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Photonic Remote and Continuous
      Biomedical Diagnostics

                      Zeev Zalevsky1,2
        1Faculty  of Engineering, Bar-Ilan University, Israel
2SAOT, Friedrich-Alexander Universität Erlangen-Nürnberg, Germany




                                                             1
Main collaborators:
Yevgeny Beiderman1
Javier Garcia2
Vicente Mico2
Israel Margelith1
Asaf Shahmoon1
Alexander Douplik3
Dan Cojoc4
1Faculty  of Engineering, Bar-Ilan University, Israel
2Departamento de Óptica, Universitat de València, Spain
3Ryerson University, Toronto, Canada
4Trieste, Italy

                                                          2
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        3
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        4
Opto-Phone: Hearing with Light


                         Imaging
                         module
                                   Camera
                                   Sensor
      Invisible L
                  aser              Laser
      projection


Any visible distance




                                            5
Opto-Phone: Hearing with Light


Hearing with Light: Features
•The ultimate voice recognition system compatible to
“hear” human speech from any point of view (even from
behind).

•There is no restriction on the position of the system in
regards to the position of the sound source.

•Capable of hearing heart beats and knowing physical
conditions without physical contact for measuring.



                                                            6
Opto-Phone: Hearing with Light


Features- cont.
•Works clearly in noisy surroundings and even through
vacuum.

•Allows separation between plurality of speakers and sounds
sources.

•Works through glass window.

•Simple and robust system (does not include interferometer
in the detection phase).


                                                        7
Let’s listen…from 80m

                 Cell phone                                                     Back part of neck

                 Counting…1,2,3,4,5,6
                                                                                Counting…5,6,7


                                                                                                  X - movement
                                                               1




                                                             0.5




                                                               0




                                                             -0.5




                  Face (profile)
                                                              -1




                                                                    120   140   160   180   200   220            240   260   280   300   320




                                                               Heart beat pulse
                   Counting…5,6
                                                               taken from a throat



All recordings were done in a very noisy constriction site at distance of more
than 80m.

                                                                                                                                               8
Results: Detection of
                                                                                                                                                 occluded objects I
                 (a).                                                         (b).                                                                                                                                          (c).




(a). Camouflaged object. (b). Camouflage without the object. (c). The object (upper left part) and the low
resolution camouflaged scenery.
                                   Spectrogram                                                                   Spectrogram                                                                  Spectrogram
                  0                                                                             0                                                                            0
                                                                       2000                                                                          900
                 50                                                                            50                                                                           50
                                                                       1800                                                                                                                                                        12
                                                                                                                                                     800
                 100                                                                           100                                                                          100
                                                                       1600
                                                                                                                                                     700                                                                           10
                 150                                                                           150                                                                          150




                                                                                                                                                           Frequency [Hz]
                                                                       1400
Frequency [Hz]




                                                                              Frequency [Hz]




                                                                                                                                                     600                    200
                 200                                                                           200
                                                                       1200                                                                                                                                                        8
                 250                                                                           250                                                   500                    250
                                                                       1000
                                                                                                                                                                                                                                   6
                 300                                                                           300                                                   400                    300
                                                                       800

                 350                                                                           350                                                   300                    350
                                                                       600                                                                                                                                                         4

                 400                                                   400                     400                                                   200                    400
                                                                                                                                                                                                                                   2
                 450                                                   200                     450                                                   100                    450

                 500                                                                           500                                                                          500
                       0   0.1   0.2     0.3   0.4   0.5   0.6   0.7                                 0   0.1   0.2     0.3   0.4   0.5   0.6   0.7                                0   0.1   0.2     0.3   0.4   0.5   0.6    0.7

(d).                                   Time [sec]                             (e).                                   Time [sec]                            (f).                                   Time [sec]



(d). The spectrogram of the camouflaged object with its engine turned on. (e). The spectrogram
of the object with its engine turned on and without the camouflage. (f). The spectrogram of the
camouflaged object without turning on its engine.
                                                                                                                                                                                                                                        9
Results: Detection of
                                                                               occluded objects II
                                                                                 Y - pos
                                    10


                       (a).           5
                                                                                                                                           (b).
                                      0




                                     -5



                                                                                     Y - pos
                                    -10
                                     10




                                    -15
                                      5
                                              0   500       1000   1500       2000   2500      3000   3500       4000     4500   5000
                                                                                 Sample
                                     0




                                     -5




                                    -10




                                    -15

                                              0         1          2             3             4             5            6        7 [sec]
                                    -20
                                          0             1000           2000           3000            4000              5000        6000
(a). The scenario of the experiment. (b). Experimental results: upper recording is of the
                                                             Sample


camouflaged subject. Lower recording is the same subject without the camouflage.
                                                                                                                                                  10
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        11
Technological Description


•Unique technological platform allows remote and
continuous wearable monitoring of many
biomedical parameters simultaneously.

