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