The present disclosure relates to systems and methods for analyzing excised/ex-vivo tissue samples in general, and to systems and methods for analyzing tissue samples that utilize digital images in particular.
Histopathology remains the gold standard for tissue analysis and identification of cancer. In surgical pathology, after the freshly excised tissue is blocked, it is sent for routine histopathology workflow that involves formalin-fixation, paraffin-embedding (FFPE), microtoming, and staining with various dyes such as hematoxylin and eosin (H&E). The slides are examined by a pathologist under a microscope, and the pathologist's interpretations of the tissue result in the pathology “read” of the sample. However, the entire FFPE process takes days to a week and is labor-intensive and subjective. Advanced optical and electromagnetic (“EM”) imaging approaches have been reported for the determination of tumor margin: These include the use of fluorescence imaging [1-2], optical tomography, radiofrequency spectroscopy, near infrared spectroscopy [3], Raman Spectroscopy [4, 5], and terahertz reflectivity [6].
Among the optical techniques, fluorescence offers a straightforward approach to providing diagnostic information which is interpretable and attributable to known biology. More recently, fluorescence-guided surgery (FGS) has been used for the detection of cancer during surgery and margin assessment [7]. Cancer imaging using FGS typically involves the use of non-specific or targeted fluorescent imaging agents/tracers such as those that bind to cell surface carbohydrates, free proteins, specific enzymes, or expressed cell surface receptors of cancer cells. However, the clinical adaptation of FGS has been hindered due to limited photostability, concern over chemical toxicity, poor tumor to background ratio, and the need for administration of a tracer before surgery.
The biomolecules present in different tissues provide discernible and repeatable autofluorescence [8-11] and reflectance [12] spectral patterns. Intrinsic fluorescence imaging has been used with varying degrees of success in assessing margins. The endogenous fluorescence signatures offer useful information that can be mapped to the functional, metabolic and morphological attributes of a biological sample, and have therefore been utilized for diagnostics purposes. The autofluorescence-based label-free approach offer significant advantages to patients by avoiding potential toxicological issues, FDA approval of contrast agents, the cost of contrast agents, and increased surgical time associated with administering fluorescence imaging agents. The advent of ultraviolet (“UV”) light-emitting diodes (“LEDs”), advancements in UV filter technology, and the emergence of artificial intelligence (“AI”) and machine learning (“ML”) have facilitated fuller exploitation of the rich optical contrast of biomolecular chromophores embedded in tissues.
According to an aspect of the present disclosure, a method of analyzing an ex-vivo tissue sample is provided. The method includes: a) sequentially interrogating the tissue sample a plurality of times, each sequential interrogation using at least one excitation light within a plurality of excitation lights and each said excitation light within the plurality of excitation lights centered on a respective wavelength distinct from the respective centered wavelengths of the other excitation lights, wherein at least one of the excitation light centered wavelengths is configured to produce autofluorescence (AF) emissions from one or more biomolecules associated with the tissue sample, and at least one of the excitation light centered wavelengths is configured to produce diffuse reflectance signals from the tissue sample; b) using at least one photodetector to detect the AF emissions, or the diffuse reflectance signals, or both from the tissue sample, and to produce photodetector signals representative of the detected said AF emissions, or the detected said diffuse reflectance signals, or both; c) processing the photodetector signals attributable to the AF emissions using at least one first classifier trained with a plurality of predetermined AF data sets to determine one or more first data sets indicative of biomolecules present within the tissue sample; d) processing the photodetector signals attributable to the diffuse reflectance signals using at least one second classifier trained with a plurality of predetermined diffuse reflectance signal data sets to determine one or more second data sets; and e) determining a type of the tissue sample using the one or more first data sets and the one or more second data sets.
In any of the aspects or embodiments described above and herein, the photodetector signals attributable to the diffuse reflectance signals may provide microstructural information relating to the tissue sample.
In any of the aspects or embodiments described above and herein, the photodetector signals attributable to the diffuse reflectance signals may provide morphological information relating to the tissue sample.
