title: Noninvasive monitoring of cerebral blood flow by a dye bolus method: separation of brain from skin and skull signals.
abstract: Tracking a bolus of contrast agent traveling through the cerebral vasculature provides a measure of the blood flow velocity in the respective cerebral tissue. This principle has been the basis for the first approaches in functional magnetic resonance (MR) imaging and is of great value for investigating patients with vascular disease, especially stroke. While bolus measurements are a standard procedure in MR imaging, optical bolus tracking is as yet not established. Here we study optical absorption changes induced by a bolus of the dye indocyanine-green with near infrared spectroscopy in healthy volunteers. The aim is to assess the latency and shape of the change in absorption. Since application in the adult human critically depends on differentiation between extra- and intracerebral vascular compartments we focus on an approach for such a separation. To do this frequency-domain and multidistance measurements are analyzed by a Monte Carlo based model for photon transport in tissue. Based on measurements of both the photon's mean time of flight (phase) and the intensity, our results allow differentiation between an upper (skin and skull) and a lower layer (brain). The bolus in the deeper tissue layers has a peak of about 10 s width, while the change in absorption in the upper layers shows a much longer recovery time. This is in qualitative agreement with MR imaging results using a gadolinium bolus. This result is promising with respect to the potential of bedside monitoring of mean transit time (MTT) changes in patients with stroke or related vascular disease.
authors.affiliation: Humboldt University, Charité Hospital, Department of Neurology, Schumannstrasse 20/21, 10117 Berlin, Germany. kohl-bareis@rheinahrcampus.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Kohl-Bareis
authors.forename: Hellmuth
authors.initials: H
authors.lastname: Obrig
authors.forename: Jens
authors.initials: J
authors.lastname: Steinbrink
authors.forename: Jasmin
authors.initials: J
authors.lastname: Malak
authors.forename: Kamil
authors.initials: K
authors.lastname: Uludag
authors.forename: Arno
authors.initials: A
authors.lastname: Villringer
mesh_terms: D000328:Adult; D055592:Biophysical Phenomena; D001703:Biophysics; D002560:Cerebrovascular Circulation; D004396:Coloring Agents / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008962:Models, Theoretical; D055095:Optics and Photonics; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D007208:Indocyanine Green; D019786:Gadolinium DTPA