•It is based upon inspection of secondary speckle
pattern back reflected from skin near main blood
artery, after properly adjusting the imaging optics.

•The biomedical monitoring capabilities include:
heart beats, breathing, blood pulse pressure,
glucose concentration, alcohol level, IOP, blood
coagulation (INR), oximetry, ICP etc.
•Unique patented IP and know how.

•Part of the applications have already been
commercialized.
                                                           12
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        13
Measuring of breathing from rat’s
                                                                 cornea reflections




                              (Abs) Spectrum
             2

            1.8
                                                                       Detected rat’s breathing beating at
                                   X: -1.872
            1.6                    Y: 1.808

                                                   Noise level
                                                                       frequency around 1.87Hz.
            1.4
Amplitude




            1.2

             1

            0.8

            0.6

            0.4

            0.2

             0
             -15   -10   -5           0        5         10       15
                                                                                      Reflected speckle pattern.
                              Frequency [Hz]                                                                       14
Measuring of heart beating from
                                                                                          human’s cornea reflections
                              (Abs) Spectrum                                                    (Abs) Spectrum                                                                    (Abs) Spectrum
            35                                                                25                                                                               12

                                        X: 1.502                                                                                                                                             X: 3.078
                                                                                                               X: 1.522                                                                      Y: 11.68
            30                          Y: 33.65
                                                                                                               Y: 19.96
                                                                                                                                                               10
                                                                              20

            25
                                                                                                                                                               8




                                                                                                                                                   Amplitude
                                                                  Amplitude
Amplitude




                                                                              15
            20                                                                                                      Noise level
                                                                                                                                                               6
            15                               Noise level                      10
                                                                                                                                                               4
            10

                                                                              5
                                                                                                                                                               2
            5


            0                                                                 0                                                                                0
            -20   -15   -10   -5    0       5      10   15   20               -20   -15   -10    -5        0        5          10        15   20               -20    -15   -10   -5    0     5         10   15   20
                              Frequency [Hz]                                                    Frequency [Hz]                                                                    Frequency [Hz]

            Subject #1 (measurement taken while                               Subject #2 (measurement taken while                                                    Reference noise level (detected
              subject was holding his breath)                                   subject was holding his breath)                                                          reflection from a wall)

                    Detected heart beating of humans at frequency of around 1.5Hz.
                                                                                    10



                                                                                    20



                                                                                    30



                                                                                    40



                                                                                    50
                                                                                                                                         Reflected speckles pattern.
                                                                                    60

                                                                                          10    20    30       40         50        60                                                                  15
Measuring breathing of pigs

                                                                                              The swine's
                                                                                              location
                     25
                                     Breath   Breath measured


                     20                                                                        The non-visible
Breaths per minute




                                                                             40 m
                                                                                               laser system


                     15



                     10



                      5


                                                                                               Laser beam
                      0
                          1   2      3    4     5    6     7     8   9

                                          Experiment

                                  Statistical breathing experiment




                                                                                                 16
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        17
Remote heart beats monitoring

                                                                                                                  The implemented optical configuration for
                                                                                                                  remote measuring of heart beats and blood
                                                                                                                  pulse pressure from subject’s hand
                                Laser
         Camera




                                    50 cm




                         Hand




                    3
                                                                                2
                                                                                                                   Temporal plot of the outcome from the
                  2.5
                                                                                0
                                                                                                                   system used in the clinical trials for two
                    2
                                                                                                                   different participants.
                                                             Amplitude [pix]
Amplitude [pix]




                  1.5                                                           -2

                    1                                                           -4
                  0.5
                                                                                -6
                    0
                                                                                -8
                  -0.5
                                                                               -10
                   -1
                     0      1              2         3   4                           0   1       2        3   4
                                        Time [sec]                                           Time [sec]




                                                                                                                                                        18
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        19
Glucose level monitoring




Temporal plot of the outcome from the system used in the clinical tests with the graphical description of the observed
                                                   parameters.



