Photoacoustic Imaging for Differential Diagnosis of Benign Polyps versus Malignant Polyps of the Gallbladder: A Preliminary Study

OBJECTIVE: To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. MATERIALS AND METHODS: A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421–647 nm and 692–917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. RESULTS: A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). CONCLUSION: These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging.

Identification of skin phototypes through in vivo photoacoustic measurements / Identificação dos fototipos de pele através de medidas fotoacústicas in vivo

The aim of the present work was to classify and identify skin phototypes through in vivo photoacoustic (PA) measurements. Fifty-seven female volunteers took part in the study, being clinically evaluated and classified according to skin phototype (Fitzpatrick classification). After cleaning the skin area to be measured, the PA signal level was obtained for the inner and outer faces of both forearms. Volunteers were then classified according to the respective PA signal amplitude; subsequently, this classification was compared to the phototype classification and to the recently proposed Baumann classification. Comparison between the PA signal of the inner and outer faces of the forearm shows a highly significant statistical difference (p < 0.005), attributed to the higher pigmentation level of the skin region continuously exposed to solar radiation, demonstrating that skin constitution and aspect are influenced by the level of sun exposure. Comparison among phototypes was performed separately for the inner and outer faces of the forearm. The results show that the PA signal level (amplitude) for the inner forearm tends to scale with skin phototype, also allowing the division of the volunteers in two groups, according to their pigmentation levels and also following the recent Baumann classification. In this way, the photoacoustic methodology presented allows an objective, numerical classification of the skin types.

O objetivo do presente trabalho foi de identificar e classificar os fototipos de pele através de mensurações fotoacústicas (PA) utilizada para caracterizar a pele em função da amplitude do sinal observado in vivo. Participaram do estudo cinquenta e sete mulheres voluntárias que incialmente foram avaliadas e classificadas de acordo com o fototipo da pele (classificação de Fritzpatrick). Foram realizadas medidas nas regiões interna e externa de ambos os antebraços, após a limpeza do mesmo com álcool 70%. As voluntárias foram classificadas de acordo com o sinal fotoacústico, em seguida comparados com a classificação proposta recentemente por Baumann. A comparação entre o sinal PA das faces interna e externa do antebraço mostra uma diferença altamente significativa (p < 0,005), atribuída ao maior nível de pigmentação da pele da região continuamente expostos à radiação solar, demonstrando que a constituição do aspecto da pele é influenciada pelo nível de exposição ao sol. A comparação entre os fototipos foi realizada separadamente para as faces interna e externa do antebraço. Os resultados mostram que o nível (amplitude) do sinal PA para a parte interna do antebraço tende a seguir a classificação em fototipos, permitindo também a divisão de voluntários em dois grupos, conforme o nível de pigmentação, seguindo assim a classificação recentemente proposta por Baumann. Assim, a metodologia fotoacústica apresentada permite uma classificação objetiva, numérica, dos tipos de pele.