An Update on FF-OCT's Light CT from LLTECH

A few weeks ago, we showcased Paris based DAMAE MEDICAL, a two-years old startup preparing for the launch of a LC-OCT skin imaging system. I thought it would be fair to give an update on the progress of 7-year old LLTECH, also  a Paris based company offering imaging systems based on the very elegant FF-OCT optical method.

Lead by talented CEO Bertrand the Poly and world-class scientist and leader CSO Pr. Claude Boccara, the company has perfected the Light CT system over the past years into a "plug-and-play"imaging system that simplifies the sample/tissue handling and preparation process thanks to an innovative 'cassette' that holds the tissue ( for instance, directly in the surgical room) and plugs directly into the imaging system.

As a reminder, Full-field optical coherence tomography (FFOCT) offers a fast and non-destructive method of obtaining "en-face" images of biological tissues at high resolution (1μm in all 3 directions), approaching traditional histological sections.

The LLTECH team is gathering more and more clinical evidence as they build their value proposition as a stain-free digital pathology system.The product is available for sale as a research only use.

Most interestingly, a significant enhancement with "time-resolved" FF-OCT is in the works, allowing frequency-resolved imaging ! now... that is exciting as one of the weaknesses of all these OCT techniques is the lack of specificity for any given biological / cellular feature ( this is just like ultrasounds.... OCT "sees"structures"and optical-index discontinuities very well, but is poorly sensitive to chemistry".  The Method is called Dynamic FF-OCT or D-FFOCT and is another brain child of Pr. Boccara and PhD candidate Clement Apelian (read publications here). Below is an image of a cancerous skin tissue (mouse) where T-cells are tagged in red because of their specific frequency response. ( Tumor are in dark green and we can see all the T-cells around and in between the tumors, in movement in the extra-tumoral collagen matrix).

In the meantime, LLTECH is raising funds both in the US and Europe. LLTech is currently listed on PropelX www.propelx.com a US funding platform linked to the MIT making the investment easy.

French DAMAE MEDICAL prepares LC-OCT Skin System

Two-years old startup DAMAE MEDICAL (Paris,France) is already an award-winning young company. Under the leadership of a charismatic female CEO, Anais Barut (who proudly posts her pictures with former president Francois Hollande...), the company readies to launch an innovative LC-OCT hand-held skin inspection system, called OLIV.

To our desapointment, LC-OCT does not stand for Low Cost OCT! But we are really excited about the quality of the LC-OCT images produced as the optical method is strategically placed between scanning OCT and Confocal microscopy. Offering a X-Y, and Z resolution of ~1micron, even at 800 micron depth, the technique offers Z-slicing or virtual biopsie and can rebuild X-Y "en face" virtual biopsies.

Real-time imaging seems to be compatible with usual motion artifacts due to patient upper limb movement during exams, which is a good news.

Target markets include dermatology virtual-biopsy tissue/skin assesment for the triage (and hopefully soon diagnostic) of both melanoma and  carcinoma.The product is not approved by FDA , nor commercialized in the US, but the team is looking for clinical partners in the US to get on-board ( "Contact" on their webpage).

In the meantime, the usual "non-regulated" markets could be a nice way to start.We are thinking about Research only Use for Skin-condition drug development, cosmeceuticals (obviously) and Tissue / biopsy quality control.

So in short:very cool. Cannot wait to see the face of the current players when the product hits the US market. If anyone wnats to join me to invest in the company.... let me know.

Skin imaging: is it clinically useful?

Yes ! that is a great title for a very serous paper.  Skin imaging: is it clinically useful?

Kudos to Dr. Deepack Rallan of the Department of Dermatology at the St Helier's Hospital (South London, Surrey, UK) for asking the right question and providing a documented and good discussion in his paper published in the Journal of experimental dermatology ( Sept 2004). Granted..it is not a "recent" paper. But the discussion and fundamentals are still up to date. Let me quote the abstract below: ( online abstract and author contact details here)

Abstract

Non-invasive skin imaging techniques have proliferated over the last decade. Whilst most have a research role, some are routinely used in dermatology clinics. Of these, the skin surface microscope (dermatoscope), a diagnostic aid for pigmented lesions, has had most clinical impact. Such devices, when linked to a videomicroscope for computer analysis, have been dubbed as 'mole scanners'. Mole scanners are increasingly available on a commercial basis even though computer diagnosis of pigmented lesions is currently no better than diagnosis by human experts. Meanwhile, other imaging techniques, such as high-resolution ultrasonography, spectroscopy and optical coherence tomography, may yet find a role in diagnosis and disease monitoring.

