e21053 Background: Circulating tumor cells have been correlated with disease state and distant metastatic spread in cancer patients. We postulated that enumerating circulating melanoma cells (CMCs) may predict the onset of distant metastasis in Stage III patients. We detected CMCs using our photoacoustic flow cytometer, in which we irradiated enriched blood samples with nanosecond pulsed laser light. While there is no effect on non-optically active leukocytes, absorption of laser light by pigmented melanoma cells resulted in robust ultrasonic waves that indicated CMCs in the sample. Methods: We tested 32 archived samples from 9 Stage III melanoma patients using our photoacoustic flow cytometer. Each patient had between 2 and 6 serial blood samples. We used a pulsed Nd:YAG laser to irradiate mononuclear cells in suspension and under flow. The number of CMCs detected after testing was recorded, indicating the time sequence of circulating tumor cell activity. Results: The numbers of CTCs for each sample is shown in the table below. The ultimate disease state, whether the patient became metastatic or not, was blinded to the investigators who performed the photoacoustic tests. One sample for patient 3 indicated 63 CMCs, though this test was known to be contaminated and had an unknown number of false detections. Conclusions: We found that patients who had a series of more than 4 CMCs were more likely to become metastatic than those patients who tested for 4 CMCs for fewer, indicating that a sequence of CMC detections in serial blood draws provides a potentially strong predictor of metastasis in Stage III melanoma patients warranting further investigation at this and lower stages of melanoma. We are developing a more rigorous model based on time series analysis of CMCs for prediction of metastasis. [Table: see text]

According to the CDC, breast cancer is the most common cancer and the second leading cause of cancer related deaths among women. Metastasis, or the presence of secondary tumors caused by the spread of cancer cells via the circulatory or lymphatic systems, significantly worsens the prognosis of any breast cancer patient. In this study, a technique is developed to detect circulating breast cancer cells in human blood using a photoacoustic flow cytometry method. A Q-switched laser with a 5 ns pulse at 532 nm is used to interrogate thousands of cells with one pulse as they flow through the beam path. Cells which are pigmented, either naturally or artificially, emit an ultrasound wave as a result of the photoacoustic (PA) effect. Breast cancer cells are targeted with chromophores through immunochemistry in order to provide pigment. After which, the device is calibrated to demonstrate a single-cell detection limit. Cultured breast cancer cells are added to whole blood to reach a biologically relevant concentration of about 25-45 breast cancer cells per 1 mL of blood. An in vitro photoacoustic flow cytometer is used to detect and isolate these cells followed by capture with the use of a micromanipulator. This method can not only be used to determine the disease state of the patient and the response to therapy, it can also be used for genetic testing and in vitro drug trials since the circulating cell can be captured and studied.

1. Cristofanilli, M, et al., Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med. 2004; 351(8): 781-91. 2. Bidard FC, et al., Detection rate and prognostic value of circulating tumor cells and circulating tumor DNA in metastatic uveal melanoma. Int J Cancer. 2014 Mar 1; 134(5):1207-13. 3. Weight RM, et al. Photoacoustic detection of metastatic melanoma cells in the human circulatory system. Opt Lett . 2006 Oct 15; 31(20):2998-3000. 4. O’Brien CM, et al. Capture of circulating tumor cells using photoacoustic flowmetry and two phase flow. J Biomed Opt . 2012 Jun; 17(6):612-21. • Circulating Uveal Melanoma Cells (CUMCs) were successfully quantified by the photoacoustic method including single cell detection. • Recovery rates of pigmented uveal melanoma cells suspended in a neutral density solution approached 25%. • 60% CUMCs are lost during PBMC isolation. Superior isolation techniques should be investigated to increase CUMC recovery. • Recovery rates for CUMCs in whole blood averaged 10% of expected cell yield (23/216 noise adjusted cell detection). • The Photoacoustic Method offers a viable platform for the detection of CUMCs. • Studies analyzing CUMCs from patients with metastatic disease are ongoing.

Here, we present a protocol to estimate material and surface optical properties using the photoacoustic effect combined with total internal reflection. Optical property evaluation of thin films and the surfaces of bulk materials is an important step in understanding new optical material systems and their applications. The method presented can estimate thickness, refractive index, and use absorptive properties of materials for detection. This metrology system uses evanescent field-based photoacoustics (EFPA), a field of research based upon the interaction of an evanescent field with the photoacoustic effect. This interaction and its resulting family of techniques allow the technique to probe optical properties within a few hundred nanometers of the sample surface. This optical near field allows for the highly accurate estimation of material properties on the same scale as the field itself such as refractive index and film thickness. With the use of EFPA and its sub techniques such as total internal reflection photoacoustic spectroscopy (TIRPAS) and optical tunneling photoacoustic spectroscopy (OTPAS), it is possible to evaluate a material at the nanoscale in a consolidated instrument without the need for many instruments and experiments that may be cost prohibitive.

