Not Applicable
Medical endoscopes have been widely used in both diagnostic and surgical procedures. A promising technique for detecting a lesion in a living body during endoscopic procedures involves near infrared (NIR) fluorescence imaging, in which NIR light is used to illuminates tissue, exogenously applied fluorophores in the tissue emit fluorescence, and an imaging system captures a fluorescent image. In addition to fluorescence imaging, normal diagnostic and surgical procedures utilize endoscopy with conventional visible light imaging.
Despite the progress made in the field of endoscopy, there is a need in the art for a system incorporating visible light endoscopy and NIR fluorescent endoscopy.
The present invention relates generally to endoscopy systems. More particularly, embodiments of the present invention relate to an apparatus and method for concurrent imaging of both visible light and NIR fluorescence during endoscopy. In a particular embodiment, an endoscope system with concurrent visible light imaging and NIR fluorescence imaging is provided. The endoscope system disclosed, comprising an endoscope working from visible to NIR spectra, a light source generating independently controllable visible light and NIR excitation light, a single image sensor camera, a controller for image processing and light source control, and a display device. The fluorescence imaging mode starts with an initialization process which adjusts intensity of the NIR excitation light and visible light independently until the brightness of fluorescence image and the contrast between fluorescence image and visible light image are ideal for observation.
According to an embodiment of the present invention, a stereoscopic endoscope system for concurrently imaging at both visible and NIR wavelengths is provided. The stereoscopic endoscope system includes an endoscope operable to transmit both visible and NIR wavelengths and a light source operable to generate visible light and NIR excitation light. An intensity of the visible light is independent of an intensity of the NIR excitation light. The stereoscopic endoscope system also includes a stereoscopic camera having a single image sensor operable to detect a left eye image or a right eye image at both visible and NIR wavelengths, a controller coupled to the light source and the stereoscopic camera, and a display device operable to be viewed using stereoscopic spectacles.
According to another embodiment of the present invention, a method of operating a stereoscopic endoscopy system is provided. The method includes concurrently illuminating a tissue with NIR excitation light and visible light and independently adjusting an intensity of the NIR excitation light and an intensity of the visible light. The method also includes imaging the tissue using a stereoscopic camera having a single detector, concurrently acquiring a left eye image at both visible and NIR wavelengths using the single detector, and concurrently acquiring a right eye image at both visible and NIR wavelengths using the single detector. The method further includes displaying the left eye image and the right eye image consecutively on a display device.
According to an embodiment of the present invention, an endoscope system for concurrently imaging at both visible and NIR wavelengths is provided. The endoscope system includes an endoscope operable to transmit both visible and NIR wavelengths and a light source operable to generate visible light and NIR excitation light. An intensity of the visible light is independent of an intensity of the NIR excitation light. The endoscope system also includes a camera having a single image sensor, a controller coupled to the visible light and the NIR excitation light, and a display device.
According to another embodiment of the present invention, a method of operating an endoscopy system is provided. The method includes concurrently illuminating a tissue with NIR excitation light and visible light, imaging the tissue using a single detector, and independently adjusting an intensity of the NIR excitation light and an intensity of the visible light.
According to a specific embodiment of the present invention, a method of initializing an endoscope is provided. The method includes illuminating tissue with NIR excitation light and imaging fluorescent emission from the tissue with a single image sensor. The method also includes adjusting an intensity of the NIR excitation light until a fluorescence image intensity is within a predetermined rage and determining fluorescence active pixels and fluorescence non-active pixels. The method further includes illuminating the tissue with visible light, imaging both the fluorescent emission from the tissue and reflected visible light with the single image sensor, computing a ratio between an average signal value of the fluorescence active pixels and the fluorescence non-active pixels, and adjusting an intensity of the visible light.
In an embodiment, an endoscope system for simultaneous imaging in both the visible and the NIR regions is provided. The endoscope system includes an endoscope with desired image quality over the visible and the NIR spectrum and a light source generating visible light and NIR excitation light. The light source is configured such that intensity of the visible light and the intensity of the NIR excitation light can be independently controlled. The endoscope system also includes a camera with a single image sensor that is operable to capture images and output image signals, a controller capable of controlling visible light and NIR excitation light independently, and a display device. The controller is configured to process the image signals and adjust the light intensity based on image processing.
