Visualization of superficial vein dynamics in dorsal hand by near-infrared imaging in response to elevated local temperature.

Mohiuddin Khan Shourav,Jungil Choi,Jung Kyung Kim

doi:10.1117/1.jbo.26.2.026003

Abstract

.Significance: Dry or moist skin-contact thermal stimulation for vein puncture (VP) and vein cannulation (VC) may not be feasible for sensitive skin. For a damaged, burned, or dark skin, near-infrared (NIR) imaging is preferred to visualize a vein. Postprocessing of NIR images is always required because the skin is a reflective material and veins need segmentation for quantitative analysis.Aim: Our pilot study aims to observe the effect of noncontact local heating on the superficial metacarpal veins in the dorsal surface of the hand and to visualize vein dynamics using an NIR imaging system.Approach: Our experiment consists of studies A and B at two ambient temperatures, 19°C and 25°C. A simple reflection-based NIR imaging system was installed to acquire sequential vein images for 5 min before and after applying 10 min of radiant thermal stimulation. To measure the vein diameter (VD), we trained a convolutional neural network (CNN) on sequential raw images to predict vein-segmentation masks as output images. Later these masked images were postprocessed for the VD measurements.Results: The average VD was significantly increased after thermal stimulation in study A. The maximum increments in VD were 39.3% and 9.19%, 1 min after thermal stimulation in studies A and B, respectively. Both the VD and skin temperature () follow negative exponentials in time, and the VD is proportional to . A multiple linear-regression model was made to predict the final VD. A significant difference was observed in the change of the VD.Conclusions: NIR imaging with CNN can be used for quantitative analyses of vein dynamics. This finding can be further extended to develop real-time, image-guided medical devices by integrating them with a radiant heater and to assist medical practitioners in achieving high success rates for VP or VC.

Highlights

NIR imaging with convolutional neural network (CNN) can be used for quantitative analyses of vein dynamics
The superficial veins of the upper limb, especially the dorsal metacarpal veins, are always the first choice to access during vein puncture (VP) and vein cannulation (VC)
We found that different ethnic groups exhibit different vein dynamics and skin temperatures (Tskin) in response to the same intensity of thermal stimulation

Summary

Introduction

The superficial veins of the upper limb, especially the dorsal metacarpal veins, are always the first choice to access during vein puncture (VP) and vein cannulation (VC). It has been reported that factors such as obesity, dark skin, intravenous drug abuse, prior chemotherapy, and old age can increase the difficulty associated with VP or VC.[1,2] The sympathetic nervous system is the most important vasopressor system in the control of venous capacitance.[3] Venoconstriction is caused by numerous factors, including hypothermia, hypotension, caffeine or nicotine use, medications (e.g., noradrenaline, 5-hydroxytryptamine, and ergot derivatives), pain from repeated attempts at VP or VC, and fear of the procedure These factors can make venous access more difficult.[1,4] There has been a report that peripheral VC failure is 12% to 40% in adults and 24% to 64% in children.[5]

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