Abstract Circulating tumor cells (CTCs) have been shown to be a prognostic marker in breast cancer1. We hypothesize that circulating melanoma cell (CMC) detection could be utilized in the management of uveal melanoma, including early intervention. Prior methodologies for circulating uveal melanoma cell (CUMC) detection have been fraught with poor sensitivity, limiting their clinical utility2. Development of an improved method is necessary to establish the clinical utility of CUMC monitoring. Photoacoustics, also referred to as laser-induced ultrasound, is a novel platform for the detection and capture of CMCs. Photoacoustics uses short duration pulsed light to create ultrasonic acoustic waves in an optically absorbing medium, in this case melanin within melanoma3. As light is absorbed by irradiated chromophores, the optical energy gets converted into kinetic thermal energy trapped within the chromophore and subsequent thermal expansion ensues. Transient thermoelastic expansion of the absorbent cell results in the propagation of ultrasonic acoustic waves which can be detected and analyzed using a piezoelectric response mechanism. In addition, detected CMCs can be isolated by a two-phase flow cell separation technique4. Due to the low cost and melanoma specific capabilities of photoacoustics, we evaluated this technology for the purpose of CUMC detection. Methods: Cells from uveal melanoma cell line UM002B, established at Thomas Jefferson, were titrated to various cell concentrations and analyzed in a neutral density solution utilizing the photoacoustic method. Uveal melanoma cells of differing concentrations were spiked into isolated healthy donor peripheral blood mononuclear cells (PBMCs) and healthy whole blood samples. PBMC isolates were analyzed for CUMCs. Results: CUMCs were successfully quantified by the photoacoustic method including single cell detection. Recovery rates of cultured cells in a neutral density solution approached 25%. Recovery rates for CUMCs in whole blood averaged 10% of expected cell yield (56/540 cells detected) with a higher detection rate at lower cell concentrations. Photoacoustics offers a viable method for the detection of CUMCs with an accuracy that meets or exceeds previously reported CUMC yields. Studies analyzing CUMCs from patients with metastatic disease are ongoing. 1. Cristofanilli, M, et al., Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med, 2004. 351(8): 781-91. 2. Bidard FC, et al., Detection rate and prognostic value of circulating tumor cells and circulating tumor DNA in metastatic uveal melanoma. Int J Cancer. 2014 Mar 1;134(5):1207-13. 3. Weight RM, et al. Photoacoustic detection of metastatic melanoma cells in the human circulatory system. Opt Lett. 2006 Oct 15;31(20):2998-3000. 4. O’Brien CM, et al. Capture of circulating tumor cells using photoacoustic flowmetry and two phase flow. J Biomed Opt. 2012 Jun;17(6):061221. Citation Format: Ryan M. Weight, Shingo Sato, Masahiro Ohara, Mizue Terai, Michael Mastrangelo, Marlana Orloff, Benjamin Goldschmidt, John Viator, Takami Sato. Detection of circulating tumor cells in high-risk primary uveal melanoma by the photoacoustic method. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 471.

9555 Background: Circulating tumor cells have been postulated as indicators of the metastatic spread of cancer via the lymphatic and circulatory systems. We have developed a photoacoustic flow cytometer to target pigmented circulating melanoma cells (CMCs) in which a laser pulse induced ultrasonic signatures in these cells while ignoring healthy blood cells. We tested a pilot group of blood samples from melanoma patients with surgically resected high-risk disease (Stages III) who either remained disease free or relapsed within two years of follow up. The photoacoustic device was used to detect, enumerate, and capture CMCs in this pilot group with the intent of using this data to develop a statistical model for predicting the onset of metastasis well before traditional imaging methods determine it. Methods: We used fourteen archived samples from Stage III melanoma patients collected at the time of diagnosis. Eight of the patients remained disease free within 2 years, while six eventually became metastatic. We used a pulsed Nd:YAG laser to irradiate mononuclear cells in suspension and under flow. Only pigmented cells absorbed the laser light, resulting in photoacoustic waves detected by an acoustic transducer. The flowmeter counted and captured cells that generated photoacoustic waves. The operator of the flowmeter was blinded to the blood samples. Results: Of the eight patients who remained disease free, six showed no CMCs and two showed at least one instance of CMCs. Of the six patients who became metastatic, five showed at least one instance of CMCs, while only one did not. Using a Fisher’s Exact Test, we calculated a p-value of 0.1 between the two groups based solely on the presence or absence of CMCs. Conclusions: This pilot experiment achieved statistical significance with a significance level of 0.1. As we continue to accrue results, we believe that a more sophisticated model that accounts for other relevant factors (age, gender, adjuvant therapy) can be developed and will be an important predictor of metastatic disease. This model, along with the ability to detect CMCs, warrants further testing as it may lead to a powerful prognostic tool for the management of high-risk melanoma.

