Abstract
.Near-infrared spectroscopy (NIRS) is emerging as a rapid, low-cost approach for point-of-care triage of hematomas resulting from traumatic brain injury. However, there remains a lack of standardized test methods for benchtop performance assessment of these devices and incomplete understanding of relevant light–tissue interactions. We propose a phantom-based test method for systems operating near the 800-nm oxy-/deoxy-hemoglobin isosbestic point and implement it to evaluate a clinical system. Semi-idealized phantom geometries are designed to represent epidural/subdural, subarachnoid, and intracerebral hemorrhages. Measurements of these phantoms are made with a commercial NIRS-based hematoma detector to quantify the effect of hematoma type, depth, and size, as well as measurement repeatability and detector positioning relative to the hematoma. Results indicated high sensitivity to epidural/subdural and subarachnoid hematomas. Intracerebral hematomas are detectable to a maximum depth of , depending on thickness and diameter. The maximum lateral detection area for the single-emitter/single-collector device studied here appears elliptical and decreases strongly with inclusion depth. Overall, this study provides unique insights into hematoma detector function and indicates the utility of modular polymer tissue phantoms in performance tests for emerging NIRS-based cerebral diagnostic technology.
Highlights
Traumatic brain injury (TBI) affects up to 2% of the population per year.[1]
Among TBI patients, a common sequela is the development of an intracranial hematoma, which presents in 25% to 45% of severe TBI cases and 3% to 12% of moderate TBI cases.[1,2]
We have addressed the lack of basic performance testing data and standardized test methods for infrared hematoma detectors operating near the 800-nm isosbestic region
Summary
Traumatic brain injury (TBI) affects up to 2% of the population per year.[1]. Among TBI patients, a common sequela is the development of an intracranial hematoma, which presents in 25% to 45% of severe TBI cases and 3% to 12% of moderate TBI cases.[1,2] The mortality rate for patients with hematoma is high: 12% to 30% for epidural hematoma[3] and 40% to 60% for subdural hematoma.[1,2] Early detection and surgical evacuation of intracranial hematomas are fundamental management principles.[1]. To enable early identification of intracranial hematomas for military medicine and civilian emergency response, portable point-of-care devices based on near-infrared spectroscopy (NIRS) have been developed and commercialized. Several studies have indicated that these devices are capable of high sensitivity and specificity for in vivo detection of hematomas larger than 3.5 mL and located within 2.5 cm of the tissue surface.[5,6,7,8] Clinical systems for hematoma detection typically use wavelengths near the 800-nm oxy–deoxy-Hb isosbestic point, due to the insensitivity of this spectral region to variations in blood oxygenation.
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