WO2017012675A1 - Procédé et dispositif permettant une cartographie des composés tissulaires au moyen d'un téléphone intelligent - Google Patents

Procédé et dispositif permettant une cartographie des composés tissulaires au moyen d'un téléphone intelligent Download PDF

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WO2017012675A1
WO2017012675A1 PCT/EP2015/066913 EP2015066913W WO2017012675A1 WO 2017012675 A1 WO2017012675 A1 WO 2017012675A1 EP 2015066913 W EP2015066913 W EP 2015066913W WO 2017012675 A1 WO2017012675 A1 WO 2017012675A1
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Prior art keywords
tissue
smartphone
mapping
camera
display
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PCT/EP2015/066913
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English (en)
Inventor
Janis Spigulis
Matiss LACIS
Ilona KUZMINA
Aleksejs Lihacovs
Zigmars RUPENHEITS
Vladimirs Upmalis
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Latvijas Universitate
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Priority to PCT/EP2015/066913 priority Critical patent/WO2017012675A1/fr
Publication of WO2017012675A1 publication Critical patent/WO2017012675A1/fr

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0071Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0075Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14552Details of sensors specially adapted therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61B5/14551Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases
    • A61B5/14556Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters for measuring blood gases by fluorescence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/44Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441Skin evaluation, e.g. for skin disorder diagnosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/44Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/443Evaluating skin constituents, e.g. elastin, melanin, water
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6887Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient mounted on external non-worn devices, e.g. non-medical devices
    • A61B5/6898Portable consumer electronic devices, e.g. music players, telephones, tablet computers

