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  • 1.
    Jonasson, Hanna
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Model-based quantitative assessment of skin microcirculatory blood flow and oxygen saturation2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Mikrocirkulationen innefattar de minsta kärlen i kroppen och det är här syretransporten till all vävnad i kroppen sker. Det är därför viktigt att kunna utvärdera mikrocirkulatoriska parametrar såsom syresättningen hos de röda blodkropparna, mängden röda blodkroppar samt deras hastighet.

    Diffus reflektansspektroskopi (DRS) kan användas för att beräkna syresättningen i blodet och mängden röda blodkroppar eftersom syresatt blod har ett karaktäristiskt sätt att absorbera ljus. Absorptionen och spridningen i vävnaden kan skattas genom att belysa huden med vitt ljus och mäta spektrumet från det tillbakaspridda ljuset. Laserdopplerbaserad flödesmätning (LDF) är en teknik som mäter blodflöde i vävnad. När laserljus träffar objekt i vävnaden som rör sig, t.ex. röda blodkroppar, så uppstår Dopplerskift. Dessa Dopplerskift kan detekteras och ett perfusionmått för vävnaden (mängden röda blodkroppar i rörelse gånger deras hastighet) kan beräknas. Med små avstånd mellan ljuskälla och detektor kan båda teknikerna mäta ytligt där den största delen av kärlen tillhör mikrocirkulationen. Fotontransporten i vävnad kan simuleras med Monte Carlo-teknik och simuleringarna ligger till grund för att modellera DRS- och LDF-spektra. De mikrocirkulatoriska parametrarna ges från den modellen som bäst passar DRS- och LDF-data.

    Avhandlingen beskriver utvecklingen och utvärderingen av en optisk metod för att simultant mäta syresättningen, mängden röda blodkroppar och hastighetsupplöst perfusion i absoluta enheter genom att integrera DRS och LDF. Genom att kombinera DRS och LDF i ett system med en gemensam hudmodell kan de två modaliteterna dra nytta av varandras styrkor. Olika kalibreringsmetoder och modellantaganden för systemet utvärderades i optiska fantomer och i hudmätningar. En enkel kalibreringsmetod med två detektoravstånd för DRS visade sig vara tillräckligt för att kunna skatta absorption och spridning i optiska fantomer. Det var också nödvändigt att modellera blod i kärl istället för homogent fördelat i huden för att uppnå noggranna parameterskattningar. Systemet utvärderades under standardprovokationer på friska försökspersoner där parametrarna stämde överens med andra studier och följde ett förväntat mönster under provokationerna. Hos patienter med diabetes typ 2 sågs en minskad mängd röda blodkroppar och kapillärt blodflöde i oprovocerad hud jämfört med friska kontroller. Skillnaden var inte kopplad till förekomsten av mikroalbuminuri, ett tecken på mikrovaskulära komplikationer i njurarna.

    Ett kombinerat system med DRS och LDF ger en mer fullständig bild av mikrocirkulationen genom att samtidigt och i absoluta enheter mäta syresättningen, mängden röda blodkroppar och hastighetsupplöst perfusion. Systemet kan användas för att utvärdera mikrocirkulationen både hos friska och sjuka individer.

    Delarbeten
    1. Can a one-layer optical skin model including melanin and inhomogeneously distributed blood explain spatially resolved diffuse reflectance spectra?
    Öppna denna publikation i ny flik eller fönster >>Can a one-layer optical skin model including melanin and inhomogeneously distributed blood explain spatially resolved diffuse reflectance spectra?
    2011 (Engelska)Ingår i: Optical Tomography and Spectroscopy of Tissue IX / [ed] Robert R. Alfano; Bruce J. Tromberg; Arjun G. Yodh; Mamoru Tamura; Eva M. Sevick-Muraca, SPIE - International Society for Optical Engineering, 2011, Vol. 7896, s. 78962Y-78962Y-9Konferensbidrag, Publicerat paper (Övrigt vetenskapligt)
    Abstract [en]

