This invention relates to object imaging. More particularly, this invention relates to reconstructing three-dimensional images from palpitations for medical purposes.
Palpation is a traditional diagnostic procedure in which physicians use their fingers to externally touch and feel body tissues. Palpation is used as part of a physical examination to determine the spatial coordinates of an anatomical landmark, assess tenderness through tissue deformation, and determine the size, shape, firmness and location of an abnormality in the body through the tactile sensing of elasticity modulus differences. Palpation can be used in finding tumors, arteries, moles, or other objects on the body.
Unfortunately, palpation is subjective inasmuch as the results may vary among physicians. The results depend on the physician's ability and experience, all of which make the results prone to error.
One system, described in U.S. Pat. No. 5,459,329 to Sinclair, uses a single light source, a deformable membrane having a reflective surface, and a camera. The object is pressed against the membrane to deform the membrane, the light source illuminates the reflective surface, and the light reflected from the surface is captured by the camera, processed, and used to identify the contours of the object. Sinclair does not disclose any algorithms for accurately rendering microscopic structures and arterial pressure pulses, nor is it capable of being packaged in a mobile, low-cost package.
In a first aspect of the invention, a system for reconstructing a three-dimensional image includes a deformable membrane that contours to a shape of at least a portion of an object, the deformable membrane having a reflective surface; a camera positioned to receive illumination reflected from the reflective surface; a light source for illuminating the reflective surface from multiple directions relative to a fixed position of the camera; and a processor for reconstructing a three-dimensional image of the shape from illumination reflected from the reflective surface.
In one embodiment, the system also includes a controller. The controller sequentially illuminates the reflective surface from the multiple directions and also causes the camera to sequentially take images of the shape from the illumination reflected from the reflective surface. In another embodiment, the light source includes a plurality of light-emitting diodes equally spaced from each other.
In a second aspect, a system for reconstructing a three-dimensional image includes a deformable membrane that contours to a shape of at least a portion of an object, the deformable membrane having a reflective surface; a camera positioned to receive illumination reflected from the reflective surface; a single-light source for illuminating the reflective surface; and a processor for reconstructing a three-dimensional image of the shape from illumination reflected from the reflective surface using a shape-from-shading algorithm. The shape-from-shading algorithm includes a brightness constraint, a smoothness constraint, an intensity gradient constraint, or any combination thereof.
In a third aspect, a system for reconstructing a three-dimensional image includes a deformable membrane that contours to a shape of at least a portion of an object, the deformable membrane having a reflective surface; a camera positioned to receive illumination reflected from the reflective surface; a single-light source for illuminating the reflective surface; and a processor for reconstructing a three-dimensional image of the shape from illumination reflected from the reflective surface using grayscale mapping.
In a fourth aspect, a system for reconstructing a three-dimensional image includes a deformable membrane that contours to a shape of at least a portion of an object, the deformable membrane having a reflective surface; a camera positioned to receive illumination reflected from the reflective surface; a light source for illuminating the reflective surface to produce reflected light onto the camera; and a processor for reconstructing a three-dimensional image of the shape from a video stream corresponding to illumination reflected from the reflective surface.
In a fifth aspect, a system for making medical diagnoses includes a computer-readable medium containing computer-executable instructions that when executed by a processor perform the method correlating one or more three-dimensional images of a body location with a stored medical diagnosis. In one embodiment, the system also comprises a library that maps differences between three-dimensional images of a body location to medical diagnoses.
A haptic sensor in accordance with embodiments of the invention is a low-cost device that enables the real-time visualization of the haptic sense of elastic modulus boundaries, which is essentially the tissue deformation caused by a specific force. The sensor captures images that describe the three-dimensional (3-D) position and movement of underlying tissue during the application of a known force, essentially what a physician feels through manual palpation.
The sensor and supporting software enable the visualization and documentation of the equivalent of 3-D tactile input from a known applied force. The sensor eliminates the subjective analysis of physical palpation examinations and gives more accurate and repeatable results, yet is less expensive to implement than MRI, ultrasound, or similar techniques.
Data processed from captured images is also a good means for documentation for patient records. This way, physicians are also able to objectively measure change over time by comparing past data. By incorporating image registration techniques, it is possible to accurately assess change over time. Physicians can also share extracted features of abnormalities together with captured images and data with other physicians for further research.
