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1.
Photodiagnosis Photodyn Ther ; 47: 104209, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38734196

RESUMO

The inability of visible light to penetrate far through biological tissue limits its use for phototherapy and photodiagnosis of deep-tissue sites of disease. This is unfortunate because many visible dyes are excellent photosensitizers and photocatalysts that can induce a wide range of photochemical processes, including photogeneration of reactive oxygen species. One potential solution is to bring the light source closer to the site of disease by using a miniature implantable LED. With this goal in mind, we fabricated a wireless LED-based device (volume of 23 mm3) that is powered by RF energy and emits light with a wavelength of 573 nm. It has the capacity to excite the green absorbing dye Rose Bengal, which is an efficient type II photosensitizer. The wireless transfer of RF power is effective even when the device is buried in chicken breast and located 6 cm from the transmitting antenna. The combination of a wireless device as light source and Rose Bengal as photosensitizer was found to induce cell death of cultured HT-29 human colorectal adenocarcinoma cells. Time-dependent generation of protruding bubbles was observed in the photoactivated cells suggesting cell death by light-induced pyroptosis and supporting evidence was gained by cell staining with the fluorescence probes Annexin-V FITC and Propidium Iodide. The results reveal a future path towards a wireless implanted LED-based device that can trigger photodynamic immunogenic cell death in deep-seated cancerous tissue.


Assuntos
Fotoquimioterapia , Fármacos Fotossensibilizantes , Piroptose , Rosa Bengala , Fármacos Fotossensibilizantes/farmacologia , Piroptose/efeitos dos fármacos , Fotoquimioterapia/métodos , Humanos , Rosa Bengala/farmacologia , Células HT29 , Tecnologia sem Fio , Animais
2.
Philos Trans A Math Phys Eng Sci ; 382(2273): 20230201, 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38736335

RESUMO

The Cassini mission provided evidence for a global subsurface ocean and ongoing hydrothermal activity on Enceladus, based on results from Cassini's mass spectrometers. Laboratory simulations of hydrothermal conditions on icy moons are needed to further constrain the composition of ejected ice grains containing hydrothermally altered organic material. Here, we present results from our newly established facility to simulate the processing of ocean material within the temperature range 80-150°C and the pressure range 80-130 bar, representing conditions suggested for the water-rock interface on Enceladus. With this new facility, we investigate the hydrothermal processing of triglycine (GGG) peptide and, for the first time, analyse the extracted samples using laser-induced liquid beam ion desorption (LILBID) mass spectrometry, a laboratory analogue for impact ionization mass spectrometry of ice grains in space. We outline an approach to elucidate hydrothermally processed GGG in ice grains ejected from icy moons based on characteristic differences between GGG anion and cation mass spectra. These differences are linked to hydrothermal processing and thus provide a fingerprint of hydrothermal activity on extraterrestrial bodies. These results will serve as important guidelines for biosignatures potentially obtained by a future Enceladus mission and the SUrface Dust Analyzer (SUDA) instrument onboard Europa Clipper. This article is part of the theme issue 'Dust in the Solar System and beyond'.

3.
IEEE Open J Eng Med Biol ; 4: 85-95, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37228451

RESUMO

An intuitive and generalisable approach to spatial-temporal feature extraction for high-density (HD) functional Near-Infrared Spectroscopy (fNIRS) brain-computer interface (BCI) is proposed, demonstrated here using Frequency-Domain (FD) fNIRS for motor-task classification. Enabled by the HD probe design, layered topographical maps of Oxy/deOxy Haemoglobin changes are used to train a 3D convolutional neural network (CNN), enabling simultaneous extraction of spatial and temporal features. The proposed spatial-temporal CNN is shown to effectively exploit the spatial relationships in HD fNIRS measurements to improve the classification of the functional haemodynamic response, achieving an average F1 score of 0.69 across seven subjects in a mixed subjects training scheme, and improving subject-independent classification as compared to a standard temporal CNN.

