Imaging Platforms for Detecting and Analyzing Skin Features and Its Stability - with Applications in Skin Health and in Using the Skin as a Body-Relative AR-HVS Position-Encoding System MASSACHUSETTS INSTITUTE T TUT MASSACHN by JUL 3 0 2015 Ina Annesha Kundu LIBRARIES B.S. in Mechanical Engineering, University of Arizona (2013) B.S. in Mathematics, University of Arizona (2013) Submitted to the Department of Mechanical Engineering in partial fulfillment of the requirements for the degree of Master of Science in Mechanical Engineering at the MASSACHUSETTS INSTITUTE OF TECHNOLOGY June 2015 @ Massachusetts Institute of Technology 2015. All rights reserved. Signature redacted . . . . . .. . . . . . Author... Department of Mechanical Engineering Certified by. Signature redacted ........... ay8, 2015 Dr. Brian Anthony Principal Research Scientist, Department of Mechanical Engineering -*Supervisor .n -. /n Signature redacted Accepted by .............. .... David E. Hardt Professor, Department of Mechanical Engineering Graduate Officer 2 Imaging Platforms for Detecting and Analyzing Skin Features and Its Stability - with Applications in Skin Health and in Using the Skin as a Body-Relative Position-Encoding System by Ina Annesha Kundu Submitted to the Department of Mechanical Engineering on May 8, 2015, in partial fulfillment of the requirements for the degree of Master of Science in Mechanical Engineering Abstract Skin imaging is a powerful, noninvasive method used with potential to aid in the diagnosis of various dermatological diseases and assess overall skin health. This thesis discusses imaging platforms that were developed to aid in studying skin features and characteristics at different time and length scales to characterize and monitor skin. Two applications are considered: (1) using natural skin features as a position encoding system and an aid for volume reconstruction of ultrasound imaging and (2) studying natural skin feature evolution or stability over time to aid in assessing skin health. A 5-axis, rigid translational scanning system was developed to capture images at specific locations and to validate skin based body registration algorithms. We show that natural skin features could be used to perform ultrasound based reconstruction accurate to 0.06 mm. A portable, handheld scanning device was designed to study skin characteristics at different time and length scales. With this imaging platform, we analyze skin features at different length scales: pim (for microreliefs), mm (for moles and pores), and cm (for distances between microreliefs and other features). Preliminary algorithms are used to automatically identify microreliefs. Further work in image processing is required to assess skin variation using these images. Thesis Supervisor: Dr. Brian Anthony Title: Principal Research Scientist, Department of Mechanical Engineering 3 4 Acknowledgments If I were to acknowledge every person and every encounter that has somehow made an impact in my life during the past two years, this section would be longer than the thesis itself. However, there are just some people that cannot go unnamed, and I take the time now to express my deepest gratitude for their help, love, and support in the past two years. First and foremost, I want to thank my family for providing a nurturing and supportive environment. I am always grateful for their never-ending love and encouragement. Throughout my life, my parents have been my role models and I can only aspire to be as kind, considerate, and selfless as they are. Despite the miles that separated us, my mom always made sure my mind and body were well nourished. She taught me that being a good person is much more respectable and valuable than being a good student; a lesson that is easily lost in the focused, studious life at MIT. A man of few words and having a very busy professional schedule, my father left the responsibilities of disciplining and guiding the kids to my mom. But he was also a silent supporter of my sister, Auni, and me. In the few stressful times we experienced in grad school, he always reminded us that we went for graduate studies for fun and echoed my mom's sentiments that "school is not everything." His sarcastic comments and far-fetched theories always brought a smile to our faces. My sister, Auni, was my anchor. Growing up as twins and constantly together, starting a new chapter separated by 2683 miles was the toughest part about grad school. But through the advances of modern technology, we managed to talk, text, and video chat enough to stay updated on each other's lives. I would definitely not be where I am without my advisor, Dr. Brian Anthony. Through his guidance, I grew as an individual and researcher. He encouraged me to "fail; fail fast, and fail often" and to make sure to "never let perfection get in the way of progress." Throughout lab lunches and meetings, he also taught me valuable life skills (like sarcasm). It will probably take the remaining years of my PhD before I can fully understand his humor, but I am always grateful to him for making the lab 5 such an enjoyable place to work. Besides my advisor, my lab mates made the basement lab of Building 35 my home away from home. Our lab lunches were always filled with spirited debates and lighthearted conversations, even at the most stressful times. Shawn Zhang, Nigel Kojimoto, and Tylor Hess were forever trying to break my notions of "good" vs. "bad" and became some of my closest confidantes. As Nigel leaves for California next month, the lab dynamic will no longer be the same, but I know the lab group will continually grow and learn from one another as we have done with former PhD students, Matthew Gilbertson and Shih-Yu Sun. I know we will continue to have stimulating conversations in the hallways or in lab, like I did over the past couple of years with my lab mates and associates: Sisir Koppaka, Kristi Oki, Aaron Zakrzewski, John Lee, Bryan Ranger, Megan Roberts, Dr. Xian Du, and Ian Lee. While the lab contributed to a significant part of the journey, the people I met outside of lab really enhanced my overall experience at Boston and MIT. From partying together to taking classes together, these people were an integral part of my assimilation in Boston. Claudio Hail and Joao Ramos of the "Three Musketeers" were the first people I met on campus - from day one of orientation to the last day of our master's thesis, we always managed to find time to explore Boston together. Times with the one and only "Hot Chocolate Society" (Affi Maragh, Claudio Hail, Joao Luiz Alemeida de Souza Ramos, Andrew Houck, Connor Mulcahy, Mustafa Mohamad, Robert Katzschmann) will be forever cherished. A special thank you to Joao and Robert for their help with controls. Last, but certainly not least, I thank Steve Racca for his friendship and all the engaging conversations over the past year. Always willing to be my test subject, I got the opportunity to test out theories to advance my research. He taught me so much, in the lab and beyond, for which I will forever be thankful. I am so fortunate to have experienced being a grad student with all my Mech E companions. It has been a pleasure taking classes, hanging out, and traveling together. Robbie Bruss: thank you for always having a positive attitude. Hearing you sing a cappella and taking ceramics class together were a welcome artistic break 6 to an otherwise technical life. To my MEng peers (Grace Fong, Ali Shabbir, Derek Straub, Shaozheng Zhang, Paramveer Toor, Siddharth Udayshankar, Aditya Prasad, Daniel Dillund, Happy Zhu, Rahul Chawla, Saksham Saxena, and Steve Racca): thank you for willing to be my subjects during the skin scanning experiments. To all my friends I met through my time at the Graduate Student Council (GSC), Graduate Association of Mechanical Engineers (GAME), and Ashdown, there are too many of you to name individually, but know that spending time with you has enriched my MIT experience. To my Boston and MIT comrades, I extend a heartfelt thank you. I could not be where I am today without you. 7 8 Contents Introduction 19 Skin Research . . . . . . . . . ......... 19 1.2 Skin Features . . . . . . . . . . 22 . Melanin Variations . . . . . . . . . . 22 1.2.2 Hair Follicles..... . . . . . . . . . . 23 1.2.3 Microrelief Structures . . . . . . . . . . 23 1.2.4 Superficial Veins . . . . . . . . . . 24 Existing Imaging Technologies . . . . . . . . . . 26 1.3.1 Imaging Hardware . . . . . . . . . . 26 1.3.2 Imaging Methodologies . . . . . . . . . . 30 . . . . . . . . . . 32 . 1.2.1 . 1.4 . . . . . . . . . 1.3 . 1.1 . . . Thesis Outline . . . . . . . . . 1 2 Ground Based Mechanical Scanning System for Evaluating Skin Based Body Registration Algorithms 33 2.1 . . . . . . . . . . . . . . . . . . . . . . 34 2.1.1 3-Axis CNC Mill . . . . . . . . . . . . . . . . . . . . . . . . . 35 2.1.2 Servo Motors . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 2.1.3 Webcam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 2.1.4 Integration of Hardware . . . . . . . . . . . . . . . . . . . . . 40 2.1.5 Ergonomic Considerations . . . . . . . . . . . . . . . . . . . . 44 Mechanical System Control Using LabView . . . . . . . . . . . . . . . 45 2.2.1 Stepper Motor Control . . . . . . . . . . . . . . . . . . . . . . 46 2.2.2 Servo Motor Control . . . . . . . . . . . . . . . . . . . . . . . 49 2.2 Mechanical System Hardware 9 2.3 2.4 2.5 2.6 Characterizing the Mechanical System ....... 2.3.1 Resolution of the 3-Axis Linear Stage . . . . . . . . . . . . . . 54 2.3.2 Quantifying Error of the System . . . . . . . . . . . . . . . . . 55 Experiments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 2.4.1 Lighting and Artificial Skin Features . . . . . . . . . . . . . . 59 2.4.2 Linear Motion Experiments . . . . . . . . . . . . . . . . . . . 62 2.4.3 Defocus Blur . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 2.4.4 Motion Blur . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 2.4.5 Underwater Experiments . . . . . . . . . . . . . . . . . . . . . 64 Validation Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 2.5.1 Linear Motion . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 2.5.2 Defocus Blur . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 2.5.3 Motion Blur . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Handheld Skin Scanning Device 3.1 3.2 3.3 52 Camera 71 73 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 3.1.1 Variable Optical Parameters . . . . . . . . . . . . . . . . . . . 76 3.1.2 Camera Control with LabView . . . . . . . . . . . . . . . . . 79 Handheld Scanning Device Design . . . . . . . . . . . . . . . . . . . . 80 3.2.1 Frame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 3.2.2 Set Working Distance . . . . . . . . . . . . . . . . . . . . . . . 82 3.2.3 Ring Stand . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 3.2.4 Iteration 1 of Handheld Scanning Device . . . . . . . . . . . . 83 3.2.5 Iteration 2 of Handheld Scanning Device . . . . . . . . . . . . 85 3.2.6 Iteration 3 of Handheld Scanning Device . . . . . . . . . . . . 86 3.2.7 Final Design of Handheld Scanning Device . . . . . . . . . . . 88 Lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 3.3.1 Uniform Lighting . . . . . . . . . . . . . . . . . . . . . . . . . 92 3.3.2 Directional Lighting 96 . . . . . . . . . . . . . . . . . . . . . . . 10 3.3.3 4 Calibrating the Light . . . . . . . . . . . . . . . . . . . . . . . 97 3.4 Skin Scanning Experiments . . . . . . . . . . . . . . . . . . . . . . . 99 3.5 Preliminary Image Analysis . . . . . . . . . . . . . . . . . . . . . . . 102 3.6 Skin Studies: Closing Comments and Ongoing Work . . . . . . . . . . 104 Conclusion 109 4.1 109 Future Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A Figures 111 B Matlab Codes 115 11 12 List of Figures Skin Furrows and Ridges . . . . . . . . . . . . . 21 1-2 Melanin and Melanocytes . . . . . . . . . . . . 23 1-3 Hair Follicle . . . . . . . . . . . . . . . . . . . . 24 1-4 Structural Aging of Skin . . . . . . . . . . . . . 25 1-5 Imaging System for Finger Knuckle Prints . . . . 27 1-6 Imaging System for Microrelief Structure . . . . 28 1-7 Handheld Imaging System for Skin Color . . . . 29 2-1 Longitudinal vs Transverse Axes . . . . . . . . . . . . . . . . . . . . 35 2-2 CN C A xes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 2-3 USB Webcam Used for Experiments . . . . . . . . . . . . . . . . . 39 2-4 USB Camera Calibration . . . . . . . . . . . . . . . . . . . . . . . . 41 2-5 Camera Scanning Arm While on Platform . . . . . . . . . . . . . . 42 2-6 Servo Motor Connection to 3-Axis Linear Stage 2-7 3D Printed Bracket to Connect Rotation Servo to 3-Axis Translational . . . . . . . . . 1-1 . . . . . . . . . . . . 43 .................................... 43 2-8 CAD Model of Ground Truth Mechanical System . . . . . . . . . . 44 2-9 Full System Integration: 3-Axis Translational Stage with Servo Motors . Stage......... . and C am era . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-10 Front Panel Inputs ....... ............................ 47 48 2-12 Flat Sequence Loop to Turn 1 Revolution . . . . . . . . . . . . . . . 49 2-13 LabView Code for Linear Axis-Full Cycles . . . . . . . . . . . . . . 50 . . . . . . . . . . . . . . . . . . . 2-11 Stepper Automation Code Flow Chart 45 13 . . . . . 51 2-15 LabView Code for Rotational Axes . . . . . . . . . . . . . . . 53 2-16 Rigid Support Behind Tattoo . . . . . . . . . . . . . . . . . . 54 2-17 Precision G rid . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 2-18 Hardware Set Up-Quantifying Two Direction Errors . . . . . . 59 2-19 Tattoo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 2-20 Experimental Images from Initial Experiments . . . . . . . . . 61 2-21 Graphic of Set Up for Defocus Blur Experiments . . . . . . . . 63 2-22 Waterproof Camera Used for Underwater Experiments . . . . . 65 2-23 Underwater Experimental Set Up . . . . . . . . . . . . . . . . 66 2-24 Underwater Image 1 . . . . . . . . . . . . . . . . . . . . . . . 66 2-25 Water-proofing the Webcam . . . . . . . . . . . . . . . . . . . 67 2-26 Reconstruction Algorithm Flow . . . . . . . . . . . . . . . . . 68 2-27 Contrast Results . . . . . . . . . . . . . . . . . . . . . . . . . 69 2-28 Defocus Blur Results . . . . . . . . . . . . . . . . . . . . . . . 70 . . . . . . . . . . . . . . 2-14 LabView Code for Linear Axis-Fractional Cycles . . . 72 3-1 Initial Image Acquired with Basler Camera . . . . . . . . . . . . . . 75 3-2 Optical Parameters . . . . . . . . . . . . . . . . . . . . . . . . . .. . 76 3-3 Set Up Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 3-4 DOF Geometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 3-5 Skin LabView Code . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 3-6 Handheld Scanning Device-Frame, LED Light Ring, Optomechanical . . . . . . 2-29 Results of Motion Blur: Algorithm vs. Experimental Results . . . . 81 3-7 Optomechanical Stiff Rods . . . . . . . . . . . . . . . . . . . . . . . 82 3-8 Handheld Scanning Device V1 . . . . . . . . . . . . . . . . . . . . . 83 3-9 Ring Stand V2 84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rods, and Camera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 . . . . . . . . . . . . . . . . . . . . . . 85 . 3-12 Handheld Scanning Device Version 2 14 . . . . . . . . . . . . . . . . . . 3-11 Handheld Device Frame V1 . . . . . . . . . . . . . . 3-10 Handheld Device Frame with Extrusions V1 87 3-13 Handheld Scanning Device V3 . . . . . . . . . . . . . . . . . . . . . . 88 3-14 Handheld Scanning Device-Final Version . . . . . . . . . . . . . . . . 89 3-15 Desktop Lamp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 3-16 Circular Shadow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 3-17 Reflective Lining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 3-18 Reflective Lining Attached to Mount . . . . . . . . . . . . . . . . . . 94 . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 3-20 Light Cover Final Design . . . . . . . . . . . . . . . . . . . . . . . . . 96 3-21 Directional Light Schematic . . . . . . . . . . . . . . . . . . . . . . . 97 . . . . . . . . . . . . . . . . . . . . . . . . 97 3-23 Light Calibration Set Up . . . . . . . . . . . . . . . . . . . . . . . . . 98 3-24 Skin Scanning Experimental Setups . . . . . . . . . . . . . . . . . . . 100 3-25 Sample Image Acquired from Skin Scanning Experiment 101 3-19 Light Cover Options 3-22 Directional Light Applied . . . . . . . 3-26 Sample Images Acquired from Skin Scanning Experiments: Skin Features 102 103 3-28 Skin Image Preprocessing . . . . . . . . . . . . . . . . . . . . . . . . 106 3-29 Skin Analysis Work Flow . . . . . . . . . . . . . . . . . . . . . . . . . 107 A-1 CAD Model of Servo Connection to CNC . . . . . . . . . . 112 A-2 CAD Model of Webcam Mount to CNC. . . . . . . . . . . 113 B-1 Quantifying Melanin Code . . . . . . . . . . . . . . . . . . . . . . . 116 B-2 Skin Image Comparisons Using SSIM . . . . . . . . . . . . . . . . . 117 . . . . . . . . . . . . . . . . . . . . . . . . . 117 B-4 SSIM for Skin Images . . . . . . . . . . . . . . . . . . . . . . . . . . 118 B-5 Quantifying Lighting Code . . . . . . . . . . . . . . . . . . . . . . . 119 . . . B-3 Grayscale Skin Images . . 3-27 Sample Images for Hair Removing Algorithm . . . . . . . . . . . . . . 