Patent Publication Number: US-2023147076-A1

Title: Quantitative evaluation system and evaluation method for color of hemangioma

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This patent application is a National Stage under  35  U.S.C. 371 of International Patent Application No. PCT/CN2021/126742, filed Oct. 27, 2021, which claims the benefit and priority of Chinese Patent Application No. 202011338568.6, filed Nov. 25, 2020, the disclosures of all of which are incorporated by reference herein in their entirety as part of the present application. 
    
    
     TECHNICAL FIELD 
     The present disclosure relates to the field of medical technology, and particularly relates to a quantitative evaluation system and evaluation method for color of hemangioma. 
     BACKGROUND ART 
     Infantile Hemangioma (IH) is the most common benign tumor in infants, which is developed from the soft tissue of infants. The IH is a vascular tumor with unbalanced vascular homeostasis caused by abnormal regulation of vascular development and formation during the embryonic period. The incidence rate of the IH is 4%-10%, and the incidence rate is higher in premature infants and low birth weight infants (infants with birth weight &lt; 1000 g). The IH often appears on the face, limbs and other body surfaces, seriously affecting the infant patient’s appearance, vision and mental health. The IH occurring in the respiratory tract and intracranial parts may cause respiratory obstruction, intracranial hemorrhage and other critical symptoms, and even cause death. The IH is one of the most common diseases that seriously endanger the physical and mental health of children. From a biological point of view, typical IH is divided into three phases: a proliferation phase, a plateau phase, and a remission phase. Natural course: lesions appear 1 to 2 weeks after birth, rapidly proliferate within 6 months, then gradually stop growing, and enter a spontaneous and slow remission phase, and this process may last for several years. In the proliferation phase of hemangioma, according to the degree of infiltration of the tumor of IH, the IH can be divided into a superficial type, a deep type and a mixed type. The superficial IH is often referred to as “strawberry hemangioma” according to its shape, and is a bright red mass with irregular protrusions on the surface and surrounded by normal skin tissue. After oral administration of propranolol, the state of an illness of sick children is relieved gradually. This process is manifested as: the tumor diameter decreases, the protrusion degree decreases, the local skin temperature changes, the tumor color changes, and the blood flow in the tumor cavity decreases. 
     At present, evaluation methods for the therapeutic effect of IH include: an Achauer percentile quartering method, a visual analog scoring method, an IH activity scoring method, an imaging auxiliary method (ultrasound, computed tomography (CT), magnetic resonance imaging (MRI)), a skin temperature method, and a measurement method of body fluids and biochemical indexes. However, there is no accurate, effective and objective evaluation method. The tumor color of IH can indirectly reflect the conditions of proliferation and remission, thereby becoming an important index for evaluating the state of an illness of sick children. Moreover, at present, for the evaluation of tumor color in sick children, clinicians’ visual evaluation with a certain subjective color is commonly used, which causes great trouble to objectively and accurately evaluate the tumor color and reflect the state of an illness of sick children. 
     SUMMARY 
     In order to overcome the problems of inaccurate and inconvenient evaluation of hemangioma in the prior art, an objective of the present disclosure is to provide a quantitative evaluation system and evaluation method of hemangioma. The evaluation system has the advantages of high accuracy, convenience, practicality, and easy promotion. 
     In order to achieve the above objective, the present disclosure provides a quantitative evaluation system for color of hemangioma. The evaluation system includes an image acquisition module, an image analysis module, a result evaluation module and a display module;
     the image acquisition module includes a light source device, an imaging device and a storage device; the imaging device acquires a hemangioma image, and the hemangioma image is stored in the storage device;   the image analysis module includes a digital signal processor and digital analysis software; the digital signal processor divides pixel points of the hemangioma image into a tumor image ( 31 ) and a tumor side image ( 32 ); the digital analysis software calculates comprehensive red, green, blue (RGB) values of the tumor image ( 31 ) and the tumor side image ( 32 ), and results are respectively recorded as a tumor comprehensive RGB value and a tumor-side comprehensive RGB value;   the result evaluation module includes a therapeutic evaluation coefficient, and the therapeutic evaluation coefficient = tumor comprehensive RGB value - tumor-side comprehensive RGB value; and   the display module includes a display screen for displaying images and numerical values.   