Complexion Imaging: the 7th Generation

This is not like the "7th Generation" of the Star Wars Series. We are talking about the sophisticated  VISIA Complexion Analysis from CANFIELD, who are now in its 7th product iteration.

The renowned company is making a complicated and tricky process (believe it or not, a robust face and complexion image is very tricky to do) into a very user-friendly system.

Standardized images required a very sophisticated imaging methodology, which includes standardized lighting (yes... including polarization and frequencies !!!) and image capture parameters. This is particularly critical when post-imaging image analysis is part of the package. Otherwise...how is is the comparison relevant.

Some of the multiple image post-analysis features offered by the company are very nice, and are relevant in practice. Other are really borderline.... like the "eyelash" analysis. Seriously?? who is ready to pay for this.

Well, we really like the product.
Is this only for cute white caucasian ladies as featured on their website. I would suggest a more diverse view of the market and marketing positioning (or is the product not capable to work on dark or asian skins ?). Hmmmm ?

New Book: "Imaging in Dermatology"

"Imaging in Dermatology" edited by Drs Michael R.Hamblin, Pinar Avci and Gaurav K.Gupta (ISBN: 978-0-12-802838-4) is a 2016 ELSEVIER publication that all the readers of this blog should be aware of.
I just ordered the book on Amazon for $120, and I can't wait to ready it and perhaps interview the authors (stay tuned). Congrats to the all the contributing Authors, Editors and ELSEVIER for their interest and work on the topic.

The table of content is rich and comprehensive (see Preview on Google Books here): 

2. Role of Clinical Photography in Dermatology

3. Dermoscopy

4. Trichoscopy: the Dermatologist's Third Eye

5. Dermatoscopy Correlates of Nail Appartus Disease

6. Optical Coherence Tomography (OCT) for Skin Cancer and Actinic Keratosis

7. OCT of Skin Scarring and Fibrosis

8. Polarization Speckles and Skin Applications

9. New Developments in Fluorescence Diagnostics

10. Ex-vivo Fluorescence Microscopy: Clinical Applications

11. Coherent Raman Scattering Microscopy in Dermatological Imaging

12.  Rapid Real-time Raman Spectroscopy and Imaging-Guided Confocal Raman Spectroscopy

13. Surface-Enhanced Raman Spectroscopy for Intradermal Measurements

14. Broadband Coherent Anti-Stokes Raman Scattering

15. In-Vivo Reflectance Confocal Microscopy (in Dematology)

16. Hyperspectral and Multispectral Imaging in Dermatology

17. Diffuse Reflectance Spectroscopy and Imaging

18. Spectral Imaging  in Dermatology

19. Applications of MultiPhoton Microscopy in Dermatology

20. Non-linear Microscopy in Clinical Dermatology

21. Confocal Reflectance Microscopy and Polarized Light Imaging

22. Polarization optical Imaging of Skin Pathology and Ageing

23. Surface Acoustic Waves

24. Photoacoustic Tomography in the diagnosis of Melanoma

25. Ultrasound imaging in Dermatology

26. Optoacoustic Imaging of Skin

27. Total Body Photography and serial Digital Dermoscopy

28.  Functional MRI behind the processing of itch (note: "?? WTH?")

...

30. Thermal Imaging in Dermatology

...

34. Imaging in Merkel Cell Carcinoma

35. Imaging Evaluation of Cutaneous Lymphoma using Functional and Structural Imaging

36. Imaging Cutaneous Squamous Cell Carcinoma of the Head and Neck

37. Imaging Patterns of Metastatic Melanoma

38. From Image to information: image Processing in dermatology and Cutaneous Biology.

(Good luck to the Google search engine to index my blog!!  will this create more traffic?)

OKU : Personal Skin Coach : is it real?

OKU Claims to be the first iPhone enabled Personal Skin Coach, and is now taking pre-orders on line.

The idea of an iPhone connected imaging interface that addresses the major challenges of reproducible and quantified skin imaging is definitely attractive, and there is a market for that..

But OKU's technology platform remains a big mystery. For engineers, the "OKU Technology" tab on the company website is simply disappointing. Name dropping "dermoscopy", "nanotechnology" and "spectroscopy" just alone simply does not work for us. Indeed, the potential of such technologies can be fantastic.... please tell us more! Show us how it works ( a little movie maybe ?) ... this is how you will make a difference as skin imaging is not trivial.

Having said that, and despite the cute but disappointing "marketing packaging" of the entire website (and lack of real product pictures, images and data), there are several product features that are quite attractive, including the portable imaging device and its docking station (please convince me that this is not "just" a webcam) and the simple and effective design of the iPhone App.