                                                                                                              20
Glucose level monitoring

                    40                                                                       210
                    35                                                                       190
Amplitude [samp];
Glucose[ml/dl/10]




                                                                           Glucose [mg/dl]
                    30                                                                       170
                    25                                                                       150
                    20                                  Glucose /10                          130
                                                                                                                             ,
                    15                                  Param.6                              110
                    10                                                                        90
                     5                                                                        70
                     0                                                                        50
                         0   5   10       15       20       25        30                           0     5       10         15         20   25        30
                                      Time [min]                                                                      time [minutes]

  Stability of the system: constant glucose level in blood (denoted                          Data of subject #1: Glucose level in blood and amplitude
  by blue line with triangles) and the estimated parameter 6                                 of positive peak (parameter #1). Glucose level is denoted
  (denoted by magenta line with rectangles). Glucose level is                                by blue line with triangles and the optically measured
  given in units of 0.1[ml/dl] (representing a constant level of 100                         parameter is denoted by magenta line with rectangles.
  [ml/dl), while the estimated optical values are given in pixels.




                                                                                                                                                 21
Glucose level monitoring

                           210                                                                                                 210
                           190                                                                                                 190
         Glucose [mg/dL]




                                                                                                             Glucose [mg/dl]
                           170                                                                                                 170
                           150                                                                                                 150
                           130                                                                                                 130
                                                                                                                                                         ,
                           110                                                                                                 110
                            90                                                                                                  90
                            70                                                                                                  70
                            50                                                                                                  50
                                 0       10              20              30        40                                                0   5   10        15          20   25
                                                   time [minutes]                                                                                 time [minutes]
                                                                                                                                                                              2230

Data of subject #3: Glucose level in blood and amplitude of positive peak                                                 Data of subject #1: Glucose level in blood and
(parameter #1). Glucose level is denoted by blue line with triangles and the                                              amplitude of positive peak (parameter #1). Glucose
optically measured parameter is denoted by magenta line with rectangles.                                                  level is denoted by blue line with triangles and the
                                                                                                                          optically measured parameter is denoted by magenta
                           190                                                                                            line with rectangles.
                           170
Glucose [mg/dl]




                           150
                           130
                           110
                            90                                                          Data of subject #4: Glucose level in blood and amplitude of
                            70                                                          positive peak (parameter #1). Glucose level is denoted by blue
                            50                                                          line with triangles and the optically measured parameter is
                                 0   5        10         15         20        25   30   denoted by magenta line with rectangles.
                                                   time [minutes]
                                                                                                                                                                             22
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        23
Blood pulse pressure measurement

                                                                                                                M , Corr(M , ) = 0.99507
                                                                      140
                                                                                                                Systolic
                                                                                                                Diastolic
                                                                                                                 = S-D
                                                                      120




                                                   Amplitude [mmHg]
                                                                      100



                                                                       80



                                                                       60



                                                                       40



                                                                       20
                                                                        -50   0   50   100    150   200   250    300     350    400
                                                                                             Time [sec]

An example of the obtained remote blood pulse pressure measurement using the proposed device for one subject
participating in the clinical test group. The reference pulse pressure is shown by the green curve (denoted as ) was
obtained using manual sleeve based reference measurement device. The blue curve (denoted as M) is the measurement
obtained using the proposed optical technique. The time duration of the measurement was 350sec. The sampling of the
camera was performed at 300Hz. One may see that strong correlation exists between the green (reference) curve and the
blue curve obtained by the developed approach.
                                                                                                                                      24
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        25
Remote IOP monitoring


                                                The proposed experimental configuration for
                                                remote continuous monitoring of the IOP.




                                              Changing IOP via applying mechanical pressure
                                              on the sclera.

Changing IOP via modifying the height of an
infusion bug.

                                                                                      26
Remote IOP monitoring

    Data amp:                 8.017                        10.7025          11.2649            11.6035      9.3484   7.2619      7.2177            6.4588
       40

                            Data amplitude:                                                                                                                      9
                  30
                            8.02 10.7 11.27                                       11.6          9.35        7.26 7.22         6.46                               8
                  20                                                                                                                                             7                  6.872                               With infusion bag
                                                                                                                                                                                                                     a mp/pressure (mmHg)

                                                                                                                                           9                     6                                                     With
                                                                                                                                                                                                                     1501     applied pressure
Amplitude [pix]




                  10




                                                                                                                                                            Amplitude
                                                                                                                                           8
                                                                                                                                           7                6.8725
                                                                                                                                           6
                   0                                                                                                                                             4



                                                                                                                               Amplitude
                                                                                                                                           5                                                              3.5404
                                                                                                                                           4                     3          3.5404                            2.9932
                  -10                                                                                                                      3                                    2.9932
                                                  6
                                                                      Data amp:   7.3465

                                                                                                                                           2                     2                       2.145        1.76402
                                                                                                                                                                                                                       2.145           1.76402
                                                                                                                                           1
                  -20
                                                  4


