Annika M. K. Nilsson

Changes in optical properties of human whole blood in vitro due to slow heating

Optical properties of human whole blood were investigated in vitro at 633 nm using a double integrating sphere set‐up. The blood flow was maintained at a constant rate through a flow cell while continuously heating the blood at 0.2–1.lC/min from approximately 25 to 55°C in a heat exchanger. A small, but rather abrupt decrease in the scattering asymmetry factor (g‐factor) of 1.7 ± 0.6% and a similar increase in the scattering coefficient of 2.9 ± 0.6% were observed at approximately 45–46°C yielding an increase in the reduced scattering coefficient of 40 ± 10%. Furthermore, a continuous, manifest increase in the absorption coefficient was seen with increasing temperature, on average 80 ± 70% from 25 to 50°C. The effect of the heating on the blood cells was also studied under a white‐light transmission microscope. A sudden change in the shape of the red blood cells, from discshaped to spherical, was observed at approximately the same temperature at which the distinct changes in g‐factor and scattering coefficient were observed, i.e. at 45–46°C. The results indicate that this shape transformation could explain the sudden change in scattering properties.

Measurements of the optical properties of tissue in conjunction with photodynamic therapy

A simple optical dosimeter was used to measure the light intensity in rat liver and muscle in vivo with fibers positioned at different depths to investigate whether the light penetration changed during photodynamic therapy (PDT). The results were then correlated with measurements of the three optical-interaction coefficients µ(s), µ(a) and g for wavelengths in the range 500-800 nm for PDT-treated and nontreated rat liver and muscle tissue in vitro. Adistinct increase in the absorption coefficient was seen immediately after treatment, in agreement with the decreasing light intensity observed during the treatment, as measured with the optical dosimeter. The collimated transmittance was measured with a narrow-beam setup, and an optical integrating sphere was used to measure the diffuse reflectance and total transmittance of the samples. The corresponding optical properties were obtained by spline interpolation of Monte Carlo-simulated data. To ensure that the measured values were correct, we performed calibration easurements with suspensions of polystyrene microspheres and ink.

The Study of Active Monitoring in Sweden (SAMS): a randomized study comparing two different follow-up schedules for active surveillance of low-risk prostate cancer.

Abstract Objective. Only a minority of patients with low-risk prostate cancer needs treatment, but the methods for optimal selection of patients for treatment are not established. This article describes the Study of Active Monitoring in Sweden (SAMS), which aims to improve those methods. Material and methods. SAMS is a prospective, multicentre study of active surveillance for low-risk prostate cancer. It consists of a randomized part comparing standard rebiopsy and follow-up with an extensive initial rebiopsy coupled with less intensive follow-up and no further scheduled biopsies (SAMS-FU), as well as an observational part (SAMS-ObsQoL). Quality of life is assessed with questionnaires and compared with patients receiving primary curative treatment. SAMS-FU is planned to randomize 500 patients and SAMS-ObsQoL to include at least 500 patients during 5 years. The primary endpoint is conversion to active treatment. The secondary endpoints include symptoms, distant metastases and mortality. All patients will be followed for 10--15 years. Results. Inclusion started in October 2011. In March 2013, 148 patients were included at 13 Swedish urological centres. Conclusions. It is hoped that the results of SAMS will contribute to fewer patients with indolent, low-risk prostate cancer receiving unnecessary treatment and more patients on active surveillance who need treatment receiving it when the disease is still curable. The less intensive investigational follow-up in the SAMS-FU trial would reduce the healthcare resources allocated to this large group of patients if it replaced the present standard schedule.

Clinical detection studies of Barrett's metaplasia and oesophageal adenocarcinoma by means of laser-induced fluorescence

Five patients with Barretts metaplastic epithelium were investigated by means of laser- induced fluorescence after low-dose i.v. injection (0.35 mg/kg b.w.) of PhotofrinR in connection with endoscopy procedures. The excitation wavelength was 405 nm. Recorded fluorescence spectra were evaluated by forming ratios with the photosensitizer fluorescence as numerator and the autofluorescence as denominator. Two patients had no evidence of malignancy and their fluorescence ratios were consequently rather small, whereas the other three patients had adenocarcinoma and showed considerably higher ratios. The results indicate that laser-induced fluorescence can be used as an aid in detecting malignant transformations in Barretts metaplasia.

Integrating Sphere Measurements of Tissue Optical Properties For Accurate Pdt Dosimetry

A set-up with an integrating sphere and a narrow-beam arrangement was used in order to derive the optical properties in vitro of 1 mm thick tissue slabs. The measured macroscopic quantities, the reflectance, and the total transmittance were correlated to the tissue optical properties by Monte Carlo simulations. Mie calculations were performed to be able to calibrate the set-up with a solution of latex spheres and ink. Finally, the optical properties of rat liver samples were measured, before and after photodynamic therapy, showing approximately a 40% increase of the absorption coefficient at 650 nm due to the treatment.