4.
J Orthop Res ; 41(1): 104-114, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35289956

RESUMO

Tourniquet use creates a reduced blood surgical field during total knee arthroplasty (TKA), however, prolonged ischemia may cause postoperative tourniquet complications. To understand the effects of tourniquet-induced ischemia, we performed a prospective observational study using quantitative broadband diffuse optical spectroscopy (DOS) to measure tissue hemodynamics and water and lipid concentrations before, during, and after tourniquet placement in subjects undergoing TKA. Data was collected for 6 months and, of the total subjects analyzed (n = 24), 22 were primary TKAs and 2 were revision TKA cases. We specifically investigated tourniquet-induced hemodynamics based upon subject-specific tissue composition and observed a significant relationship between the linear rate of deoxygenation after tourniquet inflation and water/lipid ratio (W/L, p < 0.0001) and baseline somatic tissue oxygen saturation, StO2 (p = 0.05). Subjects with a low W/L ratio exhibited a lower tissue metabolic rate of oxygen consumption, (tMRO2 ) (p = 0.008). Changes in deoxyhemoglobin [HbR] (p = 0.009) and lipid fraction (p = 0.001) were significantly different between high and low W/L subject groups during deoxygenation. No significant differences were observed for hemodynamics during reperfusion and total tourniquet time was neither significantly related to the hemodynamic hyperemic response (p = 0.73) nor the time to max StO2 after tourniquet release (p = 0.57). In conclusion, we demonstrate that DOS is capable of real-time monitoring of tissue hemodynamics distal to the tourniquet during TKA, and that tissue composition should be considered. DOS may help surgeons stratify hemodynamics based upon tissue composition and eventually aid the preoperative risk assessment of vascular occlusions from tourniquet use during TKA.


Assuntos
Artroplastia do Joelho , Hemodinâmica , Isquemia , Humanos , Artroplastia do Joelho/efeitos adversos , Isquemia/etiologia , Isquemia/prevenção & controle , Lipídeos , Análise Espectral , Torniquetes
5.
Neurophotonics ; 9(Suppl 2): S24001, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36052058

RESUMO

This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.

6.
J Cachexia Sarcopenia Muscle ; 13(2): 1238-1249, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35029054

RESUMO

BACKGROUND: Skeletal muscle wasting and dysfunction are common characteristics noted in people who suffer from chronic kidney disease (CKD). The mechanisms by which this occurs are complex, and although progress has been made, the key underpinning mechanisms are not yet fully elucidated. With work to date primarily conducted in nephrectomy-based animal models, translational capacity to our patient population has been challenging. This could be overcome if rationale developing work could be conducted in human based models with greater translational capacity. This could be achieved using cells derived from patient biopsies, if they retain phenotypic traits noted in vivo. METHODS: Here, we performed a systematic characterization of CKD derived muscle cells (CKD; n = 10; age: 54.40 ± 15.53 years; eGFR: 22.25 ± 13.22 ml/min/1.73 m2 ) in comparison with matched controls (CON; n = 10; age: 58.66 ± 14.74 years; eGFR: 85.81 ± 8.09 ml/min/1.73 m2 ). Harvested human derived muscle cells (HDMCs) were taken through proliferative and differentiation phases and investigated in the context of myogenic progression, inflammation, protein synthesis, and protein breakdown. Follow up investigations exposed HDMC myotubes from each donor type to 0, 0.4, and 100 nM of IGF-1 in order to investigate any differences in anabolic resistance. RESULTS: Harvested human derived muscle cells isolated from CKD patients displayed higher rates of protein degradation (P = 0.044) alongside elevated expression of both TRIM63 (2.28-fold higher, P = 0.054) and fbox32 (6.4-fold higher, P < 0.001) in comparison with CONs. No differences were noted in rates of protein synthesis under basal conditions (P > 0.05); however, CKD derived cells displayed a significant degree of anabolic resistance in response to IGF-1 stimulation (both doses) in comparison with matched CONs (0.4 nm: P < 0.001; 100 nM: P < 0.001). CONCLUSIONS: In summary, we report for the first time that HDMCs isolated from people suffering from CKD display key hallmarks of the well documented in vivo phenotype. Not only do these findings provide further mechanistic insight into CKD specific cachexia, but they also demonstrate this is a reliable and suitable model in which to perform targeted experiments to begin to develop novel therapeutic strategies targeting the CKD associated decline in skeletal muscle mass and function.


