Standard techniques for detection of thyroid cancer (ultrasound screening and fine-needle aspiration biopsy) have limited sensitivity and specificity, leading to a very large number of unnecessary thyroid extraction surgeries. With the aim of improving diagnosis, hybrid diffuse optics and ultrasound were used on nodules patients to obtain tissue hemodynamic information. Nodules rated 4A or 4B in the thyroid imaging reporting and data system (TI-RADS) are of clinical relevance and were classified using a logistic regression model built on our results. Fourteen benign and four malignant nodules were classified with a sensitivity of 100% and specificity of 77%.
LUCA platform combines clinical ultrasound with near-infrared time-domain and correlation spectroscopies to improve thyroid cancer screening. We characterized its precision and classified thyroid nodules in a clinical campaign on 45 subjects.
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.
Diffuse correlation spectroscopy (DCS) is an emerging diffuse optical technique that quantifies microvascular blood flow. In spite of the wide range of clinical/research applications, DCS instrumentation is not yet standardized. In this study, we have analyzed the effect of experimental parameters as the measurement duration time and the number of detectors, at different photon count-rates, on the precision of a DCS experiment. This provides a recipe for finding device and experimental settings that optimize the precision while balancing cost and temporal resolution.
The LUCA device combines clinical ultrasound, time-domain near infrared and diffuse correlation spectroscopies with the aim of improving thyroid cancer screening sensitivity and specificity. The preliminary clinical campaign on patients (n=31) with thyroid nodules and healthy controls (n=11) allowed the characterization of the precision of the instrument and demonstrated that using a couple of biomarkers the muscle-to-nodule contrast allows an area under the curve of 0.92 for single-nodule patients and 0.77 for all patients in differentiating benign and malignant nodules in a receiver operating characteristic curve. We will present the updated results from the ongoing study.
We present the current status of the LUCA project whose aim is to develop an innovative device combining ultrasound and diffuse optics for an improved screening of the thyroid cancer.
We localized the thyroid nodules in eleven subjects by ultrasound and measured the microvascular blood flow of the nodules by diffuse correlation spectroscopy.
Diffuse optical imaging can be used to probe highly scattering media like biological tissue down to a depth of few centimeters, with spatial resolution limited by light scattering. Its combination with ultrasound imaging can potentially lead to medical imaging systems with, for instance, high specificity in the examination of tumors. However, the presence of the ultrasound coupling gel between probe and tissue can have detrimental effects on the accuracy of optical imaging techniques. Here we present an experimental study on the effect of ultrasound coupling fluids on diffuse optical spectroscopy (DOS) and diffuse correlation spectroscopy (DCS). We demonstrate on tissue-mimicking phantoms that the use of standard water-clear gels, providing a direct path for the light from the source to the detection point, can distort optical measurements generating strong underestimation of both the absorption and the reduced scattering coefficients in DOS measurements, as well as underestimation of the Brownian diffusion coefficient in DCS measurements. On the contrary, various turbid fluids demonstrate excellent performance in preventing this issue.
The feasibility of in utero measurement of cerebral blood flow diffuse correlation spectroscopy was demonstrated in lamb fetuses and compared with measurements outside the uterus.
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