Comparison of the temperature accuracy between smart phone based and high-end thermal cameras using a temperature gradient phantom

Recently, low cost smart phone based thermal cameras are being considered to be used in a clinical setting for monitoring physiological temperature responses such as: body temperature change, local inflammations, perfusion changes or (burn) wound healing. These thermal cameras contain uncooled micro-bolometers with an internal calibration check and have a temperature resolution of 0.1 degree. For clinical applications a fast quality measurement before use is required (absolute temperature check) and quality control (stability, repeatability, absolute temperature, absolute temperature differences) should be performed regularly. Therefore, a calibrated temperature phantom has been developed based on thermistor heating on both ends of a black coated metal strip to create a controllable temperature gradient from room temperature 26 °C up to 100 °C. The absolute temperatures on the strip are determined with software controlled 5 PT-1000 sensors using lookup tables. In this study 3 FLIR-ONE cameras and one high end camera were checked with this temperature phantom. The results show a relative good agreement between both low-cost and high-end camera's and the phantom temperature gradient, with temperature differences of 1 degree up to 6 degrees between the camera's and the phantom. The measurements were repeated as to absolute temperature and temperature stability over the sensor area. Both low-cost and high-end thermal cameras measured relative temperature changes with high accuracy and absolute temperatures with constant deviations. Low-cost smart phone based thermal cameras can be a good alternative to high-end thermal cameras for routine clinical measurements, appropriate to the research question, providing regular calibration checks for quality control

A spectral filter array camera for clinical monitoring and diagnosis: Proof of concept for skin oxygenation imaging

The emerging technology of spectral filter array (SFA) cameras has great potential for clinical applications, due to its unique capability for real time spectral imaging, at a reasonable cost. This makes such cameras particularly suitable for quantification of dynamic processes such as skin oxygenation. Skin oxygenation measurements are useful for burn wound healing assessment and as an indicator of patient complications in the operating room. Due to their unique design, in which all pixels of the image sensor are equipped with different optical filters, SFA cameras require specific image processing steps to obtain meaningful high quality spectral image data. These steps include spatial rearrangement, SFA interpolations and spectral correction. In this paper the feasibility of a commercially available SFA camera for clinical applications is tested. A suitable general image processing pipeline is proposed. As a’proof of concept’ a complete system for spatial dynamic skin oxygenation measurements is developed and evaluated. In a study including 58 volunteers, oxygenation changes during upper arm occlusion were measured with the proposed SFA system and compared with a validated clinical device for localized oxygenation measurements. The comparison of the clinical standard measurements and SFA results show a good correlation for the relative oxygenation changes. This proposed processing pipeline for SFA cameras shows to be effective for relative oxygenation change imaging. It can be implemented in real time and developed further for absolute spatial oxygenation measurements

Imaging techniques for research and education of thermal and mechanical interactions of lasers with biological and model tissues

A setup based on color Schlieren techniques has been developed to study the interaction of energy sources, such as lasers, with biological tissues. This imaging technique enables real-time visualization of dynamic temperature gradients with high spatial and temporal resolution within a transparent tissue model. High-speed imaging techniques were combined in the setup to capture mechanical phenomena such as explosive vapor, cavitation bubbles, and shock waves. The imaging technique is especially used for qualitative studies because it is complex to obtain quantitative data by relating the colors in the images to temperatures. By positioning thermocouples in the field of view, temperature figures can be added in the image for correlation to colored areas induced by the temperature gradients. The color Schlieren setup was successfully used for various studies to obtain a better understanding of interaction of various laser, rf, and ultrasound devices used in medicine. The results contributed to the safety and the optimal settings of various medical treatments. Although the interaction of energy sources is simulated in model tissue, the video clips have proven to be of great value for educating researchers, surgeons, nurses, and students to obtain a better understanding of the mechanism of action during patient treatment

How to Tackle Legal Barriers That Threaten A Successful Implementation of eHealth Technologies?

Background: Over the years, many eHealth technologies have been developed and implemented that support patients and healthcare professionals in addition to traditional treatment. Due to increased knowledge and technical options, the possibilities of (automation of) data exchange also increased, and more and more patient-doctor relationships are taking place via technology. We therefore see a transition from the development of eHealth tools for specific purposes, to the development of “Digital Health Environments”, which automatically connect the stakeholders and data involved. Within the eHealth Junior Consortium, we aim to develop such a digital health environment for chronical ill children. This environment will integrate several scientifically validated eHealth tools that provide personalized and transdiagnostic prevention. There are many possibilities and advantages offered by (automatic) sharing of data between eHealth tools, connected ICT systems (e.g., EPD), and the children, parents and other stakeholders involved. However, legal challenges also arise in the implementation of such environments with regard to guaranteeing privacy as well as medical ethical discussions. Goals: The aim of this workshop is to identify and validate barriers and success factors related to legal aspects of implementation of eHealth technologies, and to identify how we could overcome these legal barriers. We will discuss results from a previous literature review with the participants, exchange experiences in legal issues that occurred in participants’ own (clinical and scientific) field, and brainstorm about how we could tackle or prevent these issues. Content and (interactive) activities: In a previous literature review (included both peer reviewed as grey literature), we identified several barriers and success factors related to the legal aspects of implementation of eHealth. During the workshop, we will present the results of this review as input for a discussion on the findings that are uncertain or raise questions (e.g., issues in data privacy/transparency/responsibility). We will ask participants to share their opinions and experiences with these issues (or related ones) within their daily practice/research. We cooperate with the Stimulate Healthcare Technology Program and TechMed Centre, and we will invite legal experts from our consortium (eHealth Junior) to join the workshop and support us with their knowledge. The workshop will consist of a short presentation followed by an interactive group discussion and brainstorm session. We will create a mindmap during the workshop to provide an overview of all discussed legal topics, and how these relate to each other. Our target audience are researchers, healthcare professionals and policy makers, working with health technologies. Expertise of workshop leader(s): Our research team has a lot of expertise in organizing and conducting stakeholder workshops. The workshop will be moderated by two persons from our team and one person will keep track of the mentioned points in a mindmap, during the discussion/brainstorm session, to provide an overview. We will also strength forces by collaborating with the Stimulate Healthcare Technology Program, TechMed Centre, and experts from the legal field (partners from eHealth Junior Consortium), to support us during the brainstorm and discussion sessions. These experts also participated in earlier workshops of our consortium and bring valuable knowledge on the legal aspects of implementation of eHealth from own experiences

Assessing cardiac preload by the Initial Systolic Time Interval obtained from impedance cardiography

The Initial Systolic Time Interval (ISTI), obtained from the electrocardiogram (ECG) and impedance cardiogram (ICG), is considered to be a measure for the time delay between the electrical and mechanical activity of the heart and reflects an early active period of the cardiac cycle. The clinical relevance of this time interval is subject of study. This paper introduces a method using ISTI to evaluate and predict the circulatory response to fluid administration in patients after coronary artery bypass graft surgery and presents preliminary results of a pilot study by comparing ISTI with cardiac output (CO) responsiveness. Also the use of the pulse transit time (PTT), earlier recommended for this purpose, was investigated. The results showed an inverse relationship between ISTI and CO at all moments of fluid administration and also an inverse relationship between the changes ΔISTI and ΔCO before and after full fluid administration. No relationships between PTT and CO or ΔPTT and ΔCO were found. It is concluded that ISTI is dependent upon preload, and that ISTI has the potential to be used as a clinical parameter assessing preload