This PDF file contains the front matter associated with SPIE Proceedings Volume 10480, including the Title Page, Copyright information, Table of Contents, and Conference Committee listing.

Stroke is an obstinate and dreaded disease, which present characteristics of high incidence rates, high relapse rates, high mortality rates and high disability rates. Recent World Health Organization data suggest that a stroke victim is identified every 6 seconds around the world. There are not effective therapies for stroke except surgery that caused stroke victims enormous physical and psychological trauma. Transcranial low-level light/laser therapy (LLLT) of neurological diseases and brain trauma has gained momentum due to the character of high-efficiency, safe and non-invasive in the past decade. In this study, we found three conclusions through previous studies. 1). In simulation, 810nm light/laser makes the maximum light penetration (>5cm), which allow light to cross through gray matter into white matter. Gaussian beam with the same size of lesion area achieves better therapeutic. What’s more, multi-light/laser- source has potential effect on stroke treatment. 2). In animal tests, LLLT has a positive therapeutic effect and PW mode LLLT has a better effect than XW mode LLLT on stroke treatment. 3). In clinical, large scale human experiment results are not so ideal due to the lower energy density of LLLT. In summary, it is no deny that those research results highlighted the great potential of transcranial LLLT as a novel, effective, and non-invasive therapy for stroke treatment.

The paper considers physical processes and mechanisms of laser reparation of spine cartilage, presents results of investigations aimed to optimize laser settings and to develop feedback control system for laser reconstruction of spine discs. Possible mechanisms of laser-induced regeneration include: (1) Space and temporary modulated laser beam induces non-homogeneous and pulse repetitive thermal expansion and stress in the irradiated zone of cartilage. Mechanical effect due to controllable thermal expansion of the tissue and micro and nano gas bubbles formation in the course of the moderate (up to 50 °C) heating of the NP activate biological cells (chondrocytes) and promote cartilage regeneration. (2) Non-destructive laser radiation leads to the formation of nano and micro-pores in cartilage matrix in the in the immediate vicinity of chondrocytes. That promotes water permeability and increases the feeding of biological cells. Results provide the scientific and engineering basis for the novel low-invasive laser procedures to be used in neurosurgery and orthopedics for the treatment cartilages of spine. The technology and equipment for laser reconstruction of spine discs have been tested first on animals, and then in a clinical trial. Since 2001 the laser reconstruction of intervertebral discs have been performed (i) for more than 3,200 patients with chronic symptoms of low back or neck pain who failed to improve with non-operative care; and (ii) for 1100 patients underwent hernia removal surgery. Substantial relief of back pain was obtained in 92.5% of patients treated who returned to their daily activities. LRD allowed also to decrease secondary surgeries more than three times. Optical fiber technique based on light scattering measurements have been used to promote safety and efficacy of the laser procedures.

Robotic and robotic-assisted surgeries are becoming more prevalent with the promise of improving surgical outcomes through increased precision, reduced operating times, and minimally invasive procedures. The handheld laser scalpel in neurosurgery has been shown to provide a more gentle approach to tissue manipulation on or near critical structures over classical tooling, though difficulties of control have prevented large scale adoption of the tool. This paper presents a novel approach to generating a cutting path for the volumetric resection of tissue using a computer-guided laser scalpel. A soft tissue ablation simulator is developed and used in conjunction with an optimization routine to select parameters which maximize the total resection of target tissue while minimizing the damage to surrounding tissue. The simulator predicts the ablative properties of tissue from an interrogation cut for tuning and simulates the removal of a tumorous tissue embedded on the surface of healthy tissue using a laser scalpel. We demonstrate the ability to control depth and smoothness of cut using genetic algorithms to optimize the ablation parameters and cutting path. The laser power level, cutting rate and spacing between cuts are optimized over multiple surface cuts to achieve the desired resection volumes.

Photodynamic therapy (PDT) is bringing new, effective, and less invasive, possibilities for cancer treatment. ML7710 (Modulight Inc.) medical laser system offers a platform for performing PDT for multiple indications and drugs. Latest avenue is glioblastoma treatment with 5-Aminolevulinic acid (ALA-5) and 635-nm light, where clinical trials are about to begin. Preliminary work suggests major advantages in treatment control, including active in-situ feedback. ML7710 platform has already proven itself for clinical work with intrabronchial obstructive tumors. Preliminary result with 10 patients show that intrabronchial tumors, that strongly affect both the survival and the performance of the patient, can be significantly reduced with ML7710 operated at 665 nm and sodium chlorine E6 photosensitizer. The aim in most of the patients has been a palliative recanalization of the bronchial lumen in order to alleviate the symptoms such as breathlessness and hemoptysis. The illumination dose for the target area was 50–75 J/cm2. All the patients have received multimodality cancer treatment using other intrabronchial interventions, radiotherapy and chemotherapy as needed. In most of the patients, satisfactory treatment results were achieved and it was possible to restart chemotherapy in several patients. In one patient with local cancer a complete remission was established. PDT has also the advantage that it is possible to give PDT after a maximum dose of radiation therapy has already been used and fewer side effects if used in locally advanced intraluminar lung cancer.