Assuntos
Caquexia , Insuficiência Renal Crônica , Animais , Caquexia/metabolismo , Humanos , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/patologia , Atrofia Muscular/patologia , Insuficiência Renal Crônica/metabolismo
7.
Biomed Opt Express ; 12(11): 7261-7279, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34858713

RESUMO

Frequency-domain near-infrared spectroscopy (FD-NIRS) provides quantitative noninvasive measurements of tissue optical absorption and scattering, as well as a safe and accurate method for characterizing tissue composition and metabolism. However, the poor scalability and high complexity of most FD-NIRS systems assembled to date have contributed to its limited clinical impact. To address these shortcomings, we present a scalable, digital-based FD-NIRS platform capable of measuring optical properties and tissue chromophore concentrations in real-time. The system provides single-channel FD-NIRS amplitude/phase, optical property, and chromophore data at a maximum display rate of 36.6 kHz, 17.9 kHz, and 10.2 kHz, respectively, and can be scaled to multiple channels as well as integrated into a handheld format. The entire system is enabled by several innovations including an ultra-high-speed k-nearest neighbor lookup table method (maximum of 250,000 inversions/s for a large 2500x700 table of absorption and reduced scattering coefficients), embedded FPGA and CPU high-speed co-processing, and high-speed data transfer (due to on-board processing). We show that our 6-wavelength, broad modulation bandwidth (1-400 MHz) system can be used to perform 2D high-density spatial mapping of optical properties and high speed quantification of hemodynamics.

8.
J Biomed Opt ; 26(6)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34189876

RESUMO

SIGNIFICANCE: Noninvasive diffuse optical spectroscopy (DOS) is a promising adjunct diagnostic imaging technique for distinguishing benign and malignant breast lesions. Most DOS approaches require normalizing lesion biomarkers to healthy tissue since major tissue constituents exhibit large interpatient variations. However, absolute optical biomarkers are desirable as it avoids reference measurements which may be difficult or impractical to acquire. AIM: Our goal is to determine whether absolute measurements of minor absorbers such as collagen and methemoglobin (metHb) can successfully distinguish lesions. We hypothesize that metHb would exhibit less interpatient variability and be more suitable as an absolute metric for malignancy. However, we would expect collagen to exhibit more variability, because unlike metHb, collagen is also present in the healthy tissue. APPROACH: In this retrospective clinical study, 30 lesions with breast imaging reporting and database system score ( BIRADS ) > = 3 (12 benign and 18 malignant) measured with broadband quantitative DOS were analyzed for their oxyhemoglobin (HbO), deoxyhemoglobin (HHb), water, lipids, collagen, metHb concentrations, and optical scattering characteristics. Wilcoxon rank sum test was used to compare benign and malignant lesions for all variables in both normalized and absolute forms. RESULTS: Among all absolute DOS parameters considered, only absolute metHb was observed to be significant for lesion discrimination (0.43 ± 0.18 µM for benign versus 0.87 ± 0.32 µM for malignant, p = 0.0002). Absolute metHb concentration was also determined to be the best predictor of malignancy with an area under the curve of 0.89. CONCLUSIONS: Our findings demonstrate that lesion metHb concentration measured by DOS can improve noninvasive optical diagnosis of breast malignancies. Since metHb concentration found in normal breast tissue is extremely low, metHb may be a more direct indicator of malignancy that does not depend on other biomarkers found in healthy tissue with significant variability. Furthermore, absolute parameters require reduced measurement time and can be utilized in cases where healthy reference tissue is not available.


