Application of novel hyperspectral imaging technologies in combat casualty care

Abstract

Novel hyperspectral imaging (HSI) methods may play several important roles in Combat Casualty Care: (1) HSI of the skin may provide spatial data on hemoglobin saturation of oxygen, as a "window" into perfusion during shock. (2) HSI or similar technology could be incorporated into closed-loop, feedback-controlled resuscitation systems. (3) HSI may provide information about tissue viability and/or wound infection. (4) HSI in the near-infrared range may provide information on the tissue water content--greatly affected, e.g., by fluid resuscitation. Thus, further refinements in the speed and size of HSI systems are sought to make these capabilities available on the battlefield. COMBAT CASUALTY CARE CHALLENGESThe purpose of this paper is to review the uniquely challenging characteristics of combat casualty care, and to provide an assessment of several ways in which hyperspectral imaging (HSI) could contribute to improving diagnostic and treatment capabilities in this setting. Several papers on HSI in trauma and related applications will be reviewed.Interest in HSI is not limited to its potential application on the battlefield. However, combat casualty care is a stringent test of the utility of any new medical technology. Battlefield care represents a point of departure from civilian trauma care in several important respects. These include differences in the mechanism and severity of injury; in the materiel and personnel available for care; and in the environmental circumstances under which care is provided.The leading cause of injury on the current battlefield is the improvised explosive device (IED), 1 whereas the leading cause of injury in civilian trauma systems in the U.S. is blunt trauma from falls and motor vehicle accidents. 2 The severity of injury on the current battlefield is indicated by a high percentage of patients with Injury Severity Scores (ISS) over 15 and a high massive transfusion rate (defined as > 10 units of red blood cells or whole blood over the first 24 h after injury). In one study of combat casualties treated at a single Combat Support Hospital in Iraq, of 302 patients who received any blood during the first 24 h, 80 patients (27%) received a massive transfusion. 3 The leading cause of death on the battlefield remains hemorrhagic shock, followed by neurological trauma (severe head injury). 4Our ability to provide care on the battlefield is greatly affected by constraints in the weight and cube of devices and drugs which can be utilized in the prehospital setting. In other words, combat medics are severely limited in what they can carry to the casualty at the point of injury. In essence, a decision to add a device or drug to the medic's aid bag must be accompanied by a decision to remove something from the bag: there is no room for additional items. As patients move up the evacuation chain, more equipment becomes available. The mature Combat Support Hospital, for example, routinely utilizes computed tomography (CT) scanners for the diagnosis of injury. 5 There are constraints in the training ...

Medical hyperspectral imaging: a review

“…45 Therefore, HSI is increasingly being used for medical diagnosis and image-guided surgery. For example, HSI has been applied to the diagnosis of hemorrhagic shock, 40,150 the assessment of peripheral artery disease, 151 early detection of dental caries, 57 fast characterization of kidney stone types, 96 detection of laryngeal disorders, 53 and so on. In the following section, we focus on the applications of HSI to cancer, cardiac disease, retinal disease, diabetic foot, shock, tissue pathology, and image-guided surgery.…”

Noninvasive hemoglobin sensing and imaging: optical tools for disease diagnosis

“… 76 Evaluation of hemoglobin oxygenation and melanin content in the face has been of interest for dermatological treatments such as the detection of skin cancer, assessment of scar healing, and evaluation of skin thickness. 177 – 180 Spectral imaging of hemoglobin in burns, 8 wounds, 6 and bruises 30 , 77 has been explored to assess the progress of healing in a quantitative manner. Moreover, spectral imaging of tissue has found application in intraoperative imaging.…”