So in short....taking pre-orders at $249.95 for a due-date of "late Spring 2015" is a very aggressive call, and will probably convince grand parents who want to make a graduation present to their high-school grand-daughter with chronic acne. 

Please let's be serious.... show us a real product, explain your technology, show us real data and pictures to be more convincing. there is a lot going on in this industry and we all expect more fro a incoming player.

Google alerts are active on "OKU". We shall see.

French Start up ANAPIX Tackles the Holy Grail

French Start-up ANAPIX is currently incubated by the Technology Accelerator and incubator or Mareilles and has ambitious plans to takle the Holi Grail: a iPhone enabled image capture system...coupled to cloud-based image analysis and calculators to offer Clinical Decision support to dermatologists for the Skin cancer.

This is a very ambitious project, will challenges all along the technology workflow... and the care and regulatory trajectories.  A dozen of dermatologists are piloting the system in France.

ANAPIX is current;y looking for partners to take the concept to the next steps. Please reach out to them via www.sattse.com

"SKINSPECTION" – Hybrid Imaging for Skin Diagnosis

The "SKINSPECTION" approach combines two-photon imaging with time-correlated single photon detection, autofluorescence lifetime imaging, high-frequency ultrasound and optoacoustic imaging. 

The innovative combination of these modalities allows to obtain a wide-field view with quantitative depth information of skin lesions and a close-look into particular intra-tissue compartments with quantitative hyperspectral information and subcellular resolution. The goal of the project is to provide a novel unique tool for early diagnosis and treatment control of skin cancer and skin disease. For achieving this objective, two systems for microscopic and macroscopic imaging of lesions were developed in the last 3 years by the partners JenLab GmbH and Imperial College London (two-photon microscopy/FLIM) and Fraunhofer IBMT (Fraunhofer Institute for Biomedical Engineering) and kibero GmbH (optoacoustic/ultrasound imaging). 

The systems were successfully certified for clinical studies and are currently being evaluated for imaging of skin lesions in a bicentric clinical trial at Hammersmith Hospital and Universita di Modena.

Check for the full research project description on the Europe FP7 webportal.

SCHOTT skin counseling system

(Launched Sept 9th 2013) 

SCHOTT skin counseling systems are used by international cosmetic manufacturers as marketing tools. The new i-Scope® Viewer for AndroidTM was developed to achieve a more handy counseling method using tablet computers. The product is now available on Google Play™ (!! Cool!)  in three languages: English, Japanese and Chinese.

i-Scope® Viewer for Android™ is the fitting software for i-Scope® USB 2.0. The program allows users to easily observe their skin conditions in detail: by moving the scope along their skin, shooting images and saving them, comparing two images in one screen or viewing multiple saved images simultaneously. i-Scope® USB 2.0 is a scope equipped with a 1.3 mega CMOS sensor that can be used to observe skin, scalp and hair conditions by connecting the USB cable to a computer. Five lens options are available. 

Features of i-Scope® USB 2.0 Android™ and specification of i-Scope® Viewer for Android™

•Connection: Wired (mini-USB cables sold separately)
•No additional setting necessary on tablet PC; easy connection 
•Stable view of moving pictures 
•Compatible devices: Versions after Android ver. 3.2 are USB host capable (except for some devices) 
•Can check skin conditions by shooting still images 
•Can display two images in one screen. Can check different parts of the skin 
•Can save displayed images 
•Can display multiple saved images 
•Available in English, Japanese and Chinese 

More on the Manufacturer's website here.

The clinical tomograph MPTflex™ is a novel skin imaging device

(This was announced April 2011... but we missed it...better late than never)

The clinical tomograph MPTflex™, which was developed by the German university spin-off Jenlab GmbH, is a novel skin imaging device that overcomes the poor resolution of skin imaging methods such as ultrasound, optical coherence tomography (OCT) and reflection. ( Note: Do not agree on the comment on OCT... see our blog on the LLTECH Full Field OCT system)

By using two-photon technology, the system's high-resolution skin imaging provides marker-free optical biopsies.

The tomograph is a compact system, with a flexible scan head that includes two detectors for simultaneous measurement of autofluorescence and the second-harmonic generation, used mainly for the early detection of melanoma and diagnostics of dermatological disorders. Providing a fast microscopic view into the skin without any surgery, single cancer cells, as well as elastin fibers and nanoparticles, can be imaged in vivo, and skin aging can be measured. The MPTflex™ tomograph is based on the two-photon effects predicted by the 1963 German-American Nobel Prize laureate Maria Goeppert-Mayer.

