Measurement of tissue hemodynamics provides vital information for the assessment of tissue viability. This thesis reports three noninvasive near-infrared diffuse optical systems for spectroscopic measurements and tomographic imaging of tissue hemodynamics in vulnerable tissues with the goal of disease diagnosis and treatment monitoring. A hybrid near-infrared spectroscopy/diffuse correlation spectroscopy (NIRS/DCS) instrument with a contact fiber-optic probe was developed and utilized for simultaneous and continuous monitoring of blood flow (BF), blood oxygenation, and oxidative metabolism in exercising gastrocnemius. Results measured by the hybrid NIRS/DCS instrument in 37 subjects (mean age: 67 ± 6) indicated that vitamin D supplement plus aerobic training improved muscle metabolic function in older population. To reduce the interference and potential infection risk on vulnerable tissues caused by the contact measurement, a noncontact diffuse correlation spectroscopy/tomography (ncDCS/ncDCT) system was then developed. The ncDCS/ncDCT system employed optical lenses to project limited numbers of sources and detectors on the tissue surface. A motor-driven noncontact probe scanned over a region of interest to collect boundary data for three dimensional (3D) tomographic imaging of blood flow distribution. The ncDCS was tested for BF measurements in mastectomy skin flaps. Nineteen (19) patients underwent mastectomy and implant-based breast reconstruction were measured before and immediately after mastectomy. The BF index after mastectomy in each patient was normalized to its baseline value before surgery to get relative BF (rBF). Since rBF values in the patients with necrosis (n = 4) were significantly lower than those without necrosis (n = 15), rBF levels can be used to predict mastectomy skin flap necrosis. The ncDCT was tested for 3D imaging of BF distributions in chronic wounds of 5 patients. Spatial variations in BF contrasts over the wounded tissues were observed, indicating the capability of ncDCT in detecting tissue hemodynamic heterogeneities. To improve temporal/spatial resolution and avoid motion artifacts due to a long mechanical scanning of ncDCT, an electron-multiplying charge-coupled device based noncontact speckle contrast diffuse correlation tomography (scDCT) was developed. Validation of scDCT was done by imaging both high and low BF contrasts in tissue-like phantoms and human forearms. In a wound imaging study using scDCT, significant lower BF values were observed in the burned areas/volumes compared to surrounding normal tissues in two patients with burn. One limitation in this study was the potential influence of other unknown tissue optical properties such as tissue absorption coefficient (µa) on BF measurements. A new algorithm was then developed to extract both µa and BF using light intensities and speckle contrasts measured by scDCT at multiple source-detector distances. The new algorithm was validated using tissue-like liquid phantoms with varied values of µa and BF index. In-vivo validation and application of the innovative scDCT technique with the new algorithm is the subject of future work.

Since aggressive cancers are frequently hypermetabolic with angiogenic vessels, quantification of blood flow (BF) can be vital for cancer diagnosis. Our laboratory has developed a noncontact diffuse correlation tomography (ncDCT) system for 3-D imaging of BF distribution in deep tissues (up to centimeters). The ncDCT system employs two sets of optical lenses to project source and detector fibers respectively onto the tissue surface, and applies finite element framework to model light transportation in complex tissue geometries. This thesis reports our first step to adapt the ncDCT system for 3-D imaging of BF contrasts in human breast tumors. A commercial 3-D camera was used to obtain breast surface geometry which was then converted to a solid volume mesh. An ncDCT probe scanned over a region of interest on the breast mesh surface and the measured boundary data were used for 3-D image reconstruction of BF distribution. This technique was tested with computer simulations and in 28 patients with breast tumors. Results from computer simulations suggest that relatively high accuracy can be achieved when the entire tumor was within the sensitive region of diffuse light. Image reconstruction with a priori knowledge of the tumor volume and location can significantly improve the accuracy in recovery of tumor BF contrasts. In vivo ncDCT imaging results from the majority of breast tumors showed higher BF contrasts in the tumor regions compared to the surrounding tissues. Reconstructed tumor depths and dimensions matched ultrasound imaging results when the tumors were within the sensitive region of light propagation. The results demonstrate that ncDCT system has the potential to image BF distributions in soft and vulnerable tissues without distorting tissue hemodynamics. In addition to this primary study, detector fibers with different modes (i.e., single-mode, few-mode, multimode) for photon collection were experimentally explored to improve the signal-to-noise ratio of diffuse correlation spectroscopy flow-oximeter measurements.