Assuntos
Neoplasias da Mama , Metemoglobina , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Estudos Retrospectivos , Análise Espectral
9.
J Biomed Opt ; 26(2)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33624457

RESUMO

SIGNIFICANCE: Current imaging paradigms for differential diagnosis of suspicious breast lesions suffer from high false positive rates that force patients to undergo unnecessary biopsies. Diffuse optical spectroscopic imaging (DOSI) noninvasively probes functional hemodynamic and compositional parameters in deep tissue and has been shown to be sensitive to contrast between normal and malignant tissues. AIM: DOSI methods are under investigation as an adjunct to mammography and ultrasound that could reduce false positive rates and unnecessary biopsies, particularly in radiographically dense breasts. METHODS: We performed a retrospective analysis of 212 subjects with suspicious breast lesions who underwent DOSI imaging. Physiological tissue parameters were z-score normalized to the patient's contralateral breast tissue and input to univariate logistic regression models to discriminate between malignant tumors and the surrounding normal tissue. The models were then used to differentiate malignant lesions from benign lesions. RESULTS: Models incorporating several individual hemodynamic parameters were able to accurately distinguish malignant tumors from both the surrounding background tissue and benign lesions with area under the curve (AUC) ≥0.85. Z-score normalization improved the discriminatory ability and calibration of these predictive models relative to unnormalized or ratio-normalized data. CONCLUSIONS: Findings from a large subject population study show how DOSI data normalization that accounts for normal tissue heterogeneity and quantitative statistical regression approaches can be combined to improve the ability of DOSI to diagnose malignant lesions. This improved diagnostic accuracy, combined with the modality's inherent logistical advantages of portability, low cost, and nonionizing radiation, could position DOSI as an effective adjunct modality that could be used to reduce the number of unnecessary invasive biopsies.


Assuntos
Neoplasias da Mama , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Mamografia , Estudos Retrospectivos , Análise Espectral
10.
Lasers Surg Med ; 53(4): 557-566, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32956499

RESUMO

BACKGROUND AND OBJECTIVES: Spatial frequency domain imaging (SFDI), an optical imaging technique capable of quantitatively measuring tissue hemodynamics over a large field-of-view, has captured the interest of scientists and clinicians due to its ability to image rapidly and noninvasively. The goal of this study was to apply SFDI in a preclinical murine model to assess its ability to measure hemodynamic changes due to hindlimb ischemia in vivo longitudinally. STUDY DESIGN/MATERIALS AND METHODS: Complete unilateral femoral artery ligation was performed on a total of nine C57BL/6J mice to induce ischemia in the left hindlimb. Changes in vascular perfusion in each mouse were monitored through SFDI acquisition of both the ischemic and control limbs throughout the course of 4 weeks. High-frequency pulsed-wave Doppler ultrasound was also acquired to confirm occlusion of the left femoral artery post-ligation compared with the control limb, while histological analysis was used to quantify femoral artery lumen shape and size. RESULTS: Tissue oxygen saturation in the ischemic limb normalized to the control limb decreased from a ratio of 0.96 ± 0.06 at baseline to 0.86 ± 0.10 at day 1, then 0.94 ± 0.06 at day 3, followed by 0.95 ± 0.14 at day 7, 0.91 ± 0.09 at day 14, 0.90 ± 0.09 at day 21, and 1.01 ± 0.09 at day 28. CONCLUSION: The results of this study indicate the utility of SFDI to detect hemodynamic changes in a preclinical murine model, as well as how to effectively use this tool to extract information regarding ischemia-induced hindlimb changes. In our model, we observed a decline in tissue oxygen saturation within one day post-ischemic injury, followed by a return to baseline values over the 4-week study period. While reducing skin artifacts and modifying camera hardware could still improve this murine imaging approach, our multimodality study presented here suggests that SFDI can be used to reliably characterize ischemia-mediated changes in a clinically relevant mouse model of peripheral arterial disease. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.