The haptic device is also able to be used to teach medical palpatory diagnosis. One such implementation is the Virtual Haptic Back (VHB), a virtual reality tool for teaching clinical palpatory diagnosis of the human back. Using embodiments of the invention, less experienced physicians or medical students are able to enhance their palpation perception by comparing their assessments with accurate quantitative assessments from the sensor.
The system can also be used for virtual palpation in tele-medicine and to develop applications such as remote diagnosis of medical conditions for use in rural locations.
The systems described herein have applications in palpating different body parts and improving diagnosis. The systems have applications including, but not limited to, the following areas:
In one embodiment, the controller and image processor 180 performs multiple functions: It sequentially turns the LEDs 141A-H ON and OFF such that only one of the LEDs 141A-H is ON at a time. It uses the digital pixels captured by the camera 170 to reconstruct a 3-D image of that portion of the object 110 pressing against the flexible membrane 120. While the LEDs 141A-H are sequentially turned ON and OFF, the lens 175 is held stationary relative to the reflective surface 120A.
In photometric stereo, multiple images are taken while holding the viewing direction constant. Since there is no change in imaging geometry, all picture elements (x,y) correspond to the same point in all images. The effect of changing light direction is to change the reflectance map. Therefore with multiple equations (a minimum of three), the following equations can be solved:
I1(x,y)=R1(p,q) Equation (1)
I2(x,y)=R2(p,q) Equation (2)
I3(x,y)=R3(p,q) Equation (3)
It will be appreciated that the processor 180 solves Equations 1-3 to reconstruct the 3-D image of that portion of the object 110 pressing against the membrane 120.
In diffuse reflections, Equations 1-3 can be written as I=KdN.L where Kd is the albedo. With more light sources, the reconstruction results are more accurate.
When implementing this method, two calibrations for a standard photometric stereo algorithm are performed. First, the camera 170 must be calibrated to obtain the scene irradiance from measured pixel values. Second, lighting directions and intensities must be known to uniquely determine the surface. With these two calibrations, surface orientations and albedos can be estimated uniquely from three images for Lambertian scenes.
In one experiment, the light direction calibration for the sensor 100 was performed for all the 8 light views, and the results were used to reconstruct a 3-D image of a slide 400, shown in
It will be appreciated that
In another aspect of the invention, the multiple light sources of
Shading plays an important role in human perception of shape. Shape from shading aims to recover shape from gradual variations of shading in one two-dimensional (2-D) image. This is generally a difficult problem to solve because it corresponds to a linear equation with three unknowns. In accordance with one embodiment, a unique solution to the linear equation is found by imposing certain constraints.
In solving shape from shading and representing 3-D data using gradients, since each surface point has two unknowns for the surface gradient, and each pixel provides only one gray value, the system is “under determined.” To overcome this limitation, embodiments of the invention impose any one or more of a brightness constraint, a smoothness constraint, and an intensity gradient constraint. These constraints make this reconstruction method less accurate, but much easier to construct, than the photometric stereo approach discussed in relation to
In operation, when an object is pressed against the flexible membrane 120 to deform the reflective surface 120A, the controller and image processor 180 controls the LED 145 to illuminate the reflective surface 120A. From the illumination reflected from the flexible membrane 120, the camera 170 captures a single 2-D image of the deformed flexible membrane 120. Using one or more of a brightness constraint, a smoothness constraint, and an intensity gradient constraint, the controller and image processor processes the captured 2-D image to reconstruct a 3-D image of the portion of the object pressing against the flexible membrane 120.
It will be appreciated that this example is used merely to illustrate the principles of the invention. After reading this disclosure, those skilled in the art will appreciate that changes can be made to the example in accordance with the principles of the invention. For example, constraints other than brightness, smoothness, and intensity gradient can be imposed to overcome the under determinedness of the 3-D image reconstruction algorithm.
In another aspect of the invention, an elastomer is measured for strain to determine the 3-D image of an object pressed against it.