In any of the aspects or embodiments described above and herein, the plurality of predetermined diffuse reflectance signal data sets used to train the second classifier include data sets attributable to known tissue types may include benign tissue, fibrous tissue, adipose tissue, diseased tissue, and tissue morphologies.
In any of the aspects or embodiments described above and herein, the plurality of predetermined AF data sets used to train the first classifier may include data sets attributable to known biomolecules.
In any of the aspects or embodiments described above and herein, the known biomolecules may include at least one of tryptophan, collagen, NADH, FAD, elastin, or hemoglobin.
In any of the aspects or embodiments described above and herein, the at least one first classifier may include a plurality of first classifiers and each producing a first data set, and the step of processing the photodetector signals attributable to the AF emissions may further includes providing the plurality of first data sets to a first metaclassifier, and the step of determining the type of the tissue sample may utilize an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the at least one first classifier may include a plurality of first classifiers and each producing a first data set, and the at least one second classifier may include a plurality of second classifiers and each producing a second data set, and the step of processing the photodetector signals attributable to the AF emissions may further include providing the plurality of first data sets to a first metaclassifier, and the step of processing the photodetector signals attributable to the diffuse reflectance signals may include providing the plurality of second data sets to the first metaclassifier, and the step of determining the type of the tissue sample may utilize an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the method may further include processing the photodetector signals attributable to the diffuse reflectance signals using at least one third classifier trained with a plurality of predetermined morphology signal data sets to determine one or more third data sets indicative of morphologies present within the tissue sample, and the step of determining the type of the tissue sample may further use the one or more third data sets indicative of morphologies present within the tissue sample.
In any of the aspects or embodiments described above and herein, the step of processing the photodetector signals attributable to the AF emissions using at least one first classifier may further include providing the plurality of first data sets to a first metaclassifier, the step of processing the photodetector signals attributable to the diffuse reflectance signals using at least one second classifier may include providing the plurality of second data sets to the first metaclassifier, and the step of processing the photodetector signals attributable to the diffuse reflectance signals using at least one third classifier trained with a plurality of predetermined morphology signal data sets may include providing the plurality of third data sets to the first metaclassifier, and the step of determining the type of the tissue sample may utilize an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the step of determining the type of the tissue sample may utilize a third classifier that utilizes the one or more first data sets from the at least one first classifier and the one or more second data sets from the at least one second classifier in a cascading manner.
In any of the aspects or embodiments described above and herein, the step of processing the photodetector signals attributable to the AF emissions and the step of processing the photodetector signals attributable to the diffuse reflectance signals may further include providing a first output from the at least one first classifier and a second output from the at least one second classifier to a second level classifier in an ensemble classifier architecture, and the step of determining the type of the tissue sample may utilize a third output from the second level classifier.
According to another aspect of the present disclosure, a system for analyzing an ex-vivo tissue sample is provided that includes an excitation light source, at least one photodetector, and a system controller. The excitation light source is configured to selectively produce a plurality of excitation lights. Each excitation light is centered on a wavelength distinct from the centered wavelength of the other said excitation lights. At least one of the excitation light centered wavelengths is configured to produce AF emissions from one or more biomolecules associated with a bladder wall tissue, and diffuse reflectance signals from the tissue sample. The system is configured so that the plurality of excitation lights are incident to the tissue sample. The at least one photodetector is configured to detect the AF emissions, or the diffuse reflectance signals, or both from the tissue sample as a result of the respective incident excitation light, and to produce signals representative of the detected AF emissions, or the detected diffuse reflectance signals, or both. The system controller is in communication with the excitation light source, the at least one photodetector, and a non-transitory memory storing instructions, which instructions when executed cause the system controller to: a) control the excitation light unit to sequentially produce the plurality of excitation lights; b) control the at least one photodetector to detect the AF emissions, or the diffuse reflectance signals, or both from the tissue sample, and to produce photodetector signals representative of the detected said AF emissions, or the detected said diffuse reflectance signals, or both; c) process the photodetector signals attributable to the AF emissions using at least one first classifier trained with a plurality of predetermined AF data sets to determine one or more first data sets indicative of biomolecules present within the tissue sample; d) process the photodetector signals attributable to the diffuse reflectance signals using at least one second classifier trained with a plurality of predetermined diffuse reflectance signal data sets to determine one or more second data sets; and e) determine a type of the tissue sample using the one or more first data sets and the one or more second data sets.
