Wound healing monitoring and treatment

• US 20060241495A1
• Filed: 03/23/2005
• Published: 10/26/2006
• Est. Priority Date: 03/23/2005
• Status: Abandoned Application

• Current Assignee: CareStream Health Incorporated
• Original Assignee: Eastman Kodak Company
• Inventors: Kurtz, Andrew F.
• Application Number:
  US11/087,183
• Publication Number:
  US 20060241495A1
• Time in Patent Office: Days
• US Class Current: 600/476
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/442 Evaluating skin mechanical properties, e.g. elasticity, hardness, texture, wrinkle assessment
• CPC Class Codes: A61B 5/444 Evaluating skin marks, e.g. mole, nevi, tumour, scar
• CPC Class Codes: A61B 5/445 Evaluating skin irritation or skin trauma, e.g. rash, eczema, wound, bed sore
• CPC Class Codes: A61N 2005/073 using polarised light
• CPC Class Codes: A61N 5/0616 Skin treatment other than tanning

Abstract

A polarization based diagnostic device (200) for optically examining the medical condition of tissue (290) comprises an illumination optical system (205), comprising a light source (220) and beam shaping optics. An optical detection system (210) comprises imaging optics and an optical detector array, which detects light from the tissue. Polarizing optics provided in both the illumination optical system and the optical detection system are crossed and pass orthogonal polarization states. Iterative rotational means rotate the orthogonal polarization states relative to the tissue being examined. Image enhancement means includes image processing, sequential multi-spectral illumination and imaging, and image focus control to facilitate quality imaging at varying depths within the tissue. A controller (215) operates the light source, the detector array, the multi-spectral illumination and imaging, image focus control, and image processing.

Claims

1. A polarization based diagnostic device for optically examining the medical condition of tissue comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, and beam shaping optics, which together provide illumination light to the tissue being examined;

b) an optical detection system, comprising imaging optics and an optical detector array, for detecting light from said tissue;

c) polarizing optics, provided in both said illumination optical system and said optical detection system, which are crossed so as to pass orthogonal polarization states;

d) wherein iterative rotational means are provided to rotate the orthogonal polarization states relative to the tissue being examined;

e) image enhancement means, including some combination of image processing, sequential multi-spectral illumination and imaging, and image focus control to facilitate quality imaging at varying depths within said tissue; and

f) a controller for operating said light source, said detector array, said sequential multi-spectral illumination and imaging, and said image focus control, as well as providing image processing of the captured images to aid the diagnostic process.

2. A device as in claim 1 wherein said device is used to examines birefringent tissue structures in skin tissues.

3. A device as in claim 1 wherein said device is used to examine a collagen network in said tissue.

4. A device as in claim 1 wherein said device is used to examine granulation tissue in wound healing, including a status of collagen formation and/or angiogenesis.

5. A device as in claim 1 wherein said device is used to examine birefringent tissue structures in an extra cellular matrix.

6. A device as in claim 1 wherein said polarizing optics comprise wire grid polarizers.

7. A device as in claim 1 wherein said the polarizing optics includes a polarization converter.

8. A device as in claim 1 wherein said orthogonal polarization states are rotated by rotating the polarizing optics in the illumination system synchronously with rotating polarizing optics in the detection system.

9. A device as in claim 1 wherein said light source comprises one or more LEDs, laser diodes, or super-luminescent diodes.

10. A device as in claim 1 wherein said light source provides light to the tissue within a spectral range of 500-1300 nm.

11. A device as in claim 1 wherein said illumination system includes a tunable spectral filter.

12. A device as in claim 1 wherein said beam shaping optics include light uniformization means, such as Kohler illumination, an integrating bar, or a fly'"'"'s eye integrator.

13. A device as in claim 1 wherein said illumination system provides incident light to the tissue at angles larger than those collected by the detection system.

14. A device as in claim 1 wherein said illumination system illuminates an area on the tissue larger than that imaged by the detection system.

15. A device as in claim 1 wherein said illumination system and detection system partially share a common optical path, with at least a beamsplitter and an objective lens being used in common.

16. A device as in claim 1, wherein said illumination light in incident onto said tissue as off-axis light.

17. A device as in claim 1 wherein said beamsplitter is an angle sensitive TIR prism.

18. A device as in claim 1 wherein said beamsplitter is a PBS.

19. A device as in claim 1 wherein said imaging optics comprise an objective lens.

20. A device as in claim 19 wherein said objective lens is positioned by said focus control.

21. A device as in claim 7 wherein said detector array is a CCD or CMOS sensor.

22. A device as in claim 7 wherein said detection system includes a tunable spectral filter.

23. A device as in claim 7 wherein said image processing includes the operation of applying corrections from images collected at shallow tissue depths to improve the image quality of images collected from deeper tissue depths.