    Model based analysis of calibrated diffuse reflectance spectroscopy can be used for determining oxygenation and concentration of skin chromophores. This study aimed at assessing the effect of including melanin in addition to hemoglobin (Hb) as chromophores and compensating for inhomogeneously distributed blood (vessel packaging), in a single-layer skin model. Spectra from four humans were collected during different provocations using a twochannel fiber optic probe with source-detector separations 0.4 and 1.2 mm. Absolute calibrated spectra using data from either a single distance or both distances were analyzed using inverse Monte Carlo for light transport and Levenberg-Marquardt for non-linear fitting. The model fitting was excellent using a single distance. However, the estimated model failed to explain spectra from the other distance. The two-distance model did not fit the data well at either distance. Model fitting was significantly improved including melanin and vessel packaging. The most prominent effect when fitting data from the larger separation compared to the smaller separation was a different light scattering decay with wavelength, while the tissue fraction of Hb and saturation were similar. For modeling spectra at both distances, we propose using either a multi-layer skin model or a more advanced model for the scattering phase function.

    Ort, förlag, år, upplaga, sidor
    SPIE - International Society for Optical Engineering, 2011
    Serie
    Proceedings of SPIE - International Society for Optical Engineering, ISSN 0277-786X, E-ISSN 1996-756X ; 7896
    Nyckelord
    diffuse reflectance spectroscopy, light transport, Monte Carlso simulation, tissue moedeling, vessel packaging, skin
    Nationell ämneskategori
    Medicinsk laboratorie- och mätteknik
    Identifikatorer
    urn:nbn:se:liu:diva-81240 (URN)10.1117/12.873134 (DOI)
    Konferens
    Optical Tomography and Spectroscopy of Tissue IX Conference, San Francisco, California, January 22, 2011
    Tillgänglig från: 2012-09-14 Skapad: 2012-09-10 Senast uppdaterad: 2017-02-10Bibliografiskt granskad
    2. Inverse Monte Carlo for estimation of scattering and absorption in liquid optical phantoms
    Öppna denna publikation i ny flik eller fönster >>Inverse Monte Carlo for estimation of scattering and absorption in liquid optical phantoms
    2012 (Engelska)Ingår i: Optics Express, ISSN 1094-4087, E-ISSN 1094-4087, Vol. 20, nr 11, s. 12233-12246Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    A spectroscopic probe with multiple detecting fibers was used for quantifying absorption and scattering in liquid optical phantoms. The phantoms were mixtures of Intralipid and red and blue food dyes. Intensity calibration for the detecting fibers was undertaken using either a microsphere suspension (absolute calibration) or a uniform detector illumination (relative calibration between detectors). Two different scattering phase functions were used in an inverse Monte Carlo algorithm. Data were evaluated for residual spectra (systematic deviations and magnitude) and accuracy in estimation of scattering and absorption. Spectral fitting was improved by allowing for a 10% intensity relaxation in the optimization algorithm. For a multi-detector setup, non-systematic residual spectrum was only found using the more complex Gegenbauer-kernel phase function. However, the choice of phase function did not influence the accuracy in the estimation of absorption and scattering. Similar estimation accuracy as in the multi-detector setup was also obtained using either two relative calibrated detectors or one absolute calibrated detector at a fiber separation of 0.46 mm.

