Inference of tissue haemoglobin concentration from Stereo RGB

Multispectral imaging (MSI) can provide information about tissue oxygenation, perfusion and potentially function during surgery. In this paper we present a novel, near real-time technique for intrinsic measurements of total haemoglobin (THb) and blood oxygenation (SO 22 ) in tissue using only RGB images from a stereo laparoscope. The high degree of spectral overlap between channels makes inference of haemoglobin concentration challenging, non-linear and under constrained. We decompose the problem into two constrained linear sub-problems and show that with Tikhonov regularisation the estimation significantly improves, giving robust estimation of the THb. We demonstrate by using the co-registered stereo image data from two cameras it is possible to get robust SO 22 estimation as well. Our method is closed from, providing computational efficiency even with multiple cameras. The method we present requires only spectral response calibration of each camera, without modification of existing laparoscopic imaging hardware. We validate our technique on synthetic data from Monte Carlo simulation and further, in vivo, on a multispectral porcine data set

Surgical spectral imaging

Recent technological developments have resulted in the availability of miniaturised spectral imaging sensors capable of operating in the multi- (MSI) and hyperspectral imaging (HSI) regimes. Simultaneous advances in image-processing techniques and artificial intelligence (AI), especially in machine learning and deep learning, have made these data-rich modalities highly attractive as a means of extracting biological information non-destructively. Surgery in particular is poised to benefit from this, as spectrally-resolved tissue optical properties can offer enhanced contrast as well as diagnostic and guidance information during interventions. This is particularly relevant for procedures where inherent contrast is low under standard white light visualisation. This review summarises recent work in surgical spectral imaging (SSI) techniques, taken from Pubmed, Google Scholar and arXiv searches spanning the period 2013–2019. New hardware, optimised for use in both open and minimally-invasive surgery (MIS), is described, and recent commercial activity is summarised. Computational approaches to extract spectral information from conventional colour images are reviewed, as tip-mounted cameras become more commonplace in MIS. Model-based and machine learning methods of data analysis are discussed in addition to simulation, phantom and clinical validation experiments. A wide variety of surgical pilot studies are reported but it is apparent that further work is needed to quantify the clinical value of MSI/HSI. The current trend toward data-driven analysis emphasises the importance of widely-available, standardised spectral imaging datasets, which will aid understanding of variability across organs and patients, and drive clinical translation

A Simulation Study of Spectral Cerenkov Luminescence Imaging for Tumour Margin Estimation

Breast cancer is the most common cancer in women in the world. Breast-conserving surgery (BCS) is a standard surgical treatment for breast cancer with the key objective of removing breast tissue, maintaining a negative surgical margin and providing a good cosmetic outcome. A positive surgical margin, meaning the presence of cancerous tissues on the surface of the breast specimen after surgery, is associated with local recurrence after therapy. In this study, we investigate a new imaging modality based on Cerenkov luminescence imaging (CLI) for the purpose of detecting positive surgical margins during BCS. We develop Monte Carlo (MC) simulations using the Geant4 nuclear physics simulation toolbox to study the spectrum of photons emitted given 18F-FDG and breast tissue properties. The resulting simulation spectra show that the CLI signal contains information that may be used to estimate whether the cancerous cells are at a depth of less than 1 mm or greater than 1 mm given appropriate imaging system design and sensitivity. The simulation spectra also show that when the source is located within 1 mm of the surface, the tissue parameters are not relevant to the model as the spectra do not vary significantly. At larger depths, however, the spectral information varies significantly with breast optical parameters, having implications for further studies and system design. While promising, further studies are needed to quantify the CLI response to more accurately incorporate tissue specific parameters and patient specific anatomical details

Imaging the spectral reflectance properties of bipolar radiofrequency-fused bowel tissue

Delivery of radiofrequency (RF) electrical energy is used during surgery to heat and seal tissue, such as vessels, allowing resection without blood loss. Recent work has suggested that this approach may be extended to allow surgical attachment of larger tissue segments for applications such as bowel anastomosis. In a large series of porcine surgical procedures bipolar RF energy was used to resect and re-seal the small bowel in vivo with a commercial tissue fusion device (Ligasure; Covidien PLC, USA). The tissue was then imaged with a multispectral imaging laparoscope to obtain a spectral datacube comprising both fused and healthy tissue. Maps of blood volume, oxygen saturation and scattering power were derived from the measured reflectance spectra using an optimised light-tissue interaction model. A 60% increase in reflectance of visible light (460-700 nm) was observed after fusion, with the tissue taking on a white appearance. Despite this the distinctive shape of the haemoglobin absorption spectrum was still noticeable in the 460-600 nm wavelength range. Scattering power increased in the fused region in comparison to normal serosa, while blood volume and oxygen saturation decreased. Observed fusion-induced changes in the reflectance spectrum are consistent with the biophysical changes induced through tissue denaturation and increased collagen cross-linking. The multispectral imager allows mapping of the spatial extent of these changes and classification of the zone of damaged tissue. Further analysis of the spectral data in parallel with histopathological examination of excised specimens will allow correlation of the optical property changes with microscopic alterations in tissue structure. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only

Eigenvalue calibration method for 3 × 3 Mueller polarimeters

3×3 Mueller polarimetry has shown potential for tissue characterization applications, however, calibration has not been fully addressed. We demonstrate a 3×3 Mueller polarimeter eigenvalue calibration method, inspired by those for full Mueller polarimeters. We also investigate the optimal combination of calibration measurements. Our method does not rely on modeling the polarization state generator, polarization state analyzer, or precise knowledge of calibration sample properties or orientations. It is therefore easy to implement, and the experimental results of a linear polarizer test sample, as well as a biological specimen, are presented

Psychiatry, Objectivity and Realism about Value

Many of the current debates about validity in psychiatry and psychology are predicated on the unexpected failure to validate commonly used diagnostic categories. The recognition of this failure has resulted in, what Thomas Kuhn calls, a period of extraordinary science in which validation problems are given increased weight, alternatives are proposed, methodologies are debated, and philosophical and historical analyses are seen as more relevant than usual. In this important new book in the IPPP series, a group of leading thinkers in psychiatry, psychology, and philosophy offer alternative perspectives that address both the scientific and clinical aspects of psychiatric validation, emphasizing throughout their philosophical and historical considerations

Tomosynthesis method for depth resolution of beta emitters

The motivation of this study derives from the need for tumour margin estimation after surgical excision. Conventional beta autoradiography of beta emitters can be used to image tissue sections providing high spatial resolution compared to in-vivo molecular imaging. However, it requires sectioning of the specimen and it provides a 2D image of the tissue. Imaging of the 3D tissue sample can be achieved either by imaging sequential 2D sections, which is time-consuming and laborious, or by using a specialised detector for imaging that records the particles’ direction, in addition to their position, when they hit the detector. In this work we investigate whether a novel beta-tomosynthesis approach can be used for depth resolution of beta emitters. The technique involves acquiring multiple 2D images of the intact tissue sample while the detector rotates around the sample. The images are then combined and used to reconstruct the 3D position of the sources from a limited angle of conventional 2D autoradiography images. We present the results from Geant4 forward simulations and the reconstructed images from a breast tissue sample containing a Fluorine-18 positron emission source. The experiments show that the proposed method can provide depth resolution under certain conditions, indicating that there is potential for its use as a 3D molecular imaging technique of surgical samples in the future