15 16 List of Tables 1.1 Imaging Platforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 2.1 Ergonomic Platform Choices . . . . . . . . . . . . . . . . . . . . . . . 46 2.2 Characterizing Repeatability with Position Grid . . . . . . . . . . . . 56 2.3 Error as Measured by High Resolution Camera . . . . . . . . . . . . . 57 3.1 Reflective Lining Choices . . . . . . . . . . . . . . . . . . . . . . . . . 93 3.2 Light Cover Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 3.3 Comparison of Light Sources . . . . . . . . . . . . . . . . . . . . . . . 99 3.4 SSIM Tests for Stability . . . . . . . . . . . . . . . . . . . . . 17 . . . 104 18 Chapter 1 Introduction Skin serves as the body's first line of defense against harmful pathogens and microbes; it is the largest organ. Its various properties (structure, elasticity, and color) may be used as powerful tools to aid in the diagnosis and treatment of various diseases. Observing and quantifying skin conditions over time may be useful to characterize the rate and severity of disease progression. Prior research has been done for skin cancer and its evolution 116, 37, 41] and the aging effects on skin (wrinkles) 11, 24, 44, 30, 42]. Little research has been conducted in observing skin feature stability and evolution of healthy skin. Skin feature stability characteristics is the motivation for the hardware developed and described in this thesis. 1.1 Skin Research Many skin conditions could be characterized or identified by quantifying changes of features over time. Some examples are tuberous sclerosis complex (TSC) and eczema. TSC is characterized by hypomelanotic macules (changing melanin levels) and angiofibromas (perppercorn sized bumps) 134]. Eczema is diagnosed when dermatologists notice inflamed or irritated skin patches 119]. Like eczema, other dermatological disorders are localized to different sites in the body. Grice et al. used gene phylotyping over a period of 6 months to investigate the influence of microorganisms on overall skin health [191. They found that microbes are specific to skin sites and thrive 19 under varying site-dependent conditions (i.e. sweat glands). These microbes cause dermatological disorders, such as psoriasis and eczema 1191. Skin features are also indicative of photoaging, or skin damage due to prolonged exposure to sunlight 1201. Excessive wrinkles (more than expected due to age) and irregular pigmentation are signs of UV radiation (exposure to sunlight) 1201. With prolonged exposure to UV radiation, skin loses its elasticity and firmness 1131. There are also perceived changes in the microrelief line structure (discussed in Section 1.2): a decrease in density of the lines (from 400/cm 2 to 250/cm 2 ) and a change in orientation of the lines [23, 29, 321. In modern society, the pressure to remain beautiful is synonymous with looking young and vibrant 1291. Consequently, the cosmetics industries are continuously researching and developing new anti-aging formulas for topical creams and hormonal therapies. In one example, the effects of hormone therapy on aging skin was studied over a 5 year period 1301. The viscosity and elastic properties of the cheeks were determined; aged skin was less elastic. A subgroup of women undergoing hormone therapy exhibited more elastic skin, confirming the beneficial effects of hormone therapy. Another study investigated the effects of topical vitamin C treatments on premature aging of the skin by observing the microrelief density and depth of "furrows" for six months 1201. Younger skin was found to be characterized by higher microrelief density 144] and shallow "furrows" (Figure 1-1) [44]. Skin age is affected by both physiological (natural aging) and environmental (UV exposure, hydration) effects. Literature suggests that the perceived age of skin is closely correlated with skin hydration 11]. Measuring skin hydration can be used to characterize overall skin health 113, 451. Skin hydration can be measured with the Corneometer CM 825 (discussed in Section 1.3) 1131. When the skin is less hydrated, the microrelief structure is affected; the furrows get deeper and the ridges expand, giving an aged appearance 111. Figure 1-1 provides an illustration of the skin "furrows" and "ridges." Besides aging, the various skin features have been used in identification, motion tracking, and skin growth. Fingerprints are used as a form of identification in many 20 S-k-n--......Skin Skin Furrow Ridges 00 Figure 1-1: Skin Furrows and Ridges Note: Image is adapted and modified from Shiseido [ll fields, from forensics to unlocking smartphones (touch ID sensors) [40]. Biometrics have been extensively studied in the past thirty years as computer techniques advance 1431. Fingerprints, face, iris, retina, palmprint, hand geometry, hand vein, finger surface, and finger knuckle print are just a few examples of the unique physiological characteristics that distinguish individuals 1431. The prior technology used for imaging the finger knuckle is described in Section 1.3. Some motion tracking technology used in virtual cinematography images the small High (mm) skin features on the face and hands as markers for tracking motion [221. resolution cameras with a high-frame rate were used to image the small (mm) skin features, such as wrinkles. When high resolution cameras are used to image small scale features, multiple pixels span the feature. This means the estimate of position should be based on the area of the pixels (instead of the feature point) for estimation algorithms. The last interesting and important application highlighted here is skin growth. By studying the wound healing process at the cellular, tissue, and organ level, Buganza noted that scars resulting from wounds maintained the same skin integrity ("1same microstructure, collagen content, and mechanical properties") as the native tissue skin [141. By investigating the anisotropic prestrain and deformation of newly grown used for skin expansion, Buganza illustrated that new skin had the same mechanical 21 properties as its original native state 1391. He drew a printed checker grid on the surface of pig skin (to simulate artificial skin structure) and inflated the tissue, which caused the skin to expand. The printed grid was deformed, but the mechanical properties were maintained. Since the mechanical properties of the original tissue were maintained, he proved that newly grown skin is mechanically analogous to original skin, so it can be used for defect correction 1.2 139]. Skin Features General skin features have been found to vary by location; they depend on the underlying bone and muscle structure, mobility, and tension [331. Since features vary so greatly with location, different parts of the body are imaged: forearm, upper part of inner arm, and thigh have been imaged in different studies 136, 42, 44]. Furthermore, as alluded to in Section 1.1, features are also age and gender dependent 1151. Features of various sizes could be imaged and later studied with the systems developed in this work. These are: (1) melanin variations, (2) hair follicles, (3) microrelief structures, and (4) superficial veins. In the following sections, each is described and in the context of existing literature when possible. 1.2.1 Melanin Variations Melanocytes, which are cells that contain melanin pigment, are 7 ,am in cross section 125]. Observing skin features at such a small length scale can be used for diagnostic purposes. J. Sun et al. observe the pigment variation of skin lesions at the macro level, which can be used to diagnose skin tumors 1371. Pigment variations, at dimen- sional scales of 10mm x 7mm, are caused by melanin, oxygenated hemoglobin, and deoxygenated hemoglobin [37]. The melanin proto-molecules themselves are 6 nm - 10 nm in size, though they vary based on pH levels 1251. By studying the optical reflective and scattering properties of melanin, various skin diseases may be diagnosed 1251. Although melanin is the primary contributor to overall skin color, skin color is also affected by blood flow 22 1241. Melanocyte Melanin Figure 1-2: Melanin and Melanocytes Note: Image is reproduced from Medline 1.2.2 191 Hair Follicles Hair follicles are on the order of 50pJm - 160pm and are found on the dermis 1281. Since they expose the dermis layer to the environment, it is important to study these features. One study investigated the penetration of topically applied drugs and cosmetics through hair follicles using noninvasive cyanoacrylate skin biopsies and light microscopy 1281. dependent. It was found that hair follicle size and density are location Developed in the early fetal period, hair follicles are dense and spread apart overtime as the body grows 1281. Of the seven regions sampled, the forehead had the highest hair follicle density. The calf had the largest follicles of size 160 jIm. Forearms had one of the lowest density of hair follicles and were smallest in size at 78 1um. 1.2.3 Microrelief Structures Skin at the 20 ptm to 8 mm scale reveals prominent microrelief structure. The mechanical forces imposed on the tissue create a net-like structure comprised of triangles and quadrangles 129, 441. Absorbing and excreting excess water is dependent on the microrelief structure, which affects skin hydration 1361. Microrelief structure and density vary with body location [151; they are particularly prominent on the wrists and forearms 1291. 23 Hair Follicle Figure 1-3: Hair Follicle Found in Dermis Note: Image is reproduced from Medline 181 Microrelief structure also changes with age [29, 441. As elasticity decreases, the skin folding capacity increases, forming wrinkles that are commonly seen in the elderly. Zou et. al studied the aging effects on forearm microrelief structure 1441. The sampled population ranged from 20-79 years of age. The authors identified two types of skin lines which form the skin structure: primary lines that are 20-100 fam deep and uniformly directed lines" 1441) 1331 ("wide and secondary lines that are 5-40 pm deep [331 ("all other lines with different directions not belonging to the primary sector" [441). Primary lines get deeper with age, whereas the secondary lines start to disappear 144, 331. These can be seen in Figure 1-4. 1.2.4 Superficial Veins The visibility and size of superficial veins is also location dependent 1351. Vein di- ameters are on the order of 2 mm and 0.25 cm 126, 351. Knowing the location and size of superficial veins is important in many applications. One study used the vein size to find the appropriate insertion point for dialysis treatment [351. In this study, ultrasound was used to image superficial veins over a period of 7 years. The authors found that over time, vein size decreased 1 mm in diameter every 3 years. 24 Age: 21 Gender: Female Age: 48 Gender: Female Age: 60 Gender: Male Age: 70 Gender: Male Figure 1-4: Structure of Aging Skin: Original skin images and microrelief structures detected across aged populations. Note: Image is reproduced from Zou et. al [441. 25 1.3 Existing Imaging Technologies There is a public database of skin images, which is used for disease diagnosis [16]. Accurately imaging the skin is difficult since image quality varies with imaging parameters: viewing angles and illumination angles 115, 37]. The complex optical properties of skin and the geometry of pores and wrinkles cause reflections, making it difficult to consistently image the skin. Hardware and imaging methodology technologies have been developed to address these challenges. 1.3.1 Imaging Hardware Desktop and handheld devices have been developed to image the skin. These platforms are used to capture images of microrelief structure, pigment variation, and skin hydration levels. Finger knuckle prints are unique and can be used to recognize a person's identity 143]. Like fingerprints, finger knuckle textures are distinctive and can be imaged and processed in real time with a finger-knuckle-print (FKP) imaging system (shown in Figure 1-5) as designed by Zhang et. al [43]. The finger bracket provides the subject with a consistent resting platform, which allows for repeatable finger knuckle images the finger) for a better user experience 143]. 143]. It is also ergonomic (curves around Repeatable images are desired because it simplifies data processing. The LED light source provides consistent lighting. Acquired FKP images are 768 pixels x 576 pixels with a resolution of 400 dots per inch (DPI). Repeatability of the experimental set up and the longitudinal stability of the finger knuckle print was studied by taking images at an interval of 56 days. The system is repeatable and compact, but can only be used to image a specific biometric (finger knuckle). Zou et. al studied the changing forearm microrelief structure by using a USB skin detector produced by Boseview Technology Company (illustrated in Figure 16) 144]. This system imaged the skin at 50x zoom and analyzed the "oil [content], moisture, pigment, pore, elasticity, and collagen fibers of the skin" 26 17]. However, Zou Finger Bracket LED CCD Sensor -1 . Triangular Block . - Figure 1-5: Imaging System for Finger Knuckle Prints: The data acquisition module is shown here, with a finger bracket, LED light ring, lens, and CCD sensor. The full device measures 160mm x 125mm x 100mm. Note: Image is reproduced from Zhang et. al 1431. et al. noted the drawbacks of the imaging device: there were no polarizing filters that minimized light diffusion, so there were specular reflections (i.e. hot spots) in the images for subjects with oily, smooth, or well-moisturized skin. Furthermore, directional lighting induced shadows for uneven surfaces. The effects of shadows and hot spots were eliminated by the algorithm they developed, not the device itself. This drawback is addressed in the device design presented in this thesis. Our device images the microrelief structure with minimal specular reflections and shadows. The Skin Visiometer 1131 uses the amount of light absorbed through a silicone replica of the skin (9mm x 6.7mm area) to image the skin microreliefs. The silicone replica is placed between a LED light source and a black-and-white, high resolution (5 MP) CMOS camera. A software program converts the amount of light absorbed through the silicone replica to reproduce the skin valleys and give a topographical view of the skin surface. The device weighs 2.7 kg and measures 26cm x 24cm x 7cm 15]. Other noninvasive methods to characterize the microstructure for aging effects 27 Visual Transmission Lens White LED Light CCD Figure 1-6: Imaging System for Microrelief Structure: The principle of the image acquisition device is shown here. It consists of white LED lamps to illuminate the skin surface, an optical transmission magnifying glass, and a 6mm x 8mm CCD sensor to image. Note: Image is reproduced from Zou et. al [441. are video microscopy and confocal laser scanning microscopy (CLSM) 1361. In 1361, a calibrated video microscope with a magnitude of 100x was used to capture "in vivo light reflectance images of the skin surface." The skin area imaged was minimal at 2.7mm x 2.1mm. CLSM was also used to image infant skin (at a much smaller area of 0.5mm x 0.5mm) and has been used for diagnosing dermatological conditions. Since it is a noninvasive method that can image the skin microstructure in vivo, CLSM is preferred to painful biopsies. It focuses an incident light on the skin at various depths and scans sections parallel to the skin surface. Very different from the aforementioned devices, Capacitance Imaging (CI) measures the capacitance of the microrelief structure with a 50 pm resolution 1231. The device is called SkinChip. It has a 1.8cm x 1.28cm sensor that has 92,160 capacitors to provide the fine resolution. Grayscale capacitance maps illustrate the density of the microrelief structure, which provides information about the skin surface hydration. A drawback is that CI is sensitive to patients applying moisturizers right before imaging. CI can also be used to analyze photoaging, which is used to show heterogeneous 28 patches of dry and hydrated skin. Skin hydration has been measured in a number of ways. The Corneometer 1131 uses the change in dielectric constant resulting from changing capacitance to measure skin surface hydration over an area of 49 mm 2 . It is accurate within 3%. It weighs 41 g and is 11 cm in length 161. Skin hydration may also be affected by the vascular structure 1241. To assess the vascular structure in real-time, videocapillaroscopy (VCS) is used 1241. J. Sun et al. developed a handheld camera (Figure 1-7) which was used to study varying pigmentation patterns [37]. The system acquired six color images to study the color variation in skin lesions. Each image was acquired with light coming from a different direction, free from the effects of "topographical shading, shadowing and specular reflections" [371. The skin was imaged with LED lights, with at least three LEDs illuminating the surface for any one image. Because of the diffuse lighting, however, the microrelief structure was not visible and only pigmentation was analyzed. 