Biomedical Engineering

Light and image

System developed by small business makes it possible to carry out several skin examinations in a single environment

EDUARDO CESARChromosomes are put in pairs automatically by the systemEDUARDO CESAR

Within a single standardized environment, made up of a camera coupled to a microscope, for visualizing the skin, a set of equipment called a videodermatoscope, a computer, adequate lighting and a mini locker room, it is possible to carry out several examinations, such as periodic evaluations of suspicious skin lesions, and to accompany the progress of the treatment of vitiligo and jaundice, besides taking measurements of the skull and the face, necessary in cases of deformation. All these examinations can be done by the Biometry and Corporal Mapping System (Biomap), developed by Atonus, a company from the city of São José dos Campos, São Paulo.

The system for evaluating skin lesions was installed this year in a plastic surgery clinic in the municipality and has been used to examine the patients. Two other units will be put into a laboratory in Pará, a long-standing partner of the company, and into the Valley Oncology Institute, in São José dos Campos, which throughout next summer intends to run a skin cancer prevention campaign on the beaches.

“Skin lesions are classified on the basis of characteristics like diameter, asymmetry and border irregularities, which makes a more objective evaluation possible”, says Antônio Francisco Júnior, a partner-director of Atonus, responsible for the development of the system that makes it possible to accompany the appearance and the growth of patches on the skin over time by the juxtaposition of images captured on different dates. “There is no one procedure instituted in Brazil for the photographic documentation of the skin”, the researcher says. That means that the methods currently in use do not take into account such parameters as lighting and the positioning of the patient, for the same lesion to be able to be analyzed today, two months hence or two years hence. “The examination has the advantage of allowing an early diagnosis of melanoma, a type of skin cancer”, says Antônio Francisco. Both the cure for melanoma and the increase in the patient’s survival time depend of the early detection of the disease.

Computerized system
The Biomap is not just limited to a digital microcamera that films the lesion. It encompasses the lighting, in a demarcated area where the patient must be positioned to capture images, and a technician trained to carry out the acquisition, storage and transfer of the data and images of the human epidermis by means of a computerized system. It works in a similar way to a laboratory that takes charge of carrying out the examinations and issuing the reports, subsequently analyzed by a specialist physician.

Before developing the videodermatoscope, which had support from FAPESP under the Small Business Innovation Research Program (PIPE), Antônio Francisco had already developed an automatic system for analyzing human semen. Actually, the interest of the researcher, an electronic engineer by training, for the development of equipment for application in the biomedical area had a strong influence from his family relationships. Besides his doctor father, three of his four brothers also followed the same career. Antônio Francisco used to work at the National Institute for Space Research (INPE) since 1982, designing electronic and computing systems, when he developed the system for analysis semen. “As in those days there were no image capturing boards in Brazil, I asked the development personnel to create a board (electronic circuit) to read from a video camera, connected to a satellite image storage board, with the objective of getting an image of the human semen in the microscop”, he says. The first product developed was sold to a fertility clinic in São Paulo.

Computer vision
The interest in the image processing area increased after this first successful experience. At the end of the 1980s, the researcher managed to get a scholarship from the National Council for Scientific and Technological Development (CNPq) to work in a robotics laboratory at the University of Pennsylvania, in the United States. From there, he followed on to the Royal Institute of  Technology, in Stockholm, in Sweden, where he won a scholarship from the Swedish government to do a doctorate in the area of computer vision.

He returned to Brazil in 1993 and created Atonus in 1995, housed in the now extinct Polovale foundation, in São José dos Campos. “The initial idea was to work with image analysis systems”, Antônio Francisco says. For a period, the researched fulfilled a double workload. Only in 1999, when he had the Pipe project for developing a software for analyzing skin lesions approved, did he leave the Inpe to dedicate himself full-time to the company.

Even after selling dozens of units of the videodermatoscope, Antônio Francisco reckoned that he did not have the return expected, because the equipment was used only by specialist doctors. The way out was to find a new business model for the same product. Instead of reaching only 2% of the market, represented by the specialist doctors who carry out the examination with the equipment, the objective was to reach 30%.

It was necessary to rethink the product and to change the focus. “A trained person could operate the videodermatoscope instead of the doctor, who would analyze the data obtained by the system”, says Antônio Francisco. The new business model was approved by the Research in Companies Support Program (Pappe), a partnership between FAPESP and the Ministry of Science and Technology’s the Financier of  Studies and Projects (Finep), to take to the market the results of the Pipe projects.

EDUARDO CESARThe system also evaluates skin lesionsEDUARDO CESAR

New sensors
The change in the focus of the product resulted in conceptual modifications and originated the Biomap system. The price, R$ 38 thousand, is one of the advantages of the system in relation to a videodermatoscope with software imported from Germany, which costs R$ 60 thousand. Another advantage is that it makes it possible for other functions, sensors, components and software to be added to the system, using the same unit, the same training, physical packaging and financial structure. To evaluate vitiligo and jaundice, the changes included the source of  lighting for the video camera, which must be ultraviolet, to identify the density of the patch on the skin before, during and after the treatment.

The module for examining craniofacial deformation should be developed in partnership with the Craniofacial Anomalies Rehabilitation Hospital of the University of São Paulo, in Bauru, in the interior of São Paulo, known as the Little Center. The measurements of several parameters of shape, done manually, will be carried out by the system, in all the stages of the treatment, using the same principle developed for analyzing skin lesions, with some modifications. Other functions that are also provided for to be part of the system are gait analysis and the measurement of parts of the human body, necessary, for example, for standardization in modeling clothes.

Almost at the same time that he started the project for evaluating skin lesions, Antônio Francisco began to work on the development of the system for analyzing the human chromosome, also supported by the Pipe. To carry out the examination, a biological sample, like the patient’s blood, has to be collected. The system automatically does the pairing, that is, the generation of the representation of the chromosomes in pairs, known as a karyotype, and cytogenetic evaluation, by the fluorescent in situ hybridization technique.

The technique makes use of fluorescent “chromosome probes”  that fit into part of the DNA chain of the chromosome issuing light at certain wavelengths. With this examination, it is possible to determine some diseases, and also the sex of an embryo. Today, the system is now available at several benchmark laboratories in Brazil, amongst which the Federal University of São Paulo and the Bauru “Little Center”.

The Projects
1. Biometry and Skin Lesion Electronic Capture Unit – Biocap (nº 04/13974-4); Modality Research in Companies Support Program (Pappe); Coordinator Antônio Francisco Júnior – Atonus; Investment R$ 476,160.00 (Finep)
2. A computer system for analyzing human chromosomes (nº 99/11677-2); Modality Small Business Innovation Research Program (PIPE); Coordinator Antônio Francisco Júnior – Atonus; Investment R$ 106,447.80 (FAPESP)