In a specific embodiment, the camera of the endoscope system includes an optical filter that blocks the excitation light and passes visible light and fluorescent emission. The light source can include a plurality of solid state light sources, each of which is independently controlled. The controller can be further capable of attenuating the intensity of the visible light through optical or electrical approaches.
In another embodiment, a method for simultaneously imaging visible light and NIR fluorescent emission with a single image sensor is provided. The method includes an initialization process that includes illuminating tissue only with NIR excitation light, capturing and imaging fluorescent emission with a single image sensor, and adjusting the intensity of the NIR excitation light until the brightness of the fluorescence image is at a desired level. The method also includes adding visible light with attenuated intensity for illumination, capturing and imaging fluorescent emission and reflected visible light with the single image sensor, and adjusting the intensity of visible light until the contrast between the fluorescent emission and the reflected visible light is at a desired level.
In an embodiment, the method also includes distinguishing fluorescence active pixels and fluorescence non-active pixels by applying a threshold to the fluorescence image when illuminating tissue only with the NIR excitation light. The method can also include determining a ratio between an average signal value of the fluorescence active pixels and an average signal value of the fluorescence non-active pixels when illuminating tissue with both NIR excitation light and visible light.
In a specific embodiment, an endoscope system for simultaneous visible light imaging and NIR fluorescence imaging is provided. The endoscope system includes an endoscope working from visible to NIR spectra, a light source generating independently controllable visible light and NIR excitation light, a single image sensor camera, a controller for image processing and light source control, and a display device. The fluorescence imaging mode starts with an initialization process that adjusts the intensity of the NIR excitation light and the visible light independently until the brightness of fluorescence image and the contrast between the fluorescence image and the visible light image are suitable for observation.
Numerous benefits are achieved by way of the present invention over conventional techniques. For example, embodiments of the present invention provide endoscopy systems that utilize concurrent illumination in both the NIR spectrum and the visible spectrum and imaging in both the fluorescent emission spectrum and the reflected visible spectrum to provide information for medical procedures that is not available using conventional techniques. These and other embodiments of the invention along with many of its advantages and features are described in more detail in conjunction with the text below and attached figures.
In NIR fluorescence endoscopy, exogenous fluorophores such as indocyanine green (ICG) can be administered to the patient and will combined with the tissue to be observed. In addition to IGC, other suitable dyes, such as methylene blue can be used as a source of fluorescent emission (which can also be referred to as fluorescence emission). Excitation light in the NIR spectrum with wavelengths shorter than the fluorescent emission is used to illuminate the tissue and excites the fluorophores in the tissue. The resulting fluorescent emission is detected at NIR wavelengths longer than the excitation light based on the Stokes shift. The fluorescence quantum yields give the efficiency of the fluorescence process, which is normally low. As a result, the intensity of the fluorescent emission is generally very weak compared to the intensity of the NIR excitation light. Therefore, in order to observe the fluorescence image, an optical filter is utilized to block the NIR excitation light from reaching the sensor.
A CCD or CMOS image sensor typically has a spectral response from 200 nm to 1100 nm, allowing the sensor to capture light for imaging in both the visible and NIR regions. However, the spectral response of an image sensor in the NIR spectrum is only 10%-30% of its peak response in the visible spectrum. Thus embodiments of the present invention, which provide endoscopy incorporating both visible light and NIR fluorescence imaging, utilize control of the intensity of the visible light and the intensity of the NIR excitation light so that the reflected visible light does not overwhelm the image sensor.
The endoscope system 100 includes an endoscope 102, a light source 104, a camera 106, a controller 108, a monitor 110 and a light guide 112. The endoscope 102 provides a wide transmission band over the visible and NIR spectrum with small chromatic aberration between the wavelengths in the visible and NIR spectrum. The light source 104, described more fully below, generates visible light (e.g., 400 nm-700 nm, in particular 420 nm-680 nm) as well as NIR excitation light with wavelengths in a first NIR spectrum (e.g., 790 nm-820 nm, in particular in the vicinity around 800 nm). The light source 104 can be operated in different modes depending on the imaging modes. As described more fully below, the light source is operable to output both NIR light and visible light, with independent control over each of the wavelength regions. For example, the light source can output NIR light, with no visible output. Alternatively, the light source can output visible light with no NIR light. Additionally, the light source can output both NIR light and visible light concurrently.