                                                                                                                                           0                     1
                                Amplitude [pix]




                                                  2



                                                  0
                                                                                                                                               0                 0
                                                                                                                                                                20               40              60             80
                  -30                                                                                                                                                       Pressure (mm/Hg)
                                                  -2
                                                                                                                                                                        0                  20                 40                  60             80
                  -40
                                                  -4

                                                                                                                                                                                                         Pressure (mm/Hg)
                                                  -6
                                                       0        500                    1000          1500
                                                                         Sample
                  -50
                        0                         1000                2000                    3000          4000        5000                   6000
                                                                                           Sample                                                                       Experimentally extracted readout compared to
                                                                                                                                                                        absolute reference IOP measurement obtained
                        Experimentally extracted readout                                                                                                                with Goldmann tonometer.
                        obtained when changing the height of
                        the infusion bag every 500 samples.



                                                                                                                                                                                                                                         27
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        28
Detection of malaria




An example of one out of the 20 relevant inspected parameters. Left: Healthy RBC. Right: Infected RBC.




                                                                                              29
Detection of malaria




Separation between infected and
healthy cells. Plotting the length of
the vectors versus cells’ index.




                                        30
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        31
Remote alcohol level monitoring


Camera                                 (a).                                                                      (b).




Green laser




 (a). The side (left) and top (right) view of the experimental setup. (b). Typical temporal beating signals extracted
 using the proposed remote optical sensing device, before (left) and after (right) the effect of alcohol obtained
 over the same subject.




                                                                                                            32
Remote alcohol level monitoring




Definition of the Ratio wid (through the ratio between the main   STD of background noises: long duration test with
and the secondary negative peak’s temporal positions), Main       error bars representing the std values of the
sec peak ratio (through the ratio between the main negative       measured data.
peak amplitude and the secondary positive peak’s amplitude),
and Standard deviation of background noise (STD) parameters.

                                                                                                           33
Remote alcohol level monitoring

                                          (a).                                                              (b).     Summary:




                                                 Positive pulse size [msec]
       Pulse size [msec]




                                                                                                                     (a). Pulse size, (b). Positive pulse
                                                                                                                     size, (c). Peakdis, (d). Ratio_wid,
                                                                                                                     (e). Main_sec_peak ratio, (f). Std
                                                                                                                     of background noises.
                           Time [min]                                                      Time [min]

                                          (c).                                                               (d).
Peakdis [msec]




                                                                              Ratio wid




                             Time [min]                                                       Time [min]

                                          (e).                                                                (f).
Main sec peak ratio




                                                                              Std [msec]




                           Time [min]                                                          Time [min]
                                                                                                                                                 34
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        35
Oximetry and coagulation of blood

                                       Oxygen                                                                    INR
                  3.5                                                               3

                                                                                   2.8
                   3
                                                                                   2.6

                                                                                   2.4
Amplitude [pix]




                                                                  Normilized INR
                  2.5
                                                                                   2.2

                   2                                                                2

                                                                                   1.8
                  1.5
                                                                                   1.6

                                                                                   1.4
                   1
                                                                                   1.2

                  0.5                                                               1
                        0   2     4       6      8    10     12                          0   2    4    6     8         10   12   14        16   18
                                       Test #                                                                Exp #
                                Oximetry experiment                                              Blood coagulation experiment




                                                                                                                                      36
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        37
Multi-Functional Probe


                                                                                                          The edge of the fabricated micro
                                                                                                          probe having approximately 5,000
                                                                                                          cores while each one of them is
                                                                                                          being used as light transmitting
                                                                                                          channel (each core is a single
                                                                                                          pixel in the formed image). In this
                                                                                                          image each core transmits red
                                                                                                          channel of light at wavelength of
                                                                                                          632nm.

50m
                                                                           Laser (632nm) Beam Expander Mirror      Laser Controller Camera
              Input plane                   Output plane
                            Multi core probe               F       Image
Object


                                                                           Sample
                                                                           Location


         U1                                          U2        V
                                                                                                          Beam Splitter
                                                                            Probe Location
      1     1 1
                                                                                       Objective Lens
   U1  U 2 V F
                                                                                                                                      38
Multi-Functional Probe- experiments




Experimental results of images transmitted backwards by the proposed micro probe. The scanned objects are as follows;
From left to right: black vertical lines, black rectangles, horizontal black lines, black lines and black rectangle appearing
in the left side of the backwards transmitted image.
  5m




  2m
                                         Experimental results of images with Fe beads having diameter of 1m imaged
                                         through an agar solution.