The MPTflex™ received the 2011 Prism Award for Photonics Innovation in January. Co-founded in 1999 by Prof. Dr. Karsten König, Jenlab’s primary goals are the development and the establishment of innovative bioinstrumentation based on Femtosecond Laser Technology for biotechnology, cell biology and medicine. More than 2,000 patients have already been investigated at clinics in Irvine, Brisbane, London, Modena, and Berlin. In the U.S., first clinical trials have been conducted at the University of California this year.

JenLab is translating the technology to markets. See the product brochure here and the product picture below. the Product is CE Marked.

How Skin Coloration arises

Sometimes it is good to recall the fundamentals: he skin consists of a number of layers with distinct function and distinct optical properties. 

White light shone onto the skin penetrates superficial skin layers and whilst some of it is absorbed, much is remitted back and can be registered by a camera.

The key to the interpretation of image colors in terms of the underlying histological parameters is a model of tissue coloration which provides a cross-reference between the colour and the histology. 

Here is a model discussed ( Weblink)

This model is constructed by computing the spectral composition of light remitted from the skin given parameters specifying its structure and optical properties. This step needs to be carried out only once. As the mapping between the colours and the parameters is unique for the skin, each colour corresponds to one specific set of histological parameters.

The model of normal skin coloration is representative of all the normal skins, irrespective of racial origin, age or gender. The structure remains the same, and the only differences are in the magnitudes of the parameters.

Abnormal skin coloration

The model above has been constructed for skin which has a normal structure. Skin coloration associated with abnormal conditions does not necessarily have to conform to this model.

Cool: BASF Skin Care Forum !

BASF hosts a blog on Skin Care, with articles that are well done, covering a wide spectrum of topics ranging from Skin, Air care to regulatory and Toxicology matters. 

Very well done, and we recommend a few specific recent articles:

"Geriatric Dermatology" , June 2014 by Christos Zouboulis

"Male Skin Care in the U.S. Markets", June 2014 by Zoe Draelos

"Trends in Home Care Devices," Feb 2014 by Imogen Matthews.

Now ... a search on "personalized" yields nothing... hummm perhaps we should team up there.

EMAGE Advanced Skin Imaging

The EMAGE Advanced Skin Imaging system is an Advanced, all-digital Triple Spectral Skin Analysis which allows Aesthetica Medical Spa estheticians to view and report our client’s pore and wrinkle depth, pigmentation, and vascularity, texture, porphyrin and sebum, and more, all with incredible accuracy.

Intense magnification using a 16-megapixel-imaging array reveals extensive detail, making recommendations for laser resurfacing, microdermabrasion, neurotoxins, fillers and cosmeceuticals simple and easy to explain.

With the EMAGE you can

• Examine targeted areas under intense magnification in normal, polarized, and UV light
• Create multiple, high-quality views of the face
• Map, measure and analyze fine lines, pigmentation, and vascularity
• Evaluate skin tone and texture
• Helps suggest comprehensive services/products available at Aesthetica Medical Spa and Laser Center
• Uncovers future problem areas
• Provides consistent, comparative analysis which helps Aesthetica estheticians and practitioners to track treatment effectiveness.

More on the manufacturer Website, including a Free Trial.

3Derm: Engineering undergrads win $100,000 prize for skin imaging device

A team of rising juniors at Yale beat out graduate and undergraduate students from around the country in a national competition to create novel technology for improved healthcare delivery.

Elizabeth Asai, Nick Demas and Elliot Swart won the prize for their development of an early melanoma detection device called a "Stereoscopic Plug-and-Play Dermatoscope and Web Interface." 

Their small, user-friendly, low-cost camera can be used by a doctor or patient to capture and upload 3D pictures to a web-based directory that dermatologists can access to remotely analyze and monitor the topography and volume changes of skin moles.

Next.. they create their company 3Derm:

3Derm combines breakthrough imaging hardware with secure cloud-based software to improve patient outcomes and reduce costs.

Congratulations!

Magic Ring Skin Analysis Test Machine

We are pleased to quote the recent article from "Future Ready Singapore" that showcases four Skincare Innovations for Asian women, including one specific image-based Skin Analysis tool: 

" Asian women boast a wide range of complexions and skin textures. Premium skincare brand SK-II invented the Magic Ring Skin Analysis Test Machine to provide tailor-made skincare counselling, leveraging US consumer product giant P&G’s extensive research into skin science. 

