Howard Kaufman

Analysis of acetic acid-induced whitening of high-grade squamous intraepithelial lesions

Immature and dysplastic cervical squamous epithelium whitens after the application of acetic acid during a colposcopic examination. The whitening process occurs visually over several minutes and subjectively discriminates between dysplastic and normal tissue. In this work, examples of the acetowhitening process are detailed in three ways: the color-imaged colposcopic appearance of the acetowhitening of high-grade cervical intraepithelial neoplasia (CIN 2/3), the kinetics of these reflectance patterns transformed to reduce noise in the signal, and a self-normalized green to red ratio measurement of the kinetics of these reflectance patterns. A total of six patients with biopsy confirmed CIN 2/3 were examined to obtain a set of timed images tracking the acetowhitening and the whitening-decay process over the course of 5-10 min. Regions of normal mature squamous epithelium within the same patients were also followed as an internal control. We determined that the temporal change over a 10 min time period in the ratio of green to red light intensities, taken from the respective color channels of the CCD, provides a reliable measure to clearly distinguish CIN 2/3 from normal cervical epithelium. This imaging and data normalization procedure may be applied to cervical lesions of different grades, to determine if a quantitative estimate provides predictive value during the colposcopic diagnosis.

Calibration of near-infrared frequency-domain tissue spectroscopy for absolute absorption coefficient quantitation in neonatal head-simulating phantoms

Frequency-domain tissue spectroscopy is a method to measure the absolute absorption coefficient of bulk tissues, assuming that a representative model can be found to recover the optical properties from measurements. While reliable methods exist to calculate absorption coefficients from source-detector measurements less than a few centimeters apart along a flat tissue volume, it is less obvious what methods can be used for transmittance through the larger tissue volumes typically associated with neonatal cerebral monitoring. In this study we compare the use of multiple distance frequency-domain measurements processed with (i) a modified Beer-Lambert law method, (ii) an analytic infinite-medium diffusion theory expression, and (iii) a numerical finite element solution of the diffusion equation, with the goal of recovering the absolute absorption coefficient of the medium. Based upon our observations, the modified Beer-Lambert method provides accurate absolute changes in the absorption coefficient, while analytic infinite-medium diffusion theory solutions or finite element-based numerical solutions can be used to calculate the absolute absorption coefficient, assuming that the data can be measured at multiple source-detector distances. We recommend that the infinite-medium multi-distance method or the finite element method be used across large tissue regions for calculation of the absolute absorption coefficient using frequency-domain near-infrared measurements at multiple positions along the head.

Fluorescence and reflectance spectra of freshly excised cervical tissue

Fluorescence emission and diffuse reflectance spectra of freshly excised cervical tissue were studied with two specially designed contact probes. The objective of the study was to reach a better understanding of the relationship between spectroscopic measurements and cervical tissue morphology. Tissue samples from loop electro-surgical excision and hysterectomy specimens were measured within 20 to 90 minutes of excision. Emission spectra with 337 nm excitation, and reflectance spectra were collected at wavelengths between 370 and 720 nm from different tissue sites. Hematoxylin-eosin stained slides of the measured zones were obtained and compared to the spectra. In one experiment, a contact probe with a central illumination fiber and two concentric rings of detection fibers (radii 0.1 and 1 mm), was placed in contact with the epithelium and used to measure spectra from ectocervix and endocervix. The influence of 5% acetic acid on fluorescence and reflectance spectra was also investigated. In another experiment, a single 100-micron fiber probe was placed perpendicular to a cut edge of tissue and scanned to measure spectra in depth. Depth scans were made over various areas of the cervix