The present disclosure generally relates to detecting specific tissue, and in particular, to a system and method of localization of fluorescent targets in deep tissue for guiding surgery.
This section introduces aspects that may help facilitate a better understanding of the disclosure. Accordingly, these statements are to be read in this light and are not to be understood as admissions about what is or is not prior art.
There is substantial interest in imaging deep tissue because it enables studies of targeted biochemical processes in natural environments and in vivo. However, when light is shown on a tissue, it both scatters and is absorbed, thereby making use of light transmitted through tissue exceedingly difficult. In addition, selective imaging requires reactance of tissue of interest to be different than surrounding tissue. As such, many have investigated fluorescent imaging. This type of imaging requires selective uptake of a florescent agent by a tissue of interest, exciting the tissue which causes the florescent agent to fluoresce, and detecting the fluorescence. However, such imaging presents a major challenge because the light becomes highly scattered, limiting the information that can be extracted from measurements. Near the tissue surface, microscopy methods such as optical coherence tomography and two-photon microscopy allow imaging at high resolution but with limited depth. Even with feedback control of the amplitude and phase of the incident wavefront, which enables focusing of light through tissue, the imaging depth is limited to less than about 1 mm.
In a surgical setting, it will be useful to assist the surgeon with information of exact location and size of a tissue to be resected. However, none of the above-mentioned techniques can provide information at a depth into tissue that is useful in most surgical settings.
Therefore, there is an unmet need for a novel approach to image at greater depths tissues to be resected and use such images in assisting with surgical operations.
A system for identifying a source of florescence is disclosed. The system includes a source of light configured to be shone on a subject, the light source configured to illuminate tissue of a subject at a first wavelength, and in response cause emission of light at a second wavelength from the tissue. The system also includes an optical filter configured to filter out light having the first wavelength and allow passage of light having the second wavelength. Furthermore, the system includes a method to measure light, such as an image capture device configured to capture images of the tissue at the second wavelength. In addition, the system includes a processor having software encoded on a non-transitory computer readable medium. The processor and the software are adapted to capture at least one 2 dimensional (2D) image of a subject having a plurality of pixels, establish information about approximate location of a source of fluorescence within tissue of the subject, identify a region of interest about the approximate location the source of florescence, establish a 3D topography data of the subject at least about the region of interest, map each pixel of the region of interest of the at least one 2D image to the 3D topography data, selectively generate a 3D geometric model based on physical properties of light propagation through the tissue based on the 3D topography data including a plurality of parameters defining the model, the model adapted to provide a model representation of the at least one 2D captured image, compare the modeled at least one 2D captured image to the captured at least one 2D image and generate an error signal representing a difference therebetween, iteratively adjust the plurality of parameter of the model to minimize the error signal, and output location and geometric configuration of the source of florescence within the tissue within the region of interest.
A method for identifying a source of florescence is also disclosed. The method includes shining light on a subject by a light source at a first wavelength, causing emission of light at a second wavelength from a source of florescence, filtering out light at the first wavelength and allowing passage of light at the second wavelength, capturing at least one 2 dimensional (2D) image of a subject having a plurality of pixels at the second wavelength, and establishing information about approximate location of the source of florescence within a tissue of the subject. The method also includes identifying a region of interest about the approximate location the source of florescence, establishing a 3D topography data of the subject at least about the region of interest, and mapping each pixel of the region of interest of the at least one 2D image to the 3D topography data. Furthermore, the method includes selectively generating a 3D geometric model based on physical properties of light propagation through the tissue based on the 3D topography data including a plurality of parameters defining the model, the model adapted to provide a model representation of the at least one 2D captured image. The method also includes comparing the modeled at least one 2D captured image to the captured at least 2D image and generate an error signal representing a difference therebetween. The method also includes iteratively adjusting the plurality of parameter of the model to minimize the error signal; and outputting location and geometric configuration of the source of florescence within the tissue within the region of interest.
The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of this disclosure is thereby intended.
In the present disclosure, the term “about” can allow for a degree of variability in a value or range, for example, within 10%, within 5%, or within 1% of a stated value or of a stated limit of a range.
In the present disclosure, the term “substantially” can allow for a degree of variability in a value or range, for example, within 90%, within 95%, or within 99% of a stated value or of a stated limit of a range.
