March 2021 Issue

Michelson Diagnostics, the UK manufacturer of VivoSight, is excited to issue the first edition of its bimonthly newsletter VivoScene. Every second month we’ll provide latest news, insights and pearls about VivoSight, the world’s leading OCT (Optical Coherence Tomography) skin imaging and measurement system.

VivoScene’s purpose is to enhance the work of its customers, but also to inform non-users how VivoSight can accelerate research projects and advance clinical practices.

In this first edition we feature pioneering physicians who analyze vascular patterns for advanced management of recalcitrant skin conditions. Read on about other topics and sign up to VivoScene to receive future editions on time.

Do you know the depth and diameter of recalcitrant vessels you’re attempting to treat? For what applications can VivoSight vascular images and measures be utilized? Physicians at the forefront of pioneering research and clinical practice investigate the use of new modalities to develop better solutions for difficult to treat vascular conditions.

Drs. Jill Waibel and Kristen Kelly utilized VivoSight in their seminal 2018 paper [1] where they reported that infantile hemangiomas and port wine birthmarks consist of highly variable and heterogeneous vessel sizes, morphologies, and depth distributions, suggesting that laser treatments with uniform pulse durations and standardized parameter sets may not be optimal to treat all lesions.

As they discuss in the paper, “Currently clinicians do not know the vessel characteristics of lesions they are treating. We speculate that more complex treatment protocols are required, tailored to individual vessel diameters and depths in a lesion, which can be observed using OCT”.

Dr. Roy Geronemus also added VivoSight to his practice. “We are enthusiastic about the results we are seeing with our VivoSight OCTguided treatments of Port Wine Stain birthmarks”, said Dr. Geronemus. “This new technology has great potential to change therapies for vascular conditions. The first results are very encouraging, and we are evaluating the technology to guide treatment of other conditions beyond Port Wine Stains.”

Dr. Geronemus’ group has already published two papers where VivoSight was instrumental. The first, a case report, focused on treating port wine stains using dynamic OCT-guided laser settings [Christman et. al., 2]:

  • “Matching PDL settings to vessel depth and diameter at each visit using dynamic OCT might increase the odds of clinical improvement, and lower the total number of treatments necessary for an optimal outcome for PWS birthmarks.”

The second paper examined the vasculature in melasma and measured vessel response from treatment with tranexamic acid [Pomerantz et. al., 3]:

  • “Dynamic-OCT imaging of melasma demonstrated increased blood flow and vessel diameter in both papillary and reticular dermis. Oral TXA reduced vascular flow and vessel diameter, most remarkably in the superficial dermis affected by melasma. D-OCT can potentially be used in measuring response to treatments targeting melasma, given the potential relationship between melasma and aberrant blood vessels.”

Dr. Kelly presented some of her work with VivoSight OCT at the recent “Controversies and Conversations in Laser & Cosmetic Surgery” Dec 2020 meeting and further mentioned collaboration with Dr. Lisa Arkin of the University of Wisconsin, who has acquired a VivoSight system within the Department of Dermatology.

Dr. Arkin comments, “We are enthusiastic to begin this research. Dr. Kelly and I are hopeful that use of the Vivosight system will provide granular quantitative data on Port Wine Stains that can be integrated with deep clinical phenotyping including genotype and age to help optimize precisionbased treatments for these patients.”

The VivoSight team is equally excited to be working with these renowned thought leaders. Being able to visualize and quantify vascular structures objectively, non-invasively in real-time and invivo, allows acceleration of research timelines, and helps to inform therapy options and monitor treatment effects. We’ll keep you posted here on VivoScene.

Check out our blogs on our website. A number of educational videos will help you to get more out of VivoSight and learn about latest pearls and pitfalls.

The American Society for Laser Medicine and Surgery (ASLMS) has made our paper Editor’s Choice!

In their recent article [4], Mehrabi et. al. used VivoSight OCT imaging to observe vascular changes when investigating parameters for treatment of Basal Cell Carcinoma (BCC) lesions with various long pulse (LP) Nd:YAG laser settings.

Their original understanding was that LP 1064 nm laser treatment of BCCs relied upon hemoglobin absorption as its primary target to eradicate the underlying vasculature of these skin cancers. However, immediately after laser administration OCT images and measures of treated tissue revealed increased blood flow and vasodilation resembling an erythematous response when compared with untreated skin. If the improvement of BCCs is related to a vascular event, it is not an immediate process.

On the other hand, weeks after treating with more aggressive settings, the treatment site revealed avascularity with progressive surrounding angiogenesis. VivoSight was well able to visualize and quantify both different vascular events.

