Janis Spigulis

Optical noninvasive monitoring of skin blood pulsations.

Time-resolved detection and analysis of skin backscattered optical signals (remission photoplethysmography or PPG) provide rich information on skin blood volume pulsations and can serve for reliable cardiovascular assessment. Single- and multiple-channel PPG concepts are discussed. Simultaneous data flow from several locations on the human body allows us to study heartbeat pulse-wave propagation in real time and to evaluate vascular resistance. Portable single-, dual-, and four-channel PPG monitoring devices with special software have been designed for real-time data acquisition and processing. The prototype devices have been clinically studied, and their potential for monitoring heart arrhythmias, drug-efficiency tests, steady-state cardiovascular assessment, body fitness control, and express diagnostics of the arterial occlusions has been confirmed.

Simultaneous recording of skin blood pulsations at different vascular depths by multiwavelength photoplethysmography

A new technique for parallel recording of reflection photoplethysmography (PPG) signals in a broad spectral band (violet to near-infrared) has been developed, and its potential for assessment of blood microcirculation at various depths from the skin surface is discussed. PPG signals have been simultaneously detected at cw laser wavelength sets comprising 405, 532, 645, 807, and 1064 nm. Various signal baseline responses to breath holding and different shapes of the PPG pulses originated from the same heartbeat but recorded at different wavelengths have been observed, indicating a depth variety of the skin blood pulsation dynamics.

Bilateral photoplethysmography studies of the leg arterial stenosis

A newly developed portable multi-channel photoplethysmography (PPG) device has been used for comparative studies of 20 healthy control subjects and 45 patients with diagnosed arterial stenosis in a leg. The peripheral blood pulsations were detected simultaneously at four body sites-the same fingers and toes of both arms and legs. The PPG pulses recorded at the periphery of the stenotic leg, if compared with those of the healthy leg, were much weaker, with delayed arrival as a consequence of increased pulse wave transit time (PWTT) due to higher vascular resistance. The specific PWTT delays for the occluded legs were in the range of 20-80 ms, while in the case of healthy subjects the leg PPG signals arrived without delays or with smaller time-shifts not exceeding 14 ms. The reference bilateral PPG signals detected at the fingertips did not show any notable PWTT delays in both groups. Parallel measurements of local blood pressures by means of the oscillometry method with subsequent calculation of the ankle-brachial index were performed. Convincing correlation between the bilateral differences in the local blood pressure (a routine tool for diagnostics of leg stenosis) and in the corresponding PWTT delay (Pearsons coefficient r = 0.93), as well as between the PWTT delay and the ankle-brachial index (r = -0.96) has been established. From the point of view of PWTT delay, the average value of leg stenosis diagnostic threshold was established to be in the range of 23 +/- 9 ms, with full reliability above 32 ms. The obtained data may find further applications in alternative methodologies for detection and/or assessment of arterial occlusions in human extremities.

2-D mapping of skin chromophores in the spectral range 500 - 700 nm.

The multi-spectral imaging technique has been used for distant mapping of in-vivo skin chromophores by analyzing spectral data at each reflected image pixel and constructing 2-D maps of the relative concentrations of oxy-/deoxy-haemoglobin and melanin. Instead of using a broad visible-NIR spectral range, this study focuses on narrowed spectral band 500-700 nm, speeding-up the signal processing procedure. Regression analysis confirmed that superposition of three Gaussians is optimal analytic approximation for the oxy-haemoglobin absorption tabular spectrum in this spectral band, while superposition of two Gaussians fits well for deoxy-haemoglobin absorption and exponential function - for melanin absorption. The proposed approach was clinically tested for three types of in-vivo skin provocations: ultraviolet irradiance, chemical reaction with vinegar essence and finger arterial occlusion. Spectral range 500-700 nm provided better sensitivity to oxy-haemoglobin changes and higher response stability to melanin than two reduced ranges 500-600 nm and 530-620 nm.

Clinical evaluation of melanomas and common nevi by spectral imaging.

A clinical trial on multi-spectral imaging of malignant and non-malignant skin pathologies comprising 17 melanomas and 65 pigmented common nevi was performed. Optical density data of skin pathologies were obtained in the spectral range 450–950 nm using the multispectral camera Nuance EX. An image parameter and maps capable of distinguishing melanoma from pigmented nevi were proposed. The diagnostic criterion is based on skin optical density differences at three fixed wavelengths: 540nm, 650nm and 950nm. The sensitivity and specificity of this method were estimated to be 94% and 89%, respectively. The proposed methodology and potential clinical applications are discussed.

Wearable wireless photoplethysmography sensors

Wearable health monitoring sensors may support early detection of abnormal conditions and prevention of their consequences. Recent designs of three wireless photoplethysmography monitoring devices embedded in hat, glove and sock, and connected to PC or mobile phone by means of the Bluetooth technology, are described. First results of distant monitoring of heart rate and pulse wave transit time using the newly developed devices are presented.

Real-Time Photoplethysmography Imaging System

Real-time non-contact photoplethysmography imaging (PPGI) system for high-resolution blood perfusion mapping in human skin has been proposed. The PPGI system comprises of LED lamp, webcam and computer with video processing software. The purpose of this study is to evaluate the reliability of the PPGI system when measuring blood perfusion. The validation study of PPGI and laser-Doppler perfusion imager (LDPI) was performed during local warming of palm skin. Results showed that the amplitude of PPGI increases immediately after warming and well correlated with the mean LDPI amplitude (R=0.92+-0.03, p<0.0001). We found that PPGI technique has good potential for non-contact monitoring of blood perfusion changes.

Imaging of laser-excited tissue autofluorescence bleaching rates

Experimental methodology for imaging of laser-excited tissue autofluorescence bleaching rates has been developed and clinically tested. The fluorescence images were periodically captured from the same tissue area over a certain time, with subsequent detection of the fluorescence intensity decrease rate at each image pixel and further imaging the planar distribution of those values. Spectral features at each image pixel were analyzed with a hyperspectral imaging camera. Details of the equipment and image processing are described as well as some measurement results that confirm the feasibility of the proposed technology.

Compact dielectric reflective elements. I. Half-sphere concentrators of radially emitted light.

Optical designs of aspheric internally reflective concentrators of divergent light emitted within a spatial angle of 2n sr are proposed and discussed. Four types of solid transparent element are considered: the divergence angle reducer, the small-spot illuminator, the point focuser, and the collimator. The output beam aperture in all cases is comparable with the light-source external dimensions. Expressions describing the profiles of beam-transforming surfaces and results from experiments with model devices are presented.

Multilaser photoplethysmography technique

New technique for parallel recording of reflection photoplethysmography signals in broad spectral band (violet to NIR) has been developed based on fiber-coupled laser irradiation and time-resolved spectrometric detection. Differences in photoplethysmography waveforms that were recorded simultaneously at different wavelengths confirmed the depth variety of the skin blood pulsation dynamics, thus the proposed methodology has a potential for application in skin microcirculation studies.