In operation, an object of interest 110 is pressed externally against the membrane 121, which is illuminated as described above. This results in the 3-D deformation of the membrane 121 and the attached dyed elastomer 705 and finally in the grayscale image representing the 3-D depth map of the object 110 captured by the camera 170. Different parts of the object 110 are deformed at different depths from the face plate 710, proportional to the local applied force and inversely by the modulus of the object 110. This 3-D deformation of the optically attenuating elastomer 705 causes the illumination to pass through varying thicknesses and hence varying attenuations as seen by the camera 170. The smaller the distance the light has to travel through the elastomer 705, the lighter it appears. Therefore positions on the reflecting white membrane 121 which are deformed to be nearer to the face plate 710 appear lighter than positions farther away. This results in a function that maps membrane deformation heights at each pixel location to the grey-scale intensity value of the camera 170 at that location. The sensor 700 thus functions as a real-time 3-D surface digitizer.
The haptic sensor 700 is merely illustrative of one embodiment of the invention. In another embodiment, the dyed elastomer 705 is replaced by a liquid contained within the deformable membrane 121. In one embodiment, the light ring 145 is replaced by a different illumination source (e.g., source 141A-H) configured to produce sufficient light to impinge on (1) the isotropically dyed elastomer 705, (2) a liquid, or (3) a functionally similar element, to reflect off the membrane surface 121A, and back to the camera 170. After reading this disclosure, those skilled in the art will recognize other variations that can be made in accordance with the principles of the invention.
The embodiments of the invention are able to be implemented on a mobile device, such as a suitably configured mobile phone, thus allowing diagnosticians to carry a haptic sensor with them wherever they go.
In accordance with another aspect of the invention, a haptic sensor is able to generate 3-D images of arterial pulse pressure waveforms. Any of the haptic sensors discussed above are able to be used in accordance with this aspect, with the image reconstruction algorithm discussed below. As one example, a haptic sensor in accordance with this aspect includes a white deformable membrane, an isotropically dyed elastomer or liquid, a clear rigid faceplate, an illumination source, a camera, and a processor, such as the sensor 700. Unlike prior-art pressure sensor based methods, embodiments of the invention increase accuracy to the pixel level and are portable, non-invasive, and low-cost.
Arterial pulse pressure is considered a fundamental indicator for diagnosis of several cardiovascular diseases. An arterial pulse waveform can be acquired by palpation on different areas on the body such as a finger, a wrist, a foot, or a neck. Pulse palpation is also considered a diagnostic procedure used in Chinese medicine.
The waveform acquired by palpation is considered to offer more information than the single pulse waveform from an electrocardiogram (ECG). The ECG signal only reflects bio-electrical information of the body while a pulse palpation signal, especially at different locations along an artery, reveals diagnostic information not visible in ECG signals. Different kinds of pulse patterns are defined based on different criteria such as position, rhythm, shape, etc. From shape perspectives, all of the pulses can be defined according to the presence or absence of three types of waves, a P (Percussive or primary) wave, a T (tidal or secondary) wave, and a D (Dicrotic or triplex) wave.
The percussion, tidal, and dicrotic waves can be indicators of specific conditions. For example, they can indicate the decrease in compliance of small arteries and the elasticity of blood vessel walls. In addition to the shape of the pressure pulse features such as width and rate, the position of the pulse is also important. Measuring pulse propagation time along the artery is also important in measuring blood velocity.
Referring to
Next, in the step 1015, a baseline removal step is performed. Baseline drift is visible in raw data. This is due to applied pressure variations from human movement. Multiple schemes are available for advanced baseline removal procedures, however it was experimentally determined that simple time-domain high-pass filtering with a cut-off frequency of 0.5 Hz can perform reasonably well under slow movement conditions. This filtering will not remove sudden movements which are in the passband. Slower baseline variations such as those induced as a result of breathing movements are removed by the filter.
The baseline removal step 1015 is followed by parallel maximum variance projection 920 and Karhunen-Loeve (KL) transform 1025 steps. The output of the maximum variance projection step 920 is input to a Fast-Fourier Transform (FFT) 930 and a segmentation step 940. The output of the FFT 930 is input to a rate analysis step 935, which generates an output for a segmentation step 940. The output of the segmentation step 940 is input to a Gaussian Mixed Model (GMM) step 945, whose output is used to generate peak statistics 950, used to generate a 3-D image.
