Stanislaw Wojtkiewicz

Optical system based on time-gated, intensified charge-coupled device camera for brain imaging studies.

An imaging system for brain oxygenation based on a time-gated, intensified charge-coupled device camera was developed. It allows one to image diffusely reflected light from an investigated medium at defined time windows delayed with respect to the laser pulse. Applying a fast optomechanical switch to deliver the light at a wavelength of 780 nm to nine source fibers allowed one to acquire images in times as short as 4 s. Thus, the system can be applied in in vivo studies. The system was validated in phantom experiments, in which absorbing inclusions were localized at different depths and different lateral positions. Then, the decrease in absorption of the brain tissue related to increase in oxygenation was visualized in the motor cortex area during finger tapping by a healthy volunteer.

Laser-Doppler spectrum decomposition applied for the estimation of speed distribution of particles moving in a multiple scattering medium

Recently, a method for the estimation of speed distribution of particles moving in an optically turbid medium has been proposed. The method allows potentially absolute measurement of speed of the particles and can be applied in laser-Doppler perfusion measurements. However, the decomposition technique was limited to short source-detector separations for which the assumption that one photon is Doppler scattered not more than once is fulfilled. In the present paper we show a generalized decomposition technique in which photons can be scattered more than once. We show the theoretical background for decomposition in such a case. We apply a decomposition method for the analysis of laser-Doppler spectra obtained by Monte Carlo simulations. This analysis allows showing noise limits in which the technique can be effectively applied in analysis of measured spectra. We propose an approximated scattering model based on the assumption that for one photon consecutive Doppler scattering events occur on particles moving with the same speed, and we show that this approximation does not influence significantly the uncertainty of the resulting speed distribution. The proposed decomposition procedure is validated in measurements on a physical flow model. The decomposition procedure is also validated by analysis of spectra measured on a physical phantom using laser-Doppler flow meter (Oxford Optronix, UK). A diluted solution of milk was pumped through a tube fixed in an optically turbid material with speed varying from 0 mm s(-1) to 4 mm s(-1). We observed a linear relation between actual speed of milk solution and speed estimated from results of spectra decomposition.

Optimization of the method for assessment of brain perfusion in humans using contrast-enhanced reflectometry: multidistance time-resolved measurements

Abstract. The aim of the study was to determine optimal measurement conditions for assessment of brain perfusion with the use of optical contrast agent and time-resolved diffuse reflectometry in the near-infrared wavelength range. The source-detector separation at which the distribution of time of flights (DTOF) of photons provided useful information on the inflow of the contrast agent to the intracerebral brain tissue compartments was determined. Series of Monte Carlo simulations was performed in which the inflow and washout of the dye in extra- and intracerebral tissue compartments was modeled and the DTOFs were obtained at different source-detector separations. Furthermore, tests on diffuse phantoms were carried out using a time-resolved setup allowing the measurement of DTOFs at 16 source-detector separations. Finally, the setup was applied in experiments carried out on the heads of adult volunteers during intravenous injection of indocyanine green. Analysis of statistical moments of the measured DTOFs showed that the source-detector separation of 6 cm is recommended for monitoring of inflow of optical contrast to the intracerebral brain tissue compartments with the use of continuous wave reflectometry, whereas the separation of 4 cm is enough when the higher-order moments of DTOFs are available.

Application of optical methods in the monitoring of traumatic brain injury: A review:

We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: “traumatic brain injury,” “head injury,” or “head trauma,” and “optical methods,” “NIRS,” “near-infrared spectroscopy,” “cerebral oxygenation,” or “cerebral oximetry.” Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria. Optical methods have been tested for detection of intracranial lesions, monitoring brain oxygenation, assessment of brain perfusion, and evaluation of cerebral autoregulation or intracellular metabolic processes in the brain. Some studies have also examined the applicability of optical methods during the recovery phase of traumatic brain injury . The limitations of currently available optical methods and promising directions of future development are described in this review. Considering the outstanding technical challenges, the limited number of patients studied, and the mixed results and opinions gathered from other reviews on this subject, we believe that optical methods must remain primarily research tools for the present. More studies are needed to gain confidence in the use of these techniques for neuromonitoring of traumatic brain injury patients.

