Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC 27599, USA.
Sensors (Basel). 2021 Dec 29;22(1):237. doi: 10.3390/s22010237.
Sentinel lymph node (SLN) biopsy is an integral part of treatment planning for a variety of cancers as it evaluates whether a tumor has metastasized, an event that significantly reduces survival probability. However, this invasive procedure is associated with patient morbidity, and misses small metastatic deposits, resulting in the removal of additional nodes for tumors with high metastatic probability despite a negative SLN biopsy. To prevent this over-treatment and its associated morbidities for patients that were truly negative, we propose a tissue oxygen imaging method called Photoacoustic Lifetime Imaging (PALI) as an alternative or supplementary tool for SLN biopsy. As the hyper-metabolic state of cancer cells significantly depresses tissue oxygenation compared to normal tissue even for small metastatic deposits, we hypothesize that PALI can sensitively and specifically detect metastases. Before this hypothesis is tested, however, PALI's maximum imaging depth must be evaluated to determine the cancer types for which it is best suited. To evaluate imaging depth, we developed and simulated a phantom composed of tubing in a tissue-mimicking, optically scattering liquid. Our simulation and experimental results both show that PALI's maximum imaging depth is 16 mm. As most lymph nodes are deeper than 16 mm, ways to improve imaging depth, such as directly delivering light to the node using penetrating optical fibers, must be explored.
前哨淋巴结 (SLN) 活检是各种癌症治疗计划的重要组成部分,因为它可以评估肿瘤是否已经转移,这一事件会显著降低生存概率。然而,这种有创性的程序会导致患者发病率增加,并且会遗漏微小的转移性沉积物,从而导致对高转移性肿瘤进行额外的淋巴结切除,尽管 SLN 活检呈阴性。为了防止这种过度治疗及其相关的发病率,对于真正阴性的患者,我们提出了一种称为光声寿命成像 (PALI) 的组织氧成像方法作为 SLN 活检的替代或补充工具。由于与正常组织相比,癌细胞的高代谢状态会显著降低组织氧合水平,即使是对于小的转移性沉积物,我们假设 PALI 可以敏感且特异性地检测转移。然而,在验证这一假设之前,必须评估 PALI 的最大成像深度,以确定其最适合的癌症类型。为了评估成像深度,我们开发并模拟了一种由组织模拟、光学散射液体中的管组成的体模。我们的模拟和实验结果均表明,PALI 的最大成像深度为 16 毫米。由于大多数淋巴结的深度都超过 16 毫米,因此必须探索诸如使用穿透光纤直接将光传输到淋巴结等提高成像深度的方法。