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Auditory Display of Fluorescence Image Data in an In Vivo Tumor Model.

ABSTRACT: Objectives: This research aims to apply an auditory display for tumor imaging using fluorescence data, discuss its feasibility for in vivo tumor evaluation, and check its potential for assisting enhanced cancer perception. Methods: Xenografted mice underwent fluorescence imaging after an injection of cy5.5-glucose. Spectral information from the raw data was parametrized to emphasize the near-infrared fluorescence information, and the resulting parameters were mapped to control a sound synthesis engine in order to provide the auditory display. Drag-click maneuvers using in-house data navigation software-generated sound from regions of interest (ROIs) in vivo. Results: Four different representations of the auditory display were acquired per ROI: (1) audio spectrum, (2) waveform, (3) numerical signal-to-noise ratio (SNR), and (4) sound itself. SNRs were compared for statistical analysis. Compared with the no-tumor area, the tumor area produced sounds with a heterogeneous spectrum and waveform, and featured a higher SNR as well (3.63 ± 8.41 vs. 0.42 ± 0.085, p < 0.05). Sound from the tumor was perceived by the naked ear as high-timbred and unpleasant. Conclusions: By accentuating the specific tumor spectrum, auditory display of fluorescence imaging data can generate sound which helps the listener to detect and discriminate small tumorous conditions in living animals. Despite some practical limitations, it can aid in the translation of fluorescent images by facilitating information transfer to the clinician in in vivo tumor imaging.

SUBMITTER: Lee SW

PROVIDER: S-EPMC9315571 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Protoporphyrin (PpIX) fluorescence allows discrimination of tumor and normal brain tissue during neurosurgery. A handheld fluorescence (HHF) probe can be used for spectroscopic measurement of 5-ALA-induced PpIX to enable objective detection compared to visual evaluation of fluorescence. However, current technology requires that the surgeon either views the measured values on a screen or employs an assistant to verbally relay the values. An auditory feedback system was developed and evaluated for communicating measured fluorescence intensity values directly to the surgeon.The auditory display was programmed to map the values measured by the HHF probe to the playback of tones that represented three fluorescence intensity ranges and one error signal. Ten persons with no previous knowledge of the application took part in a laboratory evaluation. After a brief training period, participants performed measurements on a tray of 96 wells of liquid fluorescence phantom and verbally stated the perceived measurement values for each well. The latency and accuracy of the participants' verbal responses were recorded. The long-term memorization of sound function was evaluated in a second set of 10 participants 2-3 and 7-12 days after training.The participants identified the played tone accurately for 98% of measurements after training. The median response time to verbally identify the played tones was 2 pulses. No correlation was found between the latency and accuracy of the responses, and no significant correlation with the musical proficiency of the participants was observed on the function responses. Responses for the memory test were 100% accurate.The employed auditory display was shown to be intuitive, easy to learn and remember, fast to recognize, and accurate in providing users with measurements of fluorescence intensity or error signal. The results of this work establish a basis for implementing and further evaluating auditory displays in clinical scenarios involving fluorescence guidance and other areas for which categorized auditory display could be useful.

Project description:Rationale: Intraoperative bleeding impairs physicians' ability to visualize the surgical field, leading to increased risk of surgical complications and reduced outcomes. Bleeding is particularly challenging during endoscopic-assisted surgical resection of hypervascular tumors in the head and neck. A tool that controls bleeding while marking tumor margins has the potential to improve gross tumor resection, reduce surgical morbidity, decrease blood loss, shorten procedure time, prevent damage to surrounding tissues, and limit postoperative pain. Herein, we develop and characterize a new system that combines pre-surgical embolization with improved visualization for endoscopic fluorescence image-guided tumor resection. Methods: Silk-elastinlike protein (SELP) polymers were employed as liquid embolic vehicles for delivery of a clinically used near-infrared dye, indocyanine green (ICG). The biophysical properties of SELP, including gelation kinetics, modulus of elasticity, and viscosity, in response to ICG incorporation using rheology, were characterized. ICG release from embolic SELP was modeled in tissue phantoms and via fluorescence imaging. The embolic capability of the SELP-ICG system was then tested in a microfluidic model of tumor vasculature. Lastly, the cytotoxicity of the SELP-ICG system in L-929 fibroblasts and human umbilical vein endothelial cells (HUVEC) was assessed. Results: ICG incorporation into SELP accelerated gelation and increased its modulus of elasticity. The SELP embolic system released 83 ± 8% of the total ICG within 24 hours, matching clinical practice for pre-surgical embolization procedures. Adding ICG to SELP did not reduce injectability, but did improve the gelation kinetics. After simulated embolization, ICG released from SELP in tissue phantoms diffused a sufficient distance to deliver dye throughout a tumor. ICG-loaded SELP was injectable through a clinical 2.3 Fr microcatheter and demonstrated deep penetration into 50-µm microfluidic-simulated blood vessels with durable occlusion. Incorporation of ICG into SELP improved biocompatibility with HUVECs, but had no effect on L-929 cell viability. Principle Conclusions: We report the development and characterization of a new, dual-functional embolization-visualization system for improving fluorescence-imaged endoscopic surgical resection of hypervascular tumors.

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Auditory Display of Fluorescence Image Data in an In Vivo Tumor Model.

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