    Ort, förlag, år, upplaga, sidor
    Optical Society of America, 2012
    Nationell ämneskategori
    Teknik och teknologier
    Identifikatorer
    urn:nbn:se:liu:diva-78815 (URN)10.1364/OE.20.012233 (DOI)000304403100070 ()
    Anmärkning

    Funding Agencies|VINNOVA||Perimed AB|2008-00149|ResearchGrow program|2011-03074|European Union||Linkoping University through the Center for Excellence NIMED-CBDP (Center for Biomedical Data Processing)||

    Tillgänglig från: 2012-06-21 Skapad: 2012-06-21 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    3. Microcirculation assessment using an individualized model for diffuse reflectance spectroscopy and conventional laser Doppler flowmetry
    Öppna denna publikation i ny flik eller fönster >>Microcirculation assessment using an individualized model for diffuse reflectance spectroscopy and conventional laser Doppler flowmetry
    Visa övriga...
    2014 (Engelska)Ingår i: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 19, nr 5, s. 057002-Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Microvascular assessment would benefit from co-registration of blood flow and hemoglobin oxygenation dynamics during stimulus response tests. We used a fiber-optic probe for simultaneous recording of white light diffuse reflectance (DRS; 475-850 nm) and laser Doppler flowmetry (LDF; 780 nm) spectra at two source-detector distances (0.4 and 1.2 mm). An inverse Monte Carlo algorithm, based on a multiparameter three-layer adaptive skin model, was used for analyzing DRS data. LDF spectra were conventionally processed for perfusion. The system was evaluated on volar forearm recordings of 33 healthy subjects during a 5-min systolic occlusion protocol. The calibration scheme and the optimal adaptive skin model fitted DRS spectra at both distances within 10%. During occlusion, perfusion decreased within 5 s while oxygenation decreased slowly (mean time constant 61 s; dissociation of oxygen from hemoglobin). After occlusion release, perfusion and oxygenation increased within 3 s (inflow of oxygenized blood). The increased perfusion was due to increased blood tissue fraction and speed. The supranormal hemoglobin oxygenation indicates a blood flow in excess of metabolic demands. In conclusion, by integrating DRS and LDF in a fiber-optic probe, a powerful tool for assessment of blood flow and oxygenation in the same microvascular bed has been presented.

    Ort, förlag, år, upplaga, sidor
    SPIE - International Society for Optical Engineering, 2014
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-107715 (URN)10.1117/1.JBO.19.5.057002 (DOI)000338334600033 ()24788373 (PubMedID)
    Tillgänglig från: 2014-06-19 Skapad: 2014-06-19 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
    4. Oxygen saturation, red blood cell tissue fraction and speed resolved perfusion — A new optical method for microcirculatory assessment
    Öppna denna publikation i ny flik eller fönster >>Oxygen saturation, red blood cell tissue fraction and speed resolved perfusion — A new optical method for microcirculatory assessment
    Visa övriga...
    2015 (Engelska)Ingår i: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 102, s. 70-77Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    We have developed a new fiber-optic system that combines diffuse reflectance spectroscopy (DRS) and laser Doppler Flowmetry (LDF) for a multi-modal assessment of the microcirculation. Quantitative data is achieved with an inverse Monte Carlo algorithm based on an individually adaptive skin model. The output parameters are calculated from the model and given in absolute units: hemoglobin oxygen saturation (%), red blood cell (RBC) tissue fraction (%), and the speed resolved RBC perfusion separated into three speed regions; 0–1 mm/s, 1–10 mm/s and above 10 mm/s (% mm/s). The aim was to explore microcirculatory parameters using the new optical method, integrating DRS and LDF in a joint skin model, during local heating of the dorsal foot and venous and arterial occlusion of the forearm in 23 healthy subjects (age 20–28 years). There were differences in the three speed regions in regard to blood flow changes due to local heating, where perfusion for high speeds increased the most. There was also a high correlation between changes in oxygenation and changes in perfusion for higher speeds. Oxygen saturation at baseline was 44% on foot, increasing to 83% at plateau after heating. The larger increase in perfusion for higher speeds than for lower speeds together with the oxygenation increase during thermal provocation, shows a local thermoregulatory blood flow in presumably arteriolar dermal vessels. In conclusion, there are improved possibilities to assess microcirculation using integrated DRS and LDF in a joint skin model by enabling both oxygenation and speed resolved blood flow assessment simultaneously and in the same skin site. Output parameters in absolute units may also yield new insights about the microcirculatory system.

