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.
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 (Pearson's 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.
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.
A clinical trial comprising 334 pigmented and vascular lesions has been performed in three Riga clinics by means of multispectral imaging analysis. The imaging system Nuance 2.4 (CRi) and self-developed software for mapping of the main skin chromophores were used. Specific features were observed and analyzed for malignant skin melanomas: notably higher absorbance (especially as the difference of optical density relative to the healthy skin), uneven chromophore distribution over the lesion area, and the possibility to select the "melanoma areas" in the correlation graphs of chromophores. The obtained results indicate clinical potential of this technology for noncontact selection of melanoma from other pigmented and vascular skin lesions.
Chromophore distribution maps are useful tools for skin malformation severity assessment and for monitoring of skin recovery after burns, surgeries, and other interactions. The chromophore maps can be obtained by processing several spectral images of skin, e.g., captured by hyperspectral or multispectral cameras during seconds or even minutes. To avoid motion artifacts and simplify the procedure, a single-snapshot technique for mapping melanin, oxyhemoglobin, and deoxyhemoglobin of in-vivo skin by a smartphone under simultaneous three-wavelength (448–532–659 nm) laser illumination is proposed and examined. Three monochromatic spectral images related to the illumination wavelengths were extracted from the smartphone camera RGB image data set with respect to crosstalk between the RGB detection bands. Spectral images were further processed accordingly to Beer’s law in a three chromophore approximation. Photon absorption path lengths in skin at the exploited wavelengths were estimated by means of Monte Carlo simulations. The technique was validated clinically on three kinds of skin lesions: nevi, hemangiomas, and seborrheic keratosis. Design of the developed add-on laser illumination system, image-processing details, and the results of clinical measurements are presented and discussed.
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