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MICHELSON DIAGNOSTICS
OCT FOR SKIN IMAGING
D. Woods
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Introduction
• Michelson Diagnostics Ltd
• Established 2006
• ~15 FT employees in UK, USA and German subsidiaries
• Clinical research collaborations in Germany, UK, USA, Denmark,
Australia, Switzerland, Italy.
• Level 1 Clinical Evidence for NMSC identification
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Michelson Diagnostics
• 2006 aim:
“To develop MultiBeam OCT technology into a viable medical
imaging tool”
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Optical coherence tomography OCT
• OCT non-invasively captures tomographic images
“OPTICAL ULTRASOUND”
y
x
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Optical Coherence Tomography
1991
2002
2010
1st generation
Ophthalmology
Cardiology
Fourier-domain OCT
2nd generation
1996
Time-domain OCT
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Dermatology
Fourier-domain
focussing
Michelson Diagnostics
trade-off
MultiBeam OCT
• MultiBeam OCT gives
• Large depth-of-focus gives poor
• Lateral resolution which is
resolution.
spatially invariant and > 2x better
• Great
resolution
gives
limited
depththan
traditional
single
beam
OCT
of-focus
• Better contrast uniformity lower
speckle noise and better
penetration in skin.
Tomlins, P H, Ferguson, R A, Hart, C, Woolliams, P D
“Point-spread function phantoms for optical coherence tomography,”
OP 2, August 2009; ISSN: 1754-2944
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VivoSight Topical OCT
• Low-power eye-safe 1300 nm laser
• Patented MultiBeam probe for increased
performance
• < 7.5 µm lateral resolution
• < 5.5 µm axial resolution
• Up to 2 mm depth penetration
• 2D or 3D – 6 x 6 x 2 mm
• Real time
• Non-invasive
• Non-ionising
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Healthy glabrous skin
2 mm
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Pathology? Basal Cell Carcinoma
Image: Dan Siegel
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Application #1
• Avoid biopsy
• Excellent correlation of diagnostic features in OCT and histology 1,2
• 7-center trial publication summer 2014
enabled
a statistically significant
250"VivoSight
patientsOCT
with
clinically
improvement
in the for
specificity
andscanned
Negative Predictive Value
suspicious lesions
BCC were
(NPV) of BCC diagnosis
over both clinical and dermoscopy in
™
VivoSight
OCT diagnosis
this cohort
of challenging
pink compared
patches. Sowith
many biopsies can
standard unnecessary,
clinical diagnosis
and OCT, patients can
be rendered
withwith
VivoSight
without dermoscopy
instead be treated non-invasively."
Results verified by biopsy and
histological analysis
Dr. med. Martina Ulrich, Berlin, Germany
http://www.vivosight.com/clinical-dermatology/
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Superficial BCC
http://www.vivosightatlas.com/
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Mohs surgery
•
•
•
•
Time consuming
Expensive
Accurate – great cosmetic results
Low recurrence
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Mohs mapping
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Mohs mapping
• “Breadslice” sampling creates a flythrough
• Reconstruction of multiple views
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Mohs mapping
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Mohs Mapping
• Typically adds just 5 minutes to a procedure
• Lowers residual tumour requirement for second slice (by 0.8
slices in USA)
• Time- and cost-saving
Hurdles remaining
• Specific training
• Clinical studies
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VivoSight
The VivoSight OCT imaging system has
been developed with the support of
clinicians. It is compliant with European
CE mark directives and has FDA 510(k)
clearance for use in the USA.
For more information please contact:
Daniel Woods
Michelson Diagnostics
Tel. +44 208 144 9836
Email: [email protected]
For clinical use in the US FDA 510(k) K093520 applies:
VivoSight is a Multi-Beam Optical Coherence Tomography (OCT) system indicated for use in the two-dimensional, cross-sectional,
real-time imaging of external tissues of the human body. This indicated use allows imaging of tissue microstructure, including skin, to
aid trained and competent clinicians in their assessment of a patient's clinical conditions.
US Federal law restricts this device to sale by or on the order of a physician.