Assuntos
Isquemia , Doença Arterial Periférica , Animais , Modelos Animais de Doenças , Hemodinâmica , Membro Posterior , Isquemia/diagnóstico por imagem , Camundongos , Camundongos Endogâmicos C57BL , Músculo Esquelético , Doença Arterial Periférica/diagnóstico por imagem
11.
Biomed Opt Express ; 11(10): 5800-5813, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33149987

RESUMO

Hemozoin (Hz) is a crystal by-product of hemoglobin consumption by malaria parasites. There are currently no in vivo deep tissue sensing methods that can quantify Hz presence noninvasively, which would be advantageous for malaria research and treatment. In this work, we describe the broadband near-infrared optical characterization of synthetic Hz in static and dynamic tissue-simulating phantoms. Using hybrid frequency domain and continuous-wave near-infrared spectroscopy, we quantified the broadband optical absorption and scattering spectra of Hz and identified the presence of Hz at a minimum tissue-equivalent concentration of 0.014 µg/mL in static lipid emulsion phantoms simulating human adipose. We then constructed a whole blood-containing tissue-simulating phantom and demonstrated the detection of Hz at physiologically-relevant tissue oxygen saturations ranging from 70-90%. Our results suggest that quantitative diffuse optical spectroscopy may be useful for detecting deep tissue Hz in vivo.

12.
Biomed Opt Express ; 11(9): 5373-5387, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33014621

RESUMO

Diffuse optical imaging and tomography based upon frequency-domain near-infrared spectroscopy (fdNIRS) is used to noninvasively measure tissue structure and function through quantitative absolute measurements of tissue optical absorption and scattering. Here we describe how utilizing a silicon photomultiplier (SiPM) detector for fdNIRS improves performance. We discuss the operation of SiPMs, how they differ from other fdNIRS photodetectors, and show theoretically that SiPMs offer similar sensitivity to photomultiplier tube (PMT) detectors while having a higher dynamic range and lower cost, size, and operating voltage. With respect to avalanche photodiode (APD) detectors, theoretical and experimental data shows drastically increased signal to noise ratio performance, up to 25dB on human breast, head, and muscle tissue. Finally, we extend the dynamic range (∼10dB) of the SiPM through a nonlinear calibration technique which reduced absorption error by a mean 16 percentage points.

13.
Breast Cancer Res ; 22(1): 29, 2020 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-32169100

RESUMO

BACKGROUND: Breast cancer patients with early-stage disease are increasingly administered neoadjuvant chemotherapy (NAC) to downstage their tumors prior to surgery. In this setting, approximately 31% of patients fail to respond to therapy. This demonstrates the need for techniques capable of providing personalized feedback about treatment response at the earliest stages of therapy to identify patients likely to benefit from changing treatment. Diffuse optical spectroscopic imaging (DOSI) has emerged as a promising functional imaging technique for NAC monitoring. DOSI uses non-ionizing near-infrared light to provide non-invasive measures of absolute concentrations of tissue chromophores such as oxyhemoglobin. In 2011, we reported a new DOSI prognostic marker, oxyhemoglobin flare: a transient increase in oxyhemoglobin capable of discriminating NAC responders within the first day of treatment. In this follow-up study, DOSI was used to confirm the presence of the flare as well as to investigate whether DOSI markers of NAC response are regimen dependent. METHODS: This dual-center study examined 54 breast tumors receiving NAC measured with DOSI before therapy and the first week following chemotherapy administration. Patients were treated with either a standard of care maximum tolerated dose (MTD) regimen or an investigational metronomic (MET) regimen. Changes in tumor chromophores were tracked throughout the first week and compared to pathologic response and treatment regimen at specific days utilizing generalized estimating equations (GEE). RESULTS: Within patients receiving MTD therapy, the oxyhemoglobin flare was confirmed as a prognostic DOSI marker for response appearing as soon as day 1 with post hoc GEE analysis demonstrating a difference of 48.77% between responders and non-responders (p < 0.0001). Flare was not observed in patients receiving MET therapy. Within all responding patients, the specific treatment was a significant predictor of day 1 changes in oxyhemoglobin, showing a difference of 39.45% (p = 0.0010) between patients receiving MTD and MET regimens. CONCLUSIONS: DOSI optical biomarkers are differentially sensitive to MTD and MET regimens at early timepoints suggesting the specific treatment regimen should be considered in future DOSI studies. Additionally, DOSI may help to identify regimen-specific responses in a more personalized manner, potentially providing critical feedback necessary to implement adaptive changes to the treatment strategy.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Hemodinâmica/efeitos dos fármacos , Terapia Neoadjuvante/métodos , Imagem Óptica/métodos , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Administração Metronômica , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Dose Máxima Tolerável , Pessoa de Meia-Idade , Resultado do Tratamento
14.
J Biomed Opt ; 24(5): 1-8, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31124346

