Primary Care Imaging

​Primary care physicians are the health care providers responsible for initial clinical decisions, including diagnosis, treatment, monitoring and referral to the specialists. Primary care physicians largely rely on physical examinations and simple magnifying tools, such as an otoscope and an ophthalmoscope. However, those magnifying devices only provide superficial and qualitative information about the body sites, limiting the diagnostic accuracy. In order to advance the diagnostic and monitoring capabilities in primary care, we have implemented our portable OCT systems to the traditional diagnostic devices, creating a new Primary Care Imaging (PCI) system. 

Ear Imaging

Otitis media (or ear infection) is any inflammation causing the accumulation of fluid in a normally air-filled middle ear space. Otitis media is an especially common health condition for children, and is a leading cause of visiting physicians and receiving antibiotics during childhood. The key diagnostic factor is to determine the presence of a fluid in the middle ear, but it is often difficult to determine using a standard otoscope. With our PCI OCT system, we can further provide quantitative information of the middle ear, potentially improving the diagnostic accuracy of otitis media.

(A) Portable, handheld Primary Care Imaging (PCI) OCT system, (B) demonstration of PCI OCT system for ear imaging and zoomed in handhled probe, and (C) depth-resolved view of normal and abnormal middle ear with standard otoscopic view in the bottom right.

 

Middle ear biofilm

Recent studies have shown that there is a correlation between chronic otitis media and the presence of middle ear biofilm. With our portable, handheld PCI OCT system, bacterial biofilm was non-invasively observed in chronic otitis media.

(A) Otoscopic image of an eardrum with chronic otitis media, (B) representative LCI A-scan showing the tympanic membrane and biofilm, (C) cross-sectional OCT B-scan image, and (D) classification of the data showing a relationship between thickness and abnormality of the middle ear.

Nyugen CT, Jung W, Kim J, Chaney EJ, Novak MA, Stewart CN, Boppart SA. Noninvasive in vivo optical detection of biofilm in the human middle ear. PNAS, 109(24):9529-9534, 2012.  PubMed Abstract PDF

 

Differentiation of Otitis Media

There are mainly two types of otitis media: acute and chronic otitis media. The accurate diagnosis of otitis media is critical, as the treatment varies among different types and stages of otitis media. We defined new metrics, such as the thickness of tympanic membrane and the presence of middle-ear biofilm, based on quantitative and non-invasive measurements from our PCI OCT system.

Representative OCT images: (A) normal, (B) acute otitis media, (C) chronic otitis media, and representative en face images from an otoscope: (D) normal, (E) acute OM, (F) chronic OM. Scale bars represent 150 microns in depth. (A-C) provide quantitative distinction among different cases.

Monroy GL, Shetlon RL, Nolan RM, Nguyen CT, Novak MA, Hill MC, McCormick DT, Boppart SA. Noninvasive Depth-Resolved Optical Measurements of the Tympanic Membrane and Middle Ear for Differentiating Otitis Media. Laryngoscope, 125:E276-E282, 2015. PubMed Abstract PDF