Gunnar Lovhoiden

Prototype vein contrast enhancer

Two different prototype vein contrast enhancers (VCEs) have been designed and constructed. The VCE is an instrument that makes vein access easier by capturing an infrared image of peripheral veins, enhancing the vein contrast using software image processing, and projecting the enhanced vein image back onto the skin using a video projector. The prototypes use software alignment to achieve alignment accuracy between the captured infrared image and the projected visible image better than 0.06 mm.

Theoretical analysis and experimental evaluation of a CsI(Tl) based electronic portal imaging system

This article discusses the design and analysis of a portal imaging system based on a thick transparent scintillator. A theoretical analysis using Monte Carlo simulation was performed to calculate the x-ray quantum detection efficiency (QDE), signal to noise ratio (SNR) and the zero frequency detective quantum efficiency [DQE(0)] of the system. A prototype electronic portal imaging device (EPID) was built, using a 12.7 mm thick, 20.32 cm diameter, Csl(Tl) scintillator, coupled to a liquid nitrogen cooled CCD TV camera. The system geometry of the prototype EPID was optimized to achieve high spatial resolution. The experimental evaluation of the prototype EPID involved the determination of contrast resolution, depth of focus, light scatter and mirror glare. Images of humanoid and contrast detail phantoms were acquired using the prototype EPID and were compared with those obtained using conventional and high contrast portal film and a commercial EPID. A theoretical analysis was also carried out for a proposed full field of view system using a large area, thinned CCD camera and a 12.7 mm thick CsI(TI) crystal. Results indicate that this proposed design could achieve DQE(0) levels up to 11%, due to its order of magnitude higher QDE compared to phosphor screen-metal plate based EPID designs, as well as significantly higher light collection compared to conventional TV camera based systems.

The clinical evaluation of vein contrast enhancement

A vein contrast enhancer (VCE) has been constructed to make vein access easier by capturing an infrared image of veins, enhancing the contrast using software, and projecting the vein image back onto the skin. The VCE also uses software to align the projected image with the vein to 0.06 mm. Clinical evaluation of earlier monitor-based vein enhancement test systems has demonstrated the clinical utility of the infrared imaging technology used in the VCE.

Commercialization of vein contrast enhancement

An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

Design of a clinical vein contrast enhancing projector

A clinical study has been initiated to compare an experimental IR device, the Vein Contrast Enhancer (VCE), with standard techniques for finding veins for venipuncture. The aims of this proposal are (1) to evaluate the performance of the VCE in a clinical setting, specifically by comparing its sensitivity of detection with existing vein-finding techniques used by experienced nurses or phlebotomists, (2) to study its usefulness in subjects who are obese, who have difficult venous access or thrombosed veins, or whose veins are not visible or difficult to palpate, and (3) to show that it performs as well on subjects with darkly pigmented skin as on subjects with lightly pigmented skin. The VCE will first be studied in adult subjects, and then in pediatric subjects.

Portal imaging with a CsI(Tl) transparent scintillator x-ray detector

In a previous paper, a portal imaging system was described that used a 101 mm diameter, 3 mm thick CsI (Tl) transparent scintillating screen coupled to a liquid-nitrogen-cooled slow- scan CCD-TV camera with a 40 mm f1.0 macro lens with a 5:1 demagnification. Meanwhile, improved images have been acquired using a 50 mm f1.1 macro lens with a 7:1 demagnification. These images were presented at an AAPM International Symposium on Electronic Portal Imaging in Detroit, MI, in May, 1997. Since the Detroit meeting, a 203 mm diameter, 13 mm thick CsI(Tl) crystal has been purchased from Bicron. This transparent screen has been used with a Nikkor 35 mm f1.4 lens to show the whole 203 mm circular field at 0.53 mm pixel size with the existing Astromed liquid nitrogen cooled CCD TV camera system. The geometry of the imaging system has been optimized to achieve high spatial resolution (1 lp/mm) in spite of the increased thickness of the screen. This increased thickness allows the high image quality achieved with the older screen at 72 MU to be maintained with the newer screen while reducing the dose to 1 MU. Images have been acquired with the new screen of lead bar patterns, low-contrast hole patterns in Lucite blocks, and anthropomorphic phantoms.

Optimization of subcutaneous vein contrast enhancement

A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This techniques uses a near IR light source and one or more IR sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patients skin using a n LCD video projector. The use of an IR transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults and children, both Caucasian and African-American, and it enhances veins quite well in all cases. The most difficult cases are those where significant deposits of subcutaneous fat are present which make the veins invisible under normal room illumination. Recent attempts to see through fat using different IR wavelength bands and both linearly and circularly polarized light were unsuccessful. The key to seeing through fat turns out to be a very diffuse source of RI light. Results on adult and pediatric subjects are shown with this new IR light source.

Enhancing the contrast of subcutaneous veins

A technique for enhancing the contrast of subcutaneous veins has been demonstrated. This technique uses a near infrared light source and one or more infrared sensitive CCD TV cameras to produce a contrast enhanced image of the subcutaneous veins. This video image of the veins is projected back onto the patients skin using an LCD vein projector. The use of an infrared transmitting filter in front of the video cameras prevents any positive feedback from the visible light from the video projector from causing instabilities in the projected image. The demonstration contrast enhancing illuminator has been tested on adults, both Caucasian and African-American, and it enhances veins quite well in most cases. Preliminary studies on a 9 month old girl indicate promise for pediatric use.

High-resolution x-ray imaging with a Gd 2 O 3 (Eu) transparent ceramic scintillator

A liquid nitrogen cooled CCD TV camera from Astromed, Ltd., has been used for quantitative x-ray medical imaging. The CCD is coupled to a Gd2O3(Eu) transparent ceramic scintillator on loan from the Ceramics Division of the General Electric Research Laboratories with an 80 mm f 1.3 oscilloscope camera lens optimized for 2:1 demagnification. High-resolution single-energy x-ray images have been acquired of lead bar patterns, human heel bones, and human teeth. Dual-energy bone-mineral densitometry images have been acquired of the foot and the femur of a rat.

High-accuracy x-ray imaging: screen, lens, and CCD

A liquid nitrogen cooled CCD TV camera from Astromed, Ltd. has been used for quantitative X-ray medical imaging. The CCD camera is coupled to a Kodak Lanex Regular X-ray intensifying screen with a 5:1 macro lens for bone mineral densitometry of the femur of a rat for a study of the development of osteoporosis. As a feasibility study of the use of the CCD for mammography, a 2:1 macro lens has been used to couple the CCD to a clear CsI(Tl) crystal, 100 mm in diameter and 3 mm thick. The spatial resolution and quantum efficiency of the system is significantly improved by replacing the Lanex Regular screen with the CsI(Tl) crystal.