The output light from the light source 104 is sent through a light guide 112 into the endoscope 102 to illuminate a target tissue 101 and its surrounding area. In an embodiment, the light guide is an optical fiber cable such as a glass fiber bundle including a plurality of multimode optical fibers, liquid light guides, or the like. The reflected visible light and the excited fluorescent emission with wavelengths in a second NIR spectrum (e.g., 830 nm-900 nm) are received by the endoscope 102 to be imaged by the camera 106. In the exemplary endoscope system 100 illustrated in
The controller 108 receives image signals from the camera 106 and processes the image signals for display. The controller 108 is capable of independently adjusting the visible light and the NIR excitation light in the light source 104 using feedback control based on analyzing the image signals, which will be described in detail later. The live image signals captured by the camera 106 and processed by the controller 108 are eventually displayed on the monitor 110.
In some embodiments, multiple fluorescent dyes and multiple excitation wavelengths are utilized, with optical filters (i.e., notch filters) utilized in the imaging optical path that block the excitation light from each of the excitation sources from passing to the detector. An optical filter with multiple notches (e.g. dual notch) having low transmission or multiple single notch optical filters are utilized in these embodiments. Reflected visible light and fluorescent light from the target tissue (at multiple fluorescent wavelengths in the case of multiple fluorescent dies) is transmitted through the optical filter(s) for subsequent detection at the detector. Since the two dyes can have different responses to the excitation light, embodiments provide benefits not available using conventional techniques. In some implementations, the NIR excitation source provides excitation light peaking at multiple wavelengths in order to produce efficient fluorescence from each of the fluorescent dies. Moreover, in some embodiments, the NIR excitation source is controllable to produce light having a single and adjustable excitation peak, multiple excitation peaks, or the like depending on the fluorescent dies that are being utilized during a particular medical procedure.
Embodiments of the present invention provide for concurrent illumination in both the visible and NIR spectrum as well as concurrent imaging of both the visible light reflected from the sample, tissue, or specimen and the fluorescent light emitted by the fluorescent dye, which can be associated with the sample, tissue, or specimen. This concurrent or simultaneous imaging of both visible reflected light and fluorescent emitted light using a single sensor contrasts with conventional systems that utilize time sequential imaging at these differing wavelengths or multiple image sensors for these different wavelengths that utilize an optical system to split the different wavelengths to direct the different wavelength to each of the multiple image sensors.
In the embodiment illustrated in
The NIR laser 220, red LED 221, green LED 222 and blue LED 223 are each independently controlled by the controller 108. Through the use of the controller, the intensity of the NIR excitation light and the intensity of the visible light can be adjusted, for example, by changing the driving current provided to the NIR laser and the LEDs. In the fluorescence imaging mode, as described more fully below, the intensity of the visible light is adjusted (e.g., attenuated) in order to achieve the desired contrast between the fluorescence image and the visible light image. Additional optical approaches, such as the use of neutral density filters, or electrical approaches, such as modulation methods, can be applied to attenuate the visible light significantly and/or adjust the light intensity with the desired precision.
As discussed in relation to
As an example, the endoscopy system illustrated in
During operation in the visible light imaging mode, the NIR excitation light is typically in the off condition or is switched off The visible light, either generated from combining the red, green, and blue LEDs as discussed in relation to
The controller 108 receives and processes the electrical signal associated with the visible light image. The monitor 110 displays the visible light image for use by the system operator, including medical personnel. In some embodiments, the controller can adjust the light intensity automatically based on the received electrical signal associated with the visible light image. In an embodiment, the adjustment by the controller is based on calculating the maximum and average signal values of the image sensor pixels. In this embodiment, the controller adjusts the intensity of the visible light source so that the maximum signal value does not exceed the saturation value of the image sensor while the average signal value is maintained above a predetermined threshold value to provide sufficient light intensity during operation. This adjustment process can be performed manually or automatically depending on the particular implementation. One of ordinary skill in the art would recognize many variations, modifications, and alternatives.