                                                                                                                    39
Phantom fabrication




             (a)                        (b)                                         (c)

(a) Fabricated phantom. (b) shows a 3D view sketch of the phantom having two drilled channels with diameter of
400µm each. One longitudinal channel (along the x axis) while another angled channel was made making both
channel crossed inside the phantom. The openings indicated as “in” and “out” enable the connection of microfluidic
system. (c) shows a cross-sectional schematic view of the fabricated phantom.


                                                                                                        40
Experimental results with phantom


                                                                                           Experimental results of Fe micro
                                                                                           particles imaged inside a drilled
                                                                                           phantom




Imaging of a manipulated micro wire (indicated by
the solid arrows) inside an hemoglobin mixture.




                                                             (a) Top view microscope image of the resolution target. (b) imaging
Imaging of fluorescence protein. HEK 293 cells transfected   of the resolution target using the microendoscope device. Inset.
with pEGFP-N3. Left: Top view microscope image. Right:       Zoom image of the encompass area. Scales bar of (a) and (b) are 10
Imaging using the microendoscope device. Scales bar of       µm and 20 µm, respectively.
left and right image are 50 and 20 µm, respectively.
                                                                                                                     41
Experimental results with phantom


                                        Monitoring Hemoglobin Concentration

                            1
                           0,9
                           0,8
   Normalized mean value




                           0,7
                           0,6
                           0,5
                           0,4
                           0,3
                           0,2
                           0,1
                            0
                                 Reference   Saline   16.25 [gr/L] 32.5 [gr/L]   65 [gr/L]   130 [gr/L]
                                                          Type of solution


Monitoring different hemoglobin concentrations inside the phantom.
                                                                                                          42
In-vivo experimental results

         Imaging along a blood vein
         of a chicken wing. The solid
         arrows indicate the blood
         vein, while the dashed arrows
         as well as the labeling letter
         indicate the cascading point
         between the images for
         constructing an image with a
         larger field of view




                                 43
In-vivo experimental results




Imaging of blood vessel inside the rat’s brain using the micro endoscope
                                                                           44
In-vivo experimental results




                       45
Outline
•“Hearing” with light – Introduction
•Biomedical monitoring:
   •Introduction
   •Measuring of breathing
   •Heart beats monitoring
   •Glucose level monitoring
   •Blood pulse pressure monitoring
   •IOP monitoring
   •Malaria detection
   •Alcohol detection
   •Oximetry and coagulation of blood
•Micro endoscope
•Conclusions
                                        46
Conclusions:
• A new technology for accurate remote and continuous sensing of
  movements was developed.
• The technique is based upon processing of back reflected secondary
  speckles statistics.
• We demonstrated remote estimation of breathing, heart beating, blood
  pulse pressure, alcohol and glucose concentration in the blood stream,
  intra-ocular pressure measurement, oximetry, coagulation of blood etc.
• To extract precise absolute value for the measured biomedical
  parameters periodic personalized calibration is needed every 2-3 years.
• Ultra thin and multi-functional micro endoscope for minimally invasive
  medical treatment and diagnostics was presented
                                                                    47

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Zeev Zalevsky for Knowledge Stream