Invented in Japan, the device takes a high-resolution picture of the skin and then analyses skin conditions in areas such as texture, firmness, wrinkles, radiance and spots. 

Based on the results, the beauty advisor then suggests a personalised skincare treatment regime."

April 16th , 2014: Nice review on INSTYLES. See here

January 2013 : First Bloggers Workshop in Singapore. See Here.

DermaCompare: "designed to revolutionize the process of diagnosing melanoma" (...Really ?)

Out of Israel, DermaCompare, a market-centric spin off from Esmeral Medical, is promoting a Cloud-based sophisticated image processing technology fro skin imaging. The skin lesions detection software solution is designed to revolutionize the process of diagnosing  melanoma, the major cause of skin cancer related mortality. 

DermaCompare supports early stage diagnosis of skin cancer by providing constant monitoring of suspicious skin lesions using various  imaging methods, thereby significantly increasing the chances of treating the condition, as well as lowering the cost and complexity of treatment.


The product is not FDA approved and detailed information / case studies / performance of the system is not very accessible. We would love to know more ( leave a comment).

Their YouTube clip provides some fuzzy screen captures, some insights on the technology platform ( " we use aerial defense technology to save 420 million people from skin cancer") but does not discuss clinical efficacy nor business models. 

Wide-field Fluorescent and Darkfield Imaging on a cell-phone

UCLA researchers have developed a matchbox-sized attachment that converts a cell phone's camera into a fluorescent microscope. The device utilizes an inexpensive lens and battery-powered, light-emitting diodes to create a field of view some two orders of magnitude larger than previous cell-phone fluorescent microscopy technology.

It is more than five times smaller than previous cell phone microscopes.

By using side-illumination geometry, the device is also capable of dark-field microscopy on both fluorescent and non-fluorescent specimens, an illumination technique in which only light shown on a biological sample is captured, making it appear as if the sample is on a black background and enhancing the image. The side-illumination technique negates the need for more expensive thin-film interference filters typically used in fluorescent microscopy; an inexpensive plastic color filter can be used for this purpose.

Full publication here, with possible applications in Skin Imaging

$15 micro lens turns your smartphone into a microscope

The Micro Phone Lens, measuring just 1/4" in diameter, is designed to stick onto the lens of most cellphones (recommended 5 megapixel camera resolution), and easily capture images and videos ranging from 15X magnification up to 60X (using the phone's digital zoom feature). The design of the little lens is said to be a product of a "patent pending platinum catalyzed silicone technology" that yields an optical quality identical to that of glass, and yet is impervious to scratching and can be cleaned with soap and water. It self-adheres to the camera lens and can be installed or removed quickly and easily. Once the lens is on the phone, all you need to do is focus your image and click the shutter.

Imagine the possibilities when applied to skin imaging !

The Micro Phone Lens is currently in a crowdfunding phase on Kickstarter, and has gone well past its original goal of raising $5000. If you'd like to be one of the first to pick up one for your phone, a $15 pledge will secure your ability to soon take microscopic photos with your mobile.

Mobile Thermal Imaging is Coming

In our Industry Report published late August 2013, we discussed how mobile imaging was becoming more and more sophisticated. We discussed the emergence of iPad -based microscopes and also announced possible applications of IR-imaging iPads for Applied Skin Care.
The IR-Blue Thermal Imaging Smartphone affordable accessory is a good example of the technologies soon to be available.
The IR-Blue supports Bluetooth 2 and Bluetooth 4 BLE. It works with the iPhone 4S, 5, the New iPads and the 5th gen iPod Touch. It also works with Android 2.3 and newer devices with at least 480 x 800 resolution displays.

See KickStarter for a description of the venture.

Mobile Microscopy: CellScope and iPadScope

At the Fletcher Lab at the University of California, Berkeley, has designed equipment to turn the camera of a standard cell phone into a diagnostic-quality microscope with a magnification of 5x-60x. Cell-phone microscopy enables visualization of samples, followed by capture, organization, and transmission of images critical for diagnosis. This technology is applicable in a wide range of applications beyond diagnostic medicine. The team has developed a suite of devices to image everything from sub-micron bacteria to the surface of the eye.

See” Cell-phone Based Platform for Biomedical Device Development and Education Applications” where “we report the development of two attachments to a commercial cell phone that transform the phone's integrated lens and image sensor into a 350× microscope and visible-light spectrometer. The microscope is capable of transmission and polarized microscopy modes and is shown to have 1.5 micron resolution and a usable field-of-view of 150×150 microns^2 with no image processing, and approximately 350×350 microns^2 when post-processing is applied. “