First-in-human pilot study of a spatial frequency domain oxygenation imaging system

Abstract

Abstract. Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a firstin-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

Real-time, profile-corrected single snapshot imaging of optical properties

“…Finally, the sample distance and angle are used to correct the intensity of the SFDI acquisition at each pixel. This approach has been validated and translated to the clinic [7].…”

“…in a multipixel approach). SFDI has shown significant promise in performing wide-field surgical guidance and specimen examination, both in animals and in humans, ex vivo and in vivo [7][8][9][10][11][12][13].…”

Real-time endoscopic optical properties imaging

“…Several steps have been made to improve the technique's robustness and processing schemes, including a fast 2-D look-up Table [15], a 3-D height correction method [16,17], and an optimization of wavelengths for spectroscopic fitting of tissue constituent concentrations [18]. These developments led to a first-in-human pilot study that measured skin flap oxygenation during reconstructive breast surgery [19]. However, further work was needed in order to avoid motion artifacts and to approach real-time image acquisition for image-guided surgery.…”

In vivoisolation of the effects of melanin from underlying hemodynamics across skin types using spatial frequency domain spectroscopy

“…This wide-field imaging approach has been applied for monitoring of port wine stain treatments and tissue transfer flap reperfusion and for assessments of burn wounds and nonmelanoma skin cancers. [11][12][13][14][15][16][17][18][19][20][21] Spatial frequency domain spectroscopy (SFDS) (which we have formerly referred to as spatially modulated quantitative spectroscopy) is a spatial frequency domain method for which the detection scheme employs a fiber coupled spectrometer rather than a two-dimensional camera, thereby trading spatial resolution in favor of high spectral resolution (∼1 nm) and spectral range (∼400 to 1100 nm). As with many other diffuse optical measurement methods, SFDS has been validated through homogeneous optical phantoms of known optical properties, demonstrating that this technique is capable of quantifying the absorption and scattering properties of turbid media in both visible and near-infrared (NIR) wavelength regimes.…”