  • 1. Photonic Remote and Continuous Biomedical Diagnostics Zeev Zalevsky1,2 1Faculty of Engineering, Bar-Ilan University, Israel 2SAOT, Friedrich-Alexander Universität Erlangen-Nürnberg, Germany 1
  • 2. Main collaborators: Yevgeny Beiderman1 Javier Garcia2 Vicente Mico2 Israel Margelith1 Asaf Shahmoon1 Alexander Douplik3 Dan Cojoc4 1Faculty of Engineering, Bar-Ilan University, Israel 2Departamento de Óptica, Universitat de València, Spain 3Ryerson University, Toronto, Canada 4Trieste, Italy 2
  • 3. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 3
  • 4. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 4
  • 5. Opto-Phone: Hearing with Light Imaging module Camera Sensor Invisible L aser Laser projection Any visible distance 5
  • 6. Opto-Phone: Hearing with Light Hearing with Light: Features •The ultimate voice recognition system compatible to “hear” human speech from any point of view (even from behind). •There is no restriction on the position of the system in regards to the position of the sound source. •Capable of hearing heart beats and knowing physical conditions without physical contact for measuring. 6
  • 7. Opto-Phone: Hearing with Light Features- cont. •Works clearly in noisy surroundings and even through vacuum. •Allows separation between plurality of speakers and sounds sources. •Works through glass window. •Simple and robust system (does not include interferometer in the detection phase). 7
  • 8. Let’s listen…from 80m Cell phone Back part of neck Counting…1,2,3,4,5,6 Counting…5,6,7 X - movement 1 0.5 0 -0.5 Face (profile) -1 120 140 160 180 200 220 240 260 280 300 320 Heart beat pulse Counting…5,6 taken from a throat All recordings were done in a very noisy constriction site at distance of more than 80m. 8
  • 9. Results: Detection of occluded objects I (a). (b). (c). (a). Camouflaged object. (b). Camouflage without the object. (c). The object (upper left part) and the low resolution camouflaged scenery. Spectrogram Spectrogram Spectrogram 0 0 0 2000 900 50 50 50 1800 12 800 100 100 100 1600 700 10 150 150 150 Frequency [Hz] 1400 Frequency [Hz] Frequency [Hz] 600 200 200 200 1200 8 250 250 500 250 1000 6 300 300 400 300 800 350 350 300 350 600 4 400 400 400 200 400 2 450 200 450 100 450 500 500 500 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 (d). Time [sec] (e). Time [sec] (f). Time [sec] (d). The spectrogram of the camouflaged object with its engine turned on. (e). The spectrogram of the object with its engine turned on and without the camouflage. (f). The spectrogram of the camouflaged object without turning on its engine. 9
  • 10. Results: Detection of occluded objects II Y - pos 10 (a). 5 (b). 0 -5 Y - pos -10 10 -15 5 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Sample 0 -5 -10 -15 0 1 2 3 4 5 6 7 [sec] -20 0 1000 2000 3000 4000 5000 6000 (a). The scenario of the experiment. (b). Experimental results: upper recording is of the Sample camouflaged subject. Lower recording is the same subject without the camouflage. 10
  • 11. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 11
  • 12. Technological Description •Unique technological platform allows remote and continuous wearable monitoring of many biomedical parameters simultaneously. •It is based upon inspection of secondary speckle pattern back reflected from skin near main blood artery, after properly adjusting the imaging optics. •The biomedical monitoring capabilities include: heart beats, breathing, blood pulse pressure, glucose concentration, alcohol level, IOP, blood coagulation (INR), oximetry, ICP etc. •Unique patented IP and know how. •Part of the applications have already been commercialized. 12
  • 13. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 13
  • 14. Measuring of breathing from rat’s cornea reflections (Abs) Spectrum 2 1.8 Detected rat’s breathing beating at X: -1.872 1.6 Y: 1.808 Noise level frequency around 1.87Hz. 1.4 Amplitude 1.2 1 0.8 0.6 0.4 0.2 0 -15 -10 -5 0 5 10 15 Reflected speckle pattern. Frequency [Hz] 14
  • 15. Measuring of heart beating from human’s cornea reflections (Abs) Spectrum (Abs) Spectrum (Abs) Spectrum 35 25 12 X: 1.502 X: 3.078 X: 1.522 Y: 11.68 30 Y: 33.65 Y: 19.96 10 20 25 8 Amplitude Amplitude Amplitude 15 20 Noise level 6 15 Noise level 10 4 10 5 2 5 0 0 0 -20 -15 -10 -5 0 5 10 15 20 -20 -15 -10 -5 0 5 10 15 20 -20 -15 -10 -5 0 5 10 15 20 Frequency [Hz] Frequency [Hz] Frequency [Hz] Subject #1 (measurement taken while Subject #2 (measurement taken while Reference noise level (detected subject was holding his breath) subject was holding his breath) reflection from a wall) Detected heart beating of humans at frequency of around 1.5Hz. 10 20 30 40 50 Reflected speckles pattern. 60 10 20 30 40 50 60 15
  • 16. Measuring breathing of pigs The swine's location 25 Breath Breath measured 20 The non-visible Breaths per minute 40 m laser system 15 10 5 Laser beam 0 1 2 3 4 5 6 7 8 9 Experiment Statistical breathing experiment 16
  • 17. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 17
