A revolution in medical imaging is coming

Issue: BCMJ, vol. 61 , No. 5 , June 2019 , Pages 203 Letters

MRIs can cost millions to buy, hundreds of thousands yearly to maintain, and have a resolution of a few millimetres. Compare this to a machine that is a thousandfold cheaper to buy that provides images that are a million times cheaper to produce with a billion times the resolution. That is like buying a cellphone to take a picture at the resolution of an individual neuron.

And this technology is closer than you may think. The technology I am referring to is based on near-infrared light. Biological tissue scatters red light and silicon chips manufactured by the billions for cellphone cameras are very sensitive to it.

Remember when you were a kid in a tent in the backyard shining a flashlight onto the palm of your hand to make your hand light up? For illustration, take a laser pointer and shine it onto your finger. Your finger becomes translucent red because the laser’s red light is scattered by the tissue. The scattering is random, so no information can be obtained about the tissue that it went through. But what if you could accurately measure both the angle of each ray of light and how faded in intensity it was by the finger it just went through? You could then reconstruct a holographic picture of the tissue that the beam of infrared light passed through.

In April 2018, Mary Lou Jepsen gave a TED Talk in Vancouver in which she described a prototype machine developed by her start-up, Open Water, which does exactly this. Basically that 30-ton MRI machine with its large magnet and liquid helium cooling system can be replaced with a wearable sensor weighing a few pounds.

When you shine red light onto a beaker of blood no light passes through. The blood totally absorbs the light. When going through tissue, light is scattered, which is why your finger is translucent red. Your body is 3% blood but a cancer over 1 millimetre or so develops a strange leaky vasculature that increases that amount to 15% in the tumor. This machine will be able to detect this at pretty much the cellular level of resolution.

This will profoundly alter the business model of screening for breast cancer. In my field of anesthesiology the potential is breathtaking because this imaging can now visualize and also alter the firing of neurons. Why use a pharmaceutical that has to be given in whopping big doses to cross the blood-brain barrier, poisoning the entire brain, to obtain adequate anesthesia in one part of the patient’s body, when you can use a photon to pinpoint the anesthesia effect?
—Mark Elliott, MD
Vancouver

Mark Elliott, MD, FRCPC. A revolution in medical imaging is coming. BCMJ, Vol. 61, No. 5, June, 2019, Page(s) 203 - Letters.



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