Monte Carlo simulations of time-resolved blood flow index: times-of-flight beyond ∼1 ns are necessary for...

Achieving adequate brain sensitivity remains a significant obstacle to noninvasive optical measurements of pulsatile cerebral blood flow. Increasing source-detector separation (SDS), utilizing time-of-flight (ToF) information, and/or increasing acquisition frequency can increase brain sensitivity. However, optimizing these parameters is nontrivial and must balance the need to achieve sufficient signal-to-noise ratio.

We aim to guide hardware optimization by evaluating the benefits of ToF gating, autocorrelation time-lag gating, and increased source-detector separation in recovering pulsatile cerebral blood flow.

Monte Carlo simulations of ToF-resolved pulsatile blood flow index at 1064 nm were performed. A simulation and analysis pipeline is presented and validated against phantom and in vivo measurements.

Brain sensitivity deteriorates for autocorrelation time-lags >1 to $10\mu s$ . Continuous-wave diffuse correlation spectroscopy (CW-DCS) at 40 mm SDS achieves equivalent brain sensitivity to time-resolved measurements with a 1.2 ns ToF gate. For median adult brain depths, a 31 mm SDS (CW-DCS), 35 mm SDS (speckle contrast optical spectroscopy), or 0.9 ns ToF are needed for brain-dominated signals. For the 85th percentile of brain depth, these thresholds increase to 40 mm, 46 mm, and 1.2 ns, respectively.

We quantitatively compare source-detector separation, ToF gating, and acquisition frequency and identify crucial performance requirements for clinically viable optical monitors of cerebral blood flow.