In any of the aspects or embodiments described above and herein, the at least one first classifier may include a plurality of first classifiers, each producing a first data set. The instructions that when executed cause the system controller to process the photodetector signals attributable to the AF emissions, may further cause the system controller to provide the plurality of first data sets to a first metaclassifier, and the determination of the tissue sample type may utilize an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the at least one first classifier may include a plurality of first classifiers, each producing a first data set. The at least one second classifier may include a plurality of second classifiers, each producing a second data set. The instructions that when executed cause the system controller to process the photodetector signals attributable to the AF emissions, may further cause the system controller to provide the plurality of first data sets to a first metaclassifier. The instructions that when executed cause the system controller to process the photodetector signals attributable to the diffuse reflectance signals, may further cause the system controller to provide the plurality of second data sets to the first metaclassifier. The instructions that when executed cause the system controller to determine the type of the tissue sample may utilize an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the instructions that when executed may further cause the system controller to process the photodetector signals attributable to the diffuse reflectance signals using at least one third classifier trained with a plurality of predetermined morphology signal data sets to determine one or more third data sets indicative of morphologies present within the tissue sample. The instructions that when executed cause the system controller to determine the type of the tissue sample may further use the one or more third data sets indicative of morphologies present within the tissue sample.
In any of the aspects or embodiments described above and herein, the instructions that when executed cause the system controller to process the photodetector signals attributable to the AF emissions using the at least one first classifier may further cause the system controller to provide the plurality of first data sets to a first metaclassifier. The instructions that when executed cause the system controller to process the photodetector signals attributable to the diffuse reflectance signals using the at least one second classifier may further cause the system controller to provide the plurality of second data sets to the first metaclassifier. The instructions that when executed cause the system controller to process the photodetector signals attributable to the diffuse reflectance signals using the at least one third classifier trained with a plurality of predetermined morphology signal data sets may further cause the system controller to provide the plurality of third data sets to the first metaclassifier. The instructions that when executed cause the system controller to determine the type of the tissue sample may use an output of the first metaclassifier.
In any of the aspects or embodiments described above and herein, the instructions that when executed cause the system controller to determine the type of the tissue sample may utilize a third classifier that utilizes the one or more first data sets from the at least one first classifier and the one or more second data sets from the at least one second classifier in a cascading manner.
In any of the aspects or embodiments described above and herein, the instructions that when executed cause the system controller to process the photodetector signals attributable to the AF emissions and to process the photodetector signals attributable to the diffuse reflectance signals may further cause the system to provide a first output from the at least one first classifier and a second output from the at least one second classifier to a second level classifier in an ensemble classifier architecture. The instructions that when executed cause the system controller to determine the type of the tissue sample may utilize a third output from the second level classifier.
The foregoing features and elements may be combined in various combinations without exclusivity, unless expressly indicated otherwise. These features and elements as well as the operation thereof will become more apparent in light of the following description and the accompanying drawings. It should be understood, however, the following description and drawings are intended to be exemplary in nature and non-limiting.
The present disclosure is directed to a novel dye-free multimodal optical approach that combines multispectral autofluorescence (“AF”) imaging with multispectral reflectance imaging to measure both tissue emission and absorption characteristics to provide comprehensive analysis and profiling of excised/ex-vivo tissue. The present disclosure system includes an excitation light source, one or more photodetectors, a system controller, as well as other components. As will be described herein, embodiments of the present disclosure are configured for imaging/analysis of ex-vivo tissue samples.