4 cm CCD ~Detached Light Shed Lens LED Skin Camera Figure 1-7: Handheld Imaging System for Skin Color: The skin analyzer uses a IEEE1394 digital camera, a high-resolution compact lens, and six white LEDs with a 40" spread. Note: Image is reproduced from J. Sun et. al 137]. A colorimeter (Minolta chomameter CR-200) was used to characterize skin color, 29 especially the red hues resulting from blood flow 1241. Optical coherence tomography (OCT) was used to construct a 3D volume of the tissue by acquiring images at 2 frames per second (fps) 1311. It was used as a diagnostic tool because the 3D volume could be used to investigate different internal features. To acquire the 3D volume, a two beam interferometer was used. At a specific height, an image of the object plane was obtained; one beam scanned the object depth while the other beam scanned the object transversally. Since the microscopic level also provides insight into skin health (young skin has a thicker epidermis than aged skin 1421), a microscope can also be used to image skin. A suitable microscope is the AM4815T Dino-Lite Edge microscope. It comes with lights on board, has a high frame rate (30 fps), a 20x - 220x optical zoom, and an extended depth of field [4]. A drawback is a very limited field of view (FOV). The portability of this microscope inspired the handheld device design described in this thesis. Table 1.1 provides a summary of the various imaging platforms described above. 1.3.2 Imaging Methodologies Cula et. al argue that highly specialized equipment is not necessary for analysis of skin texture; instead a number of camera and lighting positions are required (a method known as bidrectional lighting) [15, 16]. They image with a high magnification, high resolution Sony DFW-V500 IEEE-1394 camera on an articulated arm that allows 6 degrees of freedom (DOF) to view pores and fine wrinkles. The camera has manual focus. Since dermatologists use a regular digital camera and image in ambient lighting, a DC-regulated light source is used without special filters or polar lenses, which mirrors the clinical lighting conditions. The camera must be calibrated before each measurement since the camera location with respect to the imaging surface changes each time the camera is removed from the articulated arm [15]. This system works best for planar and rigid objects. Setaro and Sparavigna addressed the problem of non-planar surfaces by making and imaging skin replicas 133]. They cleaned and applied silicone polymer mixed 30 Table 1.1: Imaging Platforms Imaging form FKP Plat- Application Benefits Drawbacks Finger knuckle Repeatable images; Consistent lighting; Ergonomic Image at 50x zoom; Pigment, pore, and microrelief imaged 5MP camera; Light absorption used to get skin topography 10Ox zoom Image only knuckle USB Skin Detector Microrelief Skin Visiometer Microrelief Video croscopy CLSM Microrelief Mi- Lighting can be controlled High resolution Corneometer Microrelief and diagnosis Microrelief and hydration Skin hydration Colorimeter Skin color Our handheld device Microrelief structure; Skin color; Hair follicles; Vascular structure Characterize red color resulting from blood flow Uniform lighting; portable CI Accurate to 3% Shadows; Specular reflections Skin replica required No lighting changes Small image area Sensitive to moisturizer use Uses capacitance changes to measure hydration, so cannot image other features RGB data used for skin color only USB connection; AC light source with catalyser to the skin surface to create the replicas. Silicone rubber skin replicas were 5cm x 5cm and were imaged with a stereomicroscope (Olympus Sz404STR). Repeatability was ensured by putting the replica on a horizontal plane, using a 7x objective lens, and two illumination sources with a 45* incidence. Silicone rubber skin surfaces were also used for skin relief measurements in [20]. A laser probe with an optical measuring head was used to analyze the skin. It consisted of a transmitting laser (to image the surface) and photodiodes (to receive the reflected signals). 31 finger 1.4 Thesis Outline Although numerous technologies, both hardware and imaging methodologies, exist to image skin, there is no one single device that images feature length scales (Pm to cm) in the visible spectrum. The hardware that has been developed for this thesis images pigment variation, hair follicles, microrelief structure, and superficial veins. It is hoped that by observing feature evolution and variability of these skin features, overall skin health may be assessed. This thesis focuses on systems developed to study skin features. In Chapter 2, a fixed mechanical scanning system is used for validating skin based body registration algorithms. Chapter 3 follows with a description of a handheld scanning device used to image the four features and shows preliminary experimental data. concludes with ongoing work and recommendations for future work. 32 Chapter 4 Chapter 2 Ground Based Mechanical Scanning System for Evaluating Skin Based Body Registration Algorithms A skin-based mapping algorithm was created by Dr. Shih-Yu Sun in which the skin surface was mapped while simultaneously estimating camera motion by tracking skin features 1381. The skin features that were tracked were extracted by Matlab's builtin SIFT (Scale Invariant Feature Transform) algorithm 1381. These were artificial skin features. Skin features that are robust for tracking can be artificial or natural. Artificial skin features can be achieved by feature extraction (as described above) or by a high-contrast pattern "tattoo" (discussed further in 2.4.1). Natural skin features are those that were discussed in Section 1.2 (moles, hair follicles, microrelief structure). We developed a 5-axis mechanical scanning system to serve as the ground truth to validate the accuracy of the mapping algorithms. Important parameters which influence algorithm performance include lighting variations and camera viewing angles. Thus, the platform had to incorporate methods to determine the effects of these two variables (described in Section 2.4). The algorithm performance itself would be evaluated by the accuracy of motion estimation and quality of reconstruction compared to the prescribed and known motion of the test platform. 33 Motion was prescribed and controlled by a 5-axis mechanical scanning system, which was created from a 3-axis translational Computer Numerical Control (CNC) system, two added servo motors, and a camera. The experimental intent was two fold: first, replicate and extend the results obtained by Dr. Sun with both artificial and natural skin features and second, evaluate significant parameters (i.e. linear distance traveled, distance between skin surface and camera) in order to quantify algorithm performance. This chapter discusses the design of the scanning system with a focus on the various hardware components (Section 2.1), describes the calibration of the scanning system (Section 2.3), outlines the experimental procedure, data collection, and analysis (Section 2.4), and summarizes results (Section 2.5). 2.1 Mechanical System Hardware The mechanical system consists of: (1) a 3-axis translational stage from a CNC mill, (2) two additional servo motors for rotational degrees of freedom, and (3) a camera. The 3-axis translational stage was purchased from Zen Toolworks and assembled according to the instruction manual [10]. Mach3 was used to control the 3-axis linear stage. Moving away from Mach3 and controlling the three stepper motors (motion in X, y, z axes) with LabView was challenging. LabView was chosen as the software platform to simultaneously control the 3-axis linear stage, servo motors for rotation, and camera with one program. For the clinical applications of ultrasound-camera based scanning, 5 degrees of freedom (DOF) are evaluated. The DOF identified for the applications were: 3 linear axes - along the longitudinal length of the scan region, transverse to the scan region, and compression into the scan region; 2 rotational axes - rotation about the transverse axis and rotation about the longitudinal axis. These axes can be seen in Figure 2-1. Rotation on the plane of the skin surface (scan region) was neglected since images could be re-oriented afterwards. The 3-axis linear stage system re-purposed from a CNC mill enabled the translational motions. To account for the 2 additional rotational DOF in the mechanical 34 Transverse Axis Ultrasound probe Scan Region Longitudinal Axis Figure 2-1: Longitudinal vs Transverse Axes as Shown on the Scan Region system, two servo motors were added. These were also controlled with LabView. Skin images were acquired with a Macally IceCam2 USB webcam. It was also controlled with LabView. Each of these components is discussed in greater length in the following sections. 2.1.1 3-Axis CNC Mill The 3-axis desktop CNC mill provided 3 translational DOF. It was assembled as outlined in 1101. High density PVC boards and steel guide rods make up the frame. M8xl.25 stainless steel leadscrews are used for each axis. Anti-backlash brass nuts ensure backlash is reduced. Backlash reduction is important for repeatability of experiments and calibrating the mechanical system (see Section 2.3). The x and z axes have 7" of travel, the y axis has 2" (Figure 2-2). These travel capacities are considered sufficient because, based on observation, many clinical applications (i.e. scanning the thyroid, biceps, or kidney) do not require more than 7" of travel. One system integration challenge was controlling the five axes of motion. Mach3 was the software provided for the CNC mill from Zen Toolworks. A single, scalable 35 NEMA 17 Stepper Motors Figure 2-2: CNC Axes: The 3-Axis commercially available CNC mill is equipped with 3 NEMA 17 stepper motors. Note: the image is adapted and modified from 1101. software platform is preferred; Arduino and LabView are considered. The specifications and power requirements of the motor are needed for switching software platforms. The open source Arduino codes to control stepper motors were used for early experiments. Finally, all motors were controlled with LabView (see Section 2.2.1). Choosing a motor with appropriate resolution for the clinical application is important. Assuming a 0.5 ' probe travel speed during scans 1381, the finest resolution required is 0.0125 ". This is double the resolution (smallest increment (theoreti- cally) at which images can be captured) of the Nema 17 stepper motor, which is rated for 1.8*(see Equation 2.1c). 36 3600 steps = 200 revolution 1.80 200 steps 16 microsteps = microsteps x =-3200 rev step rev M( 1 rev 1.25 mm x = 0.00625 mm2 1 rev 200 steps step (2.1a) (2.1b) (.b 1c A sinusoidal signal is supplied to drive the stepper motors, providing signals for a step and a direction. Sparkfun Big Easy motor drivers are used to drive the motors since the microcontroller (myRio) cannot provide sufficient power. Each driver requires 1.5 A from the power supply (1.5 x 3 = 4.5 A total current draw from all three motors during operation) and 2 A when stalled. Since the motors are not stalled during operation, a 5 A, 12 V power supply is sufficient. Details of the LabView code to control the stepper motors are found in Section 2.2.1. 2.1.2 Servo Motors The servo motors are used to: (1) rotate a 0.8 oz camera (Section 2.1.3), so they must have sufficient torque rating (4 oz-in), and (2) to provide the 2 rotational DOF of the mechanical system to model the clinical case when there is rotation about the longitudinal or transverse axes during scans. They must operate in the rotational range of 0* to 45* as required in clinical procedures (this range is determined after ob- serving professional radiologist, Dr. Anthony Samir, performing clinical procedures). The servo motors were selected by their ability to supply torque and the allowable rotational range. The two servo models selected from Servocity were: (1) SPG5485A Standard Rotation (provides rotation about the longitudinal axis) and (2) SPT400 Tilt System (provides rotation about the transverse axis). These servos operate with the HiTEC HS5485HB motor, which has a 623 oz-in torque rating. Although this torque rating is much greater than required, the allowable rotational range of 0* to 650 makes it appropriate for the application. 0* is the ideal case, representing no rotation about the 37 longitudinal or transverse axes. By observation, the rotation about the longitudinal or transverse axes will not be more than 45*, so an upper bound of 650 is sufficient. A pulse width modulation (PWM) signal is sent to control the servos, varying duty cycle and pulse frequency. Torque increases with voltage; the servos operate in the range 4.8 V to 6 V. In order to support the stall current, the current supplied to the motors must be at least 3 A. An adjustable 5 A, 12 V DC power source is used to supply power. Details of the LabView code to control the servo motors are found in Section 2.2.2. 2.1.3 Webcam A USB (universal serial bus) camera (Macally IceCam2 webcam) is used to capture skin images, which is the same camera used in Dr. Sun's experiments 1381. This model is selected because it allows for manual focus and has a minimum focal distance of 2 cm, which is appropriate for the clinical applications as designed in Dr. Sun's work. The camera must be calibrated at the working distance for optimum focused images (described in Section 'Camera Calibration'). Macally IceCam2 is also Direct Show compatible (common, filter-based framework that allows media to be controllable with many programming languages), so camera control can be integrated with LabView (see Section 2.2). The spatial resolution of the camera is 640 x 480 pixels, and for a selected focus and working distance is mapped to a 28 mm x 21 mm field of view (FOV) on the skin. As shown in Figure 2-3, the camera has: (1) a special 3D printed backing and (2) the lens focus "fixed" with glue after being set to the correct working distance. Camera Calibration To ensure quality images, the camera has to be calibrated against radial distortion, translational error, and motion blur at a set working distance. The final working distance of 5 cm is set based on three factors: (1) ultrasound probe geometry limitations, (2) findings from Dr. Sun, and (1) clinical observations. With the camera housing 38 Figure 2-3: USB \i\Tebcam Used for Experiments: The McCally IceCam2 shown here has a 3D printed back, which is specifically designed for kinematic coupling to the 5-axis translational stage (see Section 2.1.4). The lens has been manually focused and fixed in place with hot glue at a distance of 5 cm. mounted on the ultrasound probe, the camera is always at least 2 cm away from the skin surface. However, at such small distances, skin surface deformation is significant. Findings from Dr. Sun concluded that skin surface deformation is insignificant when the camera is more than 4 cm away from the skin surface, so the working distance must be at least 4 cm [38). In clinical observations of ultrasound-camera system imaging of thyroid and forearm for Duchenne Muscular Dystrophy monitoring (two clinical applications in which the skin based registration algorithms are used), the camera is 5 cm away from the patient skin surface. Therefore , to model the real world clinical case and limit effects of skin surface deformation, a 5 cm working distance is set. The camera calibration procedure is used to calculate the camera's intrinsic parameters (focal lengths and principal points) and radial lens distortion coefficients [3 , 38). The calibration procedure is outlined below. A black-and-white checkerboard pattern of known dimension is used. There are 13 squares, each 24 pixel x 24 pixel (or 1mmx1 mm when printed at 600 DPI), along one side of the pattern. The inner 11 squares are used for calibration, with the outer squares making corner localization more accurate and reliable [38). A small white dot is placed in the middle of the top left black square , which serves as the reference 39 when extracting grid corners across all images, since extraction always starts with the square with the white dot. Next, the grid is imaged at least 15 times at a variety of angles and orientations, to encompass the entire scanning space. The webcam is held at the working distance (Figure 2-4a). A sample calibration image is provided in Figure 2-4b. Once the images are acquired, the Camera Calibration Toolbox in Matlab is used to determine the camera intrinsic parameters (used to determine the homogeous projection matrix) and the radial lens distortion coefficients 13, 381. 1. Load images as .PNG, .TIF, or .JPG 2. Manually select grid corners; the first one is at the reference square 3. Toolbox algorithmically determines inner boundary of calibration grid (should be 11 x 11) 4. Enter the size of each square so that Matlab can extract the grid corners (this attempts to calculate the distortion coefficient, valued between -1 and 1) The calibration procedure generates information about the image coordinates, 3D grid coordinates, and grid sizes and saves them in a file, calib_ data.mat. Matlab also calculates and reports the calibration parameters: the focal length, prinicpal point, skew, distortion, and pixel error. 