     Preferably, the light source device includes a light source box and a light shield; and the light source box includes an infrared filter. 
     Preferably, a distance between the imaging device and an imaging object is fixed, and the distance is preferably 1 m. 
     Preferably, the digital signal processor classifies the pixel points of the hemangioma image into a red region and normal regions; the red region is the tumor image; by taking the largest diameter of a tumor as a diameter and a center point of the diameter as an original point, a plane rectangular coordinate system is established; four normal regions having a distance of 1 cm±0.5 mm from the outer sides of the edges of the tumor in four directions of the coordinate system and having an area of 1 cm 2  ±0.5 cm 2  constitute the tumor side image; and the tumor side image is divided into four regions, namely a tumor side I, a tumor side II, a tumor side III and a tumor side IV. 
     Preferably, the digital analysis software converts and outputs the tumor image and the tumor side image to red, green and blue values and an RGB value, respectively recorded as R, G, B and comprehensive RGB values; the comprehensive RGB value of the tumor image is recorded as a tumor comprehensive RGB value; and an average value of the comprehensive RGB values of the four regions, namely the tumor side I, the tumor side II, the tumor side III and the tumor side IV, of the tumor side image is calculated and then recorded as a tumor-side comprehensive RGB value. 
     According to the second aspect of the present disclosure, the present disclosure provides a quantitative evaluation method for color of hemangioma. The quantitative evaluation method for color of hemangioma is performed in the quantitative evaluation system for color of hemangioma in the present disclosure, and the evaluation method includes the following steps:
     S 1 : turning on the light source device and the imaging device to perform a system stability calibration process until the system stability reaches the standard;   S 2 : shooting a hemangioma image by the imaging device, and storing the hemangioma image in the storage device;   S 3 : dividing the hemangioma image into a tumor image ( 31 ) and a tumor side image ( 32 ) by the digital signal processor;   S 4 : calculating comprehensive RGB values of the tumor image ( 31 ) and the tumor side image ( 32 ) by the digital analysis software, and respectively recording results as a tumor comprehensive RGB value and a tumor-side comprehensive RGB value;   S 5 : calculating a therapeutic evaluation coefficient, where the therapeutic evaluation coefficient = tumor comprehensive RGB value - tumor-side comprehensive RGB value; and   S 6 : displaying the hemangioma image, the tumor image ( 31 ), the tumor side image ( 32 ), the tumor comprehensive RGB value, the tumor-side comprehensive RGB value and the therapeutic evaluation coefficient by the display screen.   

     Preferably, in S 1 , the system stability calibration process includes the following steps:
     a: placing a uniform white diffuse reflection plate in a measurement region, and adjusting an aperture size of a camera or a light source box to enable one component in RGB values of the shot image to reach 255;   b: placing a gray standard plate in the measurement region, and adjusting parameters of the camera to enable RGB three components of the output image to be 122, 122 and 121 respectively;   c: placing a black standard plate in the measurement region and/or covering a lens cap, and adjusting the parameters of the camera to enable the RGB three components of the output image to be 0 respectively; and   d: placing a white standard plate in the measurement region, and adjusting the parameters of the camera to enable the RGB values of the output image to be 255 respectively.   

     Preferably, in S 3 , the division of the tumor side image includes the following steps: 1) selecting a center of the tumor image as an original point, and equally dividing the tumor image into four quadrants by a first quadrant axis, a second quadrant axis, a third quadrant axis and a fourth quadrant axis; and 
     2) selecting an image having a distance of 1±0.5 cm from the outer side of the tumor image on each of the quadrant axes and having an area of 1±0.5 cm 2  as a tumor side image. 
     Preferably, the tumor side image is divided into four regions, namely a tumor side I, a tumor side II, a tumor side III and a tumor side IV. 
     Preferably, in S 3 , the tumor-side comprehensive RGB value is an average value of the comprehensive RGB values of the four regions, namely the tumor side I, the tumor side II, the tumor side III and the tumor side IV, of the tumor side image. 
     Compared with the visual measurement in the prior art, the quantitative evaluation system and method for hemangioma provided by the present disclosure are more accurate and effective, are convenient and practical, and have extremely high promotion value. 
     By objectively quantifying the color depth of the tumor color, the quantitative evaluation system and evaluation method for color of hemangioma provided by the present disclosure have the advantages of more accurately reflecting the state of an illness of sick children and guiding doctors to treat. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a schematic diagram of quadrant axes of a tumor side image divided by an image analysis module provided according to a preferred embodiment of the present disclosure. 
         FIG.  2    is a schematic diagram of a tumor side image divided by an image analysis module provided according to a preferred embodiment of the present disclosure. 
         FIG.  3    is a tumor image divided by an image analysis module provided according to a preferred embodiment of the present disclosure. 
         FIG.  4    is a schematic structural diagram of a quantitative evaluation system for hemangioma in the present disclosure. 
         FIG.  5    is a schematic diagram of a quantitative evaluation method for hemangioma in the present disclosure. 
     
