Widefield Computational Biophotonic Imaging for Spatiotemporal Cardiovascular Hemodynamic Monitoring

Cardiovascular disease is the leading cause of mortality, resulting in 17.3 million deaths per year globally. Although cardiovascular disease accounts for approximately 30% of deaths in the United States, many deleterious events can be mitigated or prevented if detected and treated early. Indeed, early intervention and healthier behaviour adoption can reduce the relative risk of first heart attacks by up to 80% compared to those who do not adopt new healthy behaviours. Cardiovascular monitoring is a vital component of disease detection, mitigation, and treatment. The cardiovascular system is an incredibly dynamic system that constantly adapts to internal and external stimuli. Monitoring cardiovascular function and response is vital for disease detection and monitoring. Biophotonic technologies provide unique solutions for cardiovascular assessment and monitoring in naturalistic and clinical settings. These technologies leverage the properties of light as it enters and interacts with the tissue, providing safe and rapid sensing that can be performed in many different environments. Light entering into human tissue undergoes a complex series of absorption and scattering events according to both the illumination and tissue properties. The field of quantitative biomedical optics seeks to quantify physiological processes by analysing the remitted light characteristics relative to the controlled illumination source. Drawing inspiration from contact-based biophotonic sensing technologies such as pulse oximetry and near infrared spectroscopy, we explored the feasibility of widefield hemodynamic assessment using computational biophotonic imaging. Specifically, we investigated the hypothesis that computational biophotonic imaging can assess spatial and temporal properties of pulsatile blood flow across large tissue regions. This thesis presents the design, development, and evaluation of a novel photoplethysmographic imaging system for assessing spatial and temporal hemodynamics in major pulsatile vasculature through the sensing and processing of subtle light intensity fluctuations arising from local changes in blood volume. This system co-integrates methods from biomedical optics, electronic control, and biomedical image and signal processing to enable non-contact widefield hemodynamic assessment over large tissue regions. A biophotonic optical model was developed to quantitatively assess transient blood volume changes in a manner that does not require a priori information about the tissue's absorption and scattering characteristics. A novel automatic blood pulse waveform extraction method was developed to encourage passive monitoring. This spectral-spatial pixel fusion method uses physiological hemodynamic priors to guide a probabilistic framework for learning pixel weights across the scene. Pixels are combined according to their signal weight, resulting in a single waveform. Widefield hemodynamic imaging was assessed in three biomedical applications using the aforementioned developed system. First, spatial vascular distribution was investigated across a sample with highly varying demographics for assessing common pulsatile vascular pathways. Second, non-contact biophotonic assessment of the jugular venous pulse waveform was assessed, demonstrating clinically important information about cardiac contractility function in a manner which is currently assessed through invasive catheterization. Lastly, non-contact biophotonic assessment of cardiac arrhythmia was demonstrated, leveraging the system's ability to extract strong hemodynamic signals for assessing subtle fluctuations in the waveform. This research demonstrates that this novel approach for computational biophotonic hemodynamic imaging offers new cardiovascular monitoring and assessment techniques, which can enable new scientific discoveries and clinical detection related to cardiovascular function

Breathing Rate Estimation From the Electrocardiogram and Photoplethysmogram: A Review.

Breathing rate (BR) is a key physiological parameter used in a range of clinical settings. Despite its diagnostic and prognostic value, it is still widely measured by counting breaths manually. A plethora of algorithms have been proposed to estimate BR from the electrocardiogram (ECG) and pulse oximetry (photoplethysmogram, PPG) signals. These BR algorithms provide opportunity for automated, electronic, and unobtrusive measurement of BR in both healthcare and fitness monitoring. This paper presents a review of the literature on BR estimation from the ECG and PPG. First, the structure of BR algorithms and the mathematical techniques used at each stage are described. Second, the experimental methodologies that have been used to assess the performance of BR algorithms are reviewed, and a methodological framework for the assessment of BR algorithms is presented. Third, we outline the most pressing directions for future research, including the steps required to use BR algorithms in wearable sensors, remote video monitoring, and clinical practice

Multispectral Video Fusion for Non-contact Monitoring of Respiratory Rate and Apnea