Definitions

  • the invention relates to imaging technologies, in particular to remote imaging of tissue chromophore and/or fluorophore distribution by means of a smartphone or a similar mobile device.
  • tissue compounds e.g. skin chromophores
  • tissue compounds e.g. skin chromophores
  • Three main chromophores that determine skin colour in normal conditions are melanin, oxy-haemoglobin and deoxy-haemoglobin (A R. Young, "Chromophores in human skin", Phys. Med. Biol. 42, 789, 1997).
  • Content of another skin chromophore - bilirubin increases in result of liver insufficiency and/or mechanical interventions (bruises, post-surgery healing; as a reference, see L.LRandeberg et al., "Skin changes following minor trauma.
  • Tissue chromophore maps can be derived from large data sets of multi- spectral and/or hyperspectral reflection images, by means of spectral fitting algorithms with respect to absorption properties of the chromophores under interest (e.g. D. Jakovels and J. Spigulis, "2-D mapping of skin chromophores in the spectral range 500-700 nm", ./. Biophoton. v.3, No. 3. pp. 125-129, 2010 ).
  • D. Jakovels and J. Spigulis "2-D mapping of skin chromophores in the spectral range 500-700 nm", ./. Biophoton. v.3, No. 3. pp. 125-129, 2010 .
  • such systems usually comprise two mutually crossed polarizers - one in front of the illuminator and the other in front of the imaging camera (US2005030372 Al Method and apparatus for characterization of chromophore content and distribution in skin using cross-polarized diffuse reflectance imaging).
  • Digital RGB cameras are also well-suited for chromophore mapping, since the red (R), green (G) and blue (B) spectral images of the target can be separated and/or specifically related (e.g. Kapsokalyvas D. et al.,. "Spectral morphological analysis of skin lesions with a polarization multispectral dermoscope. " Opt. Express. 21(4), 4826-40, 2013).
  • spectrally narrowband tissue illumination can be used, e.g. by means of different colour LEDs (D.Jakovels et al, "Noncontact monitoring of vascular lesion phototherapy efficiency by RGB multispectral imaging", J. Biomed. Opt. 18(12), 126019, 2013).
  • Skin fluorescence is useful technique for imaging of hidden tissue structures (US2014364745 Al), Multi-spectral tissue imaging). Skin fluorophore distributions can be mapped using specific lifetime imaging (as example - A.Ehlers et al., "Fluorescence lifetime imaging of human skin and hair", Proc. SPIE, v. 6089, 6089ON, 2006) or imaging of fluorescence photo-bleaching rates (J.Spigulis et al., "Imaging of laser-excited tissue autofluorescence bleaching rates, " Appl. Opt., v. 48, No. 10, pp. D163-D168, 2009).
  • specific lifetime imaging as example - A.Ehlers et al., "Fluorescence lifetime imaging of human skin and hair", Proc. SPIE, v. 6089, 6089ON, 2006
  • fluorescence photo-bleaching rates J.Spigulis et al., "Imaging of laser-excited tissue autofluorescence bleaching rates,
  • Fluorescence lifetime imaging devices usually are large-sized and robust, therefore not well- suited for clinical environment, while the known photo-bleaching rate distribution imagers typically need external computer for image processing. Wider applications of fluorescence techniques would require more compact designs.
  • Portable handheld devices with built-in illumination, imaging and processing units able to map skin chromophores and fluorophores are known, as well (e.g. LV ' 14749 A), Multimodal displaying device for non-contact skin diagnosis; J.Spigulis et al., "Sklmager: a concept device for in-vivo skin assessment by multimodal imaging", Proc. Est. Acad. Sci. 63(3), 213-220, 2014).
  • the proposed concept and prototype are at an early development stage and need further clinical validation.
  • Smartphones, tablet PCs, laptop PCs and similar mobile devices of the latest generations comprise elements that are commonly exploited for mapping of tissue compounds - high- resolution digital RGB cameras, liquid-crystal displays, powerful processing units and white LED light source(s) on the rear panel.
  • Snapshot mapping of three main skin chromophores under triple-laser illumination has been demonstrated recently (J.Spigulis and I.Oshina, "Snapshot RGB mapping of skin melanin and haemoglobin", J.Biomed.Opt, 20(5), 050503, 2015). This approach might be efficient if smartphone is used for image acquisition.
  • the regarded background information confirms that smartphones and/or similar mobile devices might be applied efficiently for distant mapping of tissue compounds if appropriate methods and supporting devices become available.
  • Goal of the invention is to ensure easy use of smartphones (or similar mobile devices, originally comprising at least one camera, display, processing unit and battery) for remote mapping of tissue compounds.
  • Invention proposes tissue chromophore and/or fluorophore mapping and/or indication of clinically critical values of their content on the display of smartphone by converting images of the same tissue area taken by smartphone camera under spectrally specific illumination and using the internal computing resources of smartphone for image processing.
  • Five supporting device designs are proposed along with two methods used for image processing.
  • Fig. l presents design scheme of the embodiment 1 without smartphone (a) and with smartphone (b).
  • Fig.2 specifies design of the ring light source covered by diffusive film and polarizer of the embodiment 1.
  • Fig.3 illustrates design of the embodiment 1 with conical shielding wall.
  • Fig.4 shows design scheme of the embodiment 3 with cylindrical (a) and conical (b) shielding wall.
  • Fig.5 presents the measured emission spectra from mono-coloured displays of the Sony Xperia Go smartphone: B - blue, G - green, R - red.
