Paul M. McNamara

Comparison of instruments for investigation of microcirculatory blood flow and red blood cell concentration

The use of laser Doppler perfusion imaging (LDPI) and laser speckle perfusion imaging (LSPI) is well known in the noninvasive investigation of microcirculatory blood flow. This work compares the two techniques with the recently developed tissue viability (TiVi) imaging system, which is proposed as a useful tool to quantify red blood cell concentration in microcirculation. Three systems are evaluated with common skin tests such as the use of vasodilating and vasoconstricting drugs (methlynicotinate and clobetasol, respectively) and a reactive hyperaemia maneuver (using a sphygmomanometer). The devices investigated are the laser Doppler line scanner (LDLS), the laser speckle perfusion imager (FLPI)-both from Moor Instruments (Axminster, United Kingdom)-and the TiVi imaging system (WheelsBridge AB, Linkoping, Sweden). Both imaging and point scanning by the devices are used to quantify the provoked reactions. Perfusion images of vasodilatation and vasoconstriction are acquired with both LDLS and FLPI, while TiVi images are acquired with the TiVi imager. Time acquisitions of an averaged region of interest are acquired for temporal studies such as the reactive hyperaemia. In contrast to the change in perfusion over time with pressure, the TiVi imager shows a different response due its measurement of blood concentration rather than perfusion. The responses can be explained by physiological understanding. Although the three devices sample different compartments of tissue, and output essentially different variables, comparisons can be seen between the three systems. The LDLS system proves to be suited to measurement of perfusion in deeper vessels, while FLPI and TiVi showed sensitivity to more superficial nutritional supply. LDLS and FLPI are insensitive to the action of the vasoconstrictor, while TiVi shows the clear boundaries of the reaction. Assessment of the resolution, penetration depth, and acquisition rate of each instrument show complimentary features that should be taken into account when choosing a system for a particular clinical measurement.

Tissue viability (TiVi) imaging: temporal effects of local occlusion studies in the volar forearm

Tissue Viability (TiVi) imaging is a promising new technology for the assessment of microcirculation in the upper human dermis. Although the technique is easily implemented and develops large amounts of observational data, its role in the clinical workplace awaits the development of standardised protocols required for routine clinical practice. The present study investigates the use of TiVi technology in a human, in vivo, localized, skin blood flow occlusion protocol. In this feasibility study, the response of the cutaneous microcirculation after provocation on the volar surface of the forearm was evaluated using a high temporal-low spatial resolution TiVi camera. 19 healthy subjects - 10 female and 9 male - were studied after a localized pressure was applied for 5 different time periods ranging from 5 to 25 seconds. Areas corresponding to 100 x 100 pixels (2.89 cm(2)) were monitored for 60 seconds prior to, during and after each occlusion period. Our results demonstrated the removal of blood from the local area and a hyperaemic response supporting the suitability of TiVi imaging for the generation of detailed provocation response data of relevance for the physiological function of the skin microcirculation in health and disease.

Assessment of curing behavior of light‐activated dental composites using intensity correlation based multiple reference optical coherence tomography

Monitoring the curing kinetics of light‐activated resin is a key area of research. These resins are used in restorative applications and particularly in dental applications. They can undergo volumetric shrinkage due to poor control of the depth dependent curing process, modulated by the intensity and duration of the curing light source. This often results in the formation of marginal gaps, causing pain and damage to the restoration site. In this study, we demonstrate the capabilities of a correlation method applied using a multiple references optical coherence tomography (MR‐OCT) architecture to monitor the curing of the resin.

In vivo full-field en face correlation mapping optical coherence tomography.

Abstract. A full-field optical coherence tomography (OCT) system has been developed for the purpose of performing nonscanning en face flow imaging. The light source is centered at 840 nm with a bandwidth of 50 nm resulting in an axial resolution of 8 μm in air. Microscope objectives with a numerical aperture of 0.1 were incorporated giving a transverse resolution of 5 μm. A magnification of 5.65 was measured, resulting in a field of view of 1260×945  μm. Pairs of interference fringe images are captured with opposing phase and a two-step phase image reconstruction method is applied to reconstruct each en face image. The OCT frame rate is 10 Hz. A two-dimensional cross-correlation technique is applied to pairs of consecutive en face images in order to distinguish dynamic from static light-scatterers. The feasibility of the method was examined by simulating blood flow by creating a phantom with 5% intralipid solution. In vivo imaging of a Xenopus laevis tadpole was also performed in order to investigate the feasibility of imaging the vascular system. We present for what we believe to be the first time, the application of correlation mapping optical coherence tomography to full-field OCT to provide in vivo functional imaging of blood vessels.

The how and why of a

Optical Coherence Tomography (OCT) is the fastest growing medical imaging modality with more than

10 optical coherence tomography system

1Bln worth of scans ordered and over

Dynamic microvascular responses with a high speed TiVi imaging system

400M worth of equipment shipped in 2010, just nine years after its commercialization. It is at various stages of acceptance and approvals for eye care, coronary care and skin cancer care and is spreading rapidly to other medical specialties. Indeed, it is the leading success of translation of biophotonics science into clinical practice. Significant effort is being made to provide sufficient evidence for efficacy across a broad range of applications, but more needs to be done to radically reduce the cost of OCT so that it can spread to underserved markets and address new, fast growing opportunities in mobile health monitoring. Currently, a clinical OCT system ranges in price from ~

Diffuse reflection imaging of sub-epidermal tissue haematocrit using a simple RGB camera

50k to ~

Development of a first-generation miniature multiple reference optical coherence tomography imaging device

150k, typically is housed on a bedside trolley, runs off AC power, and requires skilled, extensively trained technicians to operate. The cost, size, and skill level required keep this wonderful technology beyond the reach of mainstream primary care, much less individual consumers seeking to monitor their health on a routine basis outside of typical clinical settings and major urban medical centers. Beyond the first world market, there are 6.5 billion people with similar eye and skin cancer care needs which cannot be met by the current generation of large, expensive, complex, and delicate OCT systems. This paper will describe a means to manufacture a low cost, compact, simple, and robust OCT system, using parts and a configuration similar to a CD-ROM or DVD pickup unit (see figure 1). Essentially, this system—multiple reference OCT (MR-OCT)—is based on the use of a partial mirror in the reference arm of a time domain OCT system to provide multiple references, and hence A-scans, at several depths simultaneously (see figure 2). We have already shown that a system based on this configuration can achieve an SNR of greater than 90 dB, which is sufficient for many medical imaging and biometry applications.

Tissue viability (TiVi) imaging: utility in assessment of rapid changes in the cutaneous microvasculature

TiVi technology presents a high resolution, low speed methodology for imaging microcirculation. Recently, the TiVi system was adapted to produce a high speed system capable of analysing dynamic responses from human tissues at a frame rate of 30 frames per second. We present results based on this system by investigating dynamic responses such as arterial pulsations both from a controlled flow model and in vivo tissue sites. We also quantify the effects of sympathetic vasomotion, a biological effect which is evident in many tissue sites, and show that the effects of arterial pulsations and vasomotion on the resulting TiVi time traces are easily determined.