Continuous monitoring of respiratory activity is desirable in many clinical applications to detect respiratory events. Non-contact monitoring of respiration can be achieved with near- and far-infrared spectrum cameras. However, current technologies are not sufficiently robust to be used in clinical applications. For example, they fail to estimate an accurate respiratory rate (RR) during apnea. We present a novel algorithm based on multispectral data fusion that aims at estimating RR also during apnea. The algorithm independently addresses the RR estimation and apnea detection tasks. Respiratory information is extracted from multiple sources and fed into an RR estimator and an apnea detector whose results are fused into a final respiratory activity estimation. We evaluated the system retrospectively using data from 30 healthy adults who performed diverse controlled breathing tasks while lying supine in a dark room and reproduced central and obstructive apneic events. Combining multiple respiratory information from multispectral cameras improved the root mean square error (RMSE) accuracy of the RR estimation from up to 4.64 monospectral data down to 1.60 breaths/min. The median F1 scores for classifying obstructive (0.75 to 0.86) and central apnea (0.75 to 0.93) also improved. Furthermore, the independent consideration of apnea detection led to a more robust system (RMSE of 4.44 vs. 7.96 breaths/min). Our findings may represent a step towards the use of cameras for vital sign monitoring in medical applications

Blind Source Separation for the Processing of Contact-Less Biosignals

(Spatio-temporale) Blind Source Separation (BSS) eignet sich für die Verarbeitung von Multikanal-Messungen im Bereich der kontaktlosen Biosignalerfassung. Ziel der BSS ist dabei die Trennung von (z.B. kardialen) Nutzsignalen und Störsignalen typisch für die kontaktlosen Messtechniken. Das Potential der BSS kann praktisch nur ausgeschöpft werden, wenn (1) ein geeignetes BSS-Modell verwendet wird, welches der Komplexität der Multikanal-Messung gerecht wird und (2) die unbestimmte Permutation unter den BSS-Ausgangssignalen gelöst wird, d.h. das Nutzsignal praktisch automatisiert identifiziert werden kann. Die vorliegende Arbeit entwirft ein Framework, mit dessen Hilfe die Effizienz von BSS-Algorithmen im Kontext des kamera-basierten Photoplethysmogramms bewertet werden kann. Empfehlungen zur Auswahl bestimmter Algorithmen im Zusammenhang mit spezifischen Signal-Charakteristiken werden abgeleitet. Außerdem werden im Rahmen der Arbeit Konzepte für die automatisierte Kanalauswahl nach BSS im Bereich der kontaktlosen Messung des Elektrokardiogramms entwickelt und bewertet. Neuartige Algorithmen basierend auf Sparse Coding erwiesen sich dabei als besonders effizient im Vergleich zu Standard-Methoden.(Spatio-temporal) Blind Source Separation (BSS) provides a large potential to process distorted multichannel biosignal measurements in the context of novel contact-less recording techniques for separating distortions from the cardiac signal of interest. This potential can only be practically utilized (1) if a BSS model is applied that matches the complexity of the measurement, i.e. the signal mixture and (2) if permutation indeterminacy is solved among the BSS output components, i.e the component of interest can be practically selected. The present work, first, designs a framework to assess the efficacy of BSS algorithms in the context of the camera-based photoplethysmogram (cbPPG) and characterizes multiple BSS algorithms, accordingly. Algorithm selection recommendations for certain mixture characteristics are derived. Second, the present work develops and evaluates concepts to solve permutation indeterminacy for BSS outputs of contact-less electrocardiogram (ECG) recordings. The novel approach based on sparse coding is shown to outperform the existing concepts of higher order moments and frequency-domain features

Signal processing techniques for cardiovascular monitoring applications using conventional and video-based photoplethysmography

Photoplethysmography (PPG)-based monitoring devices will probably play a decisive role in healthcare environment of the future, which will be preventive, predictive, personalized and participatory. Indeed, this optical technology presents several practical advantages over gold standard methods based on electrocardiography, because PPG wearable devices can be comfortably used for long-term continuous monitoring during daily life activities. Contactless video-based PPG technique, also known as imaging photoplethysmography (iPPG), has also attracted much attention recently. In that case, the cardiac pulse is remotely measured from the subtle skin color changes resulting from the blood circulation, using a simple video camera. PPG/iPPG have a lot of potential for a wide range of cardiovascular applications. Hence, there is a substantial need for signal processing techniques to explore these applications and to improve the reliability of the PPG/iPPG-based parameters. \par A part of the thesis is dedicated to the development of robust processing schemes to estimate heart rate from the PPG/iPPG signals. The proposed approaches were built on adaptive frequency tracking algorithms that were previously developed in our group. These tools, based on adaptive band-pass filters, provide instantaneous frequency estimates of the input signal(s) with a very low time delay, making them suitable for real-time applications. In case of conventional PPG, a prior adaptive noise cancellation step involving the use of accelerometer signals was also necessary to reconstruct clean PPG signals during the regions corrupted by motion artifacts. Regarding iPPG, after comparing different regions of interest on the subject face, we hypothesized that the simultaneous use of different iPPG signal derivation methods (i.e. methods to derive the iPPG time series from the pixel values of the consecutive frames) could be advantageous. Methods to assess signal quality online and to incorporate it into instantaneous frequency estimation were also examined and successfully applied to improve system reliability. \par This thesis also explored different innovative applications involving PPG/iPPG signals. The detection of atrial fibrillation was studied. Novel features derived directly from the PPG waveforms, designed to reflect the morphological changes observed during arrhythmic episodes, were proposed and proven to be successful for atrial fibrillation detection. Arrhythmia detection and robust heart rate estimation approaches were combined in another study aimed at reducing the number of false arrhythmia alarms in the intensive care unit by exploiting signals from independent sources, including PPG. Evaluation on a hidden dataset demonstrated that the number of false alarms was drastically reduced while almost no true alarm was suppressed. Finally, other aspects of the iPPG technology were examined, such as the measurement of pulse rate variability indexes from the iPPG signals and the estimation of respiratory rate from the iPPG interbeat intervals

