Background: Hyperspectral Imaging (HSI) has a strong potential to be established as a new contact-free measuring method in medicine. Hyperspectral cameras and data processing have to fulfill requirements concerning practicability and validity to be integrated in clinical routine processes. Methods: Calculating physiological parameters which are of significant clinical value from recorded remission spectra is a complex challenge. We present a data processing method for HSI remission spectra based on a five-layer model of perfused tissue that generates perfusion parameters for every layer and presents them as depth profiles. The modeling of the radiation transport and the solution of the inverse problem are based on familiar approximations, but use partially heuristic methods for efficiency and to fulfill practical clinical requirements. Results: The parameter determination process is consistent, as the measured spectrum is practically completely reproducible by the modeling sequence; in other words, the whole spectral information is transformed into model parameters which are easily accessible for physiological interpretation. The method is flexible enough to be applicable on a wide spectrum of skin and wounds. Examples of advanced procedures utilizing extended perfusion representation in clinical application areas (flap control, burn diagnosis) are presented.
The effects of concurrent optical and magnetic stimulation (COMS) therapy on wound-healing-related parameters, such as tissue oxygenation and water index, were analyzed by hyperspectral imaging: an exploratory case series. Background: Oedema and inadequate perfusion have been identified as key factors in delayed wound healing and have been linked to reduced mitochondrial respiration. Targeting mitochondrial dysfunction is a promising approach in the treatment of therapy refractory wounds. This sub-study aimed to investigate the effects of concurrent optical and magnetic stimulation (COMS) on oedema and perfusion through measuring tissue oxygenation and water index, using hyperspectral imaging. Patients and methods: In a multi-center, prospective, comparative clinical trial, eleven patients with chronic leg and foot ulcers were treated with COMS additively to Standard of Care (SOC). Hyperspectral images were collected during patient visits before and after treatment to assess short- and long-term hemodynamic and immunomodulatory effects through changes in tissue oxygenation and water index. Results: The average time for wound onset in the eleven patients analyzed was 183 days, with 64% of them being considered unresponsive to SOC. At week 12, the rate of near-complete and complete wound closure was 64% and 45%, respectively. COMS therapy with SOC resulted in an increased short-term tissue oxygenation over the 8-week treatment phase, with oxygen levels decreasing in-between patient visits. The study further found a decrease in tissue water content after the therapy, with a general accumulation of water levels in-between patient visits. This study’s long-term analysis was hindered by the lack of absolute values in hyperspectral imaging and the dynamic nature of patient parameters during visits, resulting in high interpatient and intervisit variability. Conclusions: This study showed that COMS therapy as an adjunct to SOC had a positive short-term effect on inflammation and tissue oxygenation in chronic wounds of various etiologies. These results further supported the body of evidence for safety and effectiveness of COMS therapy as a treatment option, especially for stagnant wounds that tended to stay in the inflammatory phase and required efficient phase transition towards healing.
Introduction. Hyperspectral Imaging (HSI) combined with an augmented model-based data processing enables the measurement of the depth-resolved perfusion of burn wounds. With this methods the fundamental problem of the wound dynamics (wound conversion or progression) in the first 4 days should be parametrically analysed and evaluated.
Introduction: Hyperspectral Imaging (HSI) combined with an augmented model-based data processing enables the measurement of the depth-resolved perfusion of burn wounds. With these methods, the fundamental problem of the wound dynamics (wound conversion or progression) in the first 4 days should be parametrically analyzed and evaluated. Material and Methods: From a cohort of 59 patients with burn injuries requiring medical intervention, 281 homogenous wound segments were selected and subjected to clinical classification based on the duration of healing. The classification was retrospectively assigned to each segment during the period from day 0 to day 2 post-burn. The perfusion parameters were presented in two parameter spaces describing the upper and deeper perfusion. Results: The investigation of value distributions within the parameter spaces pertaining to four distinct categories of damage from superficial dermal to full-thickness burns during the initial four days reveals the inherent variability and distinct patterns associated with wound progression, depending on the severity of damage. The analysis highlights the challenges associated with estimating the burn degrees during this early stage and elucidates the significance of deeper tissue perfusion in the classification process, which cannot be discerned through visual inspections. Conclusions: The feasibility of early classification on day 0 or 1 was assessed, and the findings indicate a restricted level of reliability, particularly on day 0, primarily due to the substantial variability observed in wound characteristics and inherent dynamics.