The section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter described in the present application.
This invention relates generally to optical measurements of in vivo properties of a solid tissue or blood. Medical personnel often need to determine properties of human or animal subject's solid tissue or blood. For example, in a diagnostic or surgical setting, it is desirable for medical personnel to know the hematocrit (Hct) of a subject's blood, which relates to the abundance of hemoglobin (Hb) and/or concentration of red blood cells in the subject's blood.
Traditional methods of determining hematocrit of a subject's blood include drawing blood from a vein in the subject's body and then centrifuging the drawn blood to separate cellular and fluid components of the blood or by mixing a chemical agent in with the blood to facilitate colorimetric measurements. Such methods are both time consuming and expensive.
The invention, in accordance with preferred and exemplary embodiments, together with further advantages thereof, is more particularly described in the following detailed description, taken in conjunction with the accompanying drawings. The drawings are not necessarily to scale, emphasis instead generally being placed upon illustrating principles of the invention.
While the present teachings are described in conjunction with various embodiments and examples, it is not intended that the present teachings be limited to such embodiments. On the contrary, the present teachings encompass various alternatives, modifications and equivalents, as will be appreciated by those of skill in the art.
For example, in some embodiments, the detailed description describes measuring hematocrit of a human's blood. It should be understood that the methods and apparatus of the present invention can be applied to measuring numerous other properties in a human or an animal subject's solid tissues or fluids. Also, the methods and apparatus of the present invention are described in connection with a single wavelength optical beam. It should be understood that the methods and apparatus of the present invention can use one or more optical beams with more than one wavelength.
It should be understood that the individual steps of the methods of the present invention may be performed in any order and/or simultaneously as long as the invention remains operable. Furthermore, it should be understood that the apparatus of the present invention can include any number or all the described embodiments as long as the invention remains operable.
An optical source 206 that generates an optical beam 208 is positioned to illuminate the blood flowing in the capillary tube 202. In some experiments, the optical source 206 was a 70 mW laser having an 808 nm wavelength. Numerous other types of optical sources can be used to perform the methods of the present invention. In some embodiments, the optical source 206 is a super luminescent diode. Experiments have shown that using a super luminescent diode results in less spurious reflections compared with using a laser and thus, results in intensity data with a relatively high signal-to-noise ratio. Such optical sources are relatively inexpensive, have long lifetimes and are extremely reliable. The optical source 206 is oriented so that the optical beam 208 strikes the blood flowing in the glass capillary tube 202 at a non-normal angle relative to the surface 210 of the capillary tube 202. An optical element 212 is positioned so that an input 214 of the optical element 212 receives a portion of the near field optical beam 216 that is reflected from blood vessels in the capillary tube 202. The term “near field” as used herein refers to the portion of the reflected optical beam that propagates along the optical axis 116 of the optical element 212. In the embodiment shown in
The optical element 212 is designed to pass a desired near field portion of the optical beam 216 reflected from blood vessels in the capillary tube 202. In many embodiments, the optical element 212 includes a spatial filter that is designed to pass the desired near field portion of the reflected optical beam 216. In the embodiment shown in
The optical element 212 used to obtain the data presented herein was a 20× lens. The numerical aperture, which is a measure of a lens' ability to gather light and resolve fine detail, was equal to 0.42. The working distance, which is the distance from the blood vessel being illuminated to the input 214 of the optical element 212, was equal to 20 mm, and the depth of focus was equal to 1.6 μm. A relatively long working distance lens is used to reduce the angle of illumination in order to reduce forward scattering and the resulting noise.
In other embodiments, the optical element 212 is a pin hole aperture that is designed to pass the desired portion of the near field optical beam reflected from blood vessels in the capillary tube 202. In yet other embodiments, the optical element 212 includes an input to an optical fiber cable. In this embodiment, the core of the optical fiber is chosen to pass the desired portion of the near field optical beam reflected from blood vessels in the capillary tube 202. In some of these embodiments, the optical element 212 includes the lens 213 that collects the reflected optical beam 216 prior to passing the desired portion of the near field optical beam reflected from blood vessels in the capillary tube 202.
A scanning mechanism 218 is used to position the capillary tube 202 relative to the optical element 212 and the optical source 206 at a plurality of relative distances so that the optical beam 208 illuminates different illumination volumes in the capillary tube 202. The scanning mechanism 218 described in
An optical detector 220 is used to detect the portions of the near field optical beam that are reflected from blood vessels in the capillary tube 202 and that propagate through the optical element 212. The optical detector 220 includes an optical input 222 that is coupled to the output 224 of the optical element 212. The optical detector 220 generates a plurality of electrical signals at an output 226 in response to detecting a plurality of near field portions of the optical beam 208 that are reflected from blood vessels in the capillary tube 202 as the scanning mechanism 218 changes the position the optical element 212 relative to the capillary tube 202.
A processor 228 is used to acquire the data generated by the optical detector 220. For example, the processor 228 can be a computer that includes an analog-to-digital converter or other signal processor. The processor 228 includes an input 230 that is electrically connected to the output 226 of the detector 220. The processor 228 receives the plurality of signals from the output 226 of the optical detector 220 and uses the methods described herein to determine a value of hematocrit of the blood in the vessel illuminated by the optical beam.
