Linearly polarized light that illuminates skin is backscattered by superficial layers and rapidly depolarized by birefringent collagen fibers. It is possible to distinguish such superficially backscattered light from the total diffusely reflected light that is dominated by light penetrating deeply into the dermis. The method involves acquisition of two images through an analyzing linear polarizer in front of the camera, one image (I(par)) acquired with the analyzer oriented parallel to the polarization of illumination and one image (I(per)) acquired with the analyzer oriented perpendicular to the illumination. An image based on the polarization ratio, Pol=(I(par)-I(per))/(I(par)+I(per)), is created. This paper compares normal light images, represented by I(per), and Pol images of various skin pathologies in a pilot clinical study using incoherent visible-spectrum light. Images include pigmented skin sites (freckle, tattoo, pigmented nevi) and unpigmented skin sites [nonpigmented intradermal nevus, neurofibroma, actinic keratosis, malignant basal cell carcinoma, squamous cell carcinoma, vascular abnormality (venous lake), burn scar]. Images of a shadow cast from a razor blade onto a forearm skin site illustrate the behavior of Pol values near the shadow edge. Near the shadow edge, Pol approximately doubles in value because no I(per) photons are superficially scattered into the shadow-edge pixels by the shadow region while I(par) photons are directly backscattered from the superficial layer of these pixels. This result suggests that the point spread function in skin for cross-talk between Pol pixels has a half-width-half-max of about 390 microm.

Propagation of light into scattering media is a complex problem that can be modeled using statistical methods such as Monte Carlo. Few Monte Carlo programs have so far included the information regarding the status of polarization of light before and after a scattering event. Different approaches have been followed and limited numerical values have been made available to the general public. In this paper, three different ways to build a Monte Carlo program for light propagation with polarization are given. Different groups have used the first two methods; the third method is original. Comparison in between Monte Carlo runs and Adding Doubling program yielded less than 1 % error.

Photoplethysmography (PPG) is a low-cost, noninvasive optical technique that uses change in light transmission with changes in blood volume within tissue to provide information for cardiovascular health and fitness. As remote health and wearable medical devices become more prevalent, PPG devices are being developed as part of wearable systems to monitor parameters such as heart rate (HR) that do not require complex analysis of the PPG waveform. However, complex analyses of the PPG waveform yield valuable clinical information, such as: blood pressure, respiratory information, sympathetic nervous system activity, and heart rate variability. Systems aiming to derive such complex parameters do not always account for realistic sources of noise, as testing is performed within controlled parameter spaces. A wearable monitoring tool to be used beyond fitness and heart rate must account for noise sources originating from individual patient variations (e.g., skin tone, obesity, age, and gender), physiology (e.g., respiration, venous pulsation, body site of measurement, and body temperature), and external perturbations of the device itself (e.g., motion artifact, ambient light, and applied pressure to the skin). Here, we present a comprehensive review of the literature that aims to summarize these noise sources for future PPG device development for use in health monitoring.

The ability to phenotype wounds for the purposes of assessing severity, healing potential and treatment is an important function of evidence-based medicine. A variety of optical technologies are currently in development for noninvasive wound assessment. To varying extents, these optical technologies have the potential to supplement traditional clinical wound evaluation and research, by providing detailed information regarding skin components imperceptible to visual inspection. These assessments are achieved through quantitative optical analysis of tissue characteristics including blood flow, collagen remodeling, hemoglobin content, inflammation, temperature, vascular structure, and water content. Technologies that have, to this date, been applied to wound assessment include: near infrared imaging, thermal imaging, optical coherence tomography, orthogonal polarization spectral imaging, fluorescence imaging, laser Doppler imaging, microscopy, spatial frequency domain imaging, photoacoustic detection, and spectral/hyperspectral imaging. We present a review of the technologies in use or development for these purposes with three aims: (1) providing basic explanations of imaging technology concepts, (2) reviewing the wound imaging literature, and (3) providing insight into areas for further application and exploration. Noninvasive imaging is a promising advancement in wound assessment and all technologies require further validation.

Three Monte Carlo programs were developed which keep track of the status of polarization of light traveling through mono-disperse solutions of micro-spheres. These programs were described in detail in our previous article [1]. This paper illustrates a series of Monte Carlo simulations that model common experiments of light transmission and reflection of scattering media. Furthermore the codes were expanded to model light propagating through poly-disperse solutions of micro-spheres of different radii distributions.

The judgment of which wounds are expected to heal within 21 days is one of the most difficult and important tasks of the burn surgeon. The quoted accuracy of 64 to 76% by senior burn surgeons underscores the importance of an adjunct technology to help make this determination. A plethora of techniques have been developed in the last 70 years. Laser Doppler imaging (LDI) is one of the most recent and widely studied of these techniques. The technology provides an estimate of perfusion through the burn wound, the assumption being that a lower perfusion correlates with a deeper wound and, therefore, a longer time to heal. Although some reports suggest accuracy between 96 and 100% and that it does this 2 days ahead of clinical judgment, others have questioned its applicability to clinical practice. This article, the second of a two-part series, has two objectives: 1) a review of the Doppler principle and how the LDI uses it to estimate perfusion; and 2) a critical assessment of the burn literature on the LDI. Part I provides a historical perspective of the different technologies used through the last 70 years to assist in the determination of burn depth. Laser Doppler has brought technology closer to provide a reliable adjuvant to the clinical prediction of healing, yet, caution is warranted. A clear understanding of the limitations of LDI is needed to put the current research in perspective to find the right clinical application for LDI.

Skin breakdown is a prevalent and costly medical condition worldwide, with the etiologic and healing processes being complex and multifactorial. Quantitative assessment of wound healing is challenging due to the subjective measurement of wound size and related characteristics. We propose that in vivo spectral reflectance measurements can serve as valuable clinical monitoring tool/device in the study of wound healing. We have designed a multi spectral camera able to acquire 18 wavelength sensitive images in a single snapshot. A lenslets array in front of a digital camera is combined with narrowband filters (bandwidth 10 nm) ranging from 460 to 886 nm. Images taken with the spectroscopic camera are composed of 18 identical sub-images, each carrying different spectral information, that can be used in the assessment of skin chromophores. A clinical trial based on a repeated measures design was conducted at the National Rehabilitation Hospital on 15 individuals to assess whether Poly Carboxy Methyl Glucose Sulfate (PCMGS, CACIPLIQ20), a bio-engineered component of the extracellular matrix of the skin, is effective at promoting healing of a variety of wounds. Multi spectral images collected at different wavelengths combined with optical skin models were used to quantify skin oxygen saturation and its relation to the traditional measures of wound healing.

Polarization-based imaging can provide new diagnostic capabilities in clinical and preclinical studies. Various methodologies of increasing complexity have been proposed by different groups in the last 30 years. In this review we focus on the most widely used methods in polarization imaging including co- and cross-polarized-based imaging, Mueller matrix imaging, and polarization sensitive optical coherence tomography, among others. This short primer in optical instrumentation for polarization-based imagery is aimed at readers interested in including polarization in their imaging processes.