  • Fig.6 provides scheme for image capturing by front camera of smartphone with side-turned display illumination of the tissue.
  • Fig.7 illustrates design scheme of the embodiment 4 without (a) and with (b) smartphone.
  • Fig.8 explains optical system of the embodiment 5 providing tissue illumination at several laser wavelengths.
  • Fig.9a and 9b specifies design of laser illumination system of the embodiment 5.
  • Fig.10 presents the scheme of image-processing algorithm for mapping of tissue chromophores.
  • Fig.11 presents the scheme of image-processing algorithm for mapping of tissue fluorophores.
  • Embodiment 1 Universal platform for tissue chromophore mapping by smartphone.
  • the proposed device comprises a flat platform 1 with first polarizer-covered opening 2 for the rear camera of a smartphone 3 or similar mobile device with installed appropriate software.
  • the platform 1 is covered with a sticky non-smearing substance able to fix the smartphone, tablet computer or other mobile device with its camera against the opening 2 during the image acquisition.
  • This design is universal because any model of smartphone, tablet computer or other mobile device can be used, independently on its size and specifications.
  • a compartment 4 for rechargeable batteries and electronic circuits is mounted, as well as non-transparent cylindrical light shielding wall 5 that also ensures fixed distance between the camera objective and the examined tissue, placed under the cylinder in contact with it.
  • non-transparent cylindrical light shielding wall 5 that also ensures fixed distance between the camera objective and the examined tissue, placed under the cylinder in contact with it.
  • shielding cylinder 5 manually tuneable iris diaphragm 6 or, alternatively, a set of shielding rings with internal openings of different diameters, is mounted.
  • Spectrally-specific illumination of tissue is performed by a ring of suitable narrowband LEDs 7 with internal diameter larger than that of the opening 2 (Fig.2).
  • the LED ring 7 is mounted on the down- side side of platform 1 within the shielding cylinder 5 and is covered by a ring of diffusive film 8 that provides uniform illumination of the target area, and, behind it, by a ring of polarizing film 9 with orthogonal orientation relatively to the first polarizer 10, so preventing detection of the tissue surface-reflected radiation.
  • the ring 7 comprises a set of narrowband LEDs emitting at least in the blue, green and red spectral ranges.
  • Each emission colour is sequentially 0.1...1.0 second switched on by a driver mounted in the compartment 4 for taking one or several spectral images; the driver is managed by smartphone's software using either cable or wireless connection.
  • the LEDs can be also switched on simultaneously to provide white illumination for taking a colour photo of the tissue under examination. All acquired images are further processed using the method described below; the calculated tissue chromophore maps appear on the screen of smartphone within few seconds and can be examined visually and/or saved for further analysis in the smartphone memory card.
  • FIG.3 Another design option of embodiment 1 is presented on Fig.3. To ensure better access to curved, caved or hard-to-reach tissue areas, the cylindrical shielding unit is replaced by a conical shielding nozzle 11 with correspondingly reduced image field.
  • Embodiment 2 Universal platform for tissue fluorophore mapping by smartphone.
  • the Device comprises most of the elements of the embodiment 1, with some modifications to adapt the device for fluorescence measurements.
  • the ring-shaped LED illuminator 7 is uncovered and comprises one or several LEDs suitable for tissue fluorescence excitation, e.g. emitting in the spectral range 400-450nm, and one or several white LEDs for obtaining colour photos of the tissue area under examination by the smartphone camera.
  • the opening 2 is covered by an optical filter, cutting-off the wavelengths used for fluorescence excitation.
  • LEDs are operated by the smartphone software; they are continuously emitting for a predefined time interval. Fluorescence images of the same tissue area are recorded by smartphone camera in video-mode for at least 20 seconds with framerate at least 1 fr/s. The B-output signals of each image pixel or selected pixel group are used for reference, while the G- and R-outputs are imaging the tissue fluorescence and detecting its photo-bleaching over time. If several fluorophores are excited, their photo-bleaching rates may differ, causing temporal changes in output signals of the G- and R-detection bands.
  • tissue flourophores and/or their groups are identified and mapped using the method described below; the resulting maps and/or videos of tissue fluorophore distribution appear on the smartphone display and can be saved for further analysis in the memory card of smartphone.
  • Embodiment 3. Compact design for tissue chromophore and/or fluorophore mapping by smartphone.
  • the platform 1 represents a disc with external diameter equal to that of the shielding cylinder 5 or basement of the shielding cone 10 (Fig.4).
  • Both power supply and management of the LED ring 7 operation is provided by the smartphone battery and the installed appropriate software, respectively, via a flexible cable 12 connected to the USB port of the smartphone.
  • Image processing, display and saving of the tissue chromophore and/or fluorophore maps is performed as described above. This design is handier than the two previously described, but it is not that universal due to limitations of LED current provided by the battery of the specified model of smartphone or similar mobile device.
  • Embodiment 4 Smartphone holder with light-turning element for tissue chromophore mapping.