In this study, fNIRS was utilized to identify the brain activation difference between pathological gamblers (PGs) and heathy controls (HCs). We inspected the hemodynamic changes in the prefrontal cortex using fNIRS recordings during the completion of executive function and decision making tasks. Our finding revealed that the PG and HC groups exhibited significant differences in brain activation.

Down’s syndrome (DS) has been shown to be associated with many neurological complications, including cognitive deficits, seizures, early-onset dementia that resembles Alzheimer’s disease, and neurological complications of systemic disorders. DS patients show to have poor performance in executive functions (EF) and fine motor skills. In this study, we examined the brain hemodynamic responses and brain activation patterns of DS children during the completion of EF tasks. Revealing its neural mechanism of DS is not only able to contribute to the early intervention of this children with DS, but also increase understanding of developmental cascades in childhood.

As one of the main causes of traffic accidents, driving fatigue deserves researchers’ attention and its detection and monitoring during long-term driving require a new technique to realize. Since functional near-infrared spectroscopy (fNIRS) can be applied to detect cerebral hemodynamic responses, we can promisingly expect its application in fatigue level detection. Here, we performed three different kinds of experiments on a driver and recorded his cerebral hemodynamic responses when driving for long hours utilizing our device based on fNIRS. Each experiment lasted for 7 hours and one of the three specific experimental tests, detecting the driver’s response to sounds, traffic lights and direction signs respectively, was done every hour. The results showed that visual stimulus was easier to cause fatigue compared with auditory stimulus and visual stimulus induced by traffic lights scenes was easier to cause fatigue compared with visual stimulus induced by direction signs in the first few hours. We also found that fatigue related hemodynamics caused by auditory stimulus increased fastest, then traffic lights scenes, and direction signs scenes slowest. Our study successfully compared audio, visual color, and visual character stimulus in sensitivity to cause driving fatigue, which is meaningful for driving safety management.

Improved tools for providing specific intraoperative diagnoses could improve patient care. In neurosurgery, intraoperatively differentiating non-operative lesions can be challenging, often necessitating immunohistochemical (IHC) procedures which require up to 24-48 hours. Here, we evaluate the feasibility of generating rapid ex vivo specific labeling using a novel lymphoma-specific fluorescent switchable aptamer. Our B-cell lymphoma-specific switchable aptamer produced only low-level fluorescence in its unbound conformation and generated an 8-fold increase in fluorescence once bound to its target on CD20-positive lymphoma cells. The aptamer demonstrated strong binding to B-cell lymphoma cells within 10 minutes of incubation. We applied the switchable aptamer to ex vivo xenograft tissue harboring B-cell lymphoma and astrocytoma, and within one hour specific visual identification of lymphoma was routinely possible. In this proof-of-concept study in human cell culture and orthotopic xenografts, we conclude that a fluorescent switchable aptamer can provide rapid and specific labeling of B-cell lymphoma, and that developing aptamer-based labeling approaches could simplify tissue staining and drastically reduce time to histopathological diagnoses compared with IHC-based methods. We propose that switchable aptamers could enhance expeditious, accurate intraoperative decision-making.

An optically tunable, solid tissue phantom was developed in order to aid in the verification and validation of non-destructive cancer detection technologies based on fluorescence spectroscopy. The solid tissue phantom contained agarose, hemoglobin, Intralipid, NADH, and FAD. The redox ratio of the solid phantoms were shown to be tunable; thus, indicating that these phantoms could be used to tailor specific optical conditions that mimic cancerous and healthy tissues. Therefore, this solid tissue phantom can serve as a suitable test bed to evaluate fluorescence spectroscopy based cancer detection devices.

