A smartphone-based system that relies on OCT to detect jaundice in newborns will be put to use diagnosing very young patients in the U.S. and Nigeria, thanks to a nearly $500,000 grant from the National Institutes of Health (NIH). The NIH awarded the grant to the lab of Audrey Bowden, an associate professor in the Department of Biomedical Engineering at Vanderbilt University, to test the usability of the system prototype, in the vicinity of Vanderbilt and in a clinical setting in Nigeria.
The basic concept of the device was presented by lab members earlier this year at SPIE Photonics West. The device is essentially a visible light OCT system with a single-mode fiber illumination source, using the camera of a commercial smartphone and a custom application containing an algorithm that processes the collected data. The system can capture the speckle contrast of hemoglobin and deoxyhemoglobin in blood. And while such testing has traditionally been limited to stationary equipment in laboratories, the growing capabilities of smartphone-based technology has been a game changer in the development of portable technology in point-of-care settings.
“The idea is that biomarkers each have a unique spectrum,” Bowden said. “And OCT was chosen for this testing because it can separate data from different layers of tissue. Others have measured the biomarkers of jaundice, but we are trying to create a point-of-care, noninvasive method to test for the condition.”
Jaundice is a yellow color in the skin, which is caused by an excess of bilirubin, a pigment produced when red blood cells break down. Hyperbilirubinemia is extremely common in neonates — as much as 60% of normal-term babies and 80% of pre-term babies suffer from this condition, according to the NIH. The reason jaundice is so common is that babies do not yet have fully developed livers to flush out this potential toxic substance. Treatment methods can range from blood transfusions to phototherapy, wherein blue-green light is used to change the structure of bilirubin molecules to allow for easier excretion.
Audrey Bowden, the Dorothy J. Wingfield Phillips Chancellor’s Faculty Fellow and associate professor of biomedical and electrical engineering at Vanderbilt University, will use a National Institute of Biomedical Imaging and Bioengineering grant to develop a novel noninvasive smartphone-integrated device to provide accurate, point-of-care detection of jaundice in newborns of all skin tones. Courtesy of Vanderbilt University.
The most common diagnostic method is conducted through blood tests, but the frequent pricks can be painful to the infants, Bowden said. Though a light-based test called transcutaneous bilirubinometry — which directs light into the skin and measures the intensity of the return of specific wavelengths — is frequently used, studies show results of this test are more unreliable when used on patients with darker skin tones. This is generally attributed to the inability of transcutaneous bilirubinometry to differentiate between skin analytes such as melanin and blood.
The grant, to be distributed over four years, was awarded under the auspices of the NIH’s National Institute of Biomedical Imaging and Bioengineering. The first step outlined in the grant application was the miniaturization of spectroscopic OCT components, along with the refinement of the algorithm.
Moving into the testing phase, the first group to be tested with the prototype will be 100 patients in the Vanderbilt community, followed by another 100 patients at a hospital in Kano, Nigeria.
“We wanted a larger cohort of patients, but we’re also trying to establish that our concept works and that we can design a portable, point-of-care system that works in low- and middle-income countries,” Bowden said.