Evaluation of algorithms for microperfusion assessment by fast simulations of laser Doppler power spectral density

In classical laser Doppler (LD) perfusion measurements, zeroth- and first-order moments of the power spectral density of the LD signal are utilized for the calculation of a signal corresponding to the concentration, speed and flow of red blood cells (RBCs). We have analysed the nonlinearities of the moments in relation to RBC speed distributions, parameters of filters utilized in LD instruments and the signal-to-noise ratio. We have developed a new method for fast simulation of the spectrum of the LD signal. The method is based on a superposition of analytically calculated Doppler shift probability distributions derived for the assumed light scattering phase function. We have validated the method by a comparison of the analytically calculated spectra with results of Monte Carlo (MC) simulations. For the semi-infinite, homogeneous medium and the single Doppler scattering regime, the analytical calculation describes LD spectra with the same accuracy as the MC simulation. The method allows for simulating the LD signal in time domain and furthermore analysing the index of perfusion for the assumed wavelength of the light, optical properties of the tissue and concentration of RBCs. Fast simulations of the LD signal in time domain and its frequency spectrum can be utilized in applications where knowledge of the LD photocurrent is required, e.g. in the development of detectors for tissue microperfusion monitoring or in measurements of the LD autocorrelation function for perfusion measurements. The presented fast method for LD spectra calculation can be used as a tool for evaluation of signal processing algorithms used in the LD method and/or for the development of new algorithms of the LD flowmetry and imaging. We analysed LD spectra obtained by analytical calculations using a classical algorithm applied in classical LD perfusion measurements. We observed nonlinearity of the first moment M₁ for low and high speeds of particles (v < 2 mm s⁻¹, v > 10 mm s⁻¹). It was also noted that the first moment M(1) is less sensitive to the change of the mean RBC speed for flat speed distributions. The low-pass filter frequency f₂ implemented in the LD instrument has a significant influence on the first moment of the spectrum. In particular, for a cut-off frequency lower than 10 kHz the M₁ value is strongly underestimated.

Prolonged Postocclusive Hyperemia Response in Patients with Normal-Tension Glaucoma

Background It is believed that endothelial dysfunction may be a link between systemic and ocular dysregulation in glaucoma. The aim of this study was to evaluate peripheral vascular reactive hyperemia in response to occlusion test and to correlate peripheral vascular findings with retrobulbar hemodynamics parameters in patients with normal-tension glaucoma. Material/Methods Forty-eight patients with normal-tension glaucoma (mean age 58.1 years, 38 women) and 40 control subjects (mean age 54.1 years, 36 women) were subjected to a brachial arterial occlusion test and color Doppler imaging (LOGIQ 9, GE Medical Systems) of the retrobulbar arteries. Finger hyperemia was assessed by using a 2-channel laser Doppler flowmeter (MBF-3D, Moor Instruments, Ltd.). Time parameters (time to peak flow, half-time of hyperemia, time of recovery) and amplitude parameters (maximum hyperemia response, biological zero) of the post-occlusive reactive hyperemia signal pattern as well as velocities and resistance index of the ophthalmic, central retinal, and short posterior ciliary arteries were evaluated and compared between study groups. Results In glaucoma patients, time to peak flow and half-time of hyperemia were significantly longer (21.4 vs. 12.0 s, p=0.02 and 74.1 vs. 44.2 s, p=0.03, respectively) and biological zero was significantly lower (2.4 vs. 3.2, p=0.01) comparing with healthy subjects. In glaucoma patients, peak-systolic and end-diastolic velocities of central retinal artery were significantly lower (12.8 vs.14.1, p=0.03 and 3.9 vs. 4.7, p=0.01, respectively) and resistance index of this artery was significantly higher (0.69 vs. 0.67, p=0.03) compared to controls. In the glaucoma group, maximum hyperemic response was negatively correlated with the resistance index of temporal short posterior ciliary arteries (r=−0.4, p=0.01), whereas in the control group half-time of hyperemia was negatively correlated with end-diastolic velocity of the central retinal artery (r=−0.3, p=0.03). Conclusions Arterial occlusion test elicited a prolonged systemic hyperemia response in patients with glaucoma as compared with healthy subjects. Retrobulbar blood flow alterations in glaucoma patients may be related to systemic vascular dysregulation.