Biomolecules present in different tissues provide discernible and repeatable AF and reflectance spectral patterns. The endogenous fluorescence signatures offer useful information that can be mapped to functional, metabolic, and/or morphological attributes of a biological sample, and therefore may be used for diagnostic purposes. Biomolecular changes occurring in the cell and tissue state during pathological processes and disease progression result in alterations of the amount and distribution of endogenous fluorophores and can form the basis for tissue/cancer identification. Tissue AF has been proposed to detect various malignancies including cancer by measuring either differential intensity or lifetimes of the intrinsic fluorophores. Biomolecular constituents such as tryptophan, collagen, elastin, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD), elastin, porphyrins, etc. present in tissue provide discernible and repeatable autofluorescence spectral patterns.
The excitation light source may include one or more excitation light units. In some embodiments, an excitation light unit may be configured to produce excitation light centered at a particular wavelength. In those system embodiments that include a plurality of excitation light units, different excitation light units may be configured to produce excitation light centered at different wavelengths; e.g., a first excitation light unit configured to produce excitation light centered at wavelength “X”, a second excitation light unit configured to produce excitation light centered at wavelength “Y”, and the like. In some embodiments, the excitation light source may be or include a white light source. For example, the system may include a white light source in combination with one or more filters that collectively produce excitation light centered at different wavelengths. In some embodiments, the system may include a white light source used to interrogate the sample unfiltered; e.g., for registration purposes, or the like.
An excitation light unit may be configured to produce AF emissions from a tissue sample and/or may be configured to produce reflectance signals from a tissue sample. Non-limiting examples of acceptable excitation light sources include lasers and light emitting diodes (LEDs) that may be centered at particular wavelengths, or a tunable excitation light source configured to selectively produce light centered at respective different wavelengths. An example of an acceptable white light source is a flash lamp. The present disclosure is not limited to any particular type of excitation light unit. In those embodiments wherein an excitation light unit is configured to produce light centered on a particular wavelength, the respective wavelength may be chosen based on the photometric properties associated with one or more biomolecules (or tissue type, etc.) of interest. Excitation light incident to a biomolecule that acts as a fluorophore will cause the fluorophore to emit fluorescent light at a wavelength longer than the wavelength of the excitation light; i.e., via AF.
As stated above, tissue may naturally include certain fluorophores such as tryptophan, collagen, elastin, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD), elastin, porphyrins, and the like. In addition, biomolecular changes occurring in the cell and tissue state during pathological processes and as a result of disease progression often result in alterations of the amount and distribution of these endogenous fluorophores. Hence, different tissue types and states can exhibit distinct intrinsic tissue AF, or in other words an “AF signature”, that is readily identifiable. Embodiments of the present disclosure may utilize these AF characteristics/signatures to identify different tissue types and/or tissue constituents.
Excitation wavelengths may also be chosen that cause detectable light reflectance from tissue of interest. The detectable light reflectance is a function of light absorption of the tissue and/or light scattering associated with the tissue (this may be collectively referred to as diffuse reflectance). Certain tissue types or permutations thereof, or constituents thereof, have differing and detectable light reflectance characteristics (“signatures”) at certain wavelengths. Significantly, these reflectance characteristics can provide information beyond intensity; e.g., information relating to cellular or microcellular structure such as cell nucleus and extracellular components. The morphology of a first type healthy tissue cell may be different from that of a second type healthy cell, and/or different from an abnormal or diseased tissue cell. Hence, the ability to gather cellular or microstructural morphological information (sometimes referred to as “texture”) provides another tool for determining tissue types and the state and characteristics of such tissue.
The excitation light source may be configured to produce light at wavelengths in the ultraviolet (UV) region (e.g., about 100-400 nm) and in some applications may include light in the visible region (e.g., 400-700 nm). The excitation light wavelengths may be chosen based on the photometric characteristics of the biomolecules of interest (e.g., AF and absorption) and the present disclosure is not, therefore, limited to the exemplary wavelength ranges disclosed above.
Regarding the one or more photodetectors within the system, the present disclosure may utilize a variety of different photodetector types configured to sense light and provide signals that may be used to measure the same. Non-limiting examples of an acceptable photodetector include those that convert light energy into an electrical signal such as photodiodes, avalanche photodiodes, a charge coupled device (“CCD”) array, an intensified charge coupled device (“ICCD”) array, a complementary metal-oxide-semiconductor (“CMOS”) image sensor, or the like. The photodetector may take the form of a camera. As will be described below, the one or more photodetector(s) are configured to detect AF emissions from the interrogated tissue and/or diffuse reflectance from the interrogated tissue and produce signals representative of the detected light and communicate the signals to the system controller.
