Significance: Multi-laboratory initiatives are essential in performance assessment and standardization—crucial for bringing biophotonics to mature clinical use—to establish protocols and develop reference tissue phantoms that all will allow universal instrument comparison.
Aim: The largest multi-laboratory comparison of performance assessment in near-infrared diffuse optics is presented, involving 28 instruments and 12 institutions on a total of eight experiments based on three consolidated protocols (BIP, MEDPHOT, and NEUROPT) as implemented on three kits of tissue phantoms. A total of 20 synthetic indicators were extracted from the dataset, some of them defined here anew.
Approach: The exercise stems from the Innovative Training Network BitMap funded by the European Commission and expanded to include other European laboratories. A large variety of diffuse optics instruments were considered, based on different approaches (time domain/frequency domain/continuous wave), at various stages of maturity and designed for different applications (e.g., oximetry, spectroscopy, and imaging).
Results: This study highlights a substantial difference in hardware performances (e.g., nine decades in responsivity, four decades in dark count rate, and one decade in temporal resolution). Agreement in the estimates of homogeneous optical properties was within 12% of the median value for half of the systems, with a temporal stability of <5 % over 1 h, and day-to-day reproducibility of <3 % . Other tests encompassed linearity, crosstalk, uncertainty, and detection of optical inhomogeneities.
Conclusions: This extensive multi-laboratory exercise provides a detailed assessment of near-infrared Diffuse optical instruments and can be used for reference grading. The dataset—available soon in an open data repository—can be evaluated in multiple ways, for instance, to compare different analysis tools or study the impact of hardware implementations.
We show both on phantoms and in-vivo the full potential of fast time-gated acquisitions exploiting an innovative custom-developed digital silicon photomultiplier, overcoming consolidated limitations showed by single-photon avalanche diodes linked to their small sensitive area.
We present in vivo tests on healthy women through our optical mammograph in preparation for a clinical validation on neoadjuvant chemotherapy monitoring, and we report preliminary data on the first patient enrolled in the study.
Performance assessment and standardization are indispensable for instruments of clinical relevance in general and clinical instrumentation based on photon migration/diffuse optics in particular. In this direction, a multi-laboratory exercise was initiated with the aim of assessing and comparing their performances. 29 diffuse optical instruments belonging to 11 partner institutions of a European level Marie Curie Consortium BitMap1 were considered for this exercise. The enrolled instruments covered different approaches (continuous wave, CW; frequency domain, FD; time domain, TD and spatial frequency domain imaging, SFDI) and applications (e.g. mammography, oximetry, functional imaging, tissue spectroscopy). 10 different tests from 3 well-accepted protocols, namely, the MEDPHOT2 , the BIP3 , and the nEUROPt4 protocols were chosen for the exercise and the necessary phantoms kits were circulated across labs and institutions enrolled in the study. A brief outline of the methodology of the exercise is presented here. Mainly, the design of some of the synthetic descriptors, (single numeric values used to summarize the result of a test and facilitate comparison between instruments) for some of the tests will be discussed.. Future actions of the exercise aim at deploying these measurements onto an open data repository and investigating common analysis tools for the whole dataset.
The use of technologies still under development (Silicon PhotoMultipliers and Time-to-Digital Converter) for the upgrade of our time-resolved optical mammograph highlighted the crucial need for a thorough and progressive instrument characterization (from extensive laboratory tests on phantoms to in vivo measurements), potentially of general interest. Despite satisfying results on phantoms, in vivo tests urged an instrumental change, with the adoption of a just released high-throughput TDC to obtain high-quality breast scans (much wider scan area, better day-by-day reproducibility, improved signal quality, simpler set-up). A clinical study on monitoring of neoadjuvant chemotherapy is now ongoing at the San Raffaele Hospital, Milan.
