Biomedical Engineering and Bioengineering Commons^™

Diagnostic Performance Of Receptor-Specific Surgical Specimen Staining Correlates With Receptor Expression Level, Jasmin M. Schaefer, Connor W. Barth, Scott C. Davis, Summer L. Gibbs

Dartmouth Scholarship

Intraoperative margin assessment is imperative to cancer cure but is a continued challenge to successful surgery. Breast conserving surgery is a relevant example, where a cosmetically improved outcome is gained over mastectomy, but re-excision is required in >25  %   of cases due to positive or closely involved margins. Clinical translation of margin assessment modalities that must directly contact the patient or required administered contrast agents are time consuming and costly to move from bench to bedside. Tumor resections provide a unique surgical opportunity to deploy margin assessment technologies including contrast agents on the resected tissues, substantially shortening the path to …

Cherenkov Excited Short-Wavelength Infrared Fluorescence Imaging In Vivo With External Beam Radiation, Xu Cao, Shudong Jiang, Mengyu Jeremy Jia, Jason R. Gunn, Tianshun Miao, Scott C. Davis, Petr Bruza, Brian W. Pogue

Dartmouth Scholarship

Cherenkov emission induced by external beam radiation therapy from a clinical linear accelerator (LINAC) can be used to excite phosphors deep in biological tissues. As with all luminescence imaging, there is a desire to minimize the spectral overlap between the excitation light and emission wavelengths, here between the Cherenkov and the phosphor. Cherenkov excited short-wavelength infrared (SWIR, 1000 to 1700 nm) fluorescence imaging has been demonstrated for the first time, using long Stokes-shift fluorophore PdSe quantum dots (QD) with nanosecond lifetime and an optimized SWIR detection. The 1  /  λ2 intensity spectrum characteristic of Cherenkov emission leads to low overlap …

Review Of Methods For Intraoperative Margin Detection For Breast Conserving Surgery, Benjamin W. Maloney, David M. Mcclatchy, Brian W. Pogue, Keith D. Paulsen, Wendy A. Wells, Richard J. Barth

Dartmouth Scholarship

Breast conserving surgery (BCS) is an effective treatment for early-stage cancers as long as the margins of the resected tissue are free of disease according to consensus guidelines for patient management. However, 15% to 35% of patients undergo a second surgery since malignant cells are found close to or at the margins of the original resection specimen. This review highlights imaging approaches being investigated to reduce the rate of positive margins, and they are reviewed with the assumption that a new system would need high sensitivity near 95% and specificity near 85%. The problem appears to be twofold. The first …

Tissue Oxygen Saturation Predicts Response To Breast Cancer Neoadjuvant Chemotherapy Within 10 Days Of Treatment, Jeffrey M. Cochran, David R. Busch, Anais Leproux, Zheng Zhang, Thomas D. O'Sullivan, Albert E. Cerussi, Philip M. Carpenter, Rita S. Mehta, Darren Roblyer, Wei Yang, Keith D. Paulsen, Brian Pogue, Shudong Jiang, Peter A. Kaufman

Dartmouth Scholarship

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 …

Perspective Review Of What Is Needed For Molecular-Specific Fluorescence-Guided Surgery, Brian W. Pogue, Eben L. Rosenthal, Samuel Achilefu, Gooitzen M. Van Dam

Dartmouth Scholarship

Molecular image-guided surgery has the potential for translating the tools of molecular pathology to real-time guidance in surgery. As a whole, there are incredibly positive indicators of growth, including the first United States Food and Drug Administration clearance of an enzyme-biosynthetic-activated probe for surgery guidance, and a growing number of companies producing agents and imaging systems. The strengths and opportunities must be continued but are hampered by important weaknesses and threats within the field. A key issue to solve is the inability of macroscopic imaging tools to resolve microscopic biological disease heterogeneity and the limitations in microscopic systems matching surgery …