Thin films continue to show great promise for improving a wide variety of devices in applications such as medical instrumentation, material processing, and astronomical instrumentation. While ellipsometry and reflectometry are standard characterization techniques for determining thickness and refractive index, these techniques tend to require highly reflective or polished films and rely on empirical equations. We have created Quantum Tunneling Photoacoustic Spectroscopy (QTPAS) that uses light induced ultrasound to obtain thickness and refractive index estimates of transparent films. We present QTPAS to be used for the estimation of properties of single layer films as an alternative to ellipsometry and give qualitative sample measurements of the technique's estimated parameters.

Due to the often extreme energies employed, contemporary methods of laser delivery utilized in clinical dermatology allow for a dangerous amount of high-intensity laser light to reflect off a multitude of surfaces, including the patient's own skin. Such techniques consistently represent a clear and present threat to both patients and practitioners alike. The intention of this work was therefore to develop a technique that mitigates this problem by coupling the light directly into the tissue via physical contact with an optical waveguide. In this manner, planar waveguides cladded in silver with thin-film active areas were used to illuminate agar tissue phantoms with nanosecond-pulsed laser light at 532nm. The light then either refracted or optically tunneled through the active area, photoacoustically generating ultrasonic waves within the phantom, whose peak-to-peak intensity directly correlated to the internal reflection angle of the beam. Consequently, angular spectra for energy delivery were recorded for sub-wavelength silver and titanium films of variable thickness. Optimal energy delivery was achieved for internal reflection angles ranging from 43 to 50 degrees, depending on the active area and thin film geometries, with titanium films consistently delivering more energy across the entire angular spectrum due to their relatively high refractive index. The technique demonstrated herein therefore not only represents a viable method of energy delivery for biological tissue while minimizing the possibility for stray light, but also demonstrates the possibility for utilizing thin films of high refractive index metals to redirect light out of an optical waveguide.

Circulating tumor cells (CTCs) are those cells that separate from a solid tumor and spread through the blood or lymphatic systems. While there are many open questions concerning the biology of CTCs, there is mounting evidence that some of these cells go on to create secondary tumors in distant organs, thus enabling metastatic disease. Detection of CTCs may have clinical impact by providing prognostic information. Furthermore, molecular and genetic analysis of CTCs may enable cancer biologists to answer questions about the metastatic process, such as whether these cells undergo epithelial-mesenchymal transition. Using a photoacoustic flowmeter, in which we induce ultrasonic responses from circulating melanoma cells (CMCs), we identify, capture, and isolate these cells for further analysis.

Thin films continue to show great promise for improving devices in optical applications, such as improved chemical sensors based on surface plasmon resonance devices (Gardon et al. (2008) [1] and Brolo et al. (2004) [2]). While ellipsometry and reflectometry are standard characterization techniques for determining thickness and refractive index of thin films, these techniques tend to require highly reflective or polished films and rely on empirical equations like the Cauchy, Briot, Hartmann, Conrady, and Sellmeier empirical dispersion equations. While these empirical equations may be accurate in some wavelength ranges and for non-conductive materials, the researcher must identify which equation is appropriate for the film being tested and wavelength range desired. To improve ease of testing, we have created a new technique, Optical Tunneling Photoacoustic Spectroscopy (OTPAS), that uses light-induced ultrasound to measure the amount of optical tunneling that has occurred with frustrated total internal reflection through a thin film. The OTPAS system allows a researcher to obtain thickness and refractive index estimates of transparent films without polishing or knowledge of empirical equations prior to the experiment. Scans of 200nm thick MgF2 films were used to compare ellipsometry with the OTPAS technique. An example of our results shows mean refractive index and thickness estimates of 1.395±0.011 and 220±19nm versus 1.392±0.002 and 195.2±1.8nm at 532nm for ellipsometry, which suggests a general agreement between the two techniques. We present OTPAS to be used for the determination of optical properties of transparent single layer films in cases where empirical equations cannot be used or in cases of low optical reflection.

Current methods of determining the refractive index of chemicals and materials, such as ellipsometry and reflectometry, are limited by their inability to analyze highly absorbing or highly transparent materials, as well as the required prior knowledge of the sample thickness and estimated refractive index. Here, we present a method of determining the refractive index of solutions using the photoacoustic effect. We show that a photoacoustic refractometer can analyze highly absorbing dye samples to within 0.006 refractive index units of a handheld optical refractometer. Further, we use myoglobin, an early non-invasive biomarker for malignant hyperthermia, as a proof of concept that this technique is applicable for use as a medical diagnostic. Comparison of the speed, cost, simplicity, and accuracy of the techniques shows that this photoacoustic method is well-suited for optically complex systems.