2.1.4 Integration of Hardware The components described above (3-axis translation stage, servo motors for rotational motion, and camera) are integrated into a single experimental platform. Integrating Servo Motors to the 3-Axis Linear Stage The two rotational servos are mounted serially to one another as shown in Figure 26c. A bracket connects the servo motors to the y axis of the 5-axis scanning platform (Figure 2-6a). Mounting on the y axis allows for images along the transverse and 40 (a) Camera Calibration Set Up: Images are taken at various orientations with the webcam fixed at a predetermined working distance (5 cm). The calibration grid is secured to a solid surface. (b) Sample Image obtained during Camera Calibration: The image shows some rotation about the plane of the image as well rotation about an axis perpendicular to the axis. Figure 2-4: USB Camera Calibration longitudinal axes of the limb as shown in Figure 2-5. mounting axis for multiple reasons: 41 The y axis is chosen as the 1. It keeps the z axis stage free for patient limb placement, which is required for experiments: the camera is on an elevated axis from the z axis plate 2. It saves space on the system with an already limited range: the camera is mounted separately and does not interfere with the leadscrew motion, so all axes can travel the full capacity: 7" for x, z and 2" for y 3. It allows for imaging in all three translational directions at once (x, y, z) without changing the location of the camera: the y axis is coupled to the x axis, so the camera can move in one or both axes while the z stage is moving Figure 2-5: Camera Scanning Arm While on Platform: By mounting on the y axis of the desktop platform, the transverse and longitudinal axes of the arm can be scanned simultaneously (moving in x and y axes of the 3-axis translational stage). The final bracket is shown in Figures 2-6 and 2-7. For the CAD drawing, please see Figure A-1. 42 (a) Y Axis: Hole pattern of where the bracket can be mounted is visible. (b) Servo Mounted to Y The Axis of Platform: bracket lines up with the y axis mount. It does not prohibit leadscrew motion because it is sufficiently offset from the y axis frame. (c) Servos Mounted One on Top of Another: This orientation allows for the critical rotational DOF to be imaged. It also conserves space. Figure 2-6: Servo Motor Connection to 3-Axis Linear Stage (b) Servo In Mount-Side View: The Rotation servo nests comfortably in the bracket, with just enough clearance in the back for the wires connecting to the microcontroller. (a) Servo In Mount-Top View: The hole pattern for the Rotation servo is used to connect the servo to the mount. - - 20 screws are used. Figure 2-7: 3D Printed Bracket to Connect Rotation Servo to 3-Axis Translational Stage Integrating the Webcam to the Servo Motors A magnetic kinematic coupling mechanism is used to connect the webcam to the pan and tilt servo, which is inspired by the ultrasound probe housing to camera mount as 43 Figure 2-8: 3D CAD Model of 5-Axis Scanning System designed by Dr. Matthew Gilbertson 1381. The -" press fit magnet on the kinematic coupling mechanism makes it easy to repeatably attach the webcam to the mount. Using the existing hole pattern on the mounting plate of the pan and tilt servo, the camera mount can be secured. The dimensioned drawing is found in Figure A-2. Figure 2-8 shows the CAD model of the 5-Axis scanning system with all the components. The actual, developed machine is illustrated in Figure 2-9. 2.1.5 Ergonomic Considerations The ergonomics of the system was a consideration during design. The platform should be comfortable enough to keep the scan region stationary for a five minute scan. For all experiments presented in this thesis, the scan region was the arm. To support the elbow and wrist, a Belkin gel pack is used. The gel pack is almost as long as the z axis platform, which is the ideal length for scanning the forearm, and molds to the forearm for optimum comfort. It is also simple to incorporate into the structure as 44 Camera to Servo Mount Stepper Motor Servo to CNC Bracket Webcam 2 Servos IP GlPc Axis Stage Figure 2-9: 3-Axis Translational Stage with Servo Motors and Camera: The 3-axis translational stage is seen here with two additional servos (pan and rotation systems), a 3D printed servo bracket, a USB camera, and a 3D camera mount. A Belkin gel pack is put on the z axis platform for patient during scans (see Section 2.1.5). desktop tilt and printed comfort shown in Figure 2-9. Note that during experimentation, the gel pack is put on top of elevated surfaces so that the arm on the gel pack is in the line-of-sight of the camera. Several ideas were considered for an elevated, ergonomic support (see Table 2.1). Eventually none were implemented as the design moved towards a free hand scanning system (see Ch 3). 2.2 Mechanical System Control Using LabView Simultaneous control of the 3-axis linear stage, servo motors, and camera image capture is done with LabView and the myRio microcontroller. The myRio can control the five motors (three steppers and two servos) and the USB camera with an extendable USB port hub. LabView was selected because it is compatible with the myRio, 45 Table 2.1: Ergonomic Platform Choices Idea Belkin Gel Pack Benefits Appropriate length for forearm scanning, Easy to integrate into platform, Molds to forearm Half Metal Cylinder lined with foam Foam molds to forearm Vertical arm hold for subject to hold onto Space saver Adjustable table/chair Space saver, Brings camera and scan region to same level Drawbacks Not appropriate height for placing forearm in line of sight of camera, Does not allow for repeatable experiments Bulky, Cannot scan other regions (neck and thigh are bigger than forearm) Does not allow for repeatable experiments, Cannot scan other regions Extensive adjustment can be easily programmed to control the motors, and has a Vision Express VI that can be used for image capture. User inputs to the LabView Front Panel are simple (as shown in Figure 2-10): the desired travel distance (in mm) for the three Cartesian directions (x, y, z) and the desired angle (between 0" and 650) for the two rotational DOF. The block diagram is where the important parameters are calculated and from which the signals are sent. The details of the block diagram are described in the following sections. First, controlling the stepper motors is discussed; next, controlling the servo motors is outlined. Note that this is a relative motion system, so distances traveled are relative to the starting point. 2.2.1 Stepper Motor Control The stepper motors are used to move a desired linear distance from any starting point. Operating as open loop control (i.e no feedback system to determine relative distance traveled), it is imperative that no steps are skipped since counting steps gives the distance traveled. This assumption is verified (Section 2.3). To ensure no steps are skipped, the correct step mode and the frequency at which 46 Twm rpa Rwr~nO z zdketon Cuneg Pan & T* DMMW RPblbDn M2k 0 Cuuent kutdiRn (&9rees) %dwrVoft"e *Otabon)' 9 Figure 2-10: Front Panel Inputs to Control Mechanical System Using LabView to send the pulse must be determined. After much experimentation, the optimum parameters to avoid skipping steps are: frequency (f) = 400 Hz and full stepping (200 "'Ps). Using these parameters, the LabView code is constructed (Figure 2-13). Figure 2-11 provides the high-level calculations for automating the stepper motors. While Figure 2-11 outlines the procedure to move a distance that is an even 47 Distance (mm to move) + 1.25 rev # of Revolutions to Turn I 1 x (200 stepsx MS microsteps rev step # of microsteps = # of pulses for desired distance +f Hz Time for loop to run Figure 2-11: Stepper Automation Code Flow Chart: This is the pseudo code that is implemented in LabView (see Figure 2-13). It takes the user input linear distance and determines the number of revolutions the leadscrew must turn to achieve that distance. The number of revolutions is converted to the number of steps required, which provides the time the pulse is sent. 48 Turn On myRio to start sending pulse Send signal for Stop sending pulse to myRio Wait to take an image with Express Vision VI Figure 2-12: Flat Sequence Loop to turn the leadscrew 1 revolution. When the microcontroller (myRio) is sending a pulse (i.e. steps), the leadscrew is turning and the linear stage is moving linearly. After the desired distance is traveled (determined by the time the signal is sent), no more signals are sent to the microcontroller and the leadscrew stops moving. This sequence is placed in a For Loop to allow for more than 1 revolution. multiple of 1.25 mm (leadscrew pitch), the LabView code can support any distance input. The quotient resulting from the first step in Figure 2-11 provides the number of full revolutions for the For Loop. The procedure is then repeated for the remaining distance as seen in Figure 2-13. A flat sequence loop structure is used to turn the lead screw and take a picture with the camera as illustrated in Figure 2-12. In LabView, this algorithmic structure is implemented as shown in Figures 2-13 and 2-14. Although shown for the y axis, this code is implemented for all x, y, and z axes. 2.2.2 Servo Motor Control Servo motors provide the 2 rotational DOF on the 3-axis linear stage and are used to move to the desired relative angular position. Built-in potentiometers on the servo motors are used for measuring and providing feedback for the relative angular position by correlating voltage to angle. The resolution, or the smallest degree increment that the servo motor can move, is calculated in E or Duty Cycle Using the resolution of each servo motor, the voltage required to move to the desired location from the initial position is calculated. A sample calculation to rotate to a desired angle (0) on the pan and tilt system is provided in Equation 2.2. Given the geometry of the servo motors and gears, the desired angle must be in the range of 00 to 65*. This is more than sufficient for the clinical application as described in 49 x dircton+ 400 Sts/Re 10r0 Time per Rev (ms) x 0 ic iL Li Li 0 i Li Li Q_ i W-LMi LU Li i L IJ J UI UM LI LIM UI LI L 0 rd d LL ULAI d Re X~4~ turnin Paused for 5 seconds take a picture L I- Send ulse to ste Stepper turns 1 revolution | er to move Intermediate x Step Stop TOP Step Top Stepper Top Direction EM .....................---- S Vision Top 19) > t/DIO4 (Pin Imaes Acquisition5 QUITO____ 0 3Q1 1 LE 711 Figure 2-13: LabView Code for Translational Axis-Full Cycles: This code is implemented first. It allows the leadscrew to move a distance that is an even multiple of 1.25 mm. The input distance is divided by the leadscrew pitch (1.25 mm) and the quotient indicates the number of times the For Loop will be executed. Parameters for the number of steps per revolution (full stepping - 200 steps/rev) and pulse frequency (400 Hz) are optimized and set. y x+ *1I. direction X 1.25 1.25 e 001000 200 Fr ISteps/Rev 0W D0 9 0 OD 3 DOCC D0 313313,3133133 - - ==-m D13 0 3 013 3 130 13 1 J 2 1 1313 ,1313 1 1313 ryM 1 M1 RM M P% M-F2 13 l 113 3 1 13131 ff 0 3 1 1313 M 1 991MirFM 9r1199M U Stepper turns for less than 1 revolution Send pulse to get stepper to movek Paused for 5 seconds to take a picture IStop turning I, Step Back Step Side2 El0Q,0UQa1 Fna y Image Vision Acquisition4 0,MQTV -' M M~r r19919919919M Fe1R1NMA RM1 1939 9 1111 FMriai riri 9 1 391919 9 1 1919 9 1 1 Figure 2-14: LabView Code for Translational Axis-Remaining Cycles: This code is implemented immediately afterwards if there is a remainder when dividing the input number of cycles by 1.25. Parameters for the number of steps per revolution (full stepping - 200 steps/rev) and pulse frequency (400 Hz) are optimized and set. Section 2.1.2. 00 x 0.017-(Resolution of servo) = V required to move 0 from starting position (2.2) A feedback system is implemented into the LabView code to compare the current angular position to the desired. The algorithm flow is outlined below followed by a snapshot of the LabView code, which implements this algorithm (Figure 2-15). 1. Take current voltage reading from potentiometer 2. Subtract initial reading 3. Multiply the resulting voltage by resolution (5) 4. Subtract current angle from desired 5. Multiply by resolution (Duty CYcle) 6. Add to previous duty cycle 7. Make sure duty cycle is between 0.03 and 0.09 2.3 Characterizing the Mechanical System Design considerations greatly improve the performance of the mechanical platform. Since the mechanical platform is used as a ground truth system for validating skin mapping algorithms, the set up must be repeatable and consistent between experiments. The set up includes the camera that is secured in place and the tension in the cable eliminated. The camera captures images of a pattern that represents artificial skin features (called a "tattoo"). The tattoo is mounted to a rigid surface, which is kept vertically upright by a rigid block behind the tattoo. The plane of the lens and tattoo are parallel to one another. This set up is seen in Figure 2-16. 52 45'4el'd4|IPl.UIISIMMillH61JWil'Ulll@IlliI eIIIIItall.llie liliindit il'hiki.dli 6IL 101h Ub ds.Elvi IH914t|MFil<IIt i101 41611 Ilailli i -'ik 'a rd61AllEpill-1 Turn to Desired An Ma~ Servo M otor Control Paused for 5 seconds I to take a pkiture i, E - 2 PWMT* --EE;= Desired Pan & Tilt Angle (degrees) AN"lgIpt Vis*Mn Slider Voltage (Pan & Tilt) C urrent Pan & Tilt Nle (degrees) I error in MPAtno On DC o-l~e50091 --- Subtract li"ia Vokage D l Dy yde/ | Max Rotated mnW 'Image Logging I PImage Logging I Log Image error out Image Logging Ii Image -Out Intermediate z li s 2 DC 00305 Desired Rotation Angle (degrees) m- P FI Pin Slider Voltage (Rotation) 0 r i Current Rotation Angle (degrees) E1B 4.76 st [Subtract lhnit" Vote lReading Figure 2-15: LabView Code for Rotational Axes: This code is used to control the servo motors. A pulse width modulation (PWM) signal is sent to the servos. The feedback system uses the potentiometers on the hardware and is indicated by level shifters in the code. After the While Loop executes, an image is captured. Figure 2-16: Rigid Support Behind Tattoo: The tattoo is mounted to a rigid surface, which is kept vertically upright by a rigid block and metallic sheet. This helps keep the webcam and tattoo parallel to each other and are separated by a distance of 5.88 cm. f'he camera is secured to the platform and the cable tension is eliminated to avoid moving the camera as the platform moves. With this rigid, repeatable set up, the mechanical platform is characterized. Characterizing the mechanical system is two-fold: determining the resolution of the system and quantifying the error in the system. Each is described in further detail in the following sections. 2.3.1 Resolution of the 3-Axis Linear Stage The resolution of the mechanical system should be at least one order of magnitude better than the algorithm performance since it serves as the ground truth platform. There are two metrics that characterize the resolution of the system: bias and variance. The algorithm bias is the difference between the mean distance traveled as estimated by the algorithm and mean distance traveled by the 3-axis linear stage. The bias is on the order of mm. The variance describes how the algorithm esti54 mate differs from the mean estimate and is on the order of sub-mm 1381. Thus, the resolution of the mechanical system should be at most sub-mm. 2.3.2 Quantifying Error of the System To quantify the error in the set up, the one direction (move forward) and two direction (move forward and backward) repeatability are tested. This is an important calculation since the linear distance traveled is determined by the number of steps. Each is discussed further in the following sections. Note that since a feedback system is incorporated in the LabView code for the servo motor motion (Section 2.2.2), only the repeatability of the stepper motors has to be tested. One Direction Repeatability The one direction repeatability experiments quantify the open loop errors by determining if the actual distance traveled in one direction is the desired distance traveled. Multiple parameters (frequency, step mode, travel distance) were varied in the LabView code to determine how these variables affect repeatability. A high precision glass position grid is used for experiment. The grid has 10 mm separation between squares and markers with fine resolution near the square center. Figure 2-17 shows the experimental set up. The following is a step-by-step procedure describing the one direction repeatability experiment for a single axis of the 3-axis linear stage. 1. Capture image at starting point, with the center of the square in the center of the image (image center has least amount of distortion) 2. Turn x revolutions (where x x 1.25mm is a desired linear distance in mm) 3. Capture image at this new location 4. Vary x to determine how distance affects mechanical platform performance; keep some trials with same x revolutions to characterize repeatability The results of the one direction repeatability experiments are found in Table 2.2. 