Specifically, the data presented in
Many embodiments of the method of measuring hematocrit of a subject's blood according to the present invention flip the order of hematocrit data in certain ranges of relative position between the optical element 212 and the blood vessel illuminated by the optical beam 208. One explanation for why the order of hematocrit data flips in certain near field ranges as compared to far field ranges is that the type of reflections experienced by the optical beam is changing from near-surface reflections to diffuse reflections as a function of the relative z-position of the illumination and collection beams.
Near-surface reflections obey the law of Mie scattering that describes the scattering of electromagnetic radiation produced by spherical particles whose diameters are greater than 1/10 the wavelength of the scattered radiation In contrast, diffuse reflections are reflections where incoming light experiences multiple scattering events in a medium and as a result is reflected in many different directions.
Thus, one explanation for why the order of hematocrit data flips in certain ranges of the relative position is that near-surface reflections dominate in some ranges and diffuse reflections dominate in other ranges. Specifically, near-surface reflections may dominate when the optical beam 208 illuminates blood vessels that are aligned with of the optical axis 402 of the optical element 212 so that the near field portion of the reflected optical beam is aligned directly with the input 214 of the optical element 212 as described in connection with
Another possible explanation for why the order of hematocrit data flips in certain ranges of the relative position between the optical element and the blood vessel illuminated by the optical beam 208 is that there is an effective transition layer at the surface of the blood that is caused by irregular contour shaped blood vessels near the surface. This effective transition layer has a higher effective index of refraction than the deeper level of cells. The top level of cells has an effective index of refraction that is approximately equal to 1.4, which is equal to the index of refraction of a relatively high value of hematocrit and a relatively low level of blood plasma.
Near-surface reflections dominate when the optical beam 208 is reflected from the effective transition layer at the surface of the blood. The near-surface reflections from the blood vessels will increase as the concentration of hematocrit increases so that higher intensities indicate higher values of hematocrit. In contrast, deeper levels of cells have a lower effective index of refraction that is in the range of 1.33 to 1.39. Diffuse far-field reflections will dominate when the optical beam 208 is reflected from the deeper level of cells. The diffuse reflections from blood vessels will decrease as the concentration of hematocrit increases.
The separation of hematocrit measurements can be increased by computing the ratio of the intensity in the near field to the intensity in the far field. The far-field region is the region outside the near-field region, where the angular field distribution is essentially independent of distance from the source. The far field is dominated by homogeneous waves.
The data presented in
The optical fiber 602 and ball lens 604 are positioned to illuminate subcutaneous vessels in the subject's tissue 608 with the optical beam 606. The apparatus 600 includes a window 612 that passes the optical beam 606 to the subcutaneous vessels in the subject's tissue 608. For example, the window 612 can be formed of quartz or sapphire. In practice, a gel 614 is used to provide an interface between the subject's skin 610 and the window 612. In some embodiments, a scanning mechanism scans the optical beam 606 relative to the subcutaneous vessels in the subject's tissue 608.
A plurality of optical elements 616 is positioned to receive a near field portion of the optical beam 606 that is reflected from the subcutaneous vessels in the subject's tissue 608. The plurality of optical elements 616 is movable as shown in
A processor 620 is used to determine the value of hematocrit in the subcutaneous vessels illuminated by the optical beam 606 from the plurality of electrical signals generated by the detector array 616. The processor 620 has inputs that are electrically connected to the outputs of the detector array 616. The processor 620 receives the plurality of signals from the outputs of the detector array 616 and determines the hematocrit of a subject's blood from the received signals.
In other embodiments, the plurality of optical elements 616 is a bundle of fiber optic cables where each fiber optic cable is positioned so that it's input is a unique distance relative distance to the subcutaneous vessels under a subject's skin. In other embodiments, the plurality of optical elements 616 includes a plurality of pin hole apertures where each of the plurality of pin hole apertures is positioned at a unique distance relative to the subcutaneous vessels in the subject's tissue 608.
In these other embodiments, a plurality of optical detectors is used to detect the intensity of the near field portion of the optical beam 606 that is reflected from the subcutaneous vessels in the subject's tissue 608 at the unique relative distances between the optical element 616 and the subcutaneous vessels in the subject's tissue 608. Each of the plurality of optical detectors is optically coupled to an output of a respective one of the plurality of optical elements 616 and generates an electrical signal in response to detecting the near field intensity of the near field portion of the optical beam 606.
In some embodiments, the plurality of optical detectors comprises an optical multiplexer and a single optical detector. The optical multiplexer has a plurality of inputs where a respective one of the plurality of inputs is optically coupled to a respective output of the plurality of optical elements 616. The output of the optical multiplexer is optically coupled to the input of the optical detector.
The present invention includes several methods for determining the hematocrit of a subject's blood from the detected intensities of the near field portion of the optical beam that is reflected from the subcutaneous vessels under the subject's skin. In one embodiment, the detected intensities or a function of the detected intensities is compared to theoretically predicted values, such as values predicted using a photon diffusion theoretical model as described in patent application Ser. No. 11/109,409, filed Apr. 19, 2005 entitled “Optical Determination of In Vivo Properties,” which is incorporated herein by reference.