The objective of this preliminary study was to determine the potential of diffuse correlation spectroscopy (DCS) for assessment of coagulation depth. Coagulation of tissue can occur due to a number of different reasons such as thermal or electrical burns or radiofrequency ablation. DCS is a non-invasive optical technique which can be used to determine the optical and dynamic properties of tissue by fitting a theoretical model of photon propagation in multiply scattering tissue to experimental data obtained from measurements. The DCS measurements were performed on two-layered phantom models that represent healthy tissue with high flow properties with a layer of coagulated tissue with low flow properties on top. Three different phantom models were prepared using gelatin-Intralipid gels, PDMS, and nylon as an upper layer, and an Intralipid solution was used for the bottom layer for all three phantoms. DCS measurements were performed on all three phantom models with varying thicknesses of the upper layers, and varying source-detector separations. The acquired data from the DCS measurement were analyzed in MATLAB in order to obtain the electric field temporal autocorrelation function. A theoretical model describing photon propagation in a two-layered medium was fitted to the obtained data in order to extract the desired parameters. The results showed that the thickness of the gelatin-Intralipid gels could be extracted within a 0.5 mm certainty and the thickness of the PDMS phantoms could also be extracted within approximately 0.7 mm. For the nylon phantoms, the results obtained were not good because the fitting was not successful and the thickness was not extracted appropriately. There is potential in DCS for assessment of burn wound depth but further research and development has to be done in the field in order to obtain more accurate and reliable results.

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Ce mémoire par article est une étude des différences hémodynamiques entre la dextro-transposition des gros vaisseaux (TGV) avec communication interventriculaire (CIV) et la TGV avec septum intact (SI) pendant la période fœtale et périopératoire. Il est à noter que SI fait référence au septum inter ventriculaire et non au septum inter auriculaire. La présence d’une communication inter auriculaire étant, comme nous le verrons dans ce travail, un élément important de la physiologie des fœtus/nouveau-nés porteur de TGV. Le document est divisé en deux parties importantes. La première partie est composée du chapitre 1 qui présente une revue de littérature détaillant les notions importantes à la compréhension de la problématique et du chapitre 2 qui décrit la méthodologie utilisée pour répondre à la question de recherche. On détaille d’abord les méthodes d’acquisition des échocardiographies fœtales ainsi que les principales mesures effectuées à partir de celles-ci. Ensuite, on y décrit les technologies de la spectroscopie proche infrarouge avancée et de la spectroscopie à corrélation diffuse (NIRS-DCS) permettant de recueillir les données hémodynamiques sur la microvascularisation cérébrale des nouveau-nés. La seconde partie est constituée du chapitre 3 qui est le manuscrit accepté au journal Ultrasound in Obstetric & Gynecology pour publication. Celui-ci décrit les différences hémodynamiques entre les patients ayant une TGV&CIV et les TGV&SI et présente les différences retrouvées en échocardiographie fœtale et en hémodynamie cérébrale périopératoire étudiée à l’aide de la NIRS avancée. Ensuite, nous présentons dans le chapitre 4 une discussion sur les principaux impacts cliniques et sur d’éventuelles améliorations. / This master’sthesis is composed of an article and a study. They present hemodynamic differences between patients with transposition of the great arteries (TGA) and ventricular septum defect (VSD), and TGA with intact ventricular septum (IVS) during fetal and perioperative periods. This document is divided into two principal sections. The first section includes Chapter 1 that presents a review of literature detailing important notions to understand the problematic, and Chapter 2, that describes the methodology used to answer our research question. First, we detailed acquisition data and measured parameters of the fetal echocardiography exams. Then, we describe advanced near infrared spectroscopy (NIRS-DCS) technology that allowed hemodynamic data acquisition on the cerebral microvascularization of neonates. The second section is composed of Chapter 3, the manuscript accepted in Ultrasound in Obstetric & Gynecology journal for publication. The aim of this article is to describe hemodynamic differences between patients with TGA&VSD and TGA&IVS. It describes fetal echocardiography and cerebral perioperative hemodynamic differences studied with advanced NIRS. Next, we present in Chapter 4 a more detailed discussion with principal impacts on the clinical field and future improvements.