The system controller is in communication with other system components such as the light source and the light detector and may be in communication with other system components. The system controller may be in communication with system components to control the operation of the respective component and/or to receive signals from and/or transmit signals to that component to perform the functions described herein. The system controller may include any type of computing device, computational circuit, processor(s), CPU, computer, or the like capable of executing a series of instructions that are stored in memory. The instructions may include an operating system, and/or executable software modules such as program files, system data, buffers, drivers, utilities, and the like. The executable instructions may apply to any functionality described herein to enable the system to accomplish the same algorithmically and/or coordination of system components. The system controller includes or is in communication with one or more memory devices. The present disclosure is not limited to any particular type of memory device, and the memory device may store instructions and/or data in a non-transitory manner. Examples of memory devices that may be used include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache memory, and/or any device that stores digital information. The system controller may include, or may be in communication with, an input device that enables a user to enter data and/or instructions, and may include, or be in communication with, an output device configured, for example to display information (e.g., a visual display or a printer), or to transfer data, etc. Communications between the system controller and other system components may be via a hardwire connection or via a wireless connection.
Some embodiments of the present disclosure may include optical filtering elements configured to filter excitation light, or optical filtering elements configured to filter emitted light (including reflected light), or both. Each optical filtering element may be configured to pass a defined bandpass of wavelengths associated with an excitation light source or emitted/reflected light (e.g., fluorescence or reflectance), and may take the form of a bandpass filter. Regarding filtering excitation light, the system may include an independent filtering element associated with each independent excitation light source or may include a plurality of filtering elements disposed in a movable form (e.g., a wheel or a linear array configuration) or may include a single filtering element that is operable to filter excitation light at a plurality of different wavelengths, or each excitation light source may be configured to include a filtering element, or the like. Regarding filtering emitted or reflected light, the system may include a plurality of independent filtering elements each associated with a different bandwidth or may include a plurality of filtering elements disposed in a movable form or may include a single filtering element that is operable to filter emitted/reflected light at a plurality of different wavelengths, or the like. The bandwidth of the emitted/reflected light filters are typically chosen based on the photometric properties associated with one or more biomolecules of interest. Certain biomolecules may have multiple emission or reflectance peaks. The bandwidth of the emitted/reflected light filters are typically chosen to allow only emitted/reflected light from a limited portion of the biomolecule emission/reflectance response; i.e., a portion of interest that facilitates the analysis described herein. As will be described below, the exemplary system embodiment shown in
An exemplary embodiment of a present disclosure system 20 is diagrammatically illustrated in
In the operation of the system 20 embodiment diagrammatically shown in
In the system embodiment described above and others, the signals (i.e., image) representative of the emitted light (AF and/or reflectance) captured by the photodetector arrangement (e.g., camera or plurality of photodetectors) for each excitation light wavelength may collectively provide a mosaic of information relating to the tissue sample. The chart shown in
The integrated information provided by the aforesaid emitted light images provide distinct benefits in the process of identifying biomolecule/tissue types of interest with a desirable degree of specificity and sensitivity. As can be seen from
Embodiments of the present disclosure may include a plurality of classifiers using advanced machine learning and/or AI algorithms on multispectral autofluorescence data sets, reflectance data sets, and combinations thereof to fully exploit the biochemical information content (e.g., from fluorescence) and morphological information content (e.g., both reflectance and fluorescence). This rapid and label-free approach, which offers cost-effectiveness and ease-of-use, has the potential to provide significant advantages in surgical and pathological settings.