Light Scattering Measured With Spatial Frequency Domain Imaging Can Predict Stromal Versus Epithelial Proportions In Surgically Resected Breast Tissue, David M. Mcclatchy, Elizabeth J. Rizzo, Wendy A. Wells, Candice C. Black, Keith D. Paulsen, Stephen C. Kanick, Brian W. Pogue

Dartmouth Scholarship

This study aims to determine if light scatter parameters measured with spatial frequency domain imaging (SFDI) can accurately predict stromal, epithelial, and adipose fractions in freshly resected, unstained human breast specimens. An explicit model was developed to predict stromal, epithelial, and adipose fractions as a function of light scattering parameters, which was validated against a quantitative analysis of digitized histology slides for N  =  31 specimens using leave-one-out cross-fold validation. Specimen mean stromal, epithelial, and adipose volume fractions predicted from light scattering parameters strongly correlated with those calculated from digitized histology slides (r  =  0.90, 0.77, and 0.91, respectively, p-value× …

Correcting For Targeted And Control Agent Signal Differences In Paired-Agent Molecular Imaging Of Cancer Cell-Surface Receptors, Negar Sadeghipour, Scott C. Davis, Kenneth M. Tichauer

Dartmouth Scholarship

Paired-agent kinetic modeling protocols provide one means of estimating cancer cell-surface receptors with in vivo molecular imaging. The protocols employ the coadministration of a control imaging agent with one or more targeted imaging agent to account for the nonspecific uptake and retention of the targeted agent. These methods require the targeted and control agent data be converted to equivalent units of concentration, typically requiring specialized equipment and calibration, and/or complex algorithms that raise the barrier to adoption. This work evaluates a kinetic model capable of correcting for targeted and control agent signal differences. This approach was compared with an existing …

Radiotherapy-Induced Cherenkov Luminescence Imaging In A Human Body Phantom, Syed Rakin Ahmed, Mengyu Jia, Petr Bruza, Sergei A. Vinogradov, Shudong Jiang, David J. Gladstone, Lesley A. Jarvis, Brian W. Pogue

Dartmouth Scholarship

Radiation therapy produces Cherenkov optical emission in tissue, and this light can be utilized to activate molecular probes. The feasibility of sensing luminescence from a tissue molecular oxygen sensor from within a human body phantom was examined using the geometry of the axillary lymph node region. Detection of regions down to 30-mm deep was feasible with submillimeter spatial resolution with the total quantity of the phosphorescent sensor PtG4 near 1 nanomole. Radiation sheet scanning in an epi-illumination geometry provided optimal coverage, and maximum intensity projection images provided illustration of the concept. This work provides the preliminary information needed to attempt …

Optimal Wavelength Selection For Optical Spectroscopy Of Hemoglobin And Water Within A Simulated Light-Scattering Tissue, Mikael Marois, Stephen L. Jacques, Keith D. Paulsen

Dartmouth Scholarship

An algorithm that selects optimal wavelengths for spectral fitting of diffuse light reflectance spectra using a nonnegative least squares method is presented. Oxyhemoglobin, deoxyhemoglobin, and water are considered representative absorbers, but the approach is not constrained or limited by absorber selection provided native basis spectra are available. The method removes wavelengths iteratively from a scattering-modulated absorption matrix by maximizing the product of its singular values and offers considerable improvements over previously published wavelength selection schemes. Resulting wavelength selections are valid for a broad range of optical properties and yield lower RMS errors than other wavelength combinations. The method is easily …

Inhibition Of Apoptosis Exacerbates Fatigue-Damage Tendon Injuries In An In Vivo Rat Model, R. Bell, M. A. Robles-Harris, M. Anderson, D. Laudier, M. B. Schaffler, E. L. Flatow, N. Andarawis-Puri

Publications and Research

Tendinopathy is a common and progressive musculoskeletal disease. Increased apoptosis is an end-stage tendinopathy manifestation, but its contribution to the pathology of the disease is unknown. A previously established in vivo model of fatigue-damage accumulation shows that increased apoptosis is correlated with the severity of induced tendon damage, even in early onset of the disease, supporting its implication in the pathogenesis of the disease. Consequently, this study aimed to determine: (1) whether apoptosis could be inhibited after fatigue damage and (2) whether its inhibition could lead to remodeling of the extracellular matrix (ECM) and pericellular matrix (PCM), to ultimately improve …