    Ort, förlag, år, upplaga, sidor
    Academic Press, 2015
    Nyckelord
    Diffuse reflectance spectroscopy; Hemoglobin oxygen saturation; Laser Doppler flowmetry; Microcirculation; Skin blood flow
    Nationell ämneskategori
    Medicinsk laboratorie- och mätteknik
    Identifikatorer
    urn:nbn:se:liu:diva-121774 (URN)10.1016/j.mvr.2015.08.006 (DOI)000362310700010 ()26279347 (PubMedID)
    Anmärkning

    Funding text:  VINNOVA (Swedens innovation agency); Perimed AB through the SamBIO research collaboration program [2008-00149]; Research&Grow program (VINNOVA) [2011-03074]; NovaMedTech - European Union Regional Development Fund [68737, 160382]

    Tillgänglig från: 2015-10-05 Skapad: 2015-10-05 Senast uppdaterad: 2017-12-01
  • 2.
    Jonasson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Bergstrand, Sara
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Nyström, Fredrik H
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken.
    Länne, Toste
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Primärvårdscentrum, Vårdcentralen Ödeshög.
    Bjarnegård, Niclas
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Perimed AB, Sweden.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Skin microvascular endothelial dysfunction is associated with type 2 diabetes independently of microalbuminuria and arterial stiffness2017Ingår i: Diabetes & Vascular Disease Research, ISSN 1479-1641, E-ISSN 1752-8984, Vol. 14, nr 4, s. 363-371, artikel-id UNSP 1479164117707706Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Skin and kidney microvascular functions may be affected independently in diabetes mellitus. We investigated skin microcirculatory function in 79 subjects with diabetes type 2, where 41 had microalbuminuria and 38 not, and in 41 age-matched controls. The oxygen saturation, fraction of red blood cells and speed-resolved microcirculatory perfusion (% red blood cells x mm/s) divided into three speed regions: 0-1, 1-10 and above 10 mm/s, were assessed during baseline and after local heating of the foot with a new device integrating diffuse reflectance spectroscopy and laser Doppler flowmetry. Arterial stiffness was assessed as carotid-femoral pulse wave velocity. Subjects with diabetes and microalbuminuria had significantly higher carotid-femoral pulse wave velocity compared to subjects without microalbuminuria and to controls. The perfusion for speeds 0-1 mm/s and red blood cell tissue fraction were reduced in subjects with diabetes at baseline and after heating, independent of microalbuminuria. These parameters were correlated to HbA1c. In conclusion, the reduced nutritive perfusion and red blood cell tissue fraction in type 2 diabetes were related to long-term glucose control but independent of microvascular changes in the kidneys and large-vessel stiffness. This may be due to different pathogenic pathways in the development of nephropathy, large-vessel stiffness and cutaneous microvascular impairment.

  • 3.
    Jonasson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Perimed AB, Järfälla, Stockholm, Sweden.
    Bergstrand, Sara
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Primärvårdscentrum, Vårdcentralen Ödeshög.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    In vivo characterization of light scattering properties of human skin in the 475- to 850-nm wavelength range in a Swedish cohort2018Ingår i: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 23, nr 12, artikel-id 121608Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We have determined in vivo optical scattering properties of normal human skin in 1734 subjects, mostly with fair skin type, within the Swedish CArdioPulmonary bioImage Study. The measurements were performed with a noninvasive system, integrating spatially resolved diffuse reflectance spectroscopy and laser Doppler flowmetry. Data were analyzed with an inverse Monte Carlo algorithm, accounting for both scattering, geometrical, and absorbing properties of the tissue. The reduced scattering coefficient was found to decrease from 3.16 ± 0.72 to 1.13 ± 0.27 mm-1 (mean ± SD) in the 475- to 850-nm wavelength range. There was a negative correlation between the reduced scattering coefficient and age, and a significant difference between men and women in the reduced scattering coefficient as well as in the fraction of small scattering particles. This large study on tissue scattering with mean values and normal variation can serve as a reference when designing diagnostic techniques or when evaluating the effect of therapeutic optical systems.