Equations 4-6 illustrate the mathematics behind one embodiment of the invention, and
In one embodiment, compressed image data at frame n is expressed by Vtc(m,n), where Vtc(m,n) represents a 128×96 matrix of grayscale pixel data. The output of the baseline removal block is then represented as a convolution:
where hHP(t) is the impulse response of the high-pass filter. Next, a one-dimensional (1-D) function of time x(t) is extracted from the 3-D XtBC(m,n) image data.
In the embodiment of
x(t)=w1T{tilde over (x)}BC(t) Equation (5)
where
{tilde over (x)}BC(t)
is a vector obtained by columnization of the matrix XtBC(m,n), and w1 is the first eigenvector of the covariance matrix
corresponding to the largest eigenvalue. Implied in this scheme is the modeling of video data as a stochastic process in time, where projecting the frames onto the first orthogonal basis image w1 obtained by the KL transform maximizes the variance of the output process x(t). Also implied is the treatment of variance as a measure of information.
While simpler approaches such as a simple summation over the image may be feasible in many instances, there are cases where these approaches will not provide sufficient precision. This occurs, for example, where an increased pressure on the membrane of the apparatus causes the liquid in the membrane to shift from one location to another, resulting in a near-zero net pixel brightness effect on the entire frame image. The KL approach in such cases ensures that the relevant data are captured appropriately by assigning negative weights to some of the pixels. The KL transform also emphasizes the image locations where most of the variation is happening, mostly discarding areas unaffected by the heartbeat pulses.
In this example, the heart rate is derived by first performing the FFT (step 1030) followed by a peak search in the interval 0.7 to 2 Hz, as shown by the graph 1200 in
The segment separation is performed by finding consecutive minimums separated by heartbeat period intervals (as derived from the FFT step 930), with a tolerance of 10%. The segments are next averaged and fitted to a set of Gaussian Mixed Models (step 1045) with multiple peaks, with each set representing one of the pulse models shown in
where
represents one heartbeat segment obtained by averaging over the individual segments obtained from x(t), Nm is the number of peaks in the mth pulse model, αk, μk, and σk are the optimization variables in the fitting process (step 945), and vm(t) is the error signal. In one embodiment, the fitting procedure is performed using the Nelder-Mead iterative method as shown by the graph 1400 in
It will be appreciated that the examples are merely illustrative. For example, the steps 1000 can be performed in different orders, some steps can be added, and other steps can be deleted. The peak search can be in an interval different from 0.7 to 2 Hz. The data collection rate can be more than or less than 60 fps. The downsampling can be to a different frame size.
In other embodiments, 3-D images are stored in a library and correlated with diagnoses.
As one example, a system takes a one 3-D image and makes a diagnosis corresponding to characteristics of the image, such as its location, size, and shape. A growth in the throat having a certain size and shape can correspond to a malignant tumor. In another embodiment, a 3-D images of an object (e.g., a growth) at a particular body location is compared to a library of previously captured 3-D images of objects at the same location. The system correlates differences between the images to make diagnoses. A patient's health can thus be tracked over time, such as by determining that a growth is growing larger, growing smaller, or spreading. Preferably, the system has a memory containing computer-executable instructions for performing the algorithms associated with these embodiments and a processor for executing these instructions.
In operation, a haptic sensor in accordance with embodiments of the invention is pressed against a portion of a patient's body. A 3-D image of the object is rendered, allowing physicians to make accurate, objective assessments of, among other things, tissue size, shape, and location.
While the examples shown above are directed to medical diagnoses, it will be appreciated that the invention is not limited in this way. Embodiments of the invention can be used in other fields.
It will be readily apparent to one skilled in the art that other modifications may be made to the embodiments without departing from the spirit and scope of the invention as defined by the appended claims.
This application claims priority under 35 U.S.C. §119(e) of the co-pending U.S. provisional patent application Ser. No. 61/577,622, filed Dec. 19, 2011, and titled “System for and Method of Quantifying On-Body Palpitation for Improved Medical Diagnosis,” which is hereby incorporated by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US12/70708 | 12/19/2012 | WO | 00 |
Number | Date | Country | |
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61577622 | Dec 2011 | US |