55 Figure 2-17: Precision Grid Used for Measuring Repeatability: The webcam is adjusted to the height of the center of one of the squares on the glass precision grid. It moves x x 1.25 mm. The initial and final images are compared. Table 2.2: Characterizing Repeatability with Position Grid: Note that a negative distance difference means that the actual travel distance fell short of the desired distance. Trial Distance Input [mm] 1 10 2 5 2.5 3 4 10 5 10 6 5 7 10 8 5 9 10 10 5 11 10 12 5 Revs Stops 8 4 2 8 8 4 8 4 8 4 8 4 8 4 2 8 8 4 8 4 8 4 8 4 Actual Travel [mm] 10.000 4.93 2.407 9.858 9.905 4.929 9.953 4.884 9.815 4.884 9.862 4.815 56 Distance Actual is% Diff of Desired [mm] 0.000 100 -0.070 98.6 -0.093 96.296 -0.142 98.578 -0.095 99.048 -0.071 98.578 -0.047 99.533 -0.116 97.674 -0.185 98.148 -0.116 97.674 -0.138 98.618 -0.185 96.296 P\i\TM Freq [Hz) 400 400 400 400 200 200 800 800 400 400 200 200 Steps/ Rev 200 200 200 200 200 200 3200 3200 3200 3200 3200 3200 Table 2.2 indicates that changing PWM frequency and step mode (full stepping vs. microstepping) has no bearing on the error in open loop motion. Desired travel distances of 10 mm (trials 1, 4, 5, 7, 9, 11) provide the lowest absolute distance difference. This is expected since the grid is created with a 10 mm separation between the squares. Across all trials, the distance differences are consistently 0.1 mm. These errors can be attributed to at least one of the following: * Webcam quality: the images are not high enough resolution to appropriately pinpoint the center of the square " Inaccuracies of determining the square center: when sufficiently zoomed into the image, multiple pixels make up the target feature * Distortion around the side of the lens: could lead to an inaccurate " count, which is used to determine the actual distance traveled While the results are consistent, 0.1 mm errors are too high for a precision control machine. To check if the errors are a consequence of a poor quality camera, a Basler high-speed, black-and-white camera is used. The camera is mounted via double stick tape to the y axis mount, looking down on the glass position grid. Four trials are conducted with images captured at the initial and final positions. The results are summarized in Table 2.3. Table 2.3: Characterizing Repeatability with Position Grid and High Precision Camera Trial Distance Input Revs Stops [mm] Actual Travel Distance Diff [mm] [mm] Actual is % PWM of Desired Freq Steps/Rev [Hz] 1 2 3 1.25 5 10 1 4 8 1 4 8 1.187 4.964 10.000 -0.063 -0.036 0.000 94.964 99.281 100.000 400 400 400 200 200 200 4 7.5 6 6 7.518 0.018 100.240 400 200 These images confirmed the results obtained by the webcam. At 10 mm, the position accuracy is very good, displaying only a 0.01 mm - 0.03 mm variation. This 57 is expected since the separation between the centers of the two squares is 10 mm. The short travel distance of 1.25 mm still has a large error; even though the actual distance is only 0.06 mm from the desired, the error is a larger percentage of the overall distance. This was comparable to the shortest distance analyzed with the webcam previously (2.5 mm). The variability across all tested distances ranged from 0.018 mm - 0.063 mm, generally much lower than the results obtained by the webcam. This further confirms that characterization of the 3-axis linear stage performance is limited by webcam resolution. Two Direction Repeatability The two direction repeatability experiments quantify the closed loop errors by determining if the camera can return to the original position after traveling forward a set distance and backward by the same distance. The following is a step-by-step procedure describing the two direction repeatability experiment for a single axis of the 3-axis linear stage. Figure 2-18 shows the experimental set up. 1. Capture image at starting point 2. Turn 1 revolution (1.25 mm linear travel) 3. Capture image at this new location 4. Turn 1 revolution backwards (to get back to starting location) 5. Capture image at this final location The first and third images are compared. If no steps are skipped, the two images will be identical. As expected, the two images have slight variations, confirming that stepper motors are susceptible to open loop errors (no feedback). This may result from: (1) backlash errors, or (2) moving too fast, missing steps. Effects of each can be reduced. An anti-backlash nut (built into the system) reduces backlash. Moving at a slow enough pace avoids skipping steps, which is verified with the algorithm (see Section 2.5). Therefore, a more costly solution of incorporating an encoder for absolute position is not required. 58 Figure 2-18: Hardware Set Up-Quantifying Two Direction Errors: The camera and pattern are parallel to each other. The pattern is mounted to a rigid surface to ensure it is vertically upright. The camera captures an image, moves forward 1.25 mm, captures an image, moves backward 1.25 mm, and captures a final image. 2.4 Experiments To validate the mechanical test system performance against the algorithm performance, the experiments of Dr. Sun were replicated 1381. The algorithm performance was tested against artificial skin features (also called a tattoo) and natural skin features. This section starts with a description of the tattoo and how it is used to mimic variable lighting conditions. The experimental set up for three parameters is outlined: linear motion traveled, defocus blur, and motion blur. This section concludes with an extension to underwater experiments using the translational scanning system. The results of these experiments are found in Section 2.5. 2.4.1 Lighting and Artificial Skin Features In his experiments, Dr. Sun uses a pattern (or tattoo) that mimics skin features. A Matlab script generates a high-contrast binary random pattern with a square of known dimensions in the top left corner (Figure 2-19). The pattern is printed on white paper for high contrast. Illumination intensity effects can be mimicked by modifying the contrast of the 59 Figure 2-19: Tattoo: binary random pattern with a square of known dimensions (3 mm x 3 mm) in upper left corner. The square of known dimensions is critical as it aids the algorithm in determining the distance traveled, so it should be visible in at least two images. tattoo. Low contrast patterns correspond to low light conditions and vice versa for high contrast patterns. A "losscontrast" parameter is introduced that varies from 0 to 1, where 0 corresponds to a full contrast pattern and 1 corresponds to no contrast. The square of known dimensions is kept in high contrast throughout for measurement purposes. Natural Skin Features Dr. Sun found that the camera could resolve various skin features (such as melanin and hemoglobin pigments) at sufficiently short distances (27 mm) from the skin surface 138]. To test the limits at which skin features can be resolved with the 3-axis linear scanning system, multiple trials are conducted with varying camera to forearm separation distances: 5.75 mm and 2.75 mm (closest to Dr. Sun's set up). The travel distance is 40 cm (approximately the length of the forearm). Lighting effects are observed by varying ambient lighting: using fluorescent room lighting, a flashlight, and a fluorescent desk lamp. Figure 2-20 shows some sample images obtained during experiments. 60 (a) Natural Skin Features, camera is 5.75 cm away from pattern, scan covers 40 mm distance: This is a sample experimental image from the first trial. The image does not appear to be in focus, perhaps due to the large working distance. A flashlight was used to illuminate the forearm. (b) Natural Skin Features , camera is 2.75 cm away from pattern, scan covers 40 mm distance: This is a sample experimental image from the second trial. The image is in focus. A flashlight was used to illuminate the forearm. (c) Natural Skin Features, camera is 2.75 cm away from pattern, scan covers 40 mm distance, desktop lamp is used: This is a sample experimental image from the third trial. This image is in focus (can make out hair follicles), but is over-saturated. The desktop lamp provides more uniform lighting. Figure 2-20: Experimental Images from Initial Experiments 61 2.4.2 Linear Motion Experiments The distance traveled in the linear axis by the system is used to validate the distance traveled as estimated by the algorithm. The experimental set up for translational motion is modeled after Dr. Sun's experimental procedure [38]. The calibrated webcam is 27 mm away from the tattoo. An image is captured every 1.25 mm (1 revolution) for 12.5 mm (10 revolutions). The square of known dimensions appears in at least two frames. This process is repeated for each pattern with the losscontrast parameter (Section 2.4.1) ranging from 0 to 0.7 in increments of 0.1, giving a total of eight different contrast patterns. Since the images are taken consecutively, consistent lighting is ensured. 2.4.3 Defocus Blur It is important to know how well the volume registration algorithm performs in the presence of defocus blur. Defocus blur occurs when the camera is out of focus, when the camera is rotated about the longitudinal or transverse axes (i.e. camera is not perpendicular to the skin surface), or if the curved surface of the scan region (i.e. curve of forearm) is in the image frame. There are multiple ways to induce defocus blur in the experimental platform. The camera can be rotated such that the plane of the lens is not perpendicular to the pattern. Another method (which was implemented) uses only the translational axes to induce defocus blur by moving closer to and further away from the pattern so that the image is out of focus. The pattern is printed with the losscontrast parameter set to 0.6, which means the pattern is printed with only 40% contrast. The experimental procedure follows: 1. Take a picture of the pattern at zero offset (27 mm away from pattern) 2. Take a picture every 1.25 mm, moving towards the pattern (forward direction) 3. Repeat step 2 seven times 62 4. Repeat steps 1-3 after moving back to the original position (27 mm from pattern), this time moving away from the pattern (backward direction). Image every 3.75 mm instead of 1.25 mm to get non-focused images. Using the above procedure, a total range of 8.75 mm is traveled in the forward direction (towards pattern) and 26.25 mm is traveled in the backward direction (away from pattern). The pattern starts to lose focus when the camera is 5 mm away from the pattern and when the camera is 18.75 mm away from the pattern. This indicates that the camera focus is better when it is further from pattern than when it is closer As the camera moves closer to the pattern, shadows are cast on the to pattern. pattern; these effects are incorporated into the results. In practice, the radiologist starts imaging in focus, but throughout the scan, the images start losing focus. To better capture the clinical scenario of some images in focus and some blurred, a slight modification to the experimental procedure is made: take the first 2 images fully focused and the remaining 9 images at the desired defocus level (see Figure 2-21 for a schematic of the experimental set up). Y z Pattern A: Camera 1.25 mm E E d: Defocus Distance 4 3 1 A 11 5 2 1.25 mm Figure 2-21: Graphic of Set Up for Defocus Blur Experiments Mimicking Clinical Situations: Shown here is the procedure for forward defocus blur, with the first 2 images in focus and the remaining 9 out of focus. Camera travels 13.75 mm in z and (27 + d) mm or (27 - d) mm in y (depending on if camera is moving away from or towards pattern). 63 2.4.4 Motion Blur Motion blur occurs when the probe mounted camera moves faster than the camera exposure time 1381. Experimentally, motion blur can be induced by overlaying two images which are taken a short distance apart. The distance between images is set to 0.5 mm based on clinical observations. This distance satisfies the constraint that the separation distance must be a multiple of 0.00625 " (the smallest linear distance the leadscrew can travel when full stepping). With the camera 27 mm away from the pattern, 12 images are taken every 0.5 mm, corresponding to 11 image pairs (or 11 blur images). The algorithm averages the images to provide 10 data points. Motion blur can also be introduced in the algorithm itself. Convolution of the image with a variable kernel introduces motion blur. This was the preferred method for validating the algorithm for motion blur. 2.4.5 Underwater Experiments Being able to accurately scan underwater has clinical applications, such as in prosthetic fitting as well as tissue imaging [171. The challenges with underwater imaging are protecting the electronics and keeping the optical target in focus. Overcoming these challenges is discussed in the following sections. Waterproof Webcam To protect the electronics, the plastic back cover of the webcam is removed and silicone poured between the front and back covers. Since the silicone secures the lens in place, the lens must be adjusted to the right focal length before this process. When plugged in for a sufficiently long time, the silicone gets warmer from heat generated by the electrical components. A circular glass piece (18 mm diameter) is cut on the waterjet and used to cover the lens. Fast drying epoxy secures the glass to the webcam rim. Mounting in a cool place is important to prevent condensation in the air gap between the lens and glass. Silicone sealant is layered to prevent water leaking in the air gap between the lens 64 and glass. The final result is shown in Figure 2-22. (a) Water Proof Camera Front View: Layers of silicone sealant to prevent water from entering the airgap between lens and glass is visible. (b) Water Proof Camera Side View: Silicone in between the front and back covers to protect the electronics. Figure 2-22: Waterproof Camera Used for Underwater Experiments Experimental Set Up for Underwater Experiments For the experimental set up, a waterproof camera and a tank that can hold water are required. The camera has to be re-calibrated since the camera intrinsic parameters are a function of the fluid medium [3). The grid pattern used for camera calibration is printed on a transparent, waterproof polymer. Figure 2-23 shows the experimental set up. The image quality is dependent upon water temperature. If the water temperature is too hot, the images are of poorer quality (not focused). At room temperature, the images are clearer. If the pattern is submerged underwater and the camera is above the water surface, the images are crisp as illustrated in Figure 2-24. \Vhen both camera and pattern are submerged , covering the lens appropriately is important. Although ultimately a glass piece was used to cover the lens, other ideas were considered and are briefly mentioned here. 65 Clinical sheaths (used by (b) Set Up for Underwater Experiments: Camera Below Surface of Water (a) Set Up for Underwater Experiments: Camera Above Surface of Water Figure 2-23: Underwater Experimental Set Up: Plastic bucket filled with room temperature water at the working distance depth (5 cm). The grid is secured on a transparent plate and submerged underwater. Figure 2-24: Pattern Submerged and Camera Above Surface: The pattern is printed on a transparent polymer so that it is waterproof. With the webcam above the water surface, the image is clear. sonographers to protect the ultrasound probe from the gel) are too opaque, making it impossible to see the pattern. Clear bags are not rigid; the creases affect image quality and result in unfocused images. Condensation forms in the air gap between the webcam lens and a transparent lens cover. Two lens covers were considered: circular transparent polymer mounted with hot glue over the lens and packing tape 66 (Figures 2-25a and 2-25b). (a) Lens Covered with a Transparency: Circular Hot Glue is Used to Mount on Rim (b) Lens Covered in PackCondensation ing Tape: forms in the air gap between lens and packing tape when lowered into the water (c) Sample Image of Underwater Experiment: Both camera and pattern are underwater. Lens is covered with packing tape. Figure 2-25: Water-proofing the Webcam: Figures 2-25a and 2-25b show two different methods to cover the webcam lens. Figure 2-25c shows the image obtained with the camera shown in Figure 2-25b. Using the waterproof webcam and the same procedure outlined in Section 2.1.3, the underwater camera calibration error is 1.7 pixels (0.07 mm). This is nearly triple the calibration errors of the webcam in air. However, 1 - 2 pixel errors for the underwater results are sufficient because the fluid properties are so different than in air. 2.5 Validation Results The images obtained during experimentation are sent to Dr. Sun for validation with his algorithm. The algorithm flow that describes the reconstruction process is reproduced from Dr. Sun's thesis and can be found in Figure 2-26 1381. The results from the linear motion, defocus blur, and motion blur experiments are summarized below. 67 extension stage H feature matching add map points & set of kframes outlier rejection & bunde adjustment between frame Iand the nearest keyframe tracking stage I *- 1+1 YES in itializationstage ~twzon~liatintae initialization feature tracking between frame and-1 -0 camera pose estimation within a RANS-AC scheme - pose refinement in a Bayeflan framework (SectionY2.3) NO end f SC cee(ecin23 enandma scan? map extension? ~~YES INPUT skin feature video, ultrasound video and calibration files N0 I +- 1+1 OUTPUT localized 2D US images and *skin map points transformation from camera 0 US coordinates scale calibration Figure 2-26: Reconstruction Algorithm Flow. Note image is reproduced from Dr. Sun's PhD Thesis 1381. 