    
    
     DESCRIPTION OF REFERENCE NUMERALS 
     
       
         
           
               
            
               
                   31  tumor image 
               
               
                   311  first quadrant axis 
               
               
                   312  second quadrant axis; 
               
               
                   313  third quadrant axis; 
               
               
                   314  fourth quadrant axis; 
               
               
                   32  tumor side image; 
               
               
                   321  tumor side I; 
               
               
                   322  tumor side II; 
               
               
                   323  tumor side III; 
               
               
                   324  tumor side IV. 
               
            
           
         
       
     
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     The specific embodiments of the present disclosure will be described in detail below with reference to the accompanying drawings. It should be understood that the embodiments described herein are merely intended to illustrate and interpret the present disclosure, rather than to limit the present disclosure. 
     As mentioned above, the present disclosure provides a quantitative evaluation system for color of hemangioma. The evaluation system includes an image acquisition module, an image analysis module, a result evaluation module and a display module. The image acquisition module includes a light source device, an imaging device and a storage device. The imaging device acquires a hemangioma image, and the hemangioma image is stored in the storage device. The image analysis module includes a digital signal processor and digital analysis software. The digital signal processor divides pixel points of the hemangioma image into a tumor image  31  and a tumor side image  32 . The digital analysis software calculates comprehensive RGB values of the tumor image  31  and the tumor side image  32 , and results are respectively recorded as a tumor comprehensive RGB value and a tumor-side comprehensive RGB value. The result evaluation module includes a therapeutic evaluation coefficient, and the therapeutic evaluation coefficient = tumor comprehensive RGB value - tumor-side comprehensive RGB value. The display module includes a display screen for displaying images and numerical values. By objectively quantifying the color depth of the tumor color, the above-mentioned scheme of the present disclosure has the advantages of more accurately reflecting the state of an illness of sick children and guiding doctors to treat. 
     Referring to  FIG.  1    to  FIG.  3   , the present disclosure provides a quantitative evaluation system for color of hemangioma. The evaluation system includes an image acquisition module, an image analysis module, a result evaluation module and a display module. 
     According to the present disclosure, the image acquisition module includes a light source device, an imaging device and a storage device. The imaging device acquires a hemangioma image, and the hemangioma image is stored in the storage device. 
     In a preferred embodiment of the present disclosure, the light source device uses a P120 light source box and a PHILIPS-TLD-36W/865 strip-shaped three-primary fluorescent lamp, the model of a lamp holder of the light source is G13, a color rendering index is 85, and the light with a color temperature of 6500 K can be emitted. The light source can be used as a full-spectrum light source to ensure the spatial uniformity of the light, so that the light can be uniformly emitted to the tumor site to be shot. 
     In a preferred embodiment of the present disclosure, the imaging device uses an Olympus digital camera with a model of D33235, a total pixel of 10 million and an effective pixel of 9.3 million, an M.Zuiko professional lens is used, and a sensor is a charge coupled device (CCD) with a size of 17.4 mm*13.0 mm. 
     According to the present disclosure, the storage device is any one or more of a network cloud disk, a semiconductor memory, a magnetic surface memory and an optical surface memory. 
     In a preferred embodiment of the present disclosure, the light source device includes a light source box and a light shield for shielding external light, thereby eliminating the influence of ambient light on a measurement system. 
     In a preferred embodiment of the present disclosure, the light source box includes an infrared filter which can effectively reduce the temperature of the output light, thereby reducing the influence of the self-heating temperature of the light on the skin color, and ensuring that the acquired image can accurately reflect the state of an illness of sick children. 
     In a preferred embodiment of the present disclosure, a distance between the imaging device and an imaging object is fixed, which is 1 m, thereby ensuring that the imaging object can be clearly imaged. 
     In a preferred embodiment of the present disclosure, the imaging device is mounted on a bracket with an adjustable direction, so that the imaging device is more convenient to use. 
     According to the present disclosure, the image analysis module includes a digital signal processor and digital analysis software. 