A novel imaging approach is provided in the present disclosure that can be used to assist a surgeon to resect tissue. In particular, imaging beyond 1 mm is desirable. Imaging at tissue depths beyond 1 mm is achievable with diffuse optical imaging (DOI), where the light propagation is approximated as a diffusion process. The diffusion process includes both light scattering as well as absorption. In fluorescence diffuse optical tomography (FDOT), a DOI method, computational imaging allows formation of three dimensional (3D) images of optical properties. FDOT provides utility for in vivo studies in mice and rats, especially when combined with another imaging modality such as computed tomography (CT) or magnetic resonance imaging (MRI) to improve spatial resolution.
FDOT and folate-targeted fluorescent contrast agents can be used to image the kidneys and liver in dead mice as well as tumors in live mice. FDOT has potential to be a useful tool for fluorescence guided surgery, where tumor nodules are identified for a surgeon to remove. However, the full volumetric reconstruction performed by FDOT requires extensive computational time, making it ill-suited for an intraoperative environment where real-time imaging is required over a period of hours. As a result, an alternative approach using fast localization methods is provided in the present disclosure where only the position of a source of florescence is determined. A mouse model is used to show that this method can find tumors in deep tissue, and can provide depth information to assist in guided surgery.
Referring to
The detector 104 is coupled to a processor (not shown) which has analyzing software on a non-transitory computer readable medium configured to determine the characteristics of the tumor 118 (or other tissue that has been treated with a florescent material). The analysis is based on a process 200 depicted as a flowchart in
Prior to describing the steps in the process 200 shown in
where r denotes the position,
ϕ(r, ω) (W/mm2) is the photon flux density,
ω is the angular modulation frequency,
D=1/[3(μs′+μa)] (mm) is the diffusion coefficient,
μ′s (mm) is the reduced scattering coefficient,
μa (mm) is the absorption coefficient,
c is the speed of light in the medium,
the subscripts x and m denote parameters at the fluorophore excitation and emission wavelengths, λx and λm, respectively,
Sx (W/mm3) is the excitation source term, and
Sf=η(1+jωτ)−1 (mm−1) is the fluorescence source term.
Equations (1) and (2) are coupled through the ϕx(r, ω) term on the right hand side of (2). These equations represent a set of partial differential equations (PDE), that can be solved numerically using the Green's function, as known to a person having ordinary skill in the art. In an infinite homogeneous space, the diffusion equation's Green's function is
where r′ is the position of a point source, and
k
2=−μaD−jω/(Dc), where
μa and D can be calculated at λx or λm in (1) or (2), respectively. Equation (3) represents the analytical solution of propagation of photons.
Based on equations (1), (2), and (3), a model can thus be generated based on the assumption that tissue surrounding the tumor is homogenous and thus diffuses light uniformly. Equations (1) and (2) can be solved on an unstructured finite element method (FEM) mesh on the assumption that the tissue is heterogeneous. However, the FEM solution requires extensive computational time, limiting its application in an operating environment. For this reason, a closed-form analytic solution can be adopted that allows fast computation.
Referring to
where w is a multiplicative constant that incorporates ηf, μa
gx(rs, rf) represent the diffusion equation Green's function for (1) at λx, and
gm(rf, ri) represent the diffusion equation Green's function for (2) at λm. The Green's functions are derived by assuming a single boundary exists such that rs and ri are on the boundary and rf is below the boundary, as shown in
If a source of florescence is present, its position can be estimated by finding the value of rf that minimizes the cost function
where y is a vector of N measurements,
f (rf) is a vector of N forward calculations fi(rf) from (5),
γ=αdiag[|y1|, . . . , |yN|] is the noise covariance matrix, for which we assume a shot noise model characterized by α. For an arbitrary vector v, ∥v∥γ
where H denotes the Hermitian transpose. Only the case where a single excitation source is present at position rs is considered. In this case, gx(rs, rf) at rf is constant, and can therefore be pulled out of f (rf), giving
where hi(rf)=gm(rf, ri) is the ith component of h(rf). Because gx(rs, rf) is a constant at rf, it can be incorporated into w as
For localization, one goal is to find the rf that minimizes (8), and we note that the inverse problem is linear in ws and nonlinear in rf. Equation (8) can therefore be minimized using a two-step procedure. First, we set the derivative of ∥y−wsh(rf)∥γ
Second, we calculate (10) at a set of positions rf within a region of interest that encompasses the true location. The maximum likelihood estimates are then
An important step in our derivation that differentiates it from previous derivations is the incorporation of gx(rs, rf) into ws. This step implies that the inverse problem can be solved without consideration or modeling of the excitation source, and only gm(rf, ri) needs to be computed for the forward model. This is of great utility because complicated illumination patterns (such as an expanded beam) do not need to be modeled.
