson,et al.  Absorption spectroscopy in tissue-simulating materials: a theoretical and experimental study of photon paths. , 1995, Applied optics.

[84]  M. Pitkänen,et al.  Radiation-induced changes in regional blood flow in human tumors. , 1982, International journal of radiation oncology, biology, physics.

[85]  L. O. Svaasand,et al.  Boundary conditions for the diffusion equation in radiative transfer. , 1994, Journal of the Optical Society of America. A, Optics, image science, and vision.

[86]  J. Bussink,et al.  Changes in Blood Perfusion and Hypoxia after Irradiation of a Human Squamous Cell Carcinoma Xenograft Tumor Line , 2000, Radiation research.

[87]  Albert Cerussi,et al.  Noninvasive functional optical spectroscopy of human breast tissue , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[88]  Rakesh K. Jain,et al.  Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy , 2001, Nature Medicine.

[89]  Arjun G. Yodh,et al.  Diffuse optical measurement of blood flow in breast tumors , 2005 .

[90]  Soren D. Konecky,et al.  Diffuse optical tomography of breast cancer during neoadjuvant chemotherapy: a case study with comparison to MRI. , 2005, Medical physics.