  • 4.
    Jonasson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan. Perimed AB, Järfälla-Stockholm, Sweden .
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Assessment of the microcirculation using combined model based diffuse reflectance spectroscopy and laser Doppler flowmetry2015Ingår i: 16th Nordic-Baltic Conference on Biomedical Engineering: 16. NBC & 10. MTD 2014 joint conferences. October 14-16, 2014, Gothenburg, Sweden, Springer, 2015, s. 52-54Konferensbidrag (Refereegranskat)
    Abstract [en]

    By using a combined inverse model for diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) the tissue fraction of red blood cells (RBCs), their oxygenation and speed-resolved perfusion are estimated in absolute units. DRS spectra (450 to 850 nm) are measured at two source-detector distances; 0.4 and 1.2 mm. LDF spectra are measured at 1.2 mm, integrated in the same fiber-optic probe. Inverse Monte Carlo technique and an adaptive tissue model is used to quantify the microcirculatory parameters. Measurements were done during venous occlusion of the tissue. The model fitting yields a good spectral fit for the two DRS spectra and the LDF spectrum. The physiological responses regarding for example which speed regions respond to provocations follows a priori expectations. The combined model gives quantitative measures of RBC tissue fraction, oxygenation and speed resolved perfusion from the same sampling volume which gives new opportunities to interpret data.

  • 5.
    Jonasson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Perimed AB, Sweden.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Validation of speed-resolved laser Doppler perfusion in a multimodal optical system using a blood-flow phantom2019Ingår i: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 24, nr 9, artikel-id 095002Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The PeriFlux 6000 EPOS system combines diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) for the assessment of oxygen saturation (expressed in percentage), red blood cell (RBC) tissue fraction (expressed as volume fraction, %RBC), and perfusion (%RBC x mm/s) in the microcirculation. It also allows the possibility of separating the perfusion into three speed regions (0 to 1, 1 to 10, and amp;gt;10 mm/s). We evaluate the speed-resolved perfusion components, i.e., the relative amount of perfusion within each speed region, using a blood-flow phantom. Human blood was pumped through microtubes with an inner diameter of 0.15 mm. Measured DRS and LDF spectra were compared to Monte Carlo-simulated spectra in an optimization routine, giving the best-fit parameters describing the measured spectra. The root-mean-square error for each of the three speed components (0 to 1, 1 to 10, and amp;gt;10 mm/s, respectively) when describing the blood-flow speed in the microtubes was 2.9%, 8.1%, and 7.7%. The presented results show that the system can accurately discriminate blood perfusion originating from different blood-flow speeds, which may enable improved measurement of healthy and dysfunctional microcirculatory flow. (C) The Authors. Published by SPIE under a Creative Commons Attribution 4.0 Unported License.

  • 6.
    Jonasson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten. Perimed AB, Datavägen 9A, 175 43 Järfälla, Stockholm, Sweden.
    Pettersson, Anders
    Perimed AB, Datavägen 9a, 175 26 Järfälla-Stockholm.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Oxygen saturation, red blood cell tissue fraction and speed resolved perfusion — A new optical method for microcirculatory assessment2015Ingår i: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 102, s. 70-77Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We have developed a new fiber-optic system that combines diffuse reflectance spectroscopy (DRS) and laser Doppler Flowmetry (LDF) for a multi-modal assessment of the microcirculation. Quantitative data is achieved with an inverse Monte Carlo algorithm based on an individually adaptive skin model. The output parameters are calculated from the model and given in absolute units: hemoglobin oxygen saturation (%), red blood cell (RBC) tissue fraction (%), and the speed resolved RBC perfusion separated into three speed regions; 0–1 mm/s, 1–10 mm/s and above 10 mm/s (% mm/s). The aim was to explore microcirculatory parameters using the new optical method, integrating DRS and LDF in a joint skin model, during local heating of the dorsal foot and venous and arterial occlusion of the forearm in 23 healthy subjects (age 20–28 years). There were differences in the three speed regions in regard to blood flow changes due to local heating, where perfusion for high speeds increased the most. There was also a high correlation between changes in oxygenation and changes in perfusion for higher speeds. Oxygen saturation at baseline was 44% on foot, increasing to 83% at plateau after heating. The larger increase in perfusion for higher speeds than for lower speeds together with the oxygenation increase during thermal provocation, shows a local thermoregulatory blood flow in presumably arteriolar dermal vessels. In conclusion, there are improved possibilities to assess microcirculation using integrated DRS and LDF in a joint skin model by enabling both oxygenation and speed resolved blood flow assessment simultaneously and in the same skin site. Output parameters in absolute units may also yield new insights about the microcirculatory system.