When fluorescence imaging is desired, the fluorescence imaging mode is selected (516). In response to selection of this mode, the system begins an initialization process to determine the intensity of NIR excitation light and the intensity of visible light (518). Additional description related to the initialization process is provided in relation to
First, the NIR excitation light is switched on and the visible light is switched off (551). At this stage, only the NIR excitation light from the NIR laser source illuminates the target tissue, generating fluorescent emission. The camera obtains the fluorescence image (552) and sends the electrical image signal to the controller. The processor in the controller applies gamma correction (553) to the received fluorescence image so that the digitized image is a linear function of the luminance. After gamma correction, the processor is utilized to determine if the maximum signal value of the pixels in the fluorescence image is within a predetermined range (554). In other words, a check is performed of the maximum signal value of the pixels in the fluorescent image.
According to embodiments, the maximum signal value is allowed to be within the predetermined range. The upper limit of this predetermined range is utilized to prevent saturation due to too much illumination. As described below, since the visible light will be utilized added in later, the upper limit of the predetermined range is selected such that signal value space is reserved to account for the increase in the signal value associated with the reflected visible light. The lower limit of the predetermined range is utilized to provide a level at which the fluorescence image has adequate brightness for observation and diagnosis.
If the maximum signal value is outside the predetermined range, then adjustments are made to the intensity of the NIR excitation light (555). If the maximum signal value is larger than the predetermined range, the controller will decrease the intensity of the NIR excitation light. If the maximum signal value is smaller than the predetermined range, the controller will increase the intensity of the NIR excitation light. The method repeats processes 552, 553, 554, and 555 as needed until the maximum signal value of the fluorescence image is within the predetermined range.
After the signal is in the predetermined range, a threshold is applied to the fluorescent image (556). The threshold applied to the fluorescence image results in the selection of only pixels with signal values above the threshold as fluorescence active pixels (557). In the embodiments described herein, fluorescence active pixels are pixels for which fluorescent emission is detected for these pixels. The other pixels that have an image intensity less than the threshold are determined to be fluorescence non-active pixels, i.e., pixels for which fluorescent emission is associated. In this way, the fluorescence active pixels are associated with the target tissue and the fluorescence non-active pixels are associated with the surrounding area, which can now be distinguished in the image.
After the NIR excitation light is adjusted to a suitable intensity as described above, the visible light is switched on, but attenuated to one of a plurality of low intensities (558). The attenuation of the visible light is utilized since, for different types of surgical procedures, the intensity of the fluorescent emission varies. Accordingly, the visible light is attenuated to different intensity levels depending on the surgical procedure. Based on experimental or empirical data, the typical intensity level of either the fluorescent excitation light, the visible light, or both for different surgical procedures can be stored and preset in the controller. Once the type of surgical procedure is selected, the controller will attenuate the visible light to this typical intensity level in process 558.
With the combined NIR excitation light and visible light illumination, the camera captures an image that includes both fluorescent emission and reflected visible light (559). The processor in the controller applies gamma correction to this image (560). The processor then calculates the average signal value of the fluorescence active pixels and the average signal value of the fluorescence non-active pixels. The processor also calculates the ratio between the average signal value of the fluorescence active pixels and the average signal value of the fluorescence non-active pixels (561). The calculated ratio is then compared to a predetermined value (562) and the controller adjusts the intensity of the visible light based on the results of the comparison (563). In other embodiments, rather than using the average value, other statistical measures, including maximum and minimum values, median values, one or more standard deviations around the mean, or the like are utilized to characterize the signal value of the fluorescence active pixels and the fluorescence non-active pixels.
If the calculated ratio is higher than the predetermined value, the brightness in the non-fluorescence surrounding area is not sufficient and the controller will increase the intensity of the visible light. If the calculated ratio is lower than the predetermined value, the brightness of the non-fluorescence surrounding area is too high and the controller will decrease the intensity of the visible light. Processes 559-563 are repeated until the visible light intensity is adjusted to an appropriate level such that the calculated ratio is equal to the predetermined value. Once the ration is equal to the predetermined value, the initialization process is complete (564).