Evanescent field sensing methods are currently used to detect many different types of disease markers and biologically important chemicals such as the HER2 breast cancer receptor. Hinoue et al. used Total Internal Reflection Photoacoustic Spectroscopy (TIRPAS) as a method of using the evanescent field to detect an optically opaque dye at a sample interface. Although their methods were successful at detecting dyes, the results at that time did not show a very practical spectroscopic technique, which was due to the less than typical sensitivity of TIRPAS as a spectroscopy modality given the low power (≈ 1 to 2 W) lasers being used. Contrarily, we have used an Nd:YAG laser with a five nanosecond pulse that gives peak power of 1 MW coupled with the TIRPAS system to increase the sensitivity of this technique for biological material sensing. All efforts were focused on the eventual detection of the optically absorbing material, hemozoin, which is created as a byproduct of a malarial infection in blood. We used an optically analogous material, β-hematin, to determine the potential for detection in the TIRPAS system. In addition, four properties which control the sensitivity were investigated to increase understanding about the sensor's function as a biosensing method.

Exploiting the plasmon resonance of gold nanoparticles and the ability to specifically target cancer cell surface proteins, photoacoustic flowmetry may be used to detect nonpigmented circulating tumor cells (CTCs). The authors targeted the EpCAM receptors to attach 50-nm gold nanoparticles to a breast cancer cell line, T47D. After determining the absorption peak and thus the most sensitive laser wavelength, they performed serial dilution trials to show detection of small numbers of breast cancer cells in suspension. This ability may allow an earlier clinical diagnosis and management of metastatic disease for a range of solid tumor types.

Malaria affects over 200 million individuals annually, resulting in 800 000 fatalities. Current tests use blood smears and can only detect the disease when 0.1-1% of blood cells are infected. We are investigating the use of photoacoustic flowmetry to sense as few as one infected cell among 10 million or more normal blood cells, thus diagnosing infection before patients become symptomatic. Photoacoustic flowmetry is similar to conventional flow cytometry, except that rare cells are targeted by nanosecond laser pulses to induce ultrasonic responses. This system has been used to detect single melanoma cells in 10 ml of blood. Our objective is to apply photoacoustic flowmetry to detection of the malaria pigment hemozoin, which is a byproduct of parasite-digested hemoglobin in the blood. However, hemozoin is difficult to purify in quantities greater than a milligram, so a synthetic analog, known as beta-hematin was derived from porcine hemin. The specific purpose of this study is to establish the efficacy of using beta-hematin, rather than hemozoin, for photoacoustic measurements. We characterized beta-hematin using UV-vis spectroscopy, TEM, and FTIR, then tested the effects of laser irradiation on the synthetic product. We finally determined its absorption spectrum using photoacoustic excitation. UV-vis spectroscopy verified that beta-hematin was distinctly different from its precursor. TEM analysis confirmed its previously established nanorod shape, and comparison of the FTIR results with published spectroscopy data showed that our product had the distinctive absorbance peaks at 1661 and 1206 cm(-1). Also, our research indicated that prolonged irradiation dramatically alters the physical and optical properties of the beta-hematin, resulting in increased absorption at shorter wavelengths. Nevertheless, the photoacoustic absorption spectrum mimicked that generated by UV-vis spectroscopy, which confirms the accuracy of the photoacoustic method and strongly suggests that photoacoustic flowmetry may be used as a tool for diagnosis of malaria infection.

Total Internal Reflection Photoacoustic Spectroscopy (TIRPAS) is a method that exploits the evanescent field of a nanosecond duration laser pulse reflecting off a glass/water interface to generate photoacoustic responses. These photoacoustic events are generated in light absorbing analytes suspended in the fluid medium in contact with the glass that are within the penetration depth of the evanescent wave. This method has been employed in previous studies by Hinoue et al. Hinoue et al. used an optically chopped HeNe laser at 632.8 nm to detect Brilliant Blue FCF dye at different angles of incidence. In recent years, the advent of high power nanosecond pulsed tunable lasers has allowed for the re-visitation of the TIRPAS idea under stress confinement and orders of magnitude larger peak power conditions. Compared to conventional detection methods, this approach has the potential to detect much smaller quantities of disease indicators, such as circulating tumor cells and hemazoin crystals in malaria, than other optical methods. The detection limit of the TIRPAS system was quantified using chlorazol black solution with an absorption coefficient of 55 cm(-1) at 532 nm. Interaction with the evanescent field was verified by varying the angle of incidence of the probe laser beam that generated the photoacoustic waves, thereby changing the penetration depth of the evanescent field as well as the photoacoustic spectroscopy effect from angled excitation.