     According to a preferred embodiment of the present disclosure, the digital signal processor and the digital analysis software are ImageJ and/or Photoshop. 
     The digital signal processor divides pixel points of the hemangioma image into a tumor image  31  and a tumor side image  32 . The digital analysis software calculates comprehensive RGB values of the tumor image  31  and the tumor side image  32 , and results are respectively recorded as a tumor comprehensive RGB value and a tumor-side comprehensive RGB value. 
     In a preferred embodiment of the present disclosure, the digital signal processor classifies the pixel points of the hemangioma image into a red region and normal regions; the red region is the tumor image  31 ; by taking the largest diameter of a tumor as a diameter and a center point of the diameter as an original point, a plane rectangular coordinate system is established; four normal regions having a distance of 1 cm from the outer sides of the edges of the tumor in four directions of the coordinate system and having an area of 1 cm 2  constitute the tumor side image  32 ; and the tumor side image  32  is divided into four regions, namely a tumor side I  321 , a tumor side II  322 , a tumor side III  323  and a tumor side IV  324 . 
     In a preferred embodiment of the present disclosure, the digital analysis software converts and outputs the tumor image  31  and the tumor side image  32  to red, green and blue values and an RGB value, respectively recorded as R, G, B and comprehensive RGB values; the comprehensive RGB value of the tumor image  31  is recorded as a tumor comprehensive RGB value; and an average value of the comprehensive RGB values of the four regions, namely the tumor side I  321 , the tumor side II  322 , the tumor side III  323  and the tumor side IV  324 , of the tumor side image  32  is calculated and then recorded as a tumor-side comprehensive RGB value. An average comprehensive RGB value of the four tumor side regions is taken as the tumor-side comprehensive RGB value to reduce system errors. 
     According to the present disclosure, the result evaluation module includes a therapeutic evaluation coefficient, and the therapeutic evaluation coefficient = tumor comprehensive RGB value - tumor-side comprehensive RGB value. The influence of the individual skin color difference of sick children on the result is reduced by the therapeutic evaluation coefficient, thereby more accurately reflecting the therapeutic effect on sick children. 
     The display screen may be a liquid crystal display screen. 
     Referring to  FIG.  4   , another aspect of the present disclosure provides a quantitative evaluation method for color of hemangioma. The evaluation method is performed in the quantitative evaluation system for hemangioma. The evaluation method includes the following steps:
     S 1 : the light source device and the imaging device are turned on to perform a system stability calibration process until the system stability reaches the standard;   S 2 : a hemangioma image is shot by the imaging device, and the hemangioma image is stored in the storage device;   S 3 : the hemangioma image is divided into a tumor image  31  and a tumor side image  32  by the digital signal processor;   S 4 : comprehensive RGB values of the tumor image  31  and the tumor side image  32  are calculated by the digital analysis software, and results are respectively recorded as a tumor comprehensive RGB value and a tumor-side comprehensive RGB value;   S 5 : a therapeutic evaluation coefficient is calculated, where the therapeutic evaluation coefficient = tumor comprehensive RGB value - tumor-side comprehensive RGB value; and   S 6 : the hemangioma image, the tumor image  31 , the tumor side image  32 , the tumor comprehensive RGB value, the tumor-side comprehensive RGB value and the therapeutic evaluation coefficient are displayed by the display screen for reference, evaluation and guidance of treatment by doctors.   

     In a preferred embodiment of the present disclosure, the stability of a measurement system is critical to the acquisition of high-quality images. The stability of the measurement system is affected by the unstable light output of a light source, the spatial unevenness of the light, the change of the spectral response characteristics of a CCD, the noise of a photoelectric conversion device, etc. In order to ensure the stability of the measurement system, the system stability calibration process includes the following steps:
     a: a uniform white diffuse reflection plate is placed in a measurement region, and an aperture size of a camera or a light source box is adjusted to enable one component in RGB values of the shot image to reach 255;   b: a gray standard plate is placed in the measurement region, and parameters of the camera are adjusted to enable RGB three components of the output image to be 122, 122 and 121 respectively;   c: a black standard plate is placed in the measurement region and/or a lens cap is covered, and the parameters of the camera are adjusted to enable the RGB three components of the output image to be 0 respectively; and   d: a white standard plate is placed in the measurement region, and the parameters of the camera are adjusted to enable the RGB values of the output image to be 255 respectively.   