RESUMO

Relatively few imaging and sensing technologies are employed to study human lactation physiology. In particular, human mammary development during pregnancy as well as mammary involution after lactation have been poorly described, despite their importance for breast cancer diagnosis and treatment during these phases. Our case study shows the potential of diffuse optical spectroscopic imaging (DOSI) to uniquely study the spatiotemporal changes in mammary tissue composition during the involution of the lactating breast toward its pre-pregnant state. At nine time intervals over a period of eight months after the cessation of breastfeeding, we reconstructed 2-D maps of mammary water content, lipid content, total hemoglobin (THb) concentration, oxygen saturation (StO2), and tissue optical scattering. Mammary lipid content in the nonareolar region showed a significant relative increase of 59%, whereas water content and THb concentration showed a significant relative decrease of 50% and 48%, respectively. Significant changes were also found in StO2 and tissue optical scattering. Our findings are consistent with the gradual replacement of fibroglandular tissue by adipose tissue and vascular regression during mammary involution. Moreover, our data provide unique insight into the dynamics of breast tissue composition and demonstrate the effectiveness of DOSI as a technique to study human lactation physiology.


Assuntos
Mama/diagnóstico por imagem , Mama/fisiologia , Lactação/fisiologia , Imagem Óptica/métodos , Adulto , Aleitamento Materno , Feminino , Hemoglobinas/análise , Humanos , Processamento de Imagem Assistida por Computador , Lipídeos/química , Imageamento por Ressonância Magnética , Oxigênio/metabolismo , Segurança do Paciente , Espalhamento de Radiação , Espectrofotometria
15.
Opt Lett ; 44(3): 562-565, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30702679

RESUMO

Diffuse optical imaging of biological tissue is a well-established methodology used to measure functional information from intrinsic contrast due to hemoglobin, water, and lipid. This information is exploited in frequency domain diffuse optical spectroscopy (FD-DOS) systems, which have been used to investigate chemotherapy response, optical mammography, and brain imaging. FD-DOS depth sensitivity and dynamic range are typically constrained by photodetector sensitivity. Here we present FD-DOS utilizing a silicon photomultiplier (SiPM) detector that has a higher signal-to-noise ratio (SNR) compared to an avalanche photodiode (APD), and thus enables extended source-detector (S/D) separations and increased depth penetration. We find the SiPM to have 10-30 dB greater SNR than a comparably sized APD while detecting 1.5-2 orders of magnitude lower light levels, down to ∼4 pW at 50 MHz modulation. The SiPM and APD recover optical property values of tissue-simulating phantoms within 13% agreement and are stable with 1% coefficient of variation over one hour. Finally, the SiPM is used to accurately recover optical properties in a reflectance geometry at S/D separations up to 48 mm in phantoms mimicking human breast tissue.