  • 7.
    Karlsson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Inverse Monte Carlo for estimation of scattering and absorption in liquid optical phantoms2012Ingår i: Optics Express, ISSN 1094-4087, E-ISSN 1094-4087, Vol. 20, nr 11, s. 12233-12246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A spectroscopic probe with multiple detecting fibers was used for quantifying absorption and scattering in liquid optical phantoms. The phantoms were mixtures of Intralipid and red and blue food dyes. Intensity calibration for the detecting fibers was undertaken using either a microsphere suspension (absolute calibration) or a uniform detector illumination (relative calibration between detectors). Two different scattering phase functions were used in an inverse Monte Carlo algorithm. Data were evaluated for residual spectra (systematic deviations and magnitude) and accuracy in estimation of scattering and absorption. Spectral fitting was improved by allowing for a 10% intensity relaxation in the optimization algorithm. For a multi-detector setup, non-systematic residual spectrum was only found using the more complex Gegenbauer-kernel phase function. However, the choice of phase function did not influence the accuracy in the estimation of absorption and scattering. Similar estimation accuracy as in the multi-detector setup was also obtained using either two relative calibrated detectors or one absolute calibrated detector at a fiber separation of 0.46 mm.

  • 8.
    Karlsson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Kvantitativa mätningar av mikrocirkulatoriska parametrar med optiska tekniker och en realistisk hudmodell2011Konferensbidrag (Övrigt vetenskapligt)
  • 9.
    Karlsson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Perimed AB, Järfälla, Sweden.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik.
    Speed resolved assessment of the microcirculation using combined model based diffuse reflectance spectroscopy and laser Doppler flowmetry2014Konferensbidrag (Övrigt vetenskapligt)
  • 10.
    Karlsson, Hanna
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Pettersson, Anders
    Perimed AB, Järfälla-Stockholm.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Can a one-layer optical skin model including melanin and inhomogeneously distributed blood explain spatially resolved diffuse reflectance spectra?2011Ingår i: Optical Tomography and Spectroscopy of Tissue IX / [ed] Robert R. Alfano; Bruce J. Tromberg; Arjun G. Yodh; Mamoru Tamura; Eva M. Sevick-Muraca, SPIE - International Society for Optical Engineering, 2011, Vol. 7896, s. 78962Y-78962Y-9Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Model based analysis of calibrated diffuse reflectance spectroscopy can be used for determining oxygenation and concentration of skin chromophores. This study aimed at assessing the effect of including melanin in addition to hemoglobin (Hb) as chromophores and compensating for inhomogeneously distributed blood (vessel packaging), in a single-layer skin model. Spectra from four humans were collected during different provocations using a twochannel fiber optic probe with source-detector separations 0.4 and 1.2 mm. Absolute calibrated spectra using data from either a single distance or both distances were analyzed using inverse Monte Carlo for light transport and Levenberg-Marquardt for non-linear fitting. The model fitting was excellent using a single distance. However, the estimated model failed to explain spectra from the other distance. The two-distance model did not fit the data well at either distance. Model fitting was significantly improved including melanin and vessel packaging. The most prominent effect when fitting data from the larger separation compared to the smaller separation was a different light scattering decay with wavelength, while the tissue fraction of Hb and saturation were similar. For modeling spectra at both distances, we propose using either a multi-layer skin model or a more advanced model for the scattering phase function.