The localization of a source of florescence can thus be demonstrated numerically, according to the present disclosure, in , according to (11).
To demonstrate the efficacy of the process 200 (see
In order to localize a tumor, tumor cells need to be first targeted with a fluorescent compound. Over forty percent of human cancer cells over-express folate receptors, enabling the cells to be identified using folate-targeted fluorescence imaging. In a typical study, a fluorophore is attached to the targeting agent (folate) and injected into the blood stream of an animal. The fluorescent agent is then distributed to the extracellular extravascular space, where it remains in circulation or is eliminated. Roughly 30 minutes after injection, the fluorescent agent is mostly cleared from the blood, and is concentrated in the kidneys, the liver, and any tumors that are present. This process introduces a contrast in fluorescence throughout the tissue, enabling fluorescence-guided surgery. In a previous study, it was shown that a surgeon can detect 5 times more malignant masses with the aid of fluorescence than with the naked eye. However, once a tumor has been identified, additional information about its location, such as its depth, could be used to minimize damage to the surrounding healthy tissue. Here, we use a mouse model to demonstrate that the location of a tumor can be estimated using our localization method. Expanded beam illumination is commonly used in fluorescence-guided surgery, further motivating the use of our approach.
Female nu/nu mice purchased from NCI Charles River Laboratories were maintained on folate deficient rodent chow for 3 weeks prior to experimental study and kept on a standard 12 hour light-dark cycle. Tumor cells (106 of L1210A) were injected intravenously into the tail vein of a six-week-old female nu/nu mouse. The cancer cells were allowed to metastasize for 30 days, at which point 10 nmol of a folate-targeted fluorescent agent (OTL0038) dissolved in saline was injected intravenously via the tail vain. The OTL0038 attached itself to the folate-receptors present in the tumors, allowing for fluorescent imaging. Two hours after injection of OTL0038, the mouse was euthanized through CO2 asphyxiation. The mouse was then placed on its side in the experimental setup shown in
The peak excitation of the OTL0038 is 770 nm and the peak emission is 790 nm. An OD4 emission bandpass filter (see filter 122 in
The 3D topography of the mouse was captured using the laser line scanner. Laser light was focused through a cylindrical lens to form a line, which was scanned along the length of the mouse to 92 positions. At each position, a CCD camera image was captured.
Localization of the tumor requires that the μs′ and μa of the tissue are known so that gm(rf, ri) can be calculated using (3) subject to the boundary condition. The μs′ and μa can be determined from the literature, or they can be estimated by incorporating them into the optimization problem. μa was estimated according to the present disclosure in order to improve the accuracy of the localization. This was accomplished by fixing μs′=1.6 mm−1 and, for each rf within the region of interest, calculating the cost in (10) for values of μa between 0 and 0.05 mm−1 separated by increments of 0.005 mm−1. The position of the source of florescence was then estimated as the position rf that minimized the cost. Because the tissue is heterogeneous and the model assumes that it is homogeneous, estimated values of μs′ and μa will not be quantitative. Therefore, μs′ and μa can be treated as fitting parameters, since for localization only position of the source of florescence is of interest.
The results of this localization procedure using data from h(
). Since the surface is slowly varying, and only one source of florescence dominates the contribution to the data at the detectors, the model fits the data well. The discrepancy could be due to autofluorescence, fluorescence from the kidney, errors in the 3D topography, or assumptions made in the forward model derivation.
The localization method was implemented in MATLAB and run on a 12 core computer with 3.47 GHz Intel X5690 processors and 96 GB RAM. In order to improve the computational time, an effort was made to parallelize the computation of the cost function across multiple processors using the MATLAB parallel computing toolbox. Without parallel processing, the computational time for the results in
Referring to
Those having ordinary skill in the art will recognize that numerous modifications can be made to the specific implementations described above. The implementations should not be limited to the particular limitations described. Other implementations may be possible.
The present patent application is a continuation-in-part application which is related to and claims the priority benefit of U.S. Non-Provisional patent application Ser. No. 15/975,211, filed May 9, 2018, published as US 2018/0325449, and is also related to and claims the priority benefit of U.S. Provisional Patent Application Ser. No. 62/723,907 filed Aug. 28, 2018, the contents of each of which are hereby incorporated by reference in its entirety into the present disclosure.
This invention was made with government support under CA182235-01A1 awarded by the National Institutes of Health. The government has certain rights in the invention.
Number | Date | Country | |
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62723907 | Aug 2018 | US |
Number | Date | Country | |
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Parent | 15975211 | May 2018 | US |
Child | 16554188 | US |