     In a preferred embodiment of the present disclosure, in S 3 , the division of the tumor side image  32  includes the following steps:
     1) a center of the tumor image  31  is selected as an original point, and the tumor image is equally divided into four quadrants by a first quadrant axis 311, a second quadrant axis 312, a third quadrant axis 313 and a fourth quadrant axis 314; and   2) an image having a distance of 1 cm from the outer side of the tumor image  31  on each of the quadrant axes and having an area of 1 cm 2  as a tumor side image  32 .   

     In a preferred embodiment of the present disclosure, the tumor side image  32  is divided into four regions, namely a tumor side I  321 , a tumor side II  322 , a tumor side III  323  and a tumor side IV  324 . 
     In a preferred embodiment of the present disclosure, in S 3 , the tumor-side comprehensive RGB value is an average value of the comprehensive RGB values of the four regions, namely the tumor side I  321 , the tumor side II  322 , the tumor side III  323  and the tumor side IV  324 , of the tumor side image  32 , so as to reduce system errors. 
     Embodiment 
     S 1 : A quantitative evaluation system for color of hemangioma is mounted: a P120 light source box and a PHILIPS-TLD-36W/865 strip-shaped three-primary fluorescent lamp are used (the model of a lamp holder of a light source is G13, a color rendering index is 85, and the light with a color temperature of 6500 K can be emitted); an Olympus digital camera with a model of D33235, a total pixel of 10 million and an effective pixel of 9.3 million is used, an M.Zuiko professional lens is used, and a sensor is a CCD with a size of 17.4 mm*13.0 mm; a distance between the imaging device and an imaging object is fixed, which is 1 m; and a network cloud disk and a computer system are connected, and a digital signal processor Image J and digital analysis software Photoshop are turned on. 
     S 2 : System stability calibration is performed:
     a: a uniform white diffuse reflection plate is placed in a measurement region, and an aperture size of a camera or a light source box is adjusted to enable one component in RGB values of the shot image to reach 255;   b: a gray standard plate is placed in the measurement region, and parameters of the camera are adjusted to enable RGB three components of the output image to be 122, 122 and 121 respectively;   c: a black standard plate is placed in the measurement region, and the parameters of the camera are adjusted to enable the RGB three components of the output image to be 0 respectively; and   d: a white standard plate is placed in the measurement region, and the parameters of the camera are adjusted to enable the RGB values of the output image to be 255 respectively.   

     S 3 : The quantitative evaluation system for color of hemangioma is used for shooting and analyzing hemangioma of infant patients to obtain a tumor comprehensive RGB value, a tumor-side comprehensive RGB value and a therapeutic evaluation coefficient. 
     A total of 218 infant patients with superficial infantile hemangioma participated in this study, where 6 infant patients withdrew on their own, 5 infant patients were excluded due to too few follow-up times (less than 4 times) and were no longer included in this study, and finally, a total of 207 cases were included in this study. The clinical information (general information of infant patients) of this study are shown in Table 1. 
     
       
         
          TABLE 1
           
               
               
             
               
                 General information of infant patients 
               
               
                 Item 
                   
               
             
            
               
                 Age/month 
                 3.48±1.96 
               
               
                 Male 
                 68 
               
               
                 Female 
                 139 
               
               
                 Average age at first consultation/month 
                 3.48±1.96 
               
               
                 Average treatment time/month 
                 3.52±1.82 
               
               
                 Tumor site: head and neck 
                 61 
               
               
                 Tumor site: limbs 
                 63 
               
               
                 Tumor site: body 
                 75 
               
               
                 Tumor site: perineum 
                 8 
               
            
           
         
       
     
     The quantitative evaluation system for color of hemangioma provided by the present disclosure and the evaluation scheme of the present disclosure were used for quantitative evaluation of tumors of infant patients. Measurement results are shown in Table 2. 
     
       
         
          TABLE 2
           
               
               
               
               
               
