By Lee Mather
Recognizing that traumatic brain injuries need instant diagnosis followed by the proper treatment in a clinical setting, a research team at the Section on Analytical and Functional Biophotonics at the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the U.S. National Institutes of Health (Bethesda, MD; led by section chief Amir H. Gandjbakhche) has developed a near-infrared (NIR) device (patent pending) that can detect brain injuries such as hematomas quickly and at the point-of-care.1
Integrating high-resolution motion tracking, Jason Riley, Ph.D., lead author of the work, told BioOptics World that the idea for the NIR device stemmed from an idea that he had about how to handle motion artifact in functional brain imaging. In researching how to detect an inclusion of blood such as a hematoma on the spot, Riley also said that a more complete scan would be useful, as would the ability to remove the need for a contra-lateral signal (due to symmetric hematomas). This led to the motion artifact removal approach Riley was developing being translated into the idea of a moving device to delineate large-scale structural hematological events (hemorrhages), he said.
The NIR device, in its proof-of-concept stage, was a fiber-based device that used one LED source with one NIR wavelength and a dual separation detector array. In the future the team would like to employ three wavelengths in order to distinguish oxygenated hemoglobin, deoxygenated hemoglobin, and methemoglobin, enabling delineation of different types of bleeding to determine severity, said Riley. Its motion tracking will be done with technologies borrowed from laser mice. The final device will be handheld and battery-operated, with a potential data bridge to a PC for imaging. Finally, a simple green indicator light will signal when it detects a hematoma (see figure).
|The device depicted scanning over the head (inset), and with the presence of a hematoma in its field of view. Then, a green light on the device lights up to indicate existence of a hematoma. (Image courtesy of Tim Mzorek, Unit on Computer Support Services, Eunice Kennedy Shriver National Institute of Child Health and Human Development)|
The finished device’s primary use will be used for fast screening prior to using expensive imaging techniques, such as CT and MRI. But they are also examining the potential for the device to move from detection and triage to becoming the standard of care for hematoma detection/imaging, said Riley. Doing so would enable use in situations where CT and MRI are unavailable for the purposes of treating such injuries, such as remote locations, portable field hospitals (combat zones), and developing countries where budgets may not allow for more expensive technologies such as CT and MRI, he said.
Further, it has great potential as an objective measure to help with ‘gameside’ monitoring of head injuries in high school and college sports, where head traumas are common.
The most exciting part of this work is its multidisciplinary and translational aspect, said Ganjbakhche. The work is a good example of bringing technology from bench to bedside, involving contributions from neurologists at NINDS, a radiologist from the Center for Neuroscience and Regenerative Medicine, and engineers and computer specialists from NIBIB and CIT.
Along with Riley and Gandjbakhche, team members involved in the work are Franck Amyot, Tom Pohida, Randall Pursley, Yasaman Ardeshirpour, Jana M. Kainerstorfer, Laleh Najafizadeh, Victor Chernomordik, Paul Smith, James Smirniotopoulos, and Eric M. Wassermann.
1. J. Riley et al., Biomed. Opt. Exp., 3, 1, 75–85 (2012).