  • micro- structured prism film http://www.film-optics.co.uk/index.php/lighting
  • the device represents a hollow holder with light- shielding walls 13, placed on the tissue surface.
  • Holder has and upper surface adapted to size of the smartphone with properly oriented micro- structured prism film (or similar light turning element) 14 supposed to be in contact with the illuminating display of smartphone (Fig.7).
  • the upper surface also comprises an opening for the front camera of smartphone, possibly covered by a properly oriented polarizing film to minimize detection of surface- reflected light.
  • the upper surface of holder is fixed at the distance x from the tissue surface. Extension of the shielding wall 15 provides optimal field of view of the front camera.
  • display of the smartphone remains open while a sloped mirror, transparent wedge or other optical element turning the front camera's field of view for the angle a observing the same geometrical condition for the distance x) is attached to the front camera of smartphone so that the display- illuminated area of tissue is optimally imaged.
  • Embodiment 5 Universal platform for single-snapshot mapping of tissue chromophores.
  • Device comprises elements 1-5 of the device-1 (Fig. l), as well as the ring-shaped polarizing film 9.
  • the LED ring 7 is replaced by a flat diffusive disc 16 with round central opening, made of a milk- glass or similar material.
  • Disc 16 is tightly covered by another ring-shaped disc 17 of the same thickness but made of a transparent material, e.g. glass, with polished 45deg-sloped external edge; the upper surfaces and sloped edges of both discs are mirror-coated (Fig.8).
  • a number of laser modules 18 emitting spectral lines with selected wavelengths are fixed so that their output beams are directed to the sloped mirrored edge of the external disc 17 and after reflection are directed radially to the diffusive disc 16.
  • the scattered in disc 16 laser light provides uniform illumination of the examined tissue surface at all exploited laser wavelengths (Fig.9).
  • the external disc 17 is replaced by a set of radially oriented flexible optical fibres or other appropriate light guide(s) that deliver the laser radiation to the diffusive ring 16 from the laser modules that are placed elsewhere.
  • the proposed design provides more uniform illumination of the selected tissue surface because disc 16 acts as an isotropic surface emitter, not as a point-source.
  • the single snapshot of selected tissue area is taken by smartphone rear camera when all lasers are switched on.
  • Image processing for obtaining tissue chromophore maps on the smartphone display is performed by software installed on the smartphone using the algorithm from the above-cited publication.
  • a reference signal from specific reflector is needed.
  • a white reflector e.g. white ceramic plate, white paper
  • Invention proposes to exploit as reference for chromophore mapping the area(s) of healthy tissue adjacent to the pathology region or sufficiently close to it - e.g. in cases when the adjacent part is inflamed or when the pathology covers nearly all field of view.
  • Smartphone software establishes equally sized regions of interest (Rol) for further analysis - e.g. at least one in central (pathology) region of the image and four at all corners of image (or a different number of differently located Rols), with subsequent averaging of the reference values of reflected intensity.
  • Rol regions of interest
  • additional reference image has to be taken from completely healthy tissue near to the pathology region.
  • the scheme of image-processing algorithm is presented on Fig.10.
  • the process of obtaining chromophore distribution maps starts with reference image obtaining 801. For reference data image of patient skin without damage is used. The reference images are obtained for every illumination wavelength. Then operator chooses priority chromophore mapping 802 which are most interesting - PH.
  • the next step 803 is obtaining 3 images I ; - one per one illumination wavelength, where every image is dedicated to chromophore i.
  • 2 algorithm variables are initialized for every chromophore i mapping - split factor for images Nj 804 and speed factor SF ; 805.
  • Speed factor SF specifies how fast algorithm converges and is adjusted for computing platform according to requirements for mapping obtaining speed and available computing resources.
  • Z C(pat)/ C(hea) (4), related to the derived concentrations of particular chromophore in the pathology region C(pat) and in the reference (healthy tissue) region C(hea).
  • Relative concentrations of chromophores are calculated from the measurement data by solving eq. (1) or by any other suitable algorithm. Then the smartphone software compares the obtained values with pre-defined clinical threshold values related to severity of the examined tissue pathology and indicates the severity level of the displayed values by different colour coding, flashing the displayed numbers at different frequencies, sound signalling, or similar.
  • Invention proposes to map tissue fluorophores or their groups accordingly to the recorded photo-bleaching rate distributions as detected separately in the G- and R-channels of the smartphone image sensor, and additionally to characterize the dynamics of photo- bleaching by providing sequential parametric images formed by the ratios of the G- and R- signals recorded from each pixel or group of pixels over time (e.g. by creating a parametric video file).
  • Both static fluorophore distribution maps and the dynamic video-recordings are displayed on the smartphone touch-screen.
  • the processing procedure involves the following steps:

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  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
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Abstract

L'invention se rapporte à des technologies d'imagerie, en particulier à une imagerie à distance d'une distribution tissulaire de chromophores et/ou de fluorophores au moyen d'un téléphone intelligent ou d'un dispositif mobile similaire. Un but de l'invention est de garantir une utilisation aisée de téléphones intelligents (ou de dispositifs mobiles similaires, comprenant à l'origine au moins un appareil de prise de vues, un dispositif d'affichage, une unité de traitement et une batterie) ayant un logiciel approprié pour réaliser une cartographique à distance de composés tissulaires. L'invention propose une cartographie tissulaire des chromophores et/ou des fluorophores et/ou l'indication de valeurs critiques d'un point de vue clinique de leur contenu sur le dispositif d'affichage d'un téléphone intelligent par conversion d'images de la même zone tissulaire prise par un appareil de prise de vues du téléphone intelligent sous un éclairage spécifique de façon spectrale et à l'aide des ressources informatiques internes du téléphone intelligent pour un traitement d'image. L'invention concerne cinq conceptions de dispositif de support conjointement avec deux procédés utilisés pour un traitement d'image.
PCT/EP2015/066913 2015-07-23 2015-07-23 Procédé et dispositif permettant une cartographie des composés tissulaires au moyen d'un téléphone intelligent WO2017012675A1 (fr)

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Cited By (4)

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EP3357416A1 (fr) * 2017-02-07 2018-08-08 Samsung Electronics Co., Ltd. Procédé de fourniture d'informations sur la peau et dispositif électronique le prenant en charge
WO2018177565A1 (fr) 2017-03-28 2018-10-04 Latvijas Universitate Dispositif d'imagerie sans chatoiement sous éclairage laser
WO2019092509A1 (fr) * 2017-11-10 2019-05-16 Galderma Research & Development Dispositif uv pour l'évaluation d'affections de la peau
WO2020014779A1 (fr) * 2018-07-16 2020-01-23 Swift Medical Inc. Appareil pour une visualisation de tissu

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WO2018177565A1 (fr) 2017-03-28 2018-10-04 Latvijas Universitate Dispositif d'imagerie sans chatoiement sous éclairage laser
WO2019092509A1 (fr) * 2017-11-10 2019-05-16 Galderma Research & Development Dispositif uv pour l'évaluation d'affections de la peau
WO2020014779A1 (fr) * 2018-07-16 2020-01-23 Swift Medical Inc. Appareil pour une visualisation de tissu
US11266345B2 (en) 2018-07-16 2022-03-08 Swift Medical Inc. Apparatus for visualization of tissue

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