00 2.5.1 Linear Motion When comparing stage motion and algorithm results, the algorithms provide a translational error of 1 mm per cm scanned. This is a 10% error per 1 cm translation when evaluating the algorithms against natural skin features. Compared to the translational error obtained with the artificial pattern (2% -3%), natural skin features estimate an error five times the error of the artificial pattern. However, his freehand scanning also incurs some rotational error (0.60 error per cm scanned) since freehand scanning is not strictly linear. Contrast The pattern contrasts are varied linearly with the "losscontrast" parameter varying from 0 to 0.7 in increments of 0.1. Reconstruction serves to estimate the frame-byframe distance, which is 1.25 mm nominally. A plot of the travel distance estimate as a function of contrasts is provided in Figure 2-27. 1.4 . ............ .... -cc 1.35 1.3 1.25 1.2 _ _ _ ... .__ 0.2 ... . _ .. ... ..... . T 1.15 0.6 0.4 0.8 1 Contrasts Figure 2-27: Algorithm performance of travel distance compared to the nominal value of 1.25 mm with varying contrast patterns As seen from Figure 2-27, the mean error is less than 2%, indicating that the influence of contrast is not statistically significant. This confirms the algorithm can 69 be used against low-contrast patterns (such as natural skin features). 2.5.2 Defocus Blur The performance of the algorithm against defocus blur is dependent upon the feature sizes in the pattern since the different kernels span the features. As seen clearly in Figure 2-28, the algorithm is not robust beyond o- = 1.5 pixels, which is related to the major feature size. At - values less than 1.5 pixels, there is little variation between the kernel sizes, indicating the algorithm performs sufficiently well for small defocus blur. The bias is noted at less than 2%. 2.51 +71 .............. ........ --+-3 - -5 ........ I 1.51-. .. .... ... .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C . . . r .... ........ . 2[ - U) U a.. a ........... 1IF ............ I-S 0.510 ............. 0 0.5 1 1.5 2 CF Figure 2-28: Algorithm Estimates of the Travel Distance with Varying o- and Pixel Size: Gaussian smoothing is applied to generate the blurred images, with the size of the kernel changing between 3, 5, and 7 pixels. 2.5.3 Motion Blur To introduce motion blur in the algorithm, a "boxcar filter" is used in the horizontal and perpendicular directions 138]. The kernel is changed from 3, 5, and 7 pixels. The graphs in Figure 2-29 indicate the algorithm performance is not robust to motion blur in either the parallel or perpendicular camera motion directions. With 70 ,,, - " 14ww , - .. I . -_ -. increasing kernel length, the variance increases. - - Bias is determined by the scale calibration and has less than 2% error. Beyond 5 pixels, a major feature size, the algorithm performs especially poorly. 2.6 Summary In summary, a translational scanning system has been developed and characterized for skin based body registration algorithms. Errors are on the order of sub-mm (maximum error of 0.063 mm) and depend on the distance traveled. By using this scanning system to validate the algorithms, the algorithm performance can be characterized. It is concluded that the algorithm can correctly perform skin based body registration volumes in the presence of lighting effects and defocus blur, but it is not robust to the effects of motion blur. 71 - ' I - - '. -, 2 Parallel -+- Perpendicular :9 E 1.51 0 C *1 T T LI LL I YT ~ ~ M-M 1 Cu L. 0.5[ 2 0 6 4 Kernel Length . K 8 (a) Motion Blur Results with Kernel of 3 Pixels 2 1.5 fT LA C C AL 1F LI . .. .... .. .. . U, 76 0.5 2 0 6 4 Kernel Length 8 (b) Motion Blur Results with Kernel of 5 Pixels 2 a) Cu U, w a) 0 C Cu .0~ 1.5 LI LI 1 0 Cu I- I- 0.5 0 2 6 4 Kernel Length 8 (c) Motion Blur Results with Kernel of 7 Pixels Figure 2-29: Results of Motion Blur: Algorithm vs. Experimental Results 72 Chapter 3 Handheld Skin Scanning Device The impetus for studying the stability of skin features all over the body with a handheld device arose from a natural extension of the mechanical scanning system, which is convenient for only select limbs. After characterizing the error of the platform and validating the skin based body registration algorithms, it was important to determine the stability of skin features over time. If stable, natural skin features can be used to aid in longitudinal (over time) reconstructions. We intend to study the stability of skin features at various length and time scales over many regions of the body. At present, not much literature exists to describe the feature stability in specific individuals over time. The feature length scales to be investigated are: 1. Melanin/Pigment variation/Moles (order of 10 mm [371) 2. Hair follicles (order of 50 pm - 160 pm [281) 3. Micro-Relief structures (order of 20 pm - 8 mm 1441) 4. Vascular structure (order of 2 mm - 0.25 cm [35]) We intend to study them over the period of hours, days, weeks, months, and years. The translational scanning system, while great for controlled scans, is limiting in its ability to vary parameters as well the areas that can be scanned. With a small, 73 elevated platform, it is difficult to get larger limbs (i.e. the thigh or abdomen) or curved surfaces (i.e. the neck) onto the machine. Furthermore, the distance from the camera and lighting are parameters that cannot be varied on the existing platform, but are important variables to get high resolution images. These challenges are overcome by creating a handheld scanning device. This chapter discusses the design and fabrication of the handheld skin scanning platform. Section 3.1 provides an in depth analysis of the camera selection process and the important optical parameters, Section 3.2 showcases the design decisions between the various iterations to get the final prototype, and Section 3.3 describes the challenges in controlling and acquiring uniform lighting for the system. The chapter concludes with an outline of the experimental procedure and closing comments on current work. 3.1 Camera A camera that has sufficient resolution to resolve the various desired features is required. It must also have a manually adjustable focus lens to better estimate the focal length compared to an auto-focusing lens [381. The notion of using non-USB interface cameras was entertained (such as the GoPro or smaller cell phone cameras), but quickly discarded due to incompatibilities with the existing LabView code. In order to use the myRio and existing LabView code, the camera must be "DirectShow" compatible 1271. To use the Vision Acquisition Module and connect to the myRio, the camera needs to have USB3 Vision support running on a USB2.0 port. USB Video Device Class (USB UVC) cameras are also supported by the Vision Acquisition Module (Section 3.1.2). The camera sensor and lens resolution is a critical parameter since resolving the desired skin features depends on the resolution. The Basler black-and-white USB camera discussed in Section 2.3 was used as a starting point in the camera search to determine the resolution required for imaging skin features. The camera was mounted to the 5-axis mechanical system (described in Chapter 2) and captured images of the 74 fore arm. In these initial images, the center of the forearm was focused to the lens center. The edges of the images, corresponding to the curved surfaces of the forearm were less in fo cus. A sample image is shown in Figure 3-1. Since microrelief structure and pigment variations were visible, the camera for the handheld device would have to be at least l.3MP (the resolution of the Basler black-and-white camera). Center of forearm is aligned with lens center and in focus Figure 3-1: Initial Image Acquired with Basler Camera: The center of the image is in focus , but the edges of the image are not. The Basler color camera (acA2040-90uc) with a C-Mount Mitutoyo lens from Computar was chosen. Some key features are highlighted here: • The resolution of the camera is 4 MP, 2040 pixel x 2046 pixels (2x the desired resolution) , with the resolution of each pixel being 5.5 µm x 5.5µm • The camera is smaller compared to other scientific cameras at 29.3mm x 29mm x 29mm • The camera requires a simple, lightweight USB to micro-USE connection cable • It is a color camera, capturing RGB data in 3 channels (used for determining pigment variations) 75 3.1.1 Variable Optical Parameters Varying optical parameters, such as depth of field, field of view, object to camera distance (working distance), and optical zoom is important to image skin features adequately. The resolution of the camera is also critical. Each parameter is defined below. Figure 3-2 shows the parameters in respect to one another. Figure 3-3 shows the parameters as they pertain to the application. For first experiments, we imaged the forearm. " Field of View: The viewable area of object under inspection (fills sensor) " Working Distance: The distance from the front of the lens to the object " Depth of Field: The amount an object is expected to move while still maintaining focus " Resolution: The minimum feature size that can be distinguished by the camera Object Plane k Angular Field of View Field of View = FOV - - -- ~0 Working Distance = WD Figure 3-2: Optical Parameters Determining Field of View: The FOV is important in the y direction (the height of the forearm/scan region) since the translation is in the x direction (along 76 Forearm FOV y 3Support Camera Figure 3-3: Optical Parameters as they Pertain to the Set Up the length of the forearm) (Figure 3-3). After imaging forearms of various subjects and determining the appropriate imaged region where skin features are visible, the FOV was estimated to be 3 in or 8 cm. Note that although this estimates the ideal FOV, the actual FOV was much smaller since the camera had to satisfy all the other parameters as well. The usable, experimental FOV was 0.077 sq.in. (or 0.33" in the y direction). Determining Working Distance: For the handheld scanning device, the working distance is the distance from the camera to the skin surface at which skin features can be adequately resolved. The working distance must be at least 5 cm, which is the clinical application when the camera is mounted on ultrasound probe. Experimentally, using the Basler acA2040-90uc camera and Mitutoyo lens, the working distance was 6.8 cm. 77 Determining Depth of Field: Depth of field is harder to estimate since amount of rotation of the scan region is region and patient dependent. Example of region dependence is the forearm; because of its small diameter, the forearm may rotate more than a scan region with larger diameter (i.e. the bicep). Patient variability is expected as some patients are more able to hold their limb stationary compared to others. For this reason, a 10* rotation (which accounts for involuntary patient movement) is considered when calculating the depth of field (DOF). The corresponding geometry is seen in Figure 3-4 and the calculations leading to a DOF range of 0.55 cm - 3.2 cm is provided (Equations 3.1a, 3.1b, 3.1c). Depth of Field =DOF ~Q1DOF/2 o DOF/2 WD WD Figure 3-4: Geometry of Set Up to determine Depth of Field DOF tan(0") (3. la) 2 WD Convert angle from degrees to radians: 00 x 1800 = a (3.1b) DOF = 2 x WD x tan(a) (3.1c) Determining Resolution: The required resolution was also obtained via experimentation. As a Basler (1.3 MP resolution, 1280x1024) camera had been used to distinguish the microrelief structures, the resolution of the final camera should be at least 2 MP. As mentioned in Section 3.1, the Basler camera model acA2040-90uc satisfied all these requirements. 78 3.1.2 Camera Control with LabView When continuously streaming, the frame rate ranges from 1.9 fps to 50.7 fps, varying inversely with the exposure time. However, since we are only interested in image capture, the video capture rate is not important. The camera is controlled with LabView as seen in Figure 3-5. A pseudocode is provided below. 1. Open and initialize the camera 2. Continuously stream the image to the front panel for user feedback 3. When the user hits 'stop,' come out of the While Loop, close the camera 4. Save image to specified location as a PNG file Camera Name 77maVe ii File Path nl -U Delay Time (s) Ti (sTake Pic Figure 3-5: LabView Code for Acquiring Skin Images: The camera is selected and initialized. A While Loop is used for continuous streaming. A time delay is inserted to mitigate errors arising from having an AC light source (see Section 3.3). When the user hits 'stop,' the camera is closed and the image is saved to a specified location as a PNG file. 79 Handheld Scanning Device Design 3.2 The purpose of designing an all-inclusive scanning mechanism is to control the parameters that influence image quality as described in Section 3.1.1. There are also other requirements for the handheld scanning device, which are listed below. The device: e Needs to be ergonomic: this is achieved by the ring stand, which provides an even surface when the handheld device is pressed against the skin (see section 3.2.3) o Needs to be portable to scan over many the body: this is achieved by having a compact system, with a small camera, that can be used to image various parts of the body o Must allow the user to perform manual, freehand scans repeatably: this is achieved by (1) framing the image with the ring stand and (2) the experimental procedure (see sections 3.2.3 and 3.4) o Must take high quality images: this is achieved by the hardware (camera) and the design - (1) the device is constructed to keep the lens perpendicular to the scan region so that the center of the scan region is in focus, and (2) cameralens system is an appropriate working distance away from the skin surface to adequately resolve the features, which is accomplished by stiff, optomechanical rods (Section 3.2.2) o Should prevent unrealistic deformation of the skin surface: this is accomplished by the ring stand (Section 3.2.3) and by imaging at a working distance greater than 4 cm where surface deformation is negligible 1381 The final design is seen in Figure 3-6. The details of individual features (frame, rods, ring stand) of the scanning device and the various iterations of the device are detailed in the following sections. 80 Figure 3-6: Handheld Scanning Device-Frame, LED Light Ring, Optomechanical Rods, and Camera 3.2.1 Frame The frame design had to incorporate an external LED light ring (see Section 3.3) and the camera. Filleted flanges were designed to keep the light ring in place. The camera requirements (hardware and optical) provided the geometrical limitations of the mount, which are listed below. Due to the intricacies of the mount design, the mount was 3D printed. 1. Hardware: " diameter had to be wide enough to encompass the objective lens with the set screws used for adjusting optical zoom and exposure " length of the frame was limited by length of the objective lens (at maximum ) zoom, length is 32.77 mm or approximately 3.3 cm 2. Optical Requirements: body length determined by the working distance 81 3.2.2 Set Working Distance The camera lens had to be a set distance away from the skin surface in order to properly resolve the skin features. To set the working distance, an optical target was used. The camera exposure was experimentally set to F8 and the optomechanical, stiff metal rod length adjusted until the target center was in focus. Threaded on both ends, the rods were screwed into the side of the camera mount and ring stand with 4-40 screws. Shown in Figure 3-7 are the rods screwed into the ring stand. Figure 3-7: Optomechanical stiff rods screwed into ring stand to prevent excessive bending while still providing the appropriate working distance The mount was then used to image the skin surface and the working distance fine tuned such that the microrelief structure was in focus. The working distance was 68.81 mm. 3.2.3 Ring Stand A 3D printed ring was fabricated to allow for even distribution of forces across the skin surface when scanning (compared to the alternative of three rods poking into the skin, locally deforming only a triad of regions). It also served to mount the reflective lining (described in Section 3.3.1). Furthermore, the ring helped with repeatability as the scan region could be approximately centered within the ring during each scan. Holes in the ring stand were used to connect the ring stand to the prongs for the first iteration (see Section 3.2.4). The holes were dimensioned exactly matching the 82 dimensions of the prongs in the 3D model and filed to size for a press-fit. Figure 3-8 shows the ring stand attached to the rest of the frame for the first iteration. Figure 3-8: Handheld Scanning Device V1-Ring fits perfectly onto the tripod extrusions with a press fit The third iteration of the ring was matched to fit the stiff rods. Instead of having cutouts, holes were aligned with the rods and countersunk to allow the screws to lie flush with the ring. From an ergonomic standpoint, this was an important design decision because the patient would be more comfortable during scanning. The ring also served to ensure the ends of all the rods would lie on the same plane (see Figure 3-9). 3.2.4 Iteration 1 of Handheld Scanning Device The first iteration of the device included three appropriately sized extrusions to provide the correct working distance. The tips were domed for ergonomic comfort during scans. However, the 3D printed extrusions were fairly compliant (acting as can- tilevered beams), affecting repeatability of images. 