Assuntos
Imagem Óptica/instrumentação , Silício , Difusão , Razão Sinal-Ruído
16.
J Biomed Opt ; 24(2): 1-11, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30338678

RESUMO

Ideally, neoadjuvant chemotherapy (NAC) assessment should predict pathologic complete response (pCR), a surrogate clinical endpoint for 5-year survival, as early as possible during typical 3- to 6-month breast cancer treatments. We introduce and demonstrate an approach for predicting pCR within 10 days of initiating NAC. The method uses a bedside diffuse optical spectroscopic imaging (DOSI) technology and logistic regression modeling. Tumor and normal tissue physiological properties were measured longitudinally throughout the course of NAC in 33 patients enrolled in the American College of Radiology Imaging Network multicenter breast cancer DOSI trial (ACRIN-6691). An image analysis scheme, employing z-score normalization to healthy tissue, produced models with robust predictions. Notably, logistic regression based on z-score normalization using only tissue oxygen saturation (StO2) measured within 10 days of the initial therapy dose was found to be a significant predictor of pCR (AUC = 0.92; 95% CI: 0.82 to 1). This observation suggests that patients who show rapid convergence of tumor tissue StO2 to surrounding tissue StO2 are more likely to achieve pCR. This early predictor of pCR occurs prior to reductions in tumor size and could enable dynamic feedback for optimization of chemotherapy strategies in breast cancer.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/métodos , Terapia Neoadjuvante , Consumo de Oxigênio/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Adulto , Biomarcadores/metabolismo , Neoplasias da Mama/metabolismo , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Testes Imediatos , Curva ROC , Análise de Sobrevida
17.
Ther Adv Chronic Dis ; 9(11): 209-226, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30364521

RESUMO

OBJECTIVE: People with nondialysis-dependent chronic kidney disease (CKD) and renal transplant recipients (RTRs) have compromised physical function and reduced physical activity (PA) levels. Whilst established in healthy older adults and other chronic diseases, this association remains underexplored in CKD. We aimed to review the existing research investigating poor physical function and PA with clinical outcome in nondialysis CKD. DATA SOURCES: Electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials) were searched until December 2017 for cohort studies reporting objective or subjective measures of PA and physical function and the associations with adverse clinical outcomes and all-cause mortality in patients with nondialysis CKD stages 1-5 and RTRs. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42016039060). REVIEW METHODS: Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare and Research Quality (AHRQ) standards. RESULTS: A total of 29 studies were included; 12 reporting on physical function and 17 on PA. Only eight studies were conducted with RTRs. The majority were classified as 'good' according to the AHRQ standards. Although not appropriate for meta-analysis due to variance in the outcome measures reported, a coherent pattern was seen with higher mortality rates or prevalence of adverse clinical events associated with lower PA and physical function levels, irrespective of the measurement tool used. Sources of bias included incomplete description of participant flow through the study and over reliance on self-report measures. CONCLUSIONS: In nondialysis CKD, survival rates correlate with greater PA and physical function levels. Further trials are required to investigate causality and the effectiveness of physical function and PA interventions in improving outcomes. Future work should identify standard assessment protocols for PA and physical function.

18.
Opt Express ; 26(16): 21033-21043, 2018 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-30119409

RESUMO

We present an approach for performing frequency domain diffuse optical spectroscopy (fd-DOS) utilizing a near-infrared tunable vertical cavity surface emitting laser (VCSEL) that enables high spectral resolution optical sensing in a miniature format. The tunable VCSEL, designed specifically for deep tissue imaging and sensing, utilizes an electrothermally tunable microelectromechanical systems topside mirror to tune the laser cavity resonance. At room temperature, the laser is tunable across 14nm from 769 to 782nm with single mode CW output and a peak output power of 1.3mW. We show that the tunable VCSEL is suitable for use in fd-DOS by measuring the optical properties of a tissue-simulating phantom over the tunable range. Optical properties were recovered within 0.0006mm-1 (absorption) and 0.09mm-1 (reduced scattering) compared to a broadband fd-DOS reference system. Our results indicate that tunable VCSELs may be an attractive choice to enable high spectral resolution optical sensing in a wearable format.