The initialization process described in relation to
The stereoscopic endoscope system depicted in
The output light from the light source 104 is sent through a light guide 112 into the endoscope 102 to illuminate a target tissue 101 and its surrounding area. The reflected visible light and the excited fluorescent emission with wavelengths in a second NIR spectrum (e.g., 830 nm-900 nm) are received by the endoscope 102 to be imaged by the stereoscopic camera 706. It will be appreciated that NIR excitation light reflected from the target tissue will be filtered in the upstream path to reduce system noise. Image data from the stereoscopic camera 706 is delivered to controller 708 through output line 711 for eventual display on monitor 110.
The stereoscopic camera 706 takes the left eye image and the right eye image in alternative frames to generate the stereoscopic image, which is described in additional below. The stereoscopic camera 706 images the reflected visible light and the fluorescent emission concurrently in each frame. The controller 708 controls the stereoscopic camera 706 through control line 713 to utilize the left eye image and the right eye image alternatively in subsequent frames. Subsequently, the image or video is displayed on the monitor 110. In an embodiment, the controller 708 controls the operation of a pair of stereoscopic spectacles 710 to create stereoscopic image. The left eyepiece and the right eyepiece of the stereoscopic spectacles 710 are opened and closed alternatively to synchronize to the left eye image or the right eye image displayed on the monitor 110.
The stereoscopic camera 706 includes a switching shutter 802, an excitation light blocking filter 804, imaging optics 806, and an image sensor 808. The switching shutter 802 acts as a controllable aperture that can open either the left or right region of an aperture and close the other region of the aperture. The switching shutter can be fabricated using liquid crystal, MEMS, or other devices that can be controlled electronically to preferentially block or pass light incident on different regions of the switching shutter. As an example, when the left region of the switching shutter is open, light transmits through the left region of the aperture and is focused by the imaging optics 806 on to the image sensor 808 to generate a left eye image. When the right region of the switching shutter is open, light transmits through the right region of the aperture and a right eye image is generated.
The excitation light blocking filter 804 can be a notch optical filter that provides a blocking band in the NIR spectral range associated with excitation light (e.g., to block a first predetermined portion of light in a particular wavelength range, for example, 790 nm to 820 nm for ICG dye) and a transmission band in the visible (e.g., to pass a second predetermined portion of visible light in a particular wavelength band, for example, 400 nm-700 nm) and the NIR spectral range associated with the fluorescent emission (e.g., to pass a third predetermined portion of the fluorescent emission in a particular wavelength band, for example, 830 nm-900 nm). The imaging optics 806 focus the visible light and the fluorescent emission from the left region or right region of the switching shutter onto the image sensor 808 to form a left eye image or a right eye image depending on the state of the switching shutter. The image sensor 808 can be a CCD or CMOS image sensor or other suitable sensor. The controller 708 controls the switching shutter so that it opens the left region and the right region alternatively. The controller 708 also controls the stereoscopic spectacle in some embodiments so that the left eyepiece and the right eyepiece are opened alternatively to view the left eye image and right eye image, respectively. In some embodiments, the excitation light blocking filter 804 can be implemented as separate optical elements that perform one or more of the functions of blocking NIR excitation light and passing visible and NIR fluorescent emission. One of ordinary skill in the art would recognize many variations, modifications, and alternatives.
Referring to
The adjacent left eye image and the right eye image form a pair of stereoscopic images. In the illustrated embodiment, the image sensor operates at a frame rate that is twice of that of the stereoscopic video. When the left eye image of both visible light and NIR fluorescent emission is displayed on the monitor, the controller controls the stereoscopic spectacles to open the left eyepiece. When the right eye image of both visible light and NIR fluorescent emission is displayed, the stereoscopic spectacle opens the right eyepiece. In this way, a stereoscopic view of the concurrent visible and NIR fluorescent image is displayed to a viewer wearing the stereoscopic spectacles.
The method also includes imaging the tissue using a stereoscopic camera having a single detector (1014), concurrently acquiring a left eye image at both visible and NIR wavelengths using the single detector (1016), and concurrently acquiring a right eye image at both visible and NIR wavelengths using the single detector (1018). As discussed herein, concurrently acquiring a left eye image and concurrently acquiring a right eye image can include concurrently imaging fluorescent emission from the tissue and visible light reflected from the tissue using the single detector. The method further includes displaying the left eye image and the right eye image consecutively on a display device (1020).
It should be appreciated that the specific steps illustrated in
It is also understood that the examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and scope of the appended claims.