  • 18. Remote heart beats monitoring The implemented optical configuration for remote measuring of heart beats and blood pulse pressure from subject’s hand Laser Camera 50 cm Hand 3 2 Temporal plot of the outcome from the 2.5 0 system used in the clinical trials for two 2 different participants. Amplitude [pix] Amplitude [pix] 1.5 -2 1 -4 0.5 -6 0 -8 -0.5 -10 -1 0 1 2 3 4 0 1 2 3 4 Time [sec] Time [sec] 18
  • 19. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 19
  • 20. Glucose level monitoring Temporal plot of the outcome from the system used in the clinical tests with the graphical description of the observed parameters. 20
  • 21. Glucose level monitoring 40 210 35 190 Amplitude [samp]; Glucose[ml/dl/10] Glucose [mg/dl] 30 170 25 150 20 Glucose /10 130 , 15 Param.6 110 10 90 5 70 0 50 0 5 10 15 20 25 30 0 5 10 15 20 25 30 Time [min] time [minutes] Stability of the system: constant glucose level in blood (denoted Data of subject #1: Glucose level in blood and amplitude by blue line with triangles) and the estimated parameter 6 of positive peak (parameter #1). Glucose level is denoted (denoted by magenta line with rectangles). Glucose level is by blue line with triangles and the optically measured given in units of 0.1[ml/dl] (representing a constant level of 100 parameter is denoted by magenta line with rectangles. [ml/dl), while the estimated optical values are given in pixels. 21
  • 22. Glucose level monitoring 210 210 190 190 Glucose [mg/dL] Glucose [mg/dl] 170 170 150 150 130 130 , 110 110 90 90 70 70 50 50 0 10 20 30 40 0 5 10 15 20 25 time [minutes] time [minutes] 2230 Data of subject #3: Glucose level in blood and amplitude of positive peak Data of subject #1: Glucose level in blood and (parameter #1). Glucose level is denoted by blue line with triangles and the amplitude of positive peak (parameter #1). Glucose optically measured parameter is denoted by magenta line with rectangles. level is denoted by blue line with triangles and the optically measured parameter is denoted by magenta 190 line with rectangles. 170 Glucose [mg/dl] 150 130 110 90 Data of subject #4: Glucose level in blood and amplitude of 70 positive peak (parameter #1). Glucose level is denoted by blue 50 line with triangles and the optically measured parameter is 0 5 10 15 20 25 30 denoted by magenta line with rectangles. time [minutes] 22
  • 23. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 23
  • 24. Blood pulse pressure measurement M , Corr(M , ) = 0.99507 140 Systolic Diastolic  = S-D 120 Amplitude [mmHg] 100 80 60 40 20 -50 0 50 100 150 200 250 300 350 400 Time [sec] An example of the obtained remote blood pulse pressure measurement using the proposed device for one subject participating in the clinical test group. The reference pulse pressure is shown by the green curve (denoted as ) was obtained using manual sleeve based reference measurement device. The blue curve (denoted as M) is the measurement obtained using the proposed optical technique. The time duration of the measurement was 350sec. The sampling of the camera was performed at 300Hz. One may see that strong correlation exists between the green (reference) curve and the blue curve obtained by the developed approach. 24
  • 25. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 25
  • 26. Remote IOP monitoring The proposed experimental configuration for remote continuous monitoring of the IOP. Changing IOP via applying mechanical pressure on the sclera. Changing IOP via modifying the height of an infusion bug. 26
  • 27. Remote IOP monitoring Data amp: 8.017 10.7025 11.2649 11.6035 9.3484 7.2619 7.2177 6.4588 40 Data amplitude: 9 30 8.02 10.7 11.27 11.6 9.35 7.26 7.22 6.46 8 20 7 6.872 With infusion bag a mp/pressure (mmHg) 9 6 With 1501 applied pressure Amplitude [pix] 10 Amplitude 8 7 6.8725 6 0 4 Amplitude 5 3.5404 4 3 3.5404 2.9932 -10 3 2.9932 6 Data amp: 7.3465 2 2 2.145 1.76402 2.145 1.76402 1 -20 4 0 1 Amplitude [pix] 2 0 0 0 20 40 60 80 -30 Pressure (mm/Hg) -2 0 20 40 60 80 -40 -4 Pressure (mm/Hg) -6 0 500 1000 1500 Sample -50 0 1000 2000 3000 4000 5000 6000 Sample Experimentally extracted readout compared to absolute reference IOP measurement obtained Experimentally extracted readout with Goldmann tonometer. obtained when changing the height of the infusion bag every 500 samples. 27
  • 28. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 28
  • 29. Detection of malaria An example of one out of the 20 relevant inspected parameters. Left: Healthy RBC. Right: Infected RBC. 29
  • 30. Detection of malaria Separation between infected and healthy cells. Plotting the length of the vectors versus cells’ index. 30
  • 31. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 31
  • 32. Remote alcohol level monitoring Camera (a). (b). Green laser (a). The side (left) and top (right) view of the experimental setup. (b). Typical temporal beating signals extracted using the proposed remote optical sensing device, before (left) and after (right) the effect of alcohol obtained over the same subject. 32
  • 33. Remote alcohol level monitoring Definition of the Ratio wid (through the ratio between the main STD of background noises: long duration test with and the secondary negative peak’s temporal positions), Main error bars representing the std values of the sec peak ratio (through the ratio between the main negative measured data. peak amplitude and the secondary positive peak’s amplitude), and Standard deviation of background noise (STD) parameters. 33
  • 34. Remote alcohol level monitoring (a). (b). Summary: Positive pulse size [msec] Pulse size [msec] (a). Pulse size, (b). Positive pulse size, (c). Peakdis, (d). Ratio_wid, (e). Main_sec_peak ratio, (f). Std of background noises. Time [min] Time [min] (c). (d). Peakdis [msec] Ratio wid Time [min] Time [min] (e). (f). Main sec peak ratio Std [msec] Time [min] Time [min] 34
  • 35. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 35
  • 36. Oximetry and coagulation of blood Oxygen INR 3.5 3 2.8 3 2.6 2.4 Amplitude [pix] Normilized INR 2.5 2.2 2 2 1.8 1.5 1.6 1.4 1 1.2 0.5 1 0 2 4 6 8 10 12 0 2 4 6 8 10 12 14 16 18 Test # Exp # Oximetry experiment Blood coagulation experiment 36
  • 37. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 37
  • 38. Multi-Functional Probe The edge of the fabricated micro probe having approximately 5,000 cores while each one of them is being used as light transmitting channel (each core is a single pixel in the formed image). In this image each core transmits red channel of light at wavelength of 632nm. 50m Laser (632nm) Beam Expander Mirror Laser Controller Camera Input plane Output plane Multi core probe F Image Object Sample Location U1 U2 V Beam Splitter Probe Location 1 1 1   Objective Lens U1  U 2 V F 38
  • 39. Multi-Functional Probe- experiments Experimental results of images transmitted backwards by the proposed micro probe. The scanned objects are as follows; From left to right: black vertical lines, black rectangles, horizontal black lines, black lines and black rectangle appearing in the left side of the backwards transmitted image. 5m 2m Experimental results of images with Fe beads having diameter of 1m imaged through an agar solution. 39
  • 40. Phantom fabrication (a) (b) (c) (a) Fabricated phantom. (b) shows a 3D view sketch of the phantom having two drilled channels with diameter of 400µm each. One longitudinal channel (along the x axis) while another angled channel was made making both channel crossed inside the phantom. The openings indicated as “in” and “out” enable the connection of microfluidic system. (c) shows a cross-sectional schematic view of the fabricated phantom. 40
  • 41. Experimental results with phantom Experimental results of Fe micro particles imaged inside a drilled phantom Imaging of a manipulated micro wire (indicated by the solid arrows) inside an hemoglobin mixture. (a) Top view microscope image of the resolution target. (b) imaging Imaging of fluorescence protein. HEK 293 cells transfected of the resolution target using the microendoscope device. Inset. with pEGFP-N3. Left: Top view microscope image. Right: Zoom image of the encompass area. Scales bar of (a) and (b) are 10 Imaging using the microendoscope device. Scales bar of µm and 20 µm, respectively. left and right image are 50 and 20 µm, respectively. 41
  • 42. Experimental results with phantom Monitoring Hemoglobin Concentration 1 0,9 0,8 Normalized mean value 0,7 0,6 0,5 0,4 0,3 0,2 0,1 0 Reference Saline 16.25 [gr/L] 32.5 [gr/L] 65 [gr/L] 130 [gr/L] Type of solution Monitoring different hemoglobin concentrations inside the phantom. 42
  • 43. In-vivo experimental results Imaging along a blood vein of a chicken wing. The solid arrows indicate the blood vein, while the dashed arrows as well as the labeling letter indicate the cascading point between the images for constructing an image with a larger field of view 43
  • 44. In-vivo experimental results Imaging of blood vessel inside the rat’s brain using the micro endoscope 44
  • 46. Outline •“Hearing” with light – Introduction •Biomedical monitoring: •Introduction •Measuring of breathing •Heart beats monitoring •Glucose level monitoring •Blood pulse pressure monitoring •IOP monitoring •Malaria detection •Alcohol detection •Oximetry and coagulation of blood •Micro endoscope •Conclusions 46
  • 47. Conclusions: • A new technology for accurate remote and continuous sensing of movements was developed. • The technique is based upon processing of back reflected secondary speckles statistics. • We demonstrated remote estimation of breathing, heart beating, blood pulse pressure, alcohol and glucose concentration in the blood stream, intra-ocular pressure measurement, oximetry, coagulation of blood etc. • To extract precise absolute value for the measured biomedical parameters periodic personalized calibration is needed every 2-3 years. • Ultra thin and multi-functional micro endoscope for minimally invasive medical treatment and diagnostics was presented 47