19.
Mil Med ; 183(suppl_1): 150-156, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29635570

RESUMO

Objective: To quantitatively measure tissue composition and hemodynamics during resuscitative endovascular balloon occlusion of the aorta (REBOA) in two tissue compartments using non-invasive two-channel broadband diffuse optical spectroscopy (DOS). Methods: Tissue concentrations of oxy- and deoxyhemoglobin (HbO2 and HbR), water, and lipid were measured in a porcine model (n = 10) of massive hemorrhage (65% total blood volume over 1 h) and 30-min REBOA superior and inferior to the aortic balloon. Results: After hemorrhage, hemoglobin oxygen saturation (StO2 = HbO2/[HbO2 + HbR]) at both sites decreased significantly (-29.9% and -42.3%, respectively). The DOS measurements correlated with mean arterial pressure (MAP) (R2 = 0.79, R2 = 0.88), stroke volume (SV) (R2 = 0.68, R2 = 0.88), and heart rate (HR) (R2 = 0.72, R2 = 0.88). During REBOA, inferior StO2 continued to decline while superior StO2 peaked 12 min after REBOA before decreasing again. Inferior DOS parameters did not associate with MAP, SV, or HR during REBOA. Conclusions: Dual-channel regional tissue DOS measurements can be used to non-invasively track the formation of hemodynamically distinct tissue compartments during hemorrhage and REBOA. Conventional systemic measures MAP, HR, and SV are uncorrelated with tissue status in inferior (downstream) sites. Multi-compartment DOS may provide a more complete picture of the efficacy of REBOA and similar resuscitation procedures.


Assuntos
Procedimentos Endovasculares/instrumentação , Hemorragia/cirurgia , Ressuscitação/normas , Análise Espectral/métodos , Animais , Aorta/cirurgia , Modelos Animais de Doenças , Procedimentos Endovasculares/métodos , Hemoglobinas/análise , Oxiemoglobinas/análise , Qualidade da Assistência à Saúde , Ressuscitação/métodos , Análise Espectral/instrumentação , Suínos/cirurgia
20.
J Biomed Opt ; 22(12): 1-9, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29264896

RESUMO

A quantitative and dynamic analysis of skeletal muscle structure and function can guide training protocols and optimize interventions for rehabilitation and disease. While technologies exist to measure body composition, techniques are still needed for quantitative, long-term functional imaging of muscle at the bedside. We evaluate whether diffuse optical spectroscopic imaging (DOSI) can be used for long-term assessment of resistance training (RT). DOSI measures of tissue composition were obtained from 12 adults before and after 5 weeks of training and compared to lean mass fraction (LMF) from dual-energy X-ray absorptiometry (DXA). Significant correlations were detected between DXA LMF and DOSI-measured oxy-hemo/myoglobin, deoxy-hemo/myoglobin, total-hemo/myoglobin, water, and lipid. RT-induced increases of ∼6% in oxy-hemo/myoglobin (3.4±1.0 µM, p=0.00314) and total-hemo/myoglobin (4.9±1.1 µM, p=0.00024) from the medial gastrocnemius were detected with DOSI and accompanied by ∼2% increases in lean soft tissue mass (36.4±12.4 g, p=0.01641) and ∼60% increases in 1 rep-max strength (41.5±6.2 kg, p=1.9E-05). DOSI measures of vascular and/or muscle changes combined with correlations between DOSI and DXA suggest that quantitative diffuse optical methods can be used to evaluate body composition, provide feedback on long-term interventions, and generate new insight into training-induced muscle adaptations.


Assuntos
Composição Corporal/fisiologia , Músculo Esquelético/diagnóstico por imagem , Imagem Óptica , Treinamento Resistido , Humanos , Análise Espectral
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