Assessment of ICG inflow to the brain by time-resolved measurements of diffuse reflectance at 16 source-detector separations

Time-resolved diffuse reflectance measurements were carried out on the head of healthy volunteer during ICG injection. Statistical moments of distributions of times of flight of photons measured at 16 source-detector separations were analyzed.

Estimation of Speed Distribution of Particles Moving in an Optically Turbid Medium Using Decomposition of a Laser-Doppler Spectrum

In this paper we present validation of laser-Doppler spectrum decomposition procedure in estimation of speed distribution of particles. Decomposition method is based on assumption that measured laser-Doppler spectrum can be approximated by linear combination of Doppler shift probability distributions calculated for different speeds of particles and anisotropy of light scattering in the medium. The Doppler shift probability distributions were calculated using Monte-Carlo simulations for Henyey-Greenstein scattering phase function. This decomposition method allows to obtain distribution of speeds of moving particles in the medium, not only average speed as it was possible in laser-Doppler perfusion monitors. Recently we reported that the method was positively verified on spectra generated for different speed distributions using Monte Carlo simulations. In this study we present results of application of the decomposition procedure in analysis of laser-Doppler spectra obtained in physical phantom experiments. A diluted solution of milk was pumped through a tube with different speeds. The dependence of the obtained distributions of speed of moving particles on the speed of flow was observed. Laser-Doppler spectra obtained during in-vivo experiment were also successfully decomposed. A healthy volunteer was investigated and the spectra of laser-Doppler signal during postocclusive hyperemia test were recorded and analyzed. We conclude that the spectrum decomposition procedure can be successfully applied in analysis of the measured laser-Doppler spectra and the amount of information provided by laser-Doppler technique can be significantly increased.

Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility

We aimed to determine whether optical methods based on bolus tracking of an optical contrast agent are useful for the confirmation of cerebral circulation cessation in patients being evaluated for brain death. Different stages of cerebral perfusion disturbance were compared in three groups of subjects: controls, patients with posttraumatic cerebral edema, and patients with brain death. We used a time-resolved near-infrared spectroscopy setup and indocyanine green (ICG) as an intravascular flow tracer. Orthogonal partial least squares-discriminant analysis (OPLS-DA) was carried out to build statistical models allowing for group separation. Thirty of 37 subjects (81.1%) were classified correctly (8 of 9 control subjects, 88.9%; 13 of 15 patients with edema, 86.7%; and 9 of 13 patients with brain death, 69.2%; p < 0.0001). Depending on the combination of variables used in the OPLS-DA model, sensitivity, specificity, and accuracy were 66.7–92.9%, 81.8–92.9%, and 77.3–89.3%, respectively. The method was feasible and promising in the demanding intensive care unit environment. However, its accuracy did not reach the level required for brain death confirmation. The potential usefulness of the method may be improved by increasing the depth of light penetration, confirming its accuracy against other methods evaluating cerebral flow cessation, and developing absolute parameters for cerebral perfusion.

Towards real time diffuse optical tomography:: Accelerating light propagation modeling employing parallel computing on GPU and CPU

Abstract. Parameter recovery in diffuse optical tomography is a computationally expensive algorithm, especially when used for large and complex volumes, as in the case of human brain functional imaging. The modeling of light propagation, also known as the forward problem, is the computational bottleneck of the recovery algorithm, whereby the lack of a real-time solution is impeding practical and clinical applications. The objective of this work is the acceleration of the forward model, within a diffusion approximation-based finite-element modeling framework, employing parallelization to expedite the calculation of light propagation in realistic adult head models. The proposed methodology is applicable for modeling both continuous wave and frequency-domain systems with the results demonstrating a 10-fold speed increase when GPU architectures are available, while maintaining high accuracy. It is shown that, for a very high-resolution finite-element model of the adult human head with ∼600,000 nodes, consisting of heterogeneous layers, light propagation can be calculated at ∼0.25  s/excitation source.