83 They were not considered for Figure 3-9: Ring Stand for Iterations 2-4 of Frame: Countersunk holes for ergonomic benefits and better assembly future iterations. Figure 3-10: Version 1 of handheld scanning device-the tripod extensions with domed tips are now highlighted. The working distance is 75.98 mm. A tight-fitting hole for the light ring cable added a constraint to secure the light in place (see Figure 3-11). In this iteration, the hole was not cut deep enough in the 84 back for the light to lie fiat. This was rectified in the next iteration (see Section 3.2.5) of the mount. Figure 3-11: Version 1 of handheld scanning device with features, such as the flange to hold the light in place and the cutout for the cable, highlighted 3.2.5 Iteration 2 of Handheld Scanning Device Major changes in the second iteration allowed for a better assembly. These are outlined below. • The extruded cut for the cable was moved to a different location on the circumference of the frame, allowing the device to take images right side up when resting on the table. • All the extruded parts were now filleted (removing stress concentrations). • The length of the snap fit flanges were reduced (keeping the light ring secure). • Pockets to insert rods of varying lengths were designed (see Figure 3-12a). This allowed for various working distances since rods of different lengths could be 85 inserted. The pockets also prevented torquing of the rods, which were can- tilevered out. However, as the rods are not used to transmit force, torquing was not a major concern. A drawback of this iteration was in the pockets. Once printed and the rods inserted, the thin walls of the holder began to plastically deform (see Figure 3-12b). The wall thicknesses would have to be increased to support inserting the rods. 3.2.6 Iteration 3 of Handheld Scanning Device Iteration 3 incorporated many features that made the system more robust to changes. These are outlined below. " Slot cuts were made into the frame to allow for real time adjustment of the exposure and optical zoom. Benefit: Real time adjustments help to obtain better quality images not only by allowing in more light (changing exposure), but also to experimentally determine the best working distance at which to resolve skin features (changing optical zoom). " The side pockets, which were originally tunnel shaped to keep the overall shape of the camera mount, were changed to circular cutouts. Benefit: This allows for rod length adjustment, which means the working distance can change, creating an overall robust structure. " Thicker walls (recommendation from Iteration 2 to prevent plastic deformation): Using the rule of thumb that 5 threads need to be engaged per 4-40 set screw, the thickness of the light rod extrusions was determined to be 3.175 mm. A major design decision in this iteration was in placing the rod extrusions. If placed right behind the flanges to hold the light in place, the structural integrity of the rods would be increased (reduced cantilevered effects), but the compliance of the flanges would be decreased (problem for putting the light ring in place). If placed right below the start of the flanges, longer rods are required, which have to be specially 86 (a) Handheld Scanning Device Iteration 2-Pockets, Shorter Flanges, Bigger Extruded Cut for Cable (b) Plastic Deformation of Pockets after Inserting Stiff Rods Figure 3-12: Handheld Scanning Device Version 2 87 Figure 3-13: Handheld Scanning Device Version 3-Circular Extrusions, Thicker walls, Cutouts for Easy Adjustment of Optical Zoom and Exposure Settings manufactured (expensive solution) in order to accommodate the working distance. Eventually, the halfway point of the flange was selected to keep the appropriate working distance with the existing rods while also keeping the structural integrity. The third iteration of the frame is seen in Figure 3-13. 3.2.7 Final Design of Handheld Scanning Device The most recent version of the mount, although allowing for better image capture, does not address the issue of all mount designs - design for assembly. With screws of different lengths required to mount the camera to the frame, the system is not very modular. Using a fully encircled design around the camera, while aesthetically pleasing, makes it difficult to attach the camera to the mount. However, the frame 88 slot cuts have been modified for easier access to real time adjustments of the exposure and optical zoom. Similar in geometry to iteration 3, the final design can be seen in Figure 3-14. (a) Handheld Scanning Device Final Version-Side View (b) Handheld Scanning Device Final Version-Front View Figure 3-14: Handheld Scanning Device-Final Version 89 Assembly Instructions Assembling the handheld scanning device is fairly intuitive. However, mounting the camera and rods to the frame are slightly more challenging. Step-by-step assembly instructions are provided below to ensure proper alignment: 1. Camera: hold front of lens and back of camera to align the camera holes with the screw holes of the mount; insert all screws loosely, then tighten in place 2. Optical Rods: start by placing one end of the rods flush against the top of the rod holder and keep in place by set screw (correct working distance will be set afterwards by imaging and using the ring stand to keep all rods on same plane) 3. Ring Stand: align the holes of the ring stand to the rods and secure in place by screw 4. Light Ring: insert the light ring sideways between two rods and snap in place by aligning the cable with the cutout 5. Light Cover: insert the cover to the light from the opening created by the ring stand and snap in place 6. Reflective Lining: Insert from the top into the inner diameter of the ring, sliding it over the light holder flanges; tape to ring stand to keep it secure 3.3 Lighting Ambient lighting greatly influences image quality and the ability to resolve skin features. For example, taking images in a dark room late at night provides more focused images in which the skin features are more prominent. However, the handheld scanning system should not depend on ambient light (sunlight, fluorescent lights or white lights in the room) to obtain quality images. Therefore, an external, repeatable light source is needed to both enhance the skin features and mitigate ambient lighting variation that results from taking images at various times of day. 90 In the first set of experiments , a desktop light was used to illuminate the skin surface , attempting to provide uniform lighting (see Figure 3-15). This highlighted the areas of the forearm that were more planar and cast in shadows the curved edges of the forearm. Fluorescent Desk Light Figure 3-15: Desktop Lamp Used During Initial Experiment to Illuminate the Skin Surface: The center of the forearm (which is viewed as planar) is saturated by the light source. The curved edges of the forearm are shadowed. Having a lighting system that integrates with the handheld device (instead of the external desktop light) provides for consistent data collection. A white LED light ring was purchased from Mainland Mart Corp. Although its inner diameter is slightly larger than the diameter of the objective lens , the low price point made it an attractive solution. However, a drawback is the AC voltage, which is noticed as flickering light when continuously streaming images. This is compensated for in the Lab View code , which incorporates a time delay between images to prevent the flickers to show up in the image. The learning curve and time required to fabricate a DC LED light ring that would have the appropriate geometry did not provide sufficient cost-benefit analysis to merit a fully engineered light source from scratch for an initial prototype. 91 3.3.1 Uniform Lighting Using the light ring, a strong, circular shadow forms in the center of the scan region (see Figure 3-16). For accurate RGB data and high quality images, this needs to be eliminated. Figure 3-16: Circular Shadow on Scan Region Resulting from Light Ring Shadows Positioning the hardware affects the shadow induced and influences the design of the handheld device. If the objective lens is flush with or behind the LED light ring (Figure 3-16) , the shadow is not affected by the objective lens. If the objective lens is in front of the light ring, the shadow induced on the scan region is darker since the shadow is caused by both the objective lens and the light ring. Reflective Lining In addition to an external light source, a reflective lining is used to control image quality by creating more diffuse lighting and eliminating shadows. A thin, reflective material lines the inner· circumference of the ring stand and rods , trapping the light 92 emitted by the light ring (see Figure 3-17). The opaque polymer, with an enhanced reflectivity substrate, is used to reflect ambient light. The other options considered are seen in Table 3.1. Table 3.1: Reflective Lining Choices Idea Aluminum Foil Printer Paper Metallic polymer layered on paper Benefits Reflective; Allows for Lambertian scattering due to wrinkles (uniform light) Smooth, so no hot spots are Drawbacks Wrinkles too easily; High and low points on the scan region are prominent filters light Ambient identified through Polymer prevents filtering of ambient light and reflects light from outside; printer paper on inner surface provides uniform lighting affecting RGB data Two materials required (paper and metallic polymer) (b) Reflective Lining - Paper Side (a) Reflective Lining - Metallic Side Figure 3-17: Reflective Lining: The paper side traps the light from the light ring and the metallic polymer keeps ambient light from filtering through the lining. Figuring out how to attach the reflective lining to the handheld scanning device was a challenge. Functionally, attaching the lining to the device for each scan had to be repeatable. From the design perspective, it had to be aesthetically pleasing when integrated with the entire device. The latter constraint was satisfied by cutting strips of paper and metallic polymer to appropriate dimensions and minimizing the visibility of attachment tape. For repeatability, the inner diameter of the ring (see 93 Section 3.2.3) and overall support structure were used to keep the reflective foil in place (Figure 3-18). Lining a tube with this material may be an elegant solution for future iterations. Figure 3-18: Reflective Foil Attached to Mount in Pleasing Manner: Sleek, Tape Not Visible Light Cover In addition to a reflective lining, a light cover provides uniform lighting over the scan region, which provides better images. The light cover acts as a diffuser, scattering light from the LED point source. The different light cover options are summarized in Table 3.2 and pictured in Figure 3-19. The final design is inspired by light bending principles. The underlying idea is to distribute the light from the point source, bending or scattering the light [11]. A cover is designed and 3D printed to snap fit onto the light ring. Its thickness is experimentally determined by comparing light intensity with and without the cover. \Ve do not want to lose too much light intensity by applying a cover. The minimum thickness is 0.05" (resolution of the 3D printer). The rough texture of the 3D printed part enables light scattering, which provides more uniform lighting. The final light 94 Table 3.2: Light Cover Choices Idea SemiOpaque Plastic Benefits Semi-opaque so no light intensity is lost Paper Uniform lighting achieved; papers of various thickness are available (printer paper, cardstock, tissue paper); can increase exposure to allow in more light (risk making images less focused), but need to incorporate a way to adjust ex- Drawbacks Wrinkles easily (not uniform thickness across all bulbs); difficult to attach to light source; shadow still apparent on scan region Opaque so light intensity is modified (dark images); difficult to achieve uniform thickness since paper strips overlap posure in real time (Section 3.2.6) Wrinkles Tape = Difficult to Attach (a) Plastic Bag Light Cover Overlapping Layers, Non- uniform Thickness (b) Paper Light Cover Figure 3-19: Light Cover Options 95 cover is seen in Figure 3-20. (b) Light Cover on Light Ring: Snap fits to ring with cutouts for precision fit (a) 3D Printed Light Cover Figure 3-20: Light Cover Final Design For a more polished look, future iterations of the light cover may include thermoformed plastics of varying opacity, thickness, and materials. 3.3.2 Directional Lighting Low angle, directional lighting casts shadows over the valleys, accentuating the microrelief structure. This lighting scheme cannot be used for round objects, such as the hand and fingers [22]. Since the middle of the forearm is considered planar 1381, direc- tional lighting can be used for accentuating features (verified by initial experiments with a fluorescent desk lamp as described in Section 3.3). But there is a trade-off with directional lighting as it adversely highlights other areas of the image (see Figure 3-22). A desk lamp alone is not intense enough to illuminate all the features; a light ring is still needed. To properly illuminate the scan region, the optimal angle between a light source and camera is 450 (see Figure 3-21) 96 1331. Light Camera 450 -- 0 Scan Region Figure 3-21: Directional Light Schematic: Optimal Angle of 45* Between Light Source and Camera Figure 3-22: Directional Light Applied: Mirco-relief structure is visible, but hot spots affect RGB data of overall image 3.3.3 Calibrating the Light To quantify the RGB data of the image (which will be used to provide information about the melanin content in the skin), the "whiteness" of the light source is evaluated. 97 When using just the LED light ring, the images indicated a clear "blue" bias. When imaging with the LED light ring covered by the 3D printed light cover, the images had more "yellow" hues. For comparison, a medical light source with multiple ring lights was purchased. Experimentally, each light source (medical light ring and LED light ring) imaged a piece of white printer paper. The light sources were enclosed by an opaque paper lining at a set distance away from a stack of printer paper (see Figure 3-23). A stack was required to ensure the paper was "white," avoiding color from the underlying surface to bleed through. (b) LED Light Calibration Set Up (a) Medical Light Calibration Set Up Figure 3-23: Light Calibration Set Up: The light is a set distance away from a stack of printer paper to ensure "whiteness." Each light is encircled with opaque lining. The images were then processed in Matlab (see Appendix B-5), obtaining the mean and standard deviation for each channel (R, G, B). These parameters were used to determine which light source is better. A higher mean value indicates bias towards that particular channel. With more variance across the image, the standard deviation increases (not desirable). The results are seen in Table 3.3. The results indicate that the medical light ring and LED light ring with cover give 98 Table 3.3: Comparison of Light Sources Medical Light LED Light LED Light with Cover Red Mean Std Dev 45.71 194.74 16.46 152.37 6.06 113.35 Green Mean Std Dev 9.87 249.51 238.52 18.46 6.74 197.60 Blue Mean Std Dev 2.42 253.98 1.99 254.18 5.49 162.16 more uniform lighting than the LED light ring alone. As expected, the higher mean values for the green and blue channels suggest these colors are more pronounced in the images illuminated by the medical light and LED light. The LED light with cover is more uniform across the color spectrum, with similar mean values for all channels. The standard deviations are high, suggesting that the color is not uniform throughout the image. This may be due to the variations in the white paper, which is not the same as a true calibration target. Thus, results of this experiment provide some insight, but more work is still required to fully characterize the light. A calibration target has been purchased for this reason. 3.4 Skin Scanning Experiments The scanning device geometry and structure allows for little variation in how the images can be taken; the ring stand must always be flush against the skin surface to capture an image. The freedom of the subject during the scans introduces variability in the data collection, affecting repeatability. Since the device is handheld, the subject has freedom in how they place their limb to get imaged, which may not be consistent from one image to the next. In first experiments, we focus on imaging the skin features on the forearm. Minimizing the effects of individual variability from one test to another is accomplished by having the subject place their forearm on a hard surface in a way that is comfortable for them. Individual comfort allows consistency from one scan to the next. The ring of the scanning device is then rotated and elevated until it touches the skin surface 99 and the lens is perpendicular to the skin surface (see Figure 3-24a). The real time streaming display in LabView is monitored until the image is roughly in the center of the display. For testing purposes, a Belkin gel hand rest is used under the forearm, preventing extraneous movement and rotation. This is especially important for subjects with small wrists (see Figure 3-24b). Without the support, in order to see the entire wrist, the hand has to be kept mid-air to be in the center of the image. Small motions are perceived in the image frame and lead to blurred images (i.e. microrelief structure is not visible). Device Rotated rs Aike Rn Ring stand flush againstflsagit skin (a) Skin Scanning Experimental Setup: Subject places arm in a comfortable position on top of a solid surface. The device is rotated and aligned with the scan region, such that the ring touches the skin surface. tn si (b) Skin Scanning Experiment on Small Wrist: Need to use a hand rest to support the arm and prevent minor movements Figure 3-24: Skin Scanning Experimental Setups Wrists were imaged and scans were acquired by taking a series of overlapping images from the wrist to the elbow. A sample experimental image is provided in Figure 3-25. For particularly hairy subjects, scan regions with less hair were initially scanned in hopes of providing better quality images. 