Blood Vessels in Malignant Melanoma

New research by international melanoma experts [5]: J. Welzel et. al use VivoSight OCT to describe vessel patterns in malignant melanoma and correlate them with disease stage for risk estimation prior to surgery

It seems that as the melanoma lesion progresses through stages I-IV, the blood vessel density increases, vessel pattern becomes more irregular and there are more atypical vessels; all observable by VivoSight Dynamic OCT. The authors suggest this could improve melanoma risk estimation prior to surgery and may be a completely new way of assessing melanoma risk.

Vascular Fingerprint of Melasma

A first in Melasma research! Pomerantz et. al. [3] from the group of Roy G. Geronemus, MD utilized VivoSight OCT to examine the vasculature in melasma and measure vessel response from treatment with tranexamic acid. The preliminary finding is that OCT can potentially be used in measuring response to treatments targeting melasma, given the potential relationship between melasma and aberrant blood vessels.

Vivosight is covered in more than 380 peer-reviewed articles. For a structured list of our publications please click here

Michelson Diagnostics, the UK manufacturer of VivoSight, teams up with AI Specialists Manchester Imaging to develop Machine Learning Algorithms for VivoSight OCT Skin Imaging System. Learn how we stay at the forefront of latest capabilities to help our customers: https://us.vivosight.com/2020/12/14/aimanchesterimaging/

Free Online VivoSight Demo

Want to experience VivoSight OCT live in action from the convenience of your home or office? We’d love to show you real time scanning and discuss how VivoSight might be of value to you. Please sign up for an online demo here: https://us.vivosight.com/how-to-order/

New Website

Our new website is growing, please check us out. It is easy to navigate among the various categories and see that we have much more going on besides vascular imaging. Make sure you download our comprehensive, informative brochure, visit our blog page and sign-up for the VivoScene newsletter.

VivoSight Posts on LinkedIn and Twitter

We post every week relevant content on Social Media, especially LinkedIn and Twitter. Don’t miss out on the latest, please connect and follow us on:

Michelson Diagnostics Ltd. is proud to introduce VivoTools, a new advanced image analysis software for the VivoSight OCT system to measure vascular and structural tissues of the skin and quantify treatment effects. See here for details: https://us.vivosight.com/vivotools/

3-Axis Precision Probe Stand

For those users who are interested in using VivoSight for scanning samples ex-vivo, the new 3-axis precision probe stand is an ideal addition to their armory. The VivoSight probe can be strapped into the stand in a moment, and fine adjust knobs control the height and x-y position for a perfectly stable and precisely controlled OCT scan of the sample. The probe stand simplifies probe handling for bench top work and will save lots of time when scanning multiple samples.

Your satisfaction, helping to advance your research and clinical efforts, and providing the best possible experience with VivoSight is our top concern. Please let us know what we could do better and how we can improve your experience with VivoSight and Michelson Diagnostics.

References

1. Waibel, J.S., Holmes, J., Rudnick, A., Woods, D. and Kelly, K.M. (2018), Angiographic optical coherence tomography imaging of hemangiomas and port wine birthmarks. Lasers Surg. Med., 50: 718-726. https://doi.org/10.1002/lsm.22816

2. Christman MP, Feng H, Holmes J, Geronemus RG, Treating port wine stain birthmarks using dynamic optical coherence tomography-guided settings, Journal of the American Academy of Dermatology (2019), doi: https://doi.org/10.1016/j.jaad.2019.08.028.

3. Pomerantz, H., Christman, M.P., Bloom, B.S., Lederhandler, M., Feng, H., Holmes, J. and Geronemus, R.G. (2021), Dynamic Optical Coherence Tomography of Cutaneous Blood Vessels in Melasma and Vessel Response to Oral Tranexamic Acid. Lasers Surg Med. https://doi.org/10.1002/lsm.23345

4. Mehrabi, J.N., Kelly, K.M., Holmes, J.D. and Zachary, C.B. (2021), Assessing the Outcomes of Focused Heating of the Skin by a Long‐Pulsed 1064 nm Laser with an Integrated Scanner, Infrared Thermal Guidance, and Optical Coherence Tomography. Lasers Surg Med. https://doi.org/10.1002/lsm.23377

5. Welzel, J., Schuh, S., De Carvalho, N., Themstrup, L., Ulrich, M., Jemec, G., Holmes, J. and Pellacani, G. (2021), Dynamic optical coherence tomography shows characteristic alterations of blood vessels in malignant melanoma. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.17080