For the AF imaging, either an entire image, or characteristics (e.g., pixel intensity) of an image, or a portion of an image (e.g., a localized grouping of pixels, sometimes referred to as a “superpixel”), or any combination thereof may be used for classification algorithm development. Single classification methods such as logistic regression, discriminant analysis, support vector machine, random forest, XG boost, and the like have been used in the past for the classification task even on hyperspectral images [13] as illustrated in
Aspects of the present disclosure utilize a novel hybrid classification approach that uses both morphological and molecular attributes of the tissues derived from AF images that may be acquired at a plurality of different excitation and emission wavelengths, and from reflectance images obtained using one or more optical techniques. Some embodiments of the present disclosure may combine AF imaging with reflectance imaging to compliment and increase the biomolecular and morphological information content and thereby increase the diagnostic power. Aspects of the present disclosure therefore leverage the fact that different tissue types absorb different amounts of light at specific wavelengths and therefore the combination and autofluorescence and reflectance imaging offers higher diagnostic power.
The stored instructions within the system controller 30 may include a plurality of trained classifiers, each “trained” using a clinically significant number of images of known tissue types (e.g., including but not limited to benign tissue types, fibrous tissue types, adipose/fat tissue types, diseased tissue types (e.g., cancerous), abnormal tissue types, tissue morphologies, etc.) and features collected at the respective excitation wavelengths. Alternatively, the system controller 30 may be in communication with a plurality of trained classifiers. The trained classifiers in turn may be used to evaluate the acquired light images (AF and/or reflectance) collected from the tissue sample at the various different excitation/emission wavelengths to determine the presence or absence of biomolecule/tissue types/features of interest. The present disclosure is not limited to any particular type of classifier; e.g., some classifiers may employ classification methodologies/algorithms such as dictionary learning, anomaly detector, convolutional neural network (CNN), deep neural network (DNN), logical regression, discriminate analysis, support vector machine (SVM), random forest, XG boost, and the like. As will be described below, a classifier may produce a binary output or a probability output, etc. In some embodiments, an ensemble classifier consisting of two or more classifiers based on the same or different classification methods can be utilized. An ensemble classifier may utilize input from one or more base classifiers provided to a second level classifier trained on such input. The second level classifier processes the aforesaid base classifier input (e.g., predictions) to produce an output that typically has a greater probability/accuracy than is produced by the constituent base classifiers. The present disclosure is not limited to these examples.
During the classifier training process, an imaging system (e.g., the same as or similar to the photodetectors described above in
Different embodiments of the present disclosure hybrid classification framework are illustrated in the present figures.
In some instances, a meta-classifier may be employed that uses machine learning/AI to combine predictions from individual base classifiers. In some instances, these classifiers may be selectively tuned to capture and maximize different aspects of classification, and their impact on the final stage can be weighted by the machine-learning training data sets. In addition, various features extracted from attribute-learning base classifiers (ABCs) might be used as input to the AI/ML-based meta classifier. Some features may be correlated to different endogenous biomolecules such as tryptophan, collagen, NADH, FAD, and the like to facilitate development of an explainable AI (XAI) or ML classifier.
The present disclosure is not limited to either AI, machine learning, or multivariate models and any combination of these techniques may be used. In some instances, classifiers trained on differing spatial dimensions or image patch size may be combined to account for both local and global tissue morphologies. For example, a classifier trained on a smaller tile will encode a more localized cellular structure, whereas a classifier trained on a bigger tile may account for tissue microenvironment of neighborhood and cancer field effect.
In some present disclosure embodiments, an integrated classifier that combines different classifiers in a cascaded manner may be used; e.g., see
In some present disclosure embodiments, a hybrid classifier utilized may have a multi-stage classification architecture, depending on tissue types under analysis. This multi-stage classification architecture (which may be referred to as a “sequential-based ensemble tissue classifier”) may be based on a plurality of data sets including AF multispectral data sets, with an initial “anomaly-based” classifier used to detect and reject one tissue type prior to subsequent meta classification with a second data set (e.g., see
As an example, in breast cancer analysis, tissue can be broadly classified as fat (adipose), benign, or cancerous. Here, the first classifier (C1) may be employed to discern whether the test tissue is fat. In a subsequent step, another classifier (e.g., C2) that is tuned, for example, to differentiate between benign and malignant tissues may be used on non-fat classified tissue for cancer detection. This serial format of “stacked” classifiers allows the stages of classification to be tuned to differentiate the type of tissue at each stage and may enable computationally efficiency (i.e., by elimination of tissue types) and improved analysis by virtue of the “lesser field” of tissue types to be considered. In some embodiments, the present classifier approach may use a plurality of data sets including AF multispectral data sets, with an initial “anomaly-based” classifier to detect and reject one tissue type prior to subsequent meta classification with a plurality of additional multispectral data sets; e.g., see
In some embodiments, the present disclosure may combine AF imaging with reflectance imaging to compliment and increase the biomolecular and morphological information content and thereby increase the diagnostic power. As stated above, in this manner the present disclosure may leverage the fact that different tissue types absorb different amounts of light at specific wavelengths and therefore the combination of AF and reflectance imaging offers higher diagnostic power.
