mavis-ii measurement of area and volume instrument system for skin wounds c.d. jones, p. plassmann...

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MAVIS-II Measurement of Area and Volume Instrument System for Skin Wounds C.D. Jones, P. Plassmann University of Glamorgan, Medical Computing Research Group

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MAVIS-II Measurement of Area and Volume Instrument System for Skin Wounds

MAVIS-II Measurement of Area and Volume Instrument System for Skin Wounds

C.D. Jones, P. PlassmannUniversity of Glamorgan,Medical Computing Research Group

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Introduction (1 of 4)

Principle Hardware Software Competitors Development Examples Performance

Why Wound Measurement?• Chronic wounds are frequent:

• 8% of bedridden/chairbound patients develop pressure ulcers

• 3.5% of all adults in the USA suffer from venous leg ulcers alone

• Wounds are costly:

• Approx. £ 500 million annually in the UK

venous leg ulcer

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Introduction (2 of 4)

Principle Hardware Software Competitors Development Examples Performance

Why Wound Measurement?• Wounds need to be healed:

• objective information required

• monitor progress of healing wound

• assess influence of clinical interventions

• increasingly important: litigation

• verify clinical trials

diabetic foot ulcer

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Introduction (3 of 4)

Principle Hardware Software Competitors Development Examples Performance

Existing techniques• Area:

• transparency tracings or photographs• 2D only• inaccurate (especially on curved wounds)

• contact with wound pain, infection

Smith & Nephew ‘Visitrak

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Introduction (4 of 4)

Principle Hardware Software Competitors Development Examples Performance

Existing techniques• Volume:

• fill wound with measured amount of saline or alginate paste

• messy & time-consuming• inaccurate• contact with wound pain, infection

MAVIS - II

Introduction

MAVIS-I MAVIS-II

Status

MAVIS - I

Principle Hardware Software Competitors Development Examples Performance

Data sheet• 110 kg, trolley mounted• £ 15,000, only 6 sold• non-contact• structured light principle

MAVIS - II

Introduction MAVIS-I

MAVIS-II

Status

MAVIS - II

Principle Hardware Software Competitors Development Examples Performance

Data sheet• light, about 1.5 kg, compact

• non-contact

• inexpensive to build, few custom parts

• accuracy & precision better than MAVIS-I

• full-colour

• stereo-photogrammetry principle

• “intelligence” in software not hardware

• no moving mechanical parts

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Principle

Principle Hardware Software Competitors Development Examples Performance

Stereo – Photogrammetry• displacement between corresponding

points in stereo images = distance

• challenge: finding corresponding points

d

Left Image

Left Image

Right Image

Right Image

camera / eyes

displacementobject point 1

object point 2 left stereo image

right stereo image

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Hardware (1 of 2)

Principle

Hardware Software Competitors Development Examples Performance

Off-the-shelf components

• any high-resolution digital camera with standard lens adapter & flash

• stereo adapter(slightly modified)

• laptop or PC

camera + stereo adapter

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Hardware (2 of 2)

Principle

Hardware Software Competitors Development Examples Performance

In-house

• range finder

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Software (1 of 2)

Principle Hardware

Software Competitors Development Examples Performance

Modular design • 3-D displacement engine

• user delineation tool

ulcerated limb

correct reconstructionfalse reconstruction

positivevolume

negativevolume

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Software (2 of 2)

Principle Hardware

Software Competitors Development Examples Performance

Modular design

• ‘minimum surface’ reconstruction

• measurement, visualisation & output module

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Competitors (1 of 2)

Principle Hardware Software

Competitors Development Examples Performance

Upper ranger: Minolta Vivid 700 • 9 kg, laser scanner• £ 70,000

Lower range: Minolta 3D 1500 • 0.5 kg, structured light• £ 2,500

And many others in-between• EOIS “Handy”, Inspec “3D Body Builder”, …..• common feature:

no wound measurement software !

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Competitors (2 of 2)

Principle Hardware Software

Competitors Development Examples Performance

Most direct: Vista Medical “VeV 3D”• standard digital camera• no volume…• …but excellent data base• 1 year free trial / subscription or purchase

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Future Developments

Principle Hardware Software Competitors

Development Examples Performance

MAVIS-II improvements (in order of urgency)

• improve automation (e.g.: image transfer from camera initiated when camera placed next to laptop, then start software)

• “package” system (own cameras, flash)

• merging multiple images (e.g. for circumferential wounds)

• addition of colour analysis (analysis of inflammation / infection status)

• enable ”telemedicine” features and measurements as online services

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Examples

Principle Hardware Software Competitors Development

Examples Performance

No more wounds now

• measurement grid overlay

• all from a single ‘shot’

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Performance (1 of 3)

Principle Hardware Software Competitors Development Examples

Performance

wound >40 cm²

wound 10-40 cm²

wound<10 cm²

0

2

4

6

8

10

12

rulers tracings digital photography

Precision error range

(one standard deviation as % of wound area)

MAVIS

Wound Area

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Performance (2 of 3)

Principle Hardware Software Competitors Development Examples

Performance

Wound Volume

saline

0%

10%

20%

30%

40%

3D Scanners casts rulers

min. precision

max. precision

(large, shallow wounds)

(deep, small wounds)

precision error range(one standard deviation in % of the wound volume)

MAVIS

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Performance (3 of 3)

Principle Hardware Software Competitors Development Examples

Performance

Calibration• against NPL

precision artifacts

• user control viaconsistency checker

MAVIS - II

Introduction MAVIS-I MAVIS-II

Status

Summary so far…

Principle Hardware Software Competitors Development Examples Performance

MAVIS – II is:

• unique

• inexpensive to manufacture, mainly from standard components

• lightweight and portable

• a precise tool for an increasingly important medical task

• More information, examples, FAQs, etc:

www.MedImaging.org/Mavis