Recent Advancements in Microcirculatory Image Acquisition and Analysis

Abstract

Since the introduction of orthogonal polarization spectral (OPS) imaging by Slaaf et al. and its implementation into a clinically-applicable hand-held microscope [1, 2], clinical microcirculation investigations have been carried out in various clinical scenarios on exposed organ and tissue surfaces [3, 4, 5, 6, 7, 8, 9]. OPS imaging has proved to be a useful modality to predict patient outcome, during disease and therapy, especially in intensive care and emergency medicine [4, 9]. OPS imaging has made an important clinical impact by assessment of the sublingual micro circulation during sepsis, shock, and resuscitation [10]. OPS imaging can be applied on numerous sites, ranging from the nailfold and sublingual microcirculation to the brain micro circulation [3, 11]. Very recently, OPS imaging was used to reveal microcirculatory alterations in malaria patients [12]. For this purpose, the investigators focused on the rectal microcirculation, since bruxism, a common feature of cerebral malaria, prevented oral introduction of the OPS probe. Additional applications of OPS imaging include wound healing and cancer and tumor development [11, 13]. Studies by several medical centers have shown that OPS observation of sublingual microcirculatory alterations (i.e., particularly changes in capillary perfusion) provided more sensitive information about patient outcome than conventional clinical parameters, such as systemic hemodynamic and oxygen derived variables [4, 6, 7, 9, 10].