Many theoretical models for predicting hematocrit of a subject's blood from detected intensities include one or more parameters, such as the wavelength of the illuminating optical beam, the scattering and absorption cross-sections of blood vessels, and other blood components at the wavelength of the optical beam, the scattering and absorption cross-sections of subcutaneous tissue, and the distances between the light illumination volume and the light detection volume.
Theoretical models and parameters useful for such models are discussed in, e.g., Reynolds, L. O., “Optical Diffuse Reflectance and Transmittance From An Anisotropically Scattering Finite Blood Medium,” Ph.D. Thesis, Dept. Electrical Eng., Univ. of Wash., 1975; Reynolds, L. O. et al., “Diffuse Reflectance From A Finite Blood Medium: Applications To The Modeling Of Fiber Optic Catheters,” Applied Optics, 15(9), 2059-2067, 1967; and Bohren, C. F. et al., “Absorption and Scattering of Light by Small Particles,” New York, Wiley & Sons, 477-482, 1983, each of which documents is incorporated herein by reference.
Other methods of the present invention determine the hematocrit of a subject's blood from the detected intensities of the near field portion of the optical beam that is reflected from the subcutaneous vessels under the subject's skin by comparing the detected intensities to experimental values. Experimental values are obtained from one or more reference subjects having a known value for hematocrit. The known values of hematocrit can be determined using an in vitro blood analysis method. Intensity values from reference subjects having about the same hematocrit value are grouped together by averaging or by other means. Such data can be plotted in reference curves or stored in a look-up table. In these methods, intensity values are compared to the intensity values from the multiple reference subjects to determine the subject's hematocrit value or other in vivo blood property.
In some embodiments, the detected intensities are corrected for background light, such as light that exits the skin after passing only through subcutaneous tissue, which contains relatively few blood vessels. Measurements of background intensities can be obtained by adjusting the position of at least one of the optical beam 208 and the blood vessels illuminated by the optical beam 208 to a position where the optical beam does not pass through any blood vessels. This is a position where the reflected optical beam has a relatively low intensity.
The intensity measurements are corrected for background intensities by subtracting the intensity measurement of the optical beam reflected from blood vessels from the background intensity. In general, the corrected intensities are more sensitive to in vivo blood properties than uncorrected detected intensities and achieve better correlation with theoretical models. Therefore, the corrected intensities are a more accurate measure of in vivo blood property than uncorrected intensities.
In some embodiments, a ratio is calculated of measured intensities obtained at different relative positions between the optical element 212 and the subcutaneous blood vessels under the subject's skin. The different relative positions cause the optical beam 208 to illuminate blood vessels that are on and displaced various distances from the optical axis 302 of the optical element 212 so that the near field portion of the reflected optical beam is scanned relative to the input of the optical element 212. Ratios of measured intensities obtained at different relative positions are a more accurate measurement of a subject's hematocrit value or other in vivo blood property. For example, the below equation can be used to determine a subject's hematocrit value.
The variables I(λIR, Z1) and I(λIR, Z2) are the measured near-infrared reflected intensities at a first and a second relative position Z1 and Z2 between the optical element 212 and the subcutaneous blood vessels. The variables (λGreen, Z1) and (λGreen, Z2) are the measured green light reflected intensities at the first and the second relative position between the optical element 212 and the subcutaneous blood vessels. The constants K1 and K2 are correction factors that relate the detected intensities to the actual value of the subject's hematocrit. The constants K1 and K2 can be determined from theoretical models, experimental data, or a combination of theoretical models and experimental data.
The intensity of green light (light having a wavelength of about 532 nm) is measured at the first and the second relative position between the optical element 212 to obtain a correction as described herein and in U.S. patent application Ser. No. 11/109,409, filed Apr. 19, 2005 entitled “Optical Determination of In Vivo Properties,” which is incorporated herein by reference. Green light does not significantly penetrate blood because blood is highly absorbing at 532 nm. Therefore, green light can be used as a reference to indicate the amount of reflections due to skin (or anything other than blood).
While the present teachings are described in conjunction with various embodiments and examples, it is not intended that the present teachings be limited to such embodiments. On the contrary, the present teachings encompass various alternatives, modifications and equivalents, as will be appreciated by those of skill in the art, may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.
The present application is a continuation-in-part of Ser. No. 11/109,409, filed Apr. 19, 2005 entitled “Optical Determination of In Vivo Properties”, which is a continuation-in-part of U.S. patent application Ser. No. 11/011,714, filed Dec. 14, 2004. The entire specification of U.S. patent application Ser. No. 11/011,714 and U.S. patent application Ser. No. 11/109,409 are incorporated herein by reference in their entirety.
Number | Date | Country | |
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Parent | 11109409 | Apr 2005 | US |
Child | 11293652 | Dec 2005 | US |
Parent | 11011714 | Dec 2004 | US |
Child | 11109409 | Apr 2005 | US |