To improve non-invasively the specificity in the diagnosis of breast cancer after a positive screening mammography or doubt/suspicious ultrasound examination, the SOLUS project developed a multimodal imaging system that combines: Bmode ultrasound (US) scans (to assess morphology), Color Doppler (to visualize vascularization), shear-wave elastography (to measure stiffness), and time domain multi-wavelength diffuse optical tomography (to estimate tissue composition in terms of oxy- and deoxy-hemoglobin, lipid, water, and collagen concentrations). The multimodal probe arranges 8 innovative photonic modules (optodes) around the US transducer, providing capability for optical tomographic reconstruction. For more accurate estimate of lesion composition, US-assessed morphological priors can be used to guide the optical reconstructions. Each optode comprises: i) 8 picosecond pulsed laser diodes with different wavelengths, covering a wide spectral range (635-1064 nm) for good probing of the different tissue constituents; ii) a large-area (variable, up to 8.6 mm2 ) fast-gated digital Silicon Photomultiplier; iii) the acquisition electronics to record the distribution of time-of-flight of the re-emitted photons. The optode is the basic element of the optical part of the system, but is also a stand-alone, ultra-compact (about 4 cm3 ) device for time domain multi-wavelength diffuse optics, with potential application in various fields.
In the last decade, multimodal imaging raised increasing interest to overcome the limits of single techniques and improve the diagnostic potential during the same examination. This gives rise to the need for phantoms and procedures for standardizing performance assessment of the multimodal instrument. The SOLUS1 project adopts this methodology with the aim to build a multimodal instrument (based on diffuse optics -DO-, shear wave elastography -SWE-, and ultrasound imaging -US-) to increase the specificity of breast cancer diagnosis. Here we propose a long-lasting phantom based on silicone material (easier to manipulate with respect to other material for bimodal phantom such as polyvinyl alcohol, PVA) and suitable for both diffuse optical imaging/tomography and ultrasound acquisitions, designed within the SOLUS project. To achieve this goal, we explored a new silicone material for diffuse optics and ultrasound (Ecoflex 00-30), creating a new fabrication recipe and demonstrating its suitability for multimodal imaging if coupled to another silicone elastomer (Sylgard 184), featuring similar optical and acoustical performances except for the echogenicity. The main advantage of the proposed phantom is the capability of tuning independently optical and acoustical performances, thus allowing one to mimic a wide range of clinical scenarios.
Time Domain Diffuse Optical Tomography (TD-DOT) at different wavelengths can be used to retrieve tissue reconstructing the components of a two-region system starting from self-normalized time-dependent measurements performed in reflectivity geometry over multiple wavelengths. The proposed method performs a fit of a limited number of tissues parameters providing a good quantification of the components’ concentrations by applying a FEM-based Diffusion approximation of the TD-DOT direct model.
Time Domain Diffuse Optical Tomography (TD-DOT) performed at multiple wavelengths can be used to non-invasively probe tissue composition. Then, tissue composition can be related to breast tissue and lesion type. Thus, TD-DOT could be used for therapy monitoring for breast cancer. We developed a software tool for multi-wavelength TD-DOT and performed a validation on meat phantoms to mimic tissue heterogeneity. An inclusion of different meat was exploited to mimic the presence of a lesion in the breast. Results show good localization of the inclusion, but poor quantification of the reconstructed breast composition. The use of a morphological prior constraint, providing information on inclusion geometry and position, significantly improves both localization and composition estimate.
Time domain Diffuse Optical Tomography (TD-DOT) non-invasively probes the optical proprieties of biological tissue. These can be related to changes in tissue composition, thus making TD-DOT potentially valuable for cancer imaging. In particular, an application of interest is therapy monitoring for breast cancer. Thus, we developed a software tool for multiwavelength TD-DOT in reflectance geometry. While the use of multiple wavelengths probes the main components of the breast, the chosen geometry offers the advantage of linking the photon flight time to the investigated depth. We validated the tool on silicon phantoms embedding an absorbing inclusion to simulate a malignant lesion in breast tissue. Also, we exploited the a priori information on position and geometry of the inclusion by using a morphological prior constraint. The results show a good localization of the depth of inclusion but a reduced quantification. When the morphological constraint is used, though, the localization improves dramatically, also reducing surface artifacts and improving quantification as well. Still, there is room for improvement in the quantification of the “lesion” properties.
An 8-channel Silicon PhotoMultiplier (SiPM) probe and Time-to-Digital-Converter (TDC) realize a higher-throughput, cheaper and compact detection chain for time-resolved optical mammography than photomultiplier tubes (PMTs) and Time Correlated Single Photon Counting (TCSPC) boards, providing comparable estimate of optical properties with increased optical responsivity.
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