Blinking Phase-Change Nanocapsules Enable Background-Free Ultrasound Imaging, Alexander S. Hannah, Geoffrey P. Luke, Stanislav Y. Emelianov

Dartmouth Scholarship

Microbubbles are widely used as contrast agents to improve the diagnostic capability of conventional, highly speckled, low-contrast ultrasound imaging. However, while microbubbles can be used for molecular imaging, these agents are limited to the vascular space due to their large size (> 1 μm). Smaller microbubbles are desired but their ultrasound visualization is limited due to lower echogenicity or higher resonant frequencies. Here we present nanometer scale, phase changing, blinking nanocapsules (BLInCs), which can be repeatedly optically triggered to provide transient contrast and enable background-free ultrasound imaging. In response to irradiation by near-infrared laser pulses, the BLInCs undergo cycles of …

Noncontact Diffuse Optical Assessment Of Blood Flow Changes In Head And Neck Free Tissue Transfer Flaps, Chong Huang, Yu Lin, Yu Shang, Guoqiang Yu, Jeffrey Radabaugh, Rony Aouad, Thomas J. Gal, Amit B. Patel, Joseph Valentino

Biomedical Engineering Faculty Publications

Knowledge of tissue blood flow (BF) changes after free tissue transfer may enable surgeons to predict the failure of flap thrombosis at an early stage. This study used our recently developed noncontact diffuse correlation spectroscopy to monitor dynamic BF changes in free flaps without getting in contact with the targeted tissue. Eight free flaps were elevated in patients with head and neck cancer; one of the flaps failed. Multiple BF measurements probing the transferred tissue were performed during and post the surgical operation. Postoperative BF values were normalized to the intraoperative baselines (assigning “1”) for the calculation of relative BF …

Technical Note: Phantom Study To Evaluate The Dose And Image Quality Effects Of A Computed Tomography Organ-Based Tube Current Modulation Technique, Diksha Gandhi, Dominic J. Crotty, Grant M. Stevens, Taly Gilat Schmidt

Biomedical Engineering Faculty Research and Publications

Purpose

This technical note quantifies the dose and image quality performance of a clinically available organ-dose-based tube current modulation (ODM) technique, using experimental and simulation phantom studies. The investigated ODM implementation reduces the tube current for the anterior source positions, without increasing current for posterior positions, although such an approach was also evaluated for comparison.

Methods

Axial CT scans at 120 kV were performed on head and chest phantoms on an ODM-equipped scanner (Optima CT660, GE Healthcare, Chalfont St. Giles, England). Dosimeters quantified dose to breast, lung, heart, spine, eye lens, and brain regions for ODM and 3D-modulation (SmartmA) settings. …

A NTh-Order Linear Algorithm For Extracting Diffuse Correlation Spectroscopy Blood Flow Indices In Heterogeneous Tissues, Yu Shang, Guoqiang Yu

Biomedical Engineering Faculty Publications

Conventional semi-infinite analytical solutions of correlation diffusion equation may lead to errors when calculating blood flow index (BFI) from diffuse correlation spectroscopy (DCS) measurements in tissues with irregular geometries. Very recently, we created an algorithm integrating a Nth-order linear model of autocorrelation function with the Monte Carlo simulation of photon migrations in homogenous tissues with arbitrary geometries for extraction of BFI (i.e., αD_B ). The purpose of this study is to extend the capability of the Nth-order linear algorithm for extracting BFI in heterogeneous tissues with arbitrary geometries. The previous linear algorithm was modified to extract BFIs …