Remote Assessment of the Cardiovascular Function Using Camera-Based Photoplethysmography

Camera-based photoplethysmography (cbPPG) is a novel measurement technique that allows the continuous monitoring of vital signs by using common video cameras. In the last decade, the technology has attracted a lot of attention as it is easy to set up, operates remotely, and offers new diagnostic opportunities. Despite the growing interest, cbPPG is not completely established yet and is still primarily the object of research. There are a variety of reasons for this lack of development including that reliable and autonomous hardware setups are missing, that robust processing algorithms are needed, that application fields are still limited, and that it is not completely understood which physiological factors impact the captured signal. In this thesis, these issues will be addressed. A new and innovative measuring system for cbPPG was developed. In the course of three large studies conducted in clinical and non-clinical environments, the system’s great flexibility, autonomy, user-friendliness, and integrability could be successfully proven. Furthermore, it was investigated what value optical polarization filtration adds to cbPPG. The results show that a perpendicular filter setting can significantly enhance the signal quality. In addition, the performed analyses were used to draw conclusions about the origin of cbPPG signals: Blood volume changes are most likely the defining element for the signal's modulation. Besides the hardware-related topics, the software topic was addressed. A new method for the selection of regions of interest (ROIs) in cbPPG videos was developed. Choosing valid ROIs is one of the most important steps in the processing chain of cbPPG software. The new method has the advantage of being fully automated, more independent, and universally applicable. Moreover, it suppresses ballistocardiographic artifacts by utilizing a level-set-based approach. The suitability of the ROI selection method was demonstrated on a large and challenging data set. In the last part of the work, a potentially new application field for cbPPG was explored. It was investigated how cbPPG can be used to assess autonomic reactions of the nervous system at the cutaneous vasculature. The results show that changes in the vasomotor tone, i.e. vasodilation and vasoconstriction, reflect in the pulsation strength of cbPPG signals. These characteristics also shed more light on the origin problem. Similar to the polarization analyses, they support the classic blood volume theory. In conclusion, this thesis tackles relevant issues regarding the application of cbPPG. The proposed solutions pave the way for cbPPG to become an established and widely accepted technology

Fusion enhancement for tracking of respiratory rate through intrinsic mode functions in photoplethysmography

Decline in respiratory regulation demonstrates the primary forewarning for the onset of physiological aberrations. In clinical environment, the obtrusive nature and cost of instrumentation have retarded the integration of continuous respiration monitoring for standard practice. Photoplethysmography (PPG) presents a non-invasive, optical method of assessing blood flow dynamics in peripheral vasculature. Incidentally, respiration couples as a surrogate constituent in PPG signal, justifying respiratory rate (RR) estimation. The physiological processes of respiration emerge as distinctive oscillations that are fluctuations in various parameters extracted from PPG signal. We propose a novel algorithm designed to account for intermittent diminishment of the respiration induced variabilities (RIV) by a fusion-based enhancement of wavelet synchrosqueezed spectra. We have combined the information on intrinsic mode functions (IMF) of five RIVs to enhance mutually occurring, instantaneous frequencies of the spectra. The respiration rate estimate is obtained by tracking the spectral ridges with a particle filter. We have evaluated the method with a dataset recorded from 29 young adult subjects (mean: 24.17 y, SD: 4.19 y) containing diverse, voluntary, and periodically metronome-assisted respiratory patterns. Bayesian inference on fusion-enhanced Respiration Induced Frequency Variability (RIFV) indicated MAE and RMSE of 1.764 and 3.996 BPM, respectively. The fusion approach was deemed to improve MAE and RMSE of RIFV by 0.185 BPM (95% HDI: 0.0285-0.3488, effect size: 0.548) and 0.250 BPM (95% HDI: 0.0733-0.431, effect size: 0.653), respectively, with further pronounced improvements to other RIVs. We conclude that the fusion of variability signals proves important to IMF localization in the spectral estimation of RR.acceptedVersionPeer reviewe