While the principles of the disclosure have been described above in connection with specific apparatuses and methods, it is to be clearly understood that this description is made only by way of example and not as limitation on the scope of the disclosure. Specific details are given in the above description to provide a thorough understanding of the embodiments. However, it is understood that the embodiments may be practiced without these specific details.
It is noted that the embodiments may be described as a process which is depicted as a flowchart, a flow diagram, a block diagram, etc. Although any one of these structures may describe the operations as a sequential process, many of the operations can be performed in parallel or concurrently. In addition, the order of the operations may be rearranged. A process may correspond to a method, a function, a procedure, a subroutine, a subprogram, etc.
The singular forms “a,” “an,” and “the” refer to one or more than one, unless the context clearly dictates otherwise. For example, the term “comprising a specimen” includes single or plural specimens and is considered equivalent to the phrase “comprising at least one specimen.” The term “or” refers to a single element of stated alternative elements or a combination of two or more elements unless the context clearly indicates otherwise. As used herein, “comprises” means “includes.” Thus, “comprising A or B,” means “including A or B, or A and B,” without excluding additional elements.
It is noted that various connections are set forth between elements in the present description and drawings (the contents of which are included in this disclosure by way of reference). It is noted that these connections are general and, unless specified otherwise, may be direct or indirect and that this specification is not intended to be limiting in this respect. Any reference to attached, fixed, connected or the like may include permanent, removable, temporary, partial, full and/or any other possible attachment option.
No element, component, or method step in the present disclosure is intended to be dedicated to the public regardless of whether the element, component, or method step is explicitly recited in the claims. No claim element herein is to be construed under the provisions of 35 U.S.C. 112(f) unless the element is expressly recited using the phrase “means for.” As used herein, the terms “comprise”, “comprising”, or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus.
While various inventive aspects, concepts and features of the disclosures may be described and illustrated herein as embodied in combination in the exemplary embodiments, these various aspects, concepts, and features may be used in many alternative embodiments, either individually or in various combinations and sub-combinations thereof. Unless expressly excluded herein all such combinations and sub-combinations are intended to be within the scope of the present application. Still further, while various alternative embodiments as to the various aspects, concepts, and features of the disclosures—such as alternative materials, structures, configurations, methods, devices, and components, and so on—may be described herein, such descriptions are not intended to be a complete or exhaustive list of available alternative embodiments, whether presently known or later developed. Those skilled in the art may readily adopt one or more of the inventive aspects, concepts, or features into additional embodiments and uses within the scope of the present application even if such embodiments are not expressly disclosed herein. For example, in the exemplary embodiments described above within the Detailed Description portion of the present specification, elements may be described as individual units and shown as independent of one another to facilitate the description. In alternative embodiments, such elements may be configured as combined elements.
This application claims priority to U.S. Patent Appln. No. 63/197,655 filed Jun. 7, 2021, and PCT Patent Application No. PCT/US2022/011343 filed Jan. 5, 2022, both of which are hereby incorporated by reference in their entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2022/032516 | 6/7/2022 | WO |
Number | Date | Country | |
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63197655 | Jun 2021 | US |
Number | Date | Country | |
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Parent | PCT/US22/11343 | Jan 2022 | WO |
Child | 18567981 | US |