Medical uses
Medical applications of NIRS center on the non-invasive measurement of the amount and oxygen content of hemoglobin, as well as the use of exogenous optical tracers in conjunction with flow kinetics.
NIRS can be used for non-invasive assessment of brain function through the intact skull in human subjects by detecting changes in blood hemoglobin concentrations associated with neural activity, e.g., in branches of Cognitive psychology as a partial replacement forfMRI techniques. NIRS can be used on infants, where fMRI cannot (at least in the United States), and NIRS is much more portable than fMRI machines, even wireless instrumentation is available, which enables investigations in freely moving subjects[4][5] . However, NIRS cannot fully replace fMRI because it can only be used to scan cortical tissue, where fMRI can be used to measure activation throughout the brain.
The application in functional mapping of the human cortex is called optical topography (OT), near infrared imaging (NIRI) or functional NIRS (fNIRS). The term optical tomography is used for three-dimensional NIRS. The terms NIRS, NIRI and OT are often used interchangeably, but they have some distinctions. The most important difference between NIRS and OT/NIRI is that OT/NIRI is used mainly to detect changes in optical properties of tissue simultaneously from multiple measurement points and display the results in the form of a map or image over a specific area, whereas NIRS provides quantitative data in absolute terms on up to a few specific points. The latter is also used to investigate other tissues such as, e.g., muscle, breast and tumors.
By employing several wavelengths and time resolved (frequency or time domain) and/or spatially resolved methods blood flow, volume and oxygenation can be quantified.[6] These measurements are a form of oximetry. Applications of oximetry by NIRS methods include the detection of illnesses which affect the blood circulation (e.g., peripheral vascular disease), the detection and assessment of breast tumors, and the optimization of training in sports medicine. These techniques can also be used for industry or agro processes in order to predict particle size/density.
The use of NIRS in conjunction with a bolus injection of indocyanine green (ICG) has been used to measure cerebral blood flow[7] and cerebral metabolic rate of oxygen consumption[8] in neonatal models.
NIRS is starting to be used in pediatric critical care, to help deal with cardiac surgery post-op. Indeed, NIRS is able to measure venous oxygen saturation (SVO2), which is determined by the cardiac output, as well as other parameters (FiO2, hemoglobin, oxygen uptake). Therefore, following the NIRS gives critical care physicians a notion of the cardiac output. NIRS is liked by patients, because it is non-invasive, is painless, and uses non-ionizing radiation.
The instrumental development of NIRS/NIRI/OT has proceeded tremendously during the last years and, in particular, in terms of quantification, imaging and miniaturization.
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