Role of frequency domain optical spectroscopy in the detection of neonatal brain hemorrhage--a newborn piglet study.
OBJECTIVE
Inability of continuous wave (CW) optical spectroscopy to measure changes in scattering, and the use of an arbitrary rather than an actual baseline, makes the CW method highly susceptible to errors that can lead to a false-positive or false-negative diagnosis. Our objective was to assess whether, and to what extent, the use of quantitative frequency domain spectroscopy would improve our ability to detect and monitor the development of brain hemorrhage.


METHODS
A dual-channel frequency-domain tissue spectrometer (Model 96208, ISS, Inc., Champaign, IL) was used to monitor the development of experimental subcortical and periventricular-intraventricular hemorrhage (IVH) in 10 newborn piglets (blood injection model). The multidistance approach was employed to calculate the absorption and reduced scattering coefficients and hemoglobin changes from the ac, dc, and phase values acquired at four different source-detector distances and at 752 nm and 830 nm.


RESULTS
There were significant absorption and scattering changes in the subcortical hematoma (n = 5) and the IVH groups (n = 5). The smallest detectable amount of blood in the brain was 0.04 ml. Changes associated with subcortical hematoma were several times higher than those associated with IVH, and correlated better with the estimated cross-sectional area of the hematoma than with the volume of the injected blood. As opposed to IVH, there was a significant absorption difference between the injured (subcortical hematoma) and normal side of the brain, probably because in case of IVH a significant volume of the injected blood had accumulated/spread beyond the reach of the probe.


CONCLUSIONS
Clearly, frequency-domain spectroscopy cannot increase our ability to quantify the volume (size) or the oxygenation of the injected blood, especially in the case of IVH. However, the ability to quantify the baseline tissue absorption and scattering would significantly improve diagnostic performance, and may allow for early identification and treatment of neonatal brain hemorrhage.
Stankovic
M R
MR
Department of Obstetrics and Gynecology, Brooklyn Hospital Center, Cornell University School of Medicine, New York 11201, USA. MILJANRS@AOL.COM
Maulik
D
D
Rosenfeld
W
W
Stubblefield
P G
PG
Kofinas
A D
AD
Gratton
E
E
Franceschini
M A
MA
Fantini
S
S
Hueber
D M
DM
D000818:Animals; D000831:Animals, Newborn; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D005260:Female; D006406:Hematoma / Q000175:diagnosis; D006454:Hemoglobins / Q000032:analysis; D008297:Male; D010108:Oxyhemoglobins / Q000032:analysis; D013057:Spectrum Analysis / Q000379:methods*; D013552:Swine
D006454:Hemoglobins; D010108:Oxyhemoglobins; C100003:deoxyhemoglobin