![Optical fiber sensors for medical applications
Research activities at University of Limerick
[Jiliang University, 10 Dec 2013]
Daniele Tosi
daniele.tosi@ul.ie
dan82ddt
www.ofsrc.ul.ie](https://image.slidesharecdn.com/dtosimedicalsensors-140224134253-phpapp01/85/Daniele-Tosi-OFSRC-presentation-at-Jiliang-University-1-320.jpg)
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University of Limerick
Optical Fibre Sensors Research Centre
[Marie Curie Fellow @ OFSRC]
Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Daniele Tosi - OFSRC presentation at Jiliang University
- 1. Optical fiber sensors for medical applications Research activities at University of Limerick [Jiliang University, 10 Dec 2013] Daniele Tosi daniele.tosi@ul.ie dan82ddt www.ofsrc.ul.ie
- 2. About University of Limerick Optical Fibre Sensors Research Centre [Marie Curie Fellow @ OFSRC] Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 3. Partnerships Cleveland Clinic EFPI cardiovascular/demo Johns Hopkins Robotic surgery UL, OFSRC Pointec (licensing) Harbin Inst. Technol. Cyprus IT (EFPI partner) Staff exchange partnership Partners Italy Politecnico di Torino (FBG) Federico II Napoli (urodynamic) Universita’ di Pavia (RFA) Politecnico di Milano (RFA) LunaTEC Shenzhen Custom catheters supplier Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 4. Outline ➡ Optical fiber sensors: properties and technology ‣EFPI - pressure, temperature, refractive index ‣Fiber Bragg grating (FBG), DTG, LPG ‣Sensor integration and interrogation ‣Catheterization ➡ Emerging applications in medical/biomedical ‣Cardiovascular, FFR, IABP ‣Urodynamics ‣Monitoring of radiofrequency thermal ablation ‣Robotic surgery tools ➡ Conclusions Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 5. OFS properties Top-notch Performance Miniature size Distribution and Integration Immunity ➡ Excellent sensitivity to press., temp., strain ➡ <1με, 0.01˚C, <10Pa resolution ➡ Cross-sensitivity abating/compensation ➡ Miniature size (∅125μm, ∅40μm custom) ➡ Lightweight, non-invasive, embeddable ➡ Versatile fiber coating and catheterization ➡ Punctual sensors ➡ Multiplexed, switched, quasi-distributed ➡ Integration (lab in a fiber) ➡ Immune to EMI, radiation, MRI ➡ Fire-safe, passive device ➡ No interference with existing equipment Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 6. EFPI EFPI: Fiber-optic Fabry-Perot interferometric sensor based on all-silica glass structure: (1) launch fiber, (2) diaphragm, (3) capillary Capillary (optional FBG) AIR-GAP Launch SM fiber Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick Diaphragm MM fiber
- 7. UL EFPI (pre-etch) Air-gap length L FP Spectrum ~ S0 + k cos[4πL/λ] L = 20.6μm Single-mode fiber phragm Dia ir-gap A L d Capillary Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 8. UL EFPI (pre-etch) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 9. UL EFPI (pre-etch) Air-gap length L = L0 - Sp ΔP FP Spectrum ~ S0 + k cos[4π(L - Sp ΔP)/λ] Temperature: L = L0 - Sp ΔP + ST ΔT FBG L0 - Sp ΔP Pressure Sp = 1.60 nm/kPa L Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 10. Commercial EFPI EFPI head: 200µm Encapsulation: 500µm Input fiber: 125µm Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 11. Commercial EFPI Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 12. Pressure detection RMSE = 2.29 mmH2O RMSE = 1.30 mmH2O Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 13. Pressure detection RMSE = 2.29 mmH2O RMSE = 2.29 mmH2O = = 0.21 mmHg RMSE = 1.30 mmH2O Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 14. Improved detection D. Tosi, S. Poeggel. G. Leen, E. Lewis, “Adaptive filter-based interrogation of high-sensitivity fiber optic Fabry-Perot interferometry sensors,” Sensors and Actuators A: Physical, in press Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 15. Fiber Bragg grating (FBG) FBG = fiber optic filter FBG cascade ⬌ Multiplexing Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 16. Fiber Bragg grating (FBG) •Information encoded in FBG optical spectrum •Linear dependance on strain and temperature •Top performance sensor •Easy interrogation Reflected Bragg wavelength shifts linearly with variation of tensile strain and temperature Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 17. Fiber Bragg grating (FBG) Strain + temperature encoded in the sensing element Strain: can be converted into force, by package Temperature: for sensing, and compensation Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 18. Draw-tower grating IOS hypertermia sensor: 5 FBG in 3 cm Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 19. Long period grating (LPG) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 20. EFPI/FBG Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 21. EFPI/FBG Δλ(ΔT, ΔP) ΔL(ΔT,ΔP) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 22. Cross-sensitivity Detuning: 0.03 kPa/°C -96% glass -99.6% mould Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 23. White light setup Courtesy of Politecnico di Torino . . . . . . ... ... ... Switch SLED FBGA Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick . . .
- 24. White light setup Courtesy of Politecnico di Torino . . . FBGA . . . FBG matrix ... ... . . . ... SLED Switch SLED FBGA Switch Circulator Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 25. Coherent light setup Courtesy of Politecnico di Torino . . . . . . FBG matrix ... ... . . . ... Switch Laser controller Photodiode Laser array Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 26. Circulator Coherent light Switch setup Courtesy of Politecnico di Torino . . . Laser FBG matrix ... ... TEC . Photodiode . . . . . ... Switch Laser controller Photodiode Laser array Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 27. Interrogation White light Coherent light Encoding Wavelength Amplitude Resolution 1 pm (150 pm) << 1 pm Throughput 1-100 Hz total >kHz/channel Switching 1/N * W 1/(N*W) # Sensors 2-50/channel <10 Cost (box) $12k $2.5k Stability Excellent Low Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 28. Further integration ➡ Lab in a fiber ‣Integration of several sensing units in a single fiber ‣FBG (array), LPG, EFPI + bio/chemical (SPR) ➡ Quasi-distributed ‣Dense monitoring of parameters, localized ‣Bundle of EFPI, array of FBG, combination EFPI/FPI ➡ Cross-compensation ‣Sensing parameter + temperature + ref. index ‣Compensation matrix, detuning Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 29. Pigtail catheter Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 30. Pigtail catheter Contrast liquid 4F 2x probes (distal) French(F) = 1/3mm Excess bending Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 31. Foley catheter Urology catheter, bi-sex Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 32. Foley catheter Seal: epoxy or medical tape 1cm FO Infusion + uroflowmetry 4F Side holes allow infusion Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 33. Needle/trocar Radiofrequency ablation needle Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 34. Needle/trocar (1) Insert FO probe/bundle, retracted (2) Expand/block into position (optional: cut needle arms to desired length) (3) Push and project fibers Trocar provides blockage Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 35. Cardiovascular Top-notch Performance Miniature size Distribution and Integration Immunity ➡ Excellent sensitivity to press., temp., strain ➡ ➡ ➡ ➡ ➡ ➡ ➡ ➡ Miniature size (∅125μm, ∅40μm custom) Lightweight, non-invasive, embeddable Versatile fiber coating and catheterization Punctual sensors Multiplexed, switched, quasi-distributed ➡ Immune to EMI, radiation, MRI ➡ ➡ No interference with existing equipment Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 36. Cardiovascular ➡ Blood pressure monitoring ‣Localized: allows localizing the phenomena without damping, spatial averaging, fluid transfer (walls) ‣Multi-sensor: 2x sensors for obstructions (FFR) ‣Requires high speed: 100 Hz hardware to detect pulse ‣Used in the study of vasodilators/vasoconstrictors, localize the pressure effect (pilot project) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 37. Fractional Flow Reserve Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 38. Fractional Flow Reserve 2x optical fiber pressure sensors allow direct detection of FFR, preand post-sthenosis Problems in long-term: - Drift: >5 mmHg/hr - Temperature compensation - Amplitude drifts Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 39. Intra-aortic balloon (IAB) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 40. Fiber-optic IAB Pressure detection FO selling points: - better stability to patients movements - better reproduction of pulse peak Fiber-optic cable Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 41. Setup phantom Heart simulator Spectrometer ASE source EFP I sp ectr Heart pumping Fiber inlet Pres sure um mea s. Sensor positioning (short access) Interrogator/processing Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 42. Cardio phantom Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 