  • 11.
    Strömberg, Tomas
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Karlsson, Hanna
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska högskolan.
    Experimental results using a three-layer skin model for diffuse reflectance spectroscopy2013Ingår i: Optical Tomography and Spectroscopy of Tissue X / [ed] Bruce J. Tromberg, Arjun G. Yodh, Eva M. Sevick-Muraca, SPIE - International Society for Optical Engineering, 2013, s. 857834-1-857834-8Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    We have previously presented an inverse Monte Carlo algorithm based on a three-layer semi-infinite skin model for analyzing diffuse reflectance spectroscopy (DRS) data. The algorithm includes pre-simulated Monte Carlo data for a range of physiologically relevant epidermal thicknesses and tissue scattering levels. The simulated photon pathlength distributions in each layer are stored and the absorption effect from tissue chromophores added in the post-processing. Recorded DRS spectra at source-detector distances of 0.4 and 1.2 mm were calibrated for the relative intensity between the two distances and matched to simulated spectra in a non-linear optimization algorithm. This study evaluates the DRS spectral fitting accuracy and presents data on the main output parameters; the tissue fraction of red blood cells and local oxygenation (SO2). As a reference, the microcirculatory perfusion (Perf) was measured simultaneously in the same probe using laser Doppler Flowmetry. Data were recorded on the volar forearm of three healthy subjects in a protocol involving a 5 min systolic occlusion. The DRS spectra were modeled with an rms-error < 2%. In two subjects, SO2 decreased during occlusion to <10%, and increased to above baseline after hyperemia, while Perf increased >7 times compared to baseline. In the third subject the SO2 decreased less during occlusion and increased to baseline values at hyperemia with only a 2-fold increase in Perf. The observed difference could be due to different microvascular beds being probed. It is concluded that integrating DRS and LDF enables new possibilities to deduce microcirculation status.

  • 12.
    Strömberg, Tomas
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Karlsson, Hanna
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Fredriksson, Ingemar
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan. Perimed AB, Järfälla, Sweden.
    Nyström, Fredrik H.
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Larsson, Marcus
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska högskolan.
    Microcirculation assessment using an individualized model for diffuse reflectance spectroscopy and conventional laser Doppler flowmetry2014Ingår i: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 19, nr 5, s. 057002-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Microvascular assessment would benefit from co-registration of blood flow and hemoglobin oxygenation dynamics during stimulus response tests. We used a fiber-optic probe for simultaneous recording of white light diffuse reflectance (DRS; 475-850 nm) and laser Doppler flowmetry (LDF; 780 nm) spectra at two source-detector distances (0.4 and 1.2 mm). An inverse Monte Carlo algorithm, based on a multiparameter three-layer adaptive skin model, was used for analyzing DRS data. LDF spectra were conventionally processed for perfusion. The system was evaluated on volar forearm recordings of 33 healthy subjects during a 5-min systolic occlusion protocol. The calibration scheme and the optimal adaptive skin model fitted DRS spectra at both distances within 10%. During occlusion, perfusion decreased within 5 s while oxygenation decreased slowly (mean time constant 61 s; dissociation of oxygen from hemoglobin). After occlusion release, perfusion and oxygenation increased within 3 s (inflow of oxygenized blood). The increased perfusion was due to increased blood tissue fraction and speed. The supranormal hemoglobin oxygenation indicates a blood flow in excess of metabolic demands. In conclusion, by integrating DRS and LDF in a fiber-optic probe, a powerful tool for assessment of blood flow and oxygenation in the same microvascular bed has been presented.

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