Dynamic Dual-Tracer Mri-Guided Fluorescence Tomography To Quantify Receptor Density In Vivo, Scott C. Davis, Kimberley S. Samkoe, Kenneth M. Tichauer, Kristian J. Sexton, Jason R. Gunn, Sophie J. Deharvengt, Tayyaba Hasan, Brian W. Pogue

Dartmouth Scholarship

The up-regulation of cell surface receptors has become a central focus in personalized cancer treatment; however, because of the complex nature of contrast agent pharmacokinetics in tumor tissue, methods to quantify receptor binding in vivo remain elusive. Here, we present a dual-tracer optical technique for noninvasive estimation of specific receptor binding in cancer. A multispectral MRI-coupled fluorescence molecular tomography system was used to image the uptake kinetics of two fluorescent tracers injected simultaneously, one tracer targeted to the receptor of interest and the other tracer a nontargeted reference. These dynamic tracer data were then fit to a dual-tracer compartmental model …

Noninvasive Optical Quantification Of Absolute Blood Flow, Blood Oxygenation, And Oxygen Consumption Rate In Exercising Skeletal Muscle, Katelyn Gurley, Yu Shang, Guoqiang Yu

Biomedical Engineering Faculty Publications

This study investigates a method using novel hybrid diffuse optical spectroscopies [near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS)] to obtain continuous, noninvasive measurement of absolute blood flow (BF), blood oxygenation, and oxygen consumption rate (V̇O₂) in exercising skeletal muscle. Healthy subjects (n=9) performed a handgrip exercise to increase BF and V̇O₂ in forearm flexor muscles, while a hybrid optical probe on the skin surface directly monitored oxy-, deoxy-, and total hemoglobin concentrations ([HbO₂], [Hb], and THC), tissue oxygen saturation (S_tO₂), relative BF (rBF), and relative oxygen …

Cell Permeabilization And Inhibition Of Voltage-Gated Ca²+ And Na+ Channel Currents By Nanosecond Pulsed Electric Fields, Vasyl Nesin, Angela M. Bowman, Shu Xiao, Andrei G. Pakhomov

Bioelectrics Publications

Previous studies have found that nanosecond pulsed electric field (nsPEF) exposure causes long-term permeabilization of the cell plasma membrane. In this study, we utilized the whole-cell patch-clamp method to study the nsPEF effect on currents of voltage-gated (VG) Ca²⁺ and Na⁺ channels (I_Ca and I_Na) in cultured GH3 and NG108 cells. We found that a single 300 or 600 ns pulse at or above 1.5-2 kV/cm caused prolonged inhibition of I_Ca and I_Na. Concurrently, nsPEF increased a non-inactivating leak current (I_leak), presumably due to the formation of nanoelectropores or larger …

Prediction Of Brain Tumor Progression Using Multiple Histogram Matched Mri Scans, Debrup Banerjee, Loc Tran, Jiang Li, Yuzhong Shen, Frederic Mckenzie, Jihong Wang, Ronald M. Summers (Ed.), Bram Van Ginneken (Ed.)

Electrical & Computer Engineering Faculty Publications

In a recent study [1], we investigated the feasibility of predicting brain tumor progression based on multiple MRI series and we tested our methods on seven patients' MRI images scanned at three consecutive visits A, B and C. Experimental results showed that it is feasible to predict tumor progression from visit A to visit C using a model trained by the information from visit A to visit B. However, the trained model failed when we tried to predict tumor progression from visit B to visit C, though it is clinically more important. Upon a closer look at the MRI scans …

Prostate Cancer Region Prediction Using Maldi Mass Spectra, Ayyappa Vadlamudi, Shao-Hui Chuang, Xiaoyan Sun, Lisa Cazares, Julius Nyalwidhe, Dean Troyer, O. John Semmes, Jiang Li, Frederic D. Mckenzie