43. Stability (1 hr) 65 EFPI Fluidic 0.63 mmHg Pressure (mmHg) 64.5 64 63.5 63 2.76 mmHg 62.5 0 10 20 30 40 50 60 Time (min) Typical FO drift ~ 5 mmHg/hr. St. Jude drift: 4mmHg/10min Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 44. Ventricular assist Demonstration at Cleveland Clinic, Mar 2013 FPI positioning Ventricular assist Reference (fluidic) Pressure readout Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 45. Ventricular assist Demonstration at Cleveland Clinic, Mar 2013 Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 46. Urodynamic Top-notch Performance Miniature size Distribution and Integration Immunity ➡ ➡ ➡ ➡ ➡ ➡ ➡ ➡ ➡ Miniature size (∅125μm, ∅40μm custom) Lightweight, non-invasive, embeddable Versatile fiber coating and catheterization Punctual sensors Multiplexed, switched, quasi-distributed ➡ ➡ ➡ No interference with existing equipment Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 47. Urodynamic “Standard” invasive urodynamics: Mid-term (20-40 minutes) monitoring of the detrusor muscle pressure and flowmetry during a urology analysis that consists of infusion and voiding of the bladder Why fiber-optic: - FO sensors have a better responsivity and lower damping than air-charged catheter - It is possible to fit multiple fibers in the bladder: change the way bladder obstructions are diagnosed Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 48. Urodynamic Diagnostic based on nomogram: detrusor pressure vs uroflowmetry ➡ Direct detection of bladder outlet obstruction (BOO) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 49. In-vivo measurement Feasibility test with Federico II University, Naples. Infusion (375ml) Urination EFPI Pico2000 Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 50. In-vivo measurement Feasibility test with Federico II University, Naples. Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 51. In-vivo measurement Feasibility test with Federico II University, Naples. Urination Cough Stimulus Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 52. Direct BOO (proposal) Differential pressure measurement Bladder outlet obstruction (BOO) diagnostic Interrogator Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 53. RF ablation of tumors Top-notch Performance Miniature size Distribution and Integration Immunity ➡ ➡ ➡ Cross-sensitivity abating/compensation ➡ ➡ ➡ ➡ ➡ ➡ Miniature size (∅125μm, ∅40μm custom) Lightweight, non-invasive, embeddable Versatile fiber coating and catheterization Multiplexed, switched, quasi-distributed Integration (lab in a fiber) ➡ Immune to EMI, radiation, MRI ➡ Fire-safe, passive device ➡ No interference with existing equipment Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 54. RFA description Radiofrequency thermal ablation (RFA): Achieving the complete ablation of a cancerous tumor by burning the tumor + surrounding by means of Joule effect. In RFA the heat field is generated through 5-50W RF Needle, 1mm diameter Ablation, ~15min/cm Tumor, up to 5cm size RF field Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 55. RFA in liver Liver tissue sets a specific problem: ebullience releases the watery part of cells, which conduct more than liver - the RF circuit is disconnected after 2-9 minutes ➡ Not possible for RFA to remove mid/large tumors, over 2 cm in diameter ➡ RFA is performed at ~60˚C rather than >100˚C. Cells mortality not guaranteed ➡ Need to resort to microwave ablation (MWA) ➡ Biocompatible gels can isolate needle from ebullient cells Numbers: 764k deceases (#3) Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 56. Heat distribution IR thermal camera - imaging Is the model confirmed by localized sensors? Is it possible to increase RFA efficiency/duration? Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 57. Heat distribution IR thermal camera - imaging Is the model confirmed by localized sensors? Is it possible to increase RFA efficiency/duration? Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 58. Ex-vivo - setup Experiments with Universita’ di Pavia, San Matteo Hospital, Politecnico di Milano Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 59. Ex-vivo experiments Experiments with Universita’ di Pavia, San Matteo Hospital, Politecnico di Milano 8mm Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 60. Ex-vivo experiments Experiments with Universita’ di Pavia, San Matteo Hospital, Politecnico di Milano 5mm Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 61. Ex-vivo experiments Experiments with Universita’ di Pavia, San Matteo Hospital, Politecnico di Milano 1mm Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 62. Preliminary conclusions The preliminary results obtained with EFPI/FBG do not match the physical model, nor the thermal camera imaging. We observe during ablation a higher temperature, and higher pressure than expected (105˚C and 80 kPa). Denser monitoring is needed to have a full reproduction of the physical phenomena. Is it possible to increase the RFA efficiency, by online monitoring of pressure/temperature field? Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 63. Robotic surgery Top-notch Performance Miniature size Distribution and Integration Immunity ➡ Excellent sensitivity to press., temp., strain ➡ <1με, 0.01˚C, <10Pa resolution ➡ Cross-sensitivity abating/compensation ➡ Miniature size (∅125μm, ∅40μm custom) ➡ ➡ ➡ ➡ Multiplexed, switched, quasi-distributed ➡ Integration (lab in a fiber) ➡ Immune to EMI, radiation, MRI ➡ ➡ Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 64. Robotic surgery •Integration of miniature FO sensors in surgical tool •Measurement of force: 3D lateral + axial, return haptic •Microsurgery (vitreoretinal surgery). •Size matter! <125μm attractive, 40μm fibers for animal... Da Vinci surgical tool: insufficient resolution to address microsurgery procedures. Need for a surgical tool that embeds sensors with <mN force detection + temperature compensation, to return a haptic feedback to the doctor. Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 65. Tool shafts X. Liu, I. Iordachita, X. He, R. T. Taylor, J. U. Kang, “Miniature fiberoptic force sensor based on low-coherence Fabry-Perot interferometry for vitreoretinal microsurgery,” Biomedical Optics Express, v. 3, n. 5, 2012 Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 66. Robotic surgery sensors •Two alternative technologies: EFPI, FBG •FBG in a spring configuration, to translate force to strain •Low sensitivity: 10 mN ⇢ 1 pm (1με) •It needs temperature compensation •EFPI promising, but larger size •Transfer of axial forces through the capillary •Proposal: all-EFPI configuration, axial+lateral+temperature Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 67. Conclusions ➡ Optical fiber sensors are well on their way to address medical opportunities, usually in multiB markets ➡ Research emphasis on multi-sensing structures: lab-in-afiber, quasi-distributed, dense monitoring ➡ Scalability is a key factor for transitioning from lab to market, but compatibly with disposable cost ➡ Emerging applications raise the bar for sensing complexity: size, integration, mechanical prop., catheters ➡ Biocompatibility is a key issue: prevalence of all-glass structures, most packages not FDA-compliant! Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 68. Acknowledgments ‣ Federico II University - Urologic Clinic ‣ Universita’ di Pavia, Politecnico di Milano ‣ Cleveland Clinic ‣ FP7 Marie Curie (299985-PROBESENSE) ‣ Science Foundation Ireland (RFP/ECE2898) ‣ Enterprise Ireland (IP-2012-0166-Y) ‣ University of Limerick, MSSI and CES depts. Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick
- 69. Thank you - Xie xie ➡ Cooperation ➡ Partnerships ➡ Funding proposals ... are welcome... Daniele Tosi - Optical fiber sensors for medical applications - Research activities at University of Limerick