Clinical applications of dynamic optical tomography in vascular disease

Vascular disease is a significant source of mortality and morbidity for many patient populations. While substantial strides in surgical therapeutics have been made in the past decade, our limited understanding of the microvascular processes, which are invisible to conventional imaging modalities and beyond the scope of our current physiologic paradigms, has slowed the advancement of medical therapeutic interventions. In this report we present data in support of an emerging body of work demonstrating that the method of dynamic optical tomography can yield critical insights into the underpinnings of microvascular pathophysiology in large tissue structures. In a series of experiments designed to characterize specific properties of the peripheral vasculature, we provide first-time descriptions of spatially mapped time-varying vascular responses. Specifically, properties delineated are (1) that inherent vascular rhythms can act as natural "contrast agents" that allow spatial discrimination of tissue components in cross-section, (2) that complex vascular responses can be decomposed into multiple spatially coincident time-evolving processes, and (3) that occult long-term "evolutionary-type" microvascular processes (e.g., chronic tobacco use) can be revealed. Taken together, these capabilities contribute to a global understanding of the peripheral vascular response, affording new opportunities for improved diagnostic and therapeutic strategies.