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.

"Integrated skin cancer sequential monitoring & telemedicine solutions"

"Integrated skin cancer sequential monitoring & telemedicine solutions". 

Well... that was enough to tease our interest when our Google Alerts bubbled this one up.

But there is nothing behind the cool pictures of the webpage.


Boooooooo !

At least.. we agree on the vision.

(Experience it by yourself here)

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.

Vivascan, by Caliber I.D.

VivaScan is a safe, painless and simple in-office procedure that provides cellular images to enable your doctor to make a diagnosis and decide on treatment. 

With harmless laser light, VivaScan produces clear images of your skin cells that reveal a level of detail that, until now, was only possible with a traditional invasive biopsy. 

Because VivaScan does not damage the skin the way a biopsy does, it can take repeat images of the same area over time. With pain-free skin imaging, precise image quality, and fast results, VivaScan gives you a new level of comfort and confidence when caring for your skin.

The VivaScan® software makes it easy to schedule patients for examinations, perform imaging examinations on one or more lesions during a visit, review, and report on images obtained during an examination. VivaScan® operates each device in the VivaScope® product line. It is used on stand-alone devices, on VivaScope® imaging and reading systems connected by intranet within the same facility, and on systems at different facilities connected by way of the VivaNet® digital telepathology network.

The VivaScan® software is designed to accommodate a wide variety of customer needs, from a solo practitioner to an imaging group with several VivaScope® systems and access to more than one dermatopathologist.

CALIBER I.D. presents a full product line for Skin Imaging / Vivascope systems:

VivaScope® systems offer clinicians and researchers in the fields of medicine and product development the possibility of a real- time, noninvasive optical biopsy of the skin.

VivaScope® 1500 and VivaScope® 3000 systems are FDA 510(k) cleared and have become an integral part of many dermatology clinics and medical institutions for the diagnosis of skin cancers and diseases, and for the evaluation of wound-healing processes and treatment outcomes.

VivaScope® 1500 Multilaser systems are well suited for a wide variety of product development applications for skin care, and have been used by scientists world-wide for the evaluation of cosmeceuticals and pharmaceuticals for more than a decade.

Benefits of VivaScope® Systems:

•Quasi-histologic, cellular imaging comparable to histopathology

•Noninvasive, repeatable imaging; no tissue damage

•Skin tumor diagnosis with high sensitivity and specificity

•Real-time visualization of blood flow and inflammatory processes

•Therapeutic monitoring of the same area of skin over time

•Quantitative data for skin layer thickness and cell sizes

•FDA 510(k) cleared medical imaging technology

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.

The Focus Camera from EXO Labs: Made for iPad

EXO Labs launches a ruggedized microscope Camera that leverages the iPad platform ( with a "free" App) as a control system and image management tool, targeting the K-12 & Higher Education and Lab needs. This $496 Digital Camera (and App)  is a plug and play accessory to any microscope and iPad device. We think this is highly priced (when compared to an iPad or School Microscope), but that is probably going to go down with adoption and volume.


There is a very little technology gap to bridge and expand to Skin or Wound Imaging, and that is why we wanted to quote this system on our Blog.

In any case.. very cool. Congrats to EXO Labs !!

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. 

Announcing the 2014 and Third Edition of The International Dermatology Institute (IDI) Technology Forum on June 10th 2014

DermaNest, and TRI/Princeton jointly announce the 2014 and Third Edition of the  International Dermatology Institute Technical Forum on Tuesday June 10^th 2014, 3 – 6 pm, on the TRI/Princeton Campus

The Technical Forums at the International Dermatology Institute offer Technology-based companies an unique opportunity to showcase their latest solution to a selected panel of industry leaders seeking for new technologies in the field (e.g. R&D Department leaders, Product Portfolio Managers, Innovation scouts of large international companies)

Participants will have the opportunity to present their solutions (45 mins presentation and product demonstration) during a highly interactive and intimate format. The three-hour event will only be offered to a limited number of companies and followed by a networking reception and product demonstration. Company representatives will have the opportunity of making quality contact with companies such as P&G , Johnson and Johnson, Ashland, Colgate…

The International Dermatology Institute (IDI) offers dermatology focused start-up companies from around the world the opportunity to effectively advance their business, especially in the US.   By leveraging the services of DermaNest and the TRI Center for Skin Science and Applied Dermatology, small companies can locate themselves within and receive services from IDI on the Princeton, NJ based TRI Campus. The Princeton area is the heart of the largest pharmaceutical, biotech, drug discovery and life-sciences ecosystem in the world, and also includes the headquarters and laboratories of many world class skin care, cosmeticeutical and wound-care companies.

TRI and DermaNest share the common mission of aiding organizations in the development of personalized dermatology and cosmetics by providing technical solutions that include predictive diagnostics, imaging devices and therapeutic methods for the advanced dermatological, cosmetic, and wound care markets. To learn more about the IDI Model, please visit TRI’s website.

TRI Princeton is a non-profit research Institute dedicated to Research, Education and Service in advanced industries for more than 80 years and is a recognized authority in cosmetic science.  TRI provides technical innovation, research and claim support to the cosmetic and dermatology industries in addition to hosting various educational forums for professional scientists, including annual international conferences.  TRI’s Center for Skin Science and Advanced Dermatology specializes in the study of skin’s structure, behavior and variability with the goal of a more personalized approach to skin protection and repair based on genetic predisposition and variations occurring from age, disease and environmental impact. 

DermaNest develops the business of International Personalized Cosmetics and Skin-Care Solutions and Services for the US Markets. Personalized Solutions include Predictive Diagnostics, Therapies and Companion Diagnostics, for the Cosmetic, Cosmeceuticals and Wound Care markets. DermaNest's business model and highly experienced team empower early stage companies to play in high growth market segments, at a fraction of the cost of alternative solutions.