Bedside imaging of intracranial hemorrhage in the neonate using light: Comparison with ultrasound, computed tomography, and magnetic resonance imaging

Medical optical imaging (MOI) uses light emitted into opaque tissues to det ermine the interior structure. Previous reports detailed a portable time-of -flight and absorbance system emitting pulses of near infrared light into t issues and measuring the emerging light. Using this system, optical images of phantoms, whole rats, and pathologic neonatal brain specimens have been tomographically reconstructed. We have now modified the existing instrument ation into a clinically relevant headband-based system to be used for optic al imaging of structure in the neonatal brain at the bedside. Eight medical optical imaging studies in the neonatal intensive care unit were performed in a blinded clinical comparison of optical images with ultrasound, comput ed tomography, and magnetic resonance imaging. Optical images were interpre ted as correct in six of eight cases, with one error attributed to the age of the clot, and one small clot not seen. In addition, one disagreement wit h ultrasound, not reported as an error, was found to be the result of a mis labeled ultrasound report rather than because of an inaccurate optical scan . Optical scan correlated well with computed tomography and magnetic resona nce imaging findings in one patient. We conclude that light-based imaging u sing a portable time-of-flight system is feasible and represents an importa nt new noninvasive diagnostic technique, with potential for continuous moni toring of critically ill neonates at risk for intraventricular hemorrhage o r stroke. Further studies are now underway to further investigate the funct ional imaging capabilities of this new diagnostic tool.