Electrical & Computer Engineering Faculty Publications

For the early detection of prostate cancer, the analysis of the Prostate-specific antigen (PSA) in serum is currently the most popular approach. However, previous studies show that 15% of men have prostate cancer even their PSA concentrations are low. MALDI Mass Spectrometry (MS) proves to be a better technology to discover molecular tools for early cancer detection. The molecular tools or peptides are termed as biomarkers. Using MALDI MS data from prostate tissue samples, prostate cancer biomarkers can be identified by searching for molecular or molecular combination that can differentiate cancer tissue regions from normal ones. Cancer tissue regions are …

Short-Pulse Laser Propagation Through Tissue Medium For Tumor Detection, Gopalendu Pal, Kunal Mitra, Tuan Vo-Dinh

Biomedical Engineering and Sciences Faculty Publications

The objective of this paper is to perform a comprehensive experimental and numerical analysis of the short pulse laser interaction with tissue medium with the goal of tumor / cancer diagnostics. For short pulse laser source, the shape of output signal is a function of the optical properties of the medium and hence the scattered temporal optical signal helps in understanding of the medium characteristics. Initially experiments are performed on tissue phantoms imbedded with inhomogeneities in order to optimize the time-resolved optical detection scheme. Both the temporal and the spatial profiles of the scattered reflected and transmitted optical signals are …

Short Pulse Laser Propagation Through Tissues, Champak Das, Ashish Trivedi, Kunal Mitra, Tuan Vo-Dinh

Biomedical Engineering and Sciences Faculty Publications

An experimental and numerical study is performed to analyze short pulse laser propagation through tissue phantoms without and with inhomogeneities/tumors imbedded in it. Short pulse laser probing techniques has distinct advantages over conventional very large pulse width or cw lasers primarily due to the additional information conveyed about the tissue interior by the temporal variation of the observed signal. Both the scattered temporal transmitted and reflected optical signals are measured experimentally using a streak camera for samples irradiated with a short pulse laser source. Parametric study involving different scattering and absorption coefficients of tissue phantoms and inhomogeneities as well as …

Novel Modeling Techniques For Tumor Diagnostics Using Pulsed Laser Sources, Mohamed Sakami, Kunal Mitra, Tuan Vo-Dinh

Biomedical Engineering and Sciences Faculty Publications

In this paper, a two-dimensional transient radiation transport algorithm is developed to analyze short pulse laser transport through a tissue medium having tumors and inhomogeneities imbedded in it. Short pulse probing techniques have distinct advantages over conventional very large pulse width or cw lasers primarily due to the additional information conveyed about the tissue interior by the temporal variation of the observed signal. The distinct feature is the multiple scattering induced temporal signatures that persists for time periods greater than the duration of the source pulse and is a function of the source pulse width, the scattering/absorbing properties and nature …

Use Of Short-Pulse Laser For Optical Tomography Of Tissues, Kunal Mitra, Tuan Vo-Dinh

Biomedical Engineering and Sciences Faculty Publications

This paper analyzes the short pulse laser propagation through tissues for development of a time-resolved optical tomography system for detection of tumors and inhomogeneities in tissues. Traditional method for analyzing optical transport in tissues is the parabolic or diffusion approximation in which the energy flux is assumed proportional to the fluence (intensity averaged over all solid angles) gradients. The inherent drawback in this model is that it predicts infinite speed of propagation of the optical signal. In this paper accurate hyperbolic or wave nature of transient radiative transfer formulation is used to overcome such drawbacks. The transmitted and reflected intensity …

Applications Of Wavelet Transforms In Biomedical Optoacoustics, Zibiao Wei, Shujun Yang, Amin N. Dharamsi, Barbara Hargrave

Biological Sciences Faculty Publications

We discuss the utility of wavelet transform methods in signal processing in general, and in particular, demonstrate the technique in optoacoustic applications. In several optoacoustic experiments with different samples, we have successfully enhanced the signal to noise ratios. Wavelet transforms optimize resolution by utilizing a tailored, variable time-window in different frequency regions. The technique's great advantage lies in the fact that the wavelet transform adds some redundancy to the original signal, and some desired features can be enhanced in the transformed space. In addition, proper choice of the basis set allows a sparse representation of the signal. Therefore, even when …