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Key papers
Banzhaf, C. & Jemec, G. B. (2012) "Imaging granulomatous lesions with optical coherence tomography" Case Rep Dermatol, 4(1), pp. 14-18.
Coleman, A. J., et al. (2013) "Histological correlates of optical coherence tomography in non-melanoma skin cancer" Skin Res Technol, 19(1), pp. e10-19.
Schmitz, l., et al. (2013) "Optical coherence tomography: its role in daily dermatological practice" German Society of Dermatology.
Wang, K. X., et al. (2013) "Optical Coherence Tomography-Based Optimization of Mohs Micrographic Surgery of Basal Cell Carcinoma: A Pilot Study" Dermatol
Surg.
Selected Other Papers
Arielle Kauvar, et al. (2013) In American Academy of Dermatology "Study of a Novel Non-invasive Topical Under-eye Contouring Technology," Miami
Donnelly, R. F., et al. (2011) "Design, optimization and characterisation of polymeric microneedle arrays prepared by a novel laser-based micromoulding
technique" Pharm Res,
Chan, C. & Rohrer, T. (2012) "Optical Coherence Tomography and Its Role in Mohs Micrographic Surgery: A Case Report" Case reports in dermatology.
Pomerantz, R., et al. (2011) "Optical Coherence Tomography Used as a Modality to Delineate Basal Cell Carcinoma prior to Mohs Micrographic Surgery" Case
Rep Dermatol, 3(3), pp. 212-218.
Seyed Arash Alawi, et al. (2013) "Optical coherence tomography for presurgical margin assessment of non-melanoma skin cancer – a practical approach" John
Wiley & S
Clark, C., et al. (2013) "Confirmation of Squamous Cell Carcinoma Clearance using Optical Coherence Tomography Imaging".
Pelosini, L., et al. (2013) "In vivo optical coherence tomography (OCT) in periocular basal cell carcinoma: correlations between in vivo OCT images and
postoperative histology" Br J Ophthalmol, 97(7), pp. 890-894.
Schmitz, L., et al. (2013) "Optical Coherence Tomography Imaging of Erythroplasia of Queyrat and Treatment with Imiquimod 5% Cream: A case report" Karger.
Themstrup, L., et al. (2012) "Cryosurgery Treatment of Actinic Keratoses Monitored by Optical Coherence Tomography: A Pilot Study" Dermatology.
Messer, D. (2013) "Revolutionary changes in the treatment of onychomycosis; laser-Foot PinPointe ".
Messer, G., et al. (2013) "Die Revolutionierung der Behondlung der Onychomykose".
Aydin, S. Z., et al. (2011) "Optical coherence tomography: a new tool to assess nail disease in psoriasis?" Dermatology, 222(4), pp. 311-313.
PSA NailAydin,
S. Z., et al. (2013) "Potential Use of Optical Coherence Tomography and High-Frequency Ultrasound for the Assessment of Nail Disease in Psoriasis and
Psoriatic Arthritis" Dermatology.
Abignano, G., Aydin, S. Z., Castillo-gallego, C., Liakouli, V., Woods, D., Meekings, A., et al. 2013. Virtual skin biopsy by optical coherence tomography: the first
quantitative imaging biomarker for scleroderma. Ann Rheum Dis.
Buckland, J. (2013) "Imaging technology acts as a ‘virtual skin biopsy’ in SSc" Nature Reviews Rheumatology.
Babalola, O., et al. (2013) "Optical coherence tomography (OCT) of collagen in normal skin and skin fibrosis" Arch Dermatol Res.
Banzhaf, C. A., et al. (2013) "In vivo Imaging of Sarcoptes scabiei Infestation Using Optical Coherence Tomography" Case Rep Dermatol, 5(2), pp. 156-162.
Ring, H. C., et al. (2013) "Optical coherence tomography imaging of telangiectasias during intense pulsed light treatment: a potential tool for rapid outcome
assessment" Arch Dermatol Res.
Welzel, J. (2013) In AADO "OCT for monitoring and quantification of treatment effects," Miami.
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