100 However, this approach was quickly Figure 3-25: Sample Image Acquired from Skin Scanning Experiment: Uniform lighting, microrelief, hair follicles, and pigment variations visible. Image is centered within frame. abandoned after realizing that not all subjects would be hairless and a robust image processing algorithm would still need to be developed. Thus, in developing a hair removing algorithm, the hairy subjects were imaged four times with the hair in four different orientations (up, down, left, and right) as shown in Figure 3-27. This allows the underlying microrelief structure to surface for future image processing. The effects of the following parameters will be studied. Note that experimental images of some of the parameters (imprints, stretching the skin, light, hand rest) have been acquired, but further image processing is required to understand the effects. e Imprints (nail, watch): to analyze how long it takes for marks to disappear e Goosebumps: to analyze similar effects as with imprints 101 Figure 3-26: Sample Images Acquired from Skin Scanning Experiments: Skin Features identified are hair follicles, moles, pigment variations, vascular structure, and microrelief structure. Note: two images are from two different subjects. " Stretching the skin in lateral and vertical directions/Flexing: to analyze how local microrelief structures change, if at all " Deyhdration: to analyze vascular structure changes, if any " Showering/Scrubbing with pumice stone: to analyze if microrelief structure is less pronounced " Light: sunlight streaming through the window affects RGB data, but not feature recognition; take images in the dark, at night, and with lights off to have effects of light ring only " Hand rest: to test for further deformations and repeatability, also mitigate effects of minor movement 3.5 Preliminary Image Analysis Preliminary image analysis is made possible by SSIM (Structural Similarity Index), a built-in Matlab image algorithm [2]. It is used to analyze the day to day stability of the various feature points. Two images are mapped on top of each other and points 102 (a) Hair Orientation Down (b) Hair Orientation Left (c) Hair Orientation Right (d) Hair Orientation Up Figure 3-27: Sample Images for Hair Removing Algorithm-Hair oriented in four different directions to highlight underlying microrelief structure. Hair does not stay in combed direction. are compared based on the grayscale values. Based off these results, it can be assumed that skin features are not stable with time. The highest correlation between images (largest R value) was obtained with a one day difference between image capture whereas the lowest R value resulted between two images that were five days apart (see Table 3.4). 103 Table 3.4: SSIM Tests for Feature Stability-Shows correlation between two images taken on different days. A "Days Between Scans" number of 0 indicates images are taken on the same day. Repeatability of taking images is critical. Number of Days Between Scans 0 1 4 5 0 1 Subject Ina Ina Ina Ina Steve Nigel Correlation Between Images (R Value) 0.7308 0.8724 0.8284 0.8122 0.8293 0.8856 However, no definite conclusion can be made based purely on these results as the algorithm is extremely sensitive to ambient lighting conditions and repeatability of image capture (repeatability of lighting, arm orientation, and camera position in the experimental set ups). Thus, SSIM is an unsuitable package to use for this application. Instead, a more rigorous image processing algorithm must be used as described in Section 3.6. 3.6 Skin Studies: Closing Comments and Ongoing Work The objective of this investigation is to observe the stability of skin features over time and assess overall skin health. To adequately address this issue, the hardware and image processing algorithms have to be developed. This thesis work focused on developing the imaging platforms. Through successful iterations, a handheld scanning device has been developed that can adequately image the four feature points (pigment variation, hair follicles, microrelief structure, and vascular structure) in the visible spectrum. Now the image processing algorithms have to be developed and implemented to address the longitudinal stability of skin features and their correlation (if any) to overall skin health. In a more rigorous image processing algorithm, the experimental images are first preprocessed and then registered and mapped, using matching al104 gorithms. During preprocessing, the RGB images are converted to grayscale images and the microrelief furrows are identified. To date, Dr. Brian Anthony and Dr. Xian Du have been able to preprocess the images and correctly determine the microrelief furrows (Figure 3-28). The intersection points of the valleys, called the "bifurcation points," have also be identified. The challenge now lies in the skin deformation measurement: how can we globally register the images and locally map the feature points? To address this challenge, constellation mapping techniques will be used as described in 1181 for accurate registration and robust mapping of skin features. The process flow is outlined in Figure 3-29. This process is commonly used for imaging biometrics, such as fingerprints, which rely on the image quality and accurately extracting and detecting the feature landmarks to guide prealignment 121]. 105 A [NO U,1 3 3 2.1945 mm (a) RGB Image of Skin Microreliefs changed to Grayscale Image L to 3 3 2.1945 mm (b) Skin microreliefs identified as seen with the red dots Figure 3-28: Skin Image Preprocessing: Convert RGB images to grayscale and identify the microrelief furrows. 106 Skin images and ROls V0 aleys BfrItopin Valleys Bifurcation points Figure 3-29: Skin Analaysis Work Flow: Optical Imaging Technique for Pathological Skin Monitoring 108 Chapter 4 Conclusion This thesis focused on the design and development of hardware that can be used to image skin, with two applications: (1) use skin features for skin based body registration algorithms and (2) study the longitudinal stability of skin features at various length scales to assess overall skin health. The hardware for tracking skin features has been developed, both in a controlled environment (5-axis scanning system) as well as a free hand scanning device. The handheld scanning system can still be modified for ensuring high quality images and a compact design. A small, DC light source will be used instead of the AC LED light ring to eliminate the effects of flickering light on the images. For better assembly, the geometry of the camera insertion point will be changed to incorporate a square cutout. While iterations can still be made on the handheld system for a more polished and compact look, there are many possible experiments that can be carried out with the current system as described in Section 4.1. 4.1 Future Work In order to assess the stability of skin features over time and its impact on overall skin health, more diverse data is required. Currently, only thirteen subjects have been imaged. There is little variance in the subjects. Primarily all in their early to mid109 twenties, the only diversity in the current population lies in gender and ethnicity. Having a larger sample size would provide an increased variance in age, race, and ethnicity, allowing for broader observations across different demographics. Studying the influence of various environmental factors on skin is also an interesting future study. In clinical practice, this means observing patients who are subject to therapies (such as laser or radiation) that penetrate the skin 1241. Other environmental effects include allergens and pollution 1121. Yet another area of further investigation is in studying goosebumps. Karmanos breast imaging has recognized the emergence of goosebumps in their patients when submerged in water. Studying the relaxation time of the skin (i.e. how quickly the goosebumps disappear) and stimulating goosebumps are all areas of experimental interest. Preliminary research and experimentation have indicated that goosebumps occur at times of intense pleasure/emotion or when the body core is cold. This means that submerging the hand in ice water or locally cooling a limb is insufficient to induce goosebumps. Finding a repeatable way to induce goosebumps and imaging the relaxation time is an interesting challenge. Currently, the handheld device (and 5-axis scanning platform) use optical imaging. The next iteration of the device could incorporate a near-infrared (NIR) camera for subdermal imaging. NIR images are also used in many diagnostic devices (i.e. skin cancer detection), so this would be a logical next step as the project moves towards transforming the handheld device into a diagnostic tool. While a powerful change, this would not require much modifications on the existing frame design as the NIR version of the camera has a similar geometry to the Basler acA2040-90uc. The applications of these devices are far-reaching: from clinician's, who are interested in the diagnostic and reconstruction applications, to the cosmetic industry, which is more focused on anti-aging skin health and hydration. With continued iterations on the mechanical structure and optical hardware, the effects of this research can have significant repercussions. 110 Appendix A Figures The hole patterns of the y axis and rotation servos are mapped onto the bracket. The rotation servo nests in the bracket to optimize the x axis travel distance. As shown in the dimensioned drawings in Figure A-1, the bracket is as long as the servo to hold it in place. It was 3D printed with high density settings, since a solid structure is required to hold the 8.2 oz motor. Post machining of the mount included drilling and tapping the - - 20 holes to mount the rotation servo. The mount is connected to the y axis with 1" long ' screws and secured with steel nuts. 111 10 1- 0 IQ 3.60 o L0 LO NC C6) -4 3.47 6x #27 hole, 2 cm depth .1 IL I 4 0 0 L 4x #27 hole through all UNLESS OTHERWISE SPECIFIED: NAME DIMENSIONS ARE IN INCHES DRAWN .RACTIONAL ANGULAR: MACH BEND TWO PLACE DECIMAL CHECKED THREE PLACE DECvIMAL ENG APPR. FA MFG APPR. INTERPRET GEOMETRIC Q.A. TOLERANCING PER: COMMENTS: TOLERANCES: PRPRIEAY So AND CCFENA TO CONDAIN FVA <INSERT COMPANY NAME HERE> IS PROHIBITED. ' 5 nt Edition. ontyASSY AP PUCATION MATERIAL USED ON FINISH DO NOT SCALE DRAWING DATE TITLE: CNC Servo Connection SIZE DWG. NO. 3D Printed Part-solid D ost machining or holes SCALE: 1:2 WEI GHT: REV SHEET 1 OF 1 3 machining of 6-32 holes Figure A-1: CAD Model of Servo Connection to CNC: 3D printed part that connects to Y axis. Post for connection to the Y axis and the 1/4-20 holes for the servo connection. 0.7 2 (p).95 (N 0i CIO3 e e. UNLESS OTHERWISE SPECIFIED: DIMENSIONS ARE IN INCHES TOLERANCES: PROPIETARY Soio AND CONFIDENIIAL PN Fq ".. ent Edition. NAeln <INSERT COMPANY NAME HERE> IS PROHIBITED. 5 FRACTIONAL ANGULAR: MACH BEND TWO PLACE DECIMAL THREE PLACE DECIMAL CHECKED INTERPRET GEOMETRIC TOLERANCIN PER: MATPR IA I Q.A. FINISH yAOSSY USED ON AP PUCATION 4 NAME DO NOT SCALE DRAWING 3 DATE DRAWN TITLE: ENG APPR. MFG APPR. COMMENTS: 3D printed part: kinematic coupling SIZE DWG. NO. REV 0kmera Mountl SCALE: 2:1 WEIGHT: SHEET 1OF 1 2 Figure A-2: CAD Model of Webcam Mount to CNC: 3D printed part that connects to Pan and Tilt servo. Tapping the hole is required. 114 Appendix B Matlab Codes 115 % Image Processing of Skin Images for Longitudinal Skin Study % Make Images Gray Scale clear all close all clc % Read the image using the file path in imread % Make the image grayscale using rgb2gray % Show the image using imshow steve = imread(['C:\Users\Ina\Dropbox (MIT)\Research\Longitudinal Skin 'Study\Experimental Images\01-21-Skin Results Day 5\stevelOx2.png'1,... 'png'); S=rgb2gray(steve); %figure('Name','Steve'),imshow(S) %title(gca,'Steve grayscale') ina = imread(['C:\Users\Ina\Dropbox (MIT)\Research\Longitudinal Skin 'Study\Experimental Images\01-21-Skin Results Day 5\ina1ox.png'],... 'png'); I = rgb2gray(ina); %figure('Name','Ina'),imshow(I) %title(gca,'Ina grayscale') % Average over the grayscale image to get the "quality" of the image to % relate to melanin (and order images accordingly) %SteveMelanin = mean(mean(S(1:end,1:end))) %InaMelanin = mean(mean(I(1:end,1:end))) % Show the color map (higher number = lighter skin) imshow(2*ones(100,100), [0 255]); imshow(255*ones(100,100), [0 255]); % User input to get region of interest and the position imshow (I); figure('Name','Ina'),imshow(I); title(gca,'Ina grayscale') h = imrect; posI = h.getPosition(; imshow (S); figure('Name','Steve'),imshow(S); title(gca,'Steve grayscale') hS = imrect; posS = hS.getPosition(); Ina_Melanin = mean(mean(I(posI(:,l):posI(:,2),posI(:,3):posI(:,4)))) % Compare image qualities ref = imread(['C:\Users\Ina\Dropbox (MIT)\Research\Longitudinal Skin 'Study\Experimental Images\01-15-Skin Results Day2\Inalx.png']); ID3 = imread(['C:\Users\Ina\Dropbox (MIT)\Research\Longitudinal Skin '.. 'Study\Experimental Images\01-16-Skin Results Day 3\Ina.png']); Figure B-1: Quantifying Melanin Code: This code was utilized to determine the effects of lighting on the skin and to characterize the melanin content in the skin. The RGB color images were changed to grayscale images for the melanin characterizations. 116 subplot(1,2,1); imshow(ref); subplot(1,2,2); imshow(ID3); [ssimval, ssimmap] title('Reference Image Ina 1x Day2'); title('Image Ina 1x Day3'); = ssim(ID3,ref); fprintf('The SSIM value is %0.4f.\n',ssimval) figure, imshow(ssimmap, []); title(sprintf('ssim Index Map - Mean ssim Value is %0.4f',ssimval)) Warning: Image is too big to fit on screen; displaying at 331 Warning: Image is too big to fit on screen; displaying at 33* Warning: Image is too big to fit on screen; displaying at 33% Warning: Image is too big to fit on screen; displaying at 33% Warning: Integer operands are required for colon operator when used as index operands are required for colon operator when used as index Warning: Integer Ina_Melanin = NaN The SSIM value is 0.9126. Warning: Image is too big to fit on screen; displaying at 33* Figure B-2: Skin Image Comparisons Using SSIM: This code was utilized to determine if the skin features were stable by comparing two images that were days apart. (b) Skin Image Grayscale-Steve (a) Skin Image Grayscale-Ina Figure B-3: Grayscale Skin Image: Used to understand the reflective spots for various lighting choices and to quantify the melanin levels in skin (darker spots indicate more melanin). 117 Reference Image Ina 1x Day2 Imege Ina 1 x Day3l (a) Skin Images Between Days: First one is reference image for SSIM algorithm maim Indx Map - Mean asim Value Is 0.9126 ~* ,.~I ~v~4 14 11 (b) SSIM Index Map: Two images mapped on top of each other. The white spots indicate the parts that map identically; darker spots are differences between the images. Figure B-4: SSIM for Skin Images 118 % Quanitifying lighting of images % For use with longitudinal skin study experiments % clear all variables, clear all close all clC close all windows, clear command window % Read the image from the appropriate location promptImageName = 'What is the image name? (Include folder destination' ... 'and file extension) '; ImageName = input (promptImageName, 's'); ImageLocation = strcat('C:\Users\Ina\Dropbox (MIT)\Research\Longitudinal' 'Skin Study\Experimental Images' , ImageName); Image = imread(ImageLocation); % Pop up the image for user to select the appropriate ROI imagesc (Image); % Prompt user for edges of ROI promptYl = 'What is the Y pixel coordinate for the first location? '; promptX1 = 'What is the X pixel coordinate for the first location? '; promptY2 = 'What is the Y pixel coordinate for the second location? '; promptX2 = 'What is the X pixel coordinate for the second location? '; Y1 = input(promptYl); X1 = input(promptXl); Y2 = input(promptY2); X2 = input (promptX2) ; ROI = Image(Yl:Y2, X1:X2, :); imagesc(ROI); Figure B-5: Quantifying Lighting Code: This code was utilized to determine the appropriate region of interest (ROI) among images during various light calibration. The idea is to select the area the ROI appropriately such that the two images have similar lighting conditions. Furthermore, due to the nature of the handheld device (with a circular ring visible in the image), the ROI of the skin would be similar to the ROI selected when calibrating the lights. 119 120 Bibliography I11 [2013]Shiseido discovered that dryness-induced marked irregularityof the skin microrelief is attributableto shrinking of cornified cells of the skin \textbar Research and Development Topics \ textbar Research and Development \textbar Shiseido group website. 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