We investigated a rapid imaging method to monitor the spatial distribution of total hemoglobin concentration (CHbT), the tissue oxygen saturation (StO2), and the scattering power b in the expression of musp=a(lambda)^-b as the scattering parameters in cerebral cortex using a digital red-green-blue camera. In the method, Monte Carlo simulation (MCS) for light transport in brain tissue is used to specify a relation among the RGB-values and the concentration of oxygenated hemoglobin (C_HbO), that of deoxygenated hemoglobin (CHbR), and the scattering power b. In the present study, we performed sequential recordings of RGB images of in vivo exposed brain of rats while changing the fraction of inspired oxygen (FiO₂), using a surgical microscope camera system. The time courses of C_HbO, C_HbR, C_HbT, and StO₂ indicated the well-known physiological responses in cerebral cortex. On the other hand, a fast decrease in the scattering power b was observed immediately after the respiratory arrest, which is similar to the negative deflection of the extracellular DC potential so-called anoxic depolarization. It is said that the DC shift coincident with a rise in extracellular potassium and can evoke cell deformation generated by water movement between intracellular and extracellular compartments, and hence the light scattering by tissue. Therefore, the decrease in the scattering power b after the respiratory arrest is indicative of changes in light scattering by tissue. The results in this study indicate potential of the method to evaluate the pathophysiological conditions and loss of tissue viability in brain tissue.

We used spatially modulated optical imaging system to assess the effect of temperature elevation on intact brain tissue in a mouse heatstress model. Heatstress or heatstroke is a medical emergency defined by abnormally elevated body temperature that causes biochemical, physiological and hematological changes. During experiments, brain temperature was measured concurrently with a thermal camera while core body temperature was monitored with rectal thermocouple probe. Changes in a battery of macroscopic brain physiological parameters, such as hemoglobin oxygen saturation level, cerebral water content, as well as intrinsic tissue optical properties were monitored during temperature elevation. These concurrent changes reflect the pathophysiology of the brain during heatstress and demonstrate successful monitoring of thermoregulation mechanisms. In addition, the variation of tissue refractive index was calculated showing a monotonous decrease with increasing wavelength. We found increased temperature to greatly affect both the scattering properties and refractive index which represent cellular and subcellular swelling indicative of neuronal damage. The overall trends detected in brain tissue parameters were consistent with previous observations using conventional medical devices and optical modalities.

During the past two decades there has been a dramatic rise in the use of functional near-infrared spectroscopy (fNIRS) as a neuroimaging technique in cognitive neuroscience research. Diffuse optical tomography (DOT) and optical topography (OT) can be employed as the optical imaging techniques for brain activity investigation. However, most current imagers with analogue detection are limited by sensitivity and dynamic range. Although photon-counting detection can significantly improve detection sensitivity, the intrinsic nature of sequential excitations reduces temporal resolution. To improve temporal resolution, sensitivity and dynamic range, we develop a multi-channel continuous-wave (CW) system for brain functional imaging based on a novel lock-in photon-counting technique. The system consists of 60 Light-emitting device (LED) sources at three wavelengths of 660nm, 780nm and 830nm, which are modulated by current-stabilized square-wave signals at different frequencies, and 12 photomultiplier tubes (PMT) based on lock-in photon-counting technique. This design combines the ultra-high sensitivity of the photon-counting technique with the parallelism of the digital lock-in technique. We can therefore acquire the diffused light intensity for all the source-detector pairs (SD-pairs) in parallel. The performance assessments of the system are conducted using phantom experiments, and demonstrate its excellent measurement linearity, negligible inter-channel crosstalk, strong noise robustness and high temporal resolution.

Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging method to monitor the cerebral hemodynamic through the optical changes measured at the scalp surface. It has played a more and more important role in psychology and medical imaging communities. Real-time imaging of brain function using NIRS makes it possible to explore some sophisticated human brain functions unexplored before. Kalman estimator has been frequently used in combination with modified Beer-Lamber Law (MBLL) based optical topology (OT), for real-time brain function imaging. However, the spatial resolution of the OT is low, hampering the application of OT in exploring some complicated brain functions. In this paper, we develop a real-time imaging method combining diffuse optical tomography (DOT) and Kalman estimator, much improving the spatial resolution. Instead of only presenting one spatially distributed image indicating the changes of the absorption coefficients at each time point during the recording process, one real-time updated image using the Kalman estimator is provided. Its each voxel represents the amplitude of the hemodynamic response function (HRF) associated with this voxel. We evaluate this method using some simulation experiments, demonstrating that this method can obtain more reliable spatial resolution images. Furthermore, a statistical analysis is also conducted to help to decide whether a voxel in the field of view is activated or not.