Optical Confirmation of Nasogastric Tube Placement with Early Photon Imaging

通过早期光子成像光学确认鼻胃管放置

• 批准号: MR/W029979/1
• 负责人: Michael Tanner
• 金额: $ 166.34万
• 依托单位: Heriot-Watt University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW029979%2F1
• 关键词: Optical; Confirmation; Nasogastric; Tube; Placement

Placement of enteral feeding tubes (nasogastric tubes/NGTs) is a standard medical procedure, yet misplacement is a serious issue (e.g. food entering the lungs with consequent death and disability from pulmonary complications). Current practice relies heavily on ionising X-ray radiation to localise medical devices during procedures causing significant disruption given the need to protect staff as well as waiting for the availability of, or transport to, X-ray equipment. There are therefore significant clinical drivers to develop alternative placement confirmation methods. We have developed an optical technology (no X-rays) to augment and guide NGT placement using a compact bed-side system.We have demonstrated a ground-breaking approach to track and show correct NGT stomach placement (or misplacement in the lung) using single photon imaging. Our approach exploits the fact that if a point source of light is placed inside the body, a tiny fraction of the light will emerge from the body effectively in a straight line. Crucially, these line-of-sight photons (particles of light) hold precise information about the spatial location of the point source inside the tissue. We can utilise this information as the line-of-sight photons exit the body faster than the more diffuse photons that have been scattered along a longer path to exit the body - we are able to use a technique known as time-correlated single-photon counting (TCSPC) to detect and specifically observe and use the fast photons. In contrast to "normal" cameras, which do not record the arrival time of the photons, TCSPC-based imaging relies on using a light source that produces short pulses at precisely known times, together with a single-photon sensitive detector that records arrival times. Therefore, TCSPC imaging allows us to design an imaging system that can selectively detect and image the location of the line-of-sight photons before the diffuse scattered photons start to emerge, allowing us to precisely locate the source.Although we have initially demonstrated the potential of this technique to locate NGTs, we are increasing the detection speed to provide real time tracking using the newest detectors - similar to those in development for self-driving cars. We have also combined our technique with new optical fibres optics placed in the NGTs, which have light sources spaced along their length allowing observation of the full NGT path during placement or reconfirmation.We now intend to finalise the clinical prototype device and complete preclinical validation, including determining diagnostic accuracy. We will then move to evaluating feasibility and safety of the devices' ability to guide NGT placement in patients.Our goal is to reduce significant adverse events associated with NGT placement (and reconfirmation), make placement faster, enhance clinical workflows (removing need for x-rays), improve patient outcomes through initiating feeding/medication earlier and reduce overall costs.

肠内营养管（鼻胃管/NGT）的放置是一种标准的医疗程序，但错位是一个严重的问题（例如，食物进入肺部，导致肺部并发症导致死亡和残疾）。目前的做法在很大程度上依赖于电离X射线辐射，以在手术过程中定位医疗设备，这会造成严重的中断，因为需要保护工作人员以及等待X射线设备的可用性或运输。因此，存在开发替代放置确认方法的重要临床驱动因素。我们已经开发了一种光学技术（无X射线），使用紧凑的床边系统来增强和引导NGT放置。我们已经证明了一种突破性的方法，使用单光子成像来跟踪和显示正确的NGT胃放置（或在肺中的错位）。我们的方法利用了这样一个事实，即如果将一个点光源放置在体内，那么一小部分光将有效地以直线从体内射出。至关重要的是，这些视线光子（光的粒子）保存着关于组织内点源空间位置的精确信息。我们可以利用这一信息，因为视线光子离开身体的速度比沿着沿着更长的路径散射的散射光子更快-我们能够使用一种称为时间相关单光子计数（TCSPC）的技术来检测并专门观察和使用快速光子。与不记录光子到达时间的“普通”相机相比，基于TCSPC的成像依赖于使用在精确已知时间产生短脉冲的光源，以及记录到达时间的单光子敏感探测器。因此，TCSPC成像使我们能够设计一种成像系统，该系统可以在漫散射光子开始出现之前选择性地检测和成像视线光子的位置，从而使我们能够精确定位源。虽然我们最初已经证明了这种技术定位NGT的潜力，我们正在提高检测速度，以使用最新的检测器提供真实的时间跟踪-类似于为自动驾驶汽车开发的检测器。我们还将我们的技术与放置在NGT中的新光纤光学器件相结合，这些光纤光学器件具有沿着其长度间隔的光源，从而可以在放置或重新确认期间观察整个NGT路径。我们现在打算完成临床原型设备并完成临床前验证，包括确定诊断准确性。我们的目标是减少与NGT放置（和再确认）相关的重大不良事件，使放置更快，增强临床工作流程（消除对X射线的需求），通过更早开始喂养/药物治疗改善患者预后，并降低总体成本。

项目成果

Time resolved photon counting CMOS SPAD arrays for clinical imaging and spectroscopy

用于临床成像和光谱学的时间分辨光子计数 CMOS SPAD 阵列

• DOI: 10.1117/12.2657883
• 发表时间: 2023
• 作者: Tanner M