24. A device as in claim 1 wherein said device is used to examine wounds of various sorts, and the progress in the healing thereof.

25. A device as in claim 1 wherein said device is used to examine the structure and integrity of the collagen network in an extra-cellular matrix.

26. A device as in claim 1 wherein said device is used to both examine said tissue and adjacent tissue for comparison.

27. A device as in claim 1 wherein said device is used to examine tissue while applying pressure to adjacent tissue so as to examine the structure of said tissue while under mechanical stress.

28. A device as in claim 1 wherein said device and the information obtained there-from is used to guide further treatment efforts to heal said tissue.

29. A device as in claim 1 wherein said device can also be operated as a light therapy device.

30. A device as in claim 1 wherein said device is used in conjunction with a light therapy device.

31. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light;

b) an optical detection system, comprising focusing optics, an optical detector array, and polarizing optics which are nominally wire grid polarizers, which receives image light;

c) a polarization beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said polarization beamsplitter and said tissue;

d) a waveplate, located after the beam combining optics, for simultaneously rotating the polarized illumination and polarized imaging light;

e) an objective lens with a focus control means for directing illumination light to the tissue and collecting image light from the tissue;

f) a controller for operating the light source, the detector array, the focus control, the rotational motion of the waveplate, and for providing image processing of the captured images to aid the diagnostic process;

g) an image enhancement means within said controller; and

wherein said polarizing optics, provided in both said illumination optical system and said optical detection system, are crossed so as to comprise orthogonal polarization states.

32. A device as in claim 31 wherein said light source can provide sequential multi-spectral illumination, either by direct operation of said light source, or by direct operation of said light source and a tunable spectral filter.

33. A device as in claim 31 wherein said polarizing optics in said detection system include a wire grid polarization beam splitter and a wire grid polarizer.

34. A device as in claim 31 wherein said polarization beamsplitter can either be wire grid polarization beam splitter or a MacNeille type polarization beamsplitter.

35. A device as in claim 31 wherein said device is used to examine the birefringent tissue structures in skin, including an extra-cellular matrix of said skin.

36. A device as in claim 31 wherein said device is used to examine a collagen network in said tissue.

37. A device as in claim 31 wherein said polarizing optics in said illumination system include a polarization converter.

38. A device as in claim 31 wherein said waveplate is rotated iteratively through some angular range, such as 90 degrees.

39. A device as in claim 31 wherein said light source comprises one or more LEDs, laser diodes, or super-luminescent diodes.

40. A device as in claim 31 wherein said device can also be operated as a light therapy device.

41. A device as in claim 31 wherein said illumination system provides incident light to said tissue at angles larger than those collected by said detection system.

42. A device as in claim 31 wherein said illumination system illuminates an area on said tissue larger than that imaged by said detection system.

43. A device as in claim 31 wherein said detection system can include a tunable spectral filter.

44. A device as in claim 31 wherein said image enhancement means uses image processing to improve the image quality of images collected from deeper in said tissue, by applying corrections from images collected at shallower depths in said tissue.

45. A device as in claim 31 wherein said image enhancement means includes which some combination of image processing, sequential multi-spectral illumination and imaging and image focus control to facilitate quality imaging at varying depths within said tissue.

46. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light to said tissue;

b) an optical detection system, comprising imaging optics, an optical detector array, and polarizing optics which are nominally wire grid polarizers, which receives image light from said tissue;

c) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

d) a waveplate, located between said beamsplitter and said tissue, for simultaneously rotating the polarized illumination and polarized imaging light;

e) an objective lens with a focus control for directing said illumination light to said tissue and collecting said image light from said tissue;

f) a controller for operating at least said light source, said detector array, said focus control, said rotational motion of said waveplate, and for providing image processing of the captured images to aid the diagnostic process;

wherein said polarizing optics, provided in said illumination optical system and said optical detection system, are crossed so as to define nominally orthogonal polarization states; and

wherein said illumination light is controlled to provide a sequential multi-spectral illumination of said tissue.

47. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light to said tissue;

b) an optical detection system, comprising imaging optics, an optical detector array, and polarizing optics which are nominally wire grid polarizers, which receives image light from said tissue;

c) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

d) an objective lens with a focus control for directing said illumination light to said tissue and collecting said image light from said tissue;

wherein said polarizing optics, provided in said illumination optical system and said optical detection system, are independently and iteratively rotated so as to define variable polarization states relative to said tissue;

wherein said illumination light is controlled to provide a sequential multi-spectral illumination of said tissue; and

e) a controller for operating at least said light source, said detector array, said focus control, said rotational motion of said polarizers, and for providing image processing of the captured images to aid the diagnostic process.

48. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light to said tissue;

b) an optical detection system, comprising imaging optics, polarizing optics, and an optical detector array, which receive image light from said tissue;

c) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

d) an objective lens with a focus control for directing said illumination light to said tissue and collecting said image light from said tissue;

wherein said polarizing optics, provided in said illumination optical system and said optical detection system, are crossed so as to define nominally orthogonal polarization states;

wherein said polarizing optics in said illumination optical system and said optical detection system are rotated iteratively, in unison, relative to the tissue being examined; and

e) a controller for operating at least said light source, said detector array, said focus control, said rotational motion, and for providing image processing of the captured images to aid the diagnostic process.

49. A device as in claim 48 wherein said illumination light is controlled to provide a sequential multi-spectral illumination of said tissue.

50. A device for light application to tissue in vivo, having a diagnostic operational mode which examines the condition of the said tissue by using polarized light, and having a therapeutic operational mode, which applies polarized incident light to said tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light;

b) an optical detection system, comprising focusing optics, polarizing optics, and an optical detector array which receives image light;

c) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

d) an objective lens with a focus control means for directing illumination light to said tissue and collecting image light from said tissue;

wherein said polarizing optics, provided in said illumination optical system and said optical detection system, are independently and iteratively rotated so as to define variable polarization states relative to said tissue;

wherein said illumination light is controlled to provide multi-spectral illumination of said tissue; and

e) a controller, used in both diagnostic mode and therapy mode, for operating said light source, said detector array, said focus control, and said rotational motion of said polarizers.

51. An apparatus for light application to tissue in vivo, having a diagnostic light operational mode which examines the condition of the said tissue by using polarized light, and having a therapeutic light operational mode, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light;

b) an optical detection system, comprising focusing optics, and polarizing optics, an optical detector array, which receives image light;

c) beam combining optics comprising a polarization beamsplitter for combining the illumination light and the imaging light;

d) a waveplate, located after the beam combining optics, for simultaneously rotating the polarized illumination and polarized imaging light;

e) an objective lens with a focus control means for directing illumination light to the tissue and collecting image light from the tissue;

wherein the polarizing optics, provided in both said illumination optical system and said optical detection system, are crossed so as to comprise orthogonal polarization states; and

f) a controller, used in both diagnostic mode and therapy mode, for operating said light source, said detector array, said focus control, said rotational motion of said waveplate.

53. A polarization diagnostic device as in claim 51 wherein said device includes a controller which operates said light source, said detection system, a multi-spectral illumination system, a focus control, rotation of said polarizers, and an image analysis system.

52. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, which provides illumination light to said tissue;

b) an optical detection system, comprising imaging optics and an optical detector array;

c) a first polarizer in said illumination system;

d) a second polarizer in said detection system;

e) wherein said first polarizer and said second polarizer are crossed so as to pass orthogonal polarization states; and

f) wherein said first and second polarizers are rotated iteratively, in unison, relative to the tissue being examined.

54. A polarization diagnostic device as in claim 52 wherein said device include an image enhancement means selected from a group comprising image processing, sequential multi-spectral illumination, and image focus control for imaging at varying depths within said tissue.

55. A polarization based diagnostic device for optically examining medical condition of tissue, comprising:

a) an illumination optical system for providing sequential multispectral illumination to said tissue;

b) an optical detection system for detecting and focusing light from said tissue;

c) a first polarizer in said illumination system;

d) a second polarizer in said detection system; and

e) wherein said first and second polarizers are independently and iteratively rotated so as to define variable polarization states relative to said tissue.

56. A polarization diagnostic device as in claim 55 wherein said device includes a controller which operates said light source, said detection system, a multi-spectral illumination system, a focus control, rotation of said polarizers, and an image analysis system.

57. A polarization diagnostic device as in claim 55 wherein said device include an image enhancement means comprising some combination of image processing, sequential multi-spectral illumination, and image focus control for imaging at varying depths within said tissue.

58. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system comprising a light source, which provides illumination light to said tissue;

b) a first polarizer in said illumination system;

c) an optical detection system comprising imaging optics and an optical detector array for detecting image light from said tissue;

d) a second polarizer in said detection system;

e) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

f) wherein said first polarizer and said second polarizer are crossed so as to define nominally orthogonal polarization states; and

g) a wave plate, located between said beamsplitter and said tissue, wherein said wave plate is rotated iteratively.

59. A polarization diagnostic device as in claim 58 wherein said device includes a controller which operates said light source, said detection system, a multi-spectral illumination system, a focus control, rotation of said polarizers, and an image analysis system.

60. A polarization diagnostic device as in claim 58 wherein said device include an image enhancement means comprising some combination of image processing, sequential multi-spectral illumination, and image focus control for imaging at varying depths within said tissue.

61. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters and illumination beam shaping optics for providing illumination light;

b) an optical detection system, comprising focusing optics and an optical detector array which receives image light;

c) polarizing optics, provided in both said illumination optical system and said optical detection system, which are crossed so as to pass orthogonal polarization states;

wherein iterative rotational means are provided to rotate the polarizers and thus rotate the orthogonal polarization states relative to the tissue being examined;

d) beam combining optics for combining the illumination light and the imaging light;

e) an objective lens with a focus control means for directing illumination light to the tissue and collecting image light from the tissue;

f) a controller for operating the light source, the detector array, the focus control, the rotational motion of the polarizers, and for providing image processing of the captured images to aid the diagnostic process; and

g) image enhancement means within said controller, which utilizes some combination of image processing, sequential multi-spectral illumination and imaging and image focus control to facilitate quality imaging at varying depths within said tissue.

62. A method for using a polarization based diagnostic device to examine the condition of tissue comprising:

a) directing polarized illumination light at the tissue using an illumination system;

b) collecting image light which is of an orthogonal polarization state to said illumination light from said tissue with an imaging system;

c) iteratively and synchronously rotating the polarization state of the illumination and the orthogonal polarization state collected by said imaging system;

d) processing image data collected by said imaging system to produce digital images and metrics related to the state of the tissue;

e) refocusing said imaging system; and

f) collecting additional images at different depths in the tissue.

63. A method as in claim 62 wherein said illumination light is varied to provide sequential multi-spectral illumination.

64. A method as in claim 62 wherein the tissue being examined is compared to other adjacent tissue by using said device.

65. A method as in claim 62 wherein tissue adjacent to the tissue being examined is subject to mechanical pressure, so to mechanically stress the tissue being examined with said device.

66. A method for using a polarization based diagnostic device to examine the condition of tissue in conjunction with light therapy, including:

a) directing polarized light at the tissue using an illumination system;

b) collecting polarized image light emerging from said tissue with an imaging system;

c) detecting said image light to produce image data;

d) processing said image data to produce digital images and diagnostic metrics concerning the state of the tissue;

e) applying the image data and diagnostic metric data to determine a protocol for light therapy treatment; and

f) applying light therapy as a treatment.

67. A method as in claim 66 wherein images are collected at different depths in the tissue, by using focus control, multi-spectral illumination and imaging, and image processing in some combination to obtain quality images.

68. A method for light therapy, comprising application of light to a patient in combination with diagnosis of the condition of the collagen network within the tissue being treated, the method comprising:

a) applying a therapeutic light treatment method to a patient;

b) sensing the condition of the collagen network in the tissue of said patient, by detecting the effect the birefringence of said collagen network has on an incident diagnostic light beam;

c) assessing the need for applying said therapeutic light treatment onto said tissue, and thereby optimizing the dosage of the light therapy relative to various parameters, including the wavelength, intensity, modulation, repeat frequency, and location of light application onto said tissue; and

d) modifying the dosage parameters of said therapeutic light treatment in accordance with the detected condition of said collagen network.

69. A polarization based diagnostic device for optically examining the medical condition of tissue, comprising:

a) an illumination optical system, comprising a light source, having one or more light emitters, illumination beam shaping optics, and polarizing optics, for providing illumination light to said tissue;

b) an optical detection system, comprising imaging optics, an optical detector array, and polarizing optics which are nominally wire grid polarizers, which receives image light from said tissue;

c) a beamsplitter for re-directing either said illumination light or said image light such that said illumination light and said image light traverse a common optical path between said beamsplitter and said tissue;

d) an objective lens with a focus control for directing said illumination light to said tissue and collecting said image light from said tissue;

wherein said illumination light is controlled to provide a sequential multi-spectral illumination of said tissue;

e) a controller for operating at least said light source, said detector array, said focus control, and for providing image processing of the captured images to aid the diagnostic process; and

wherein said device include an image enhancement means selected from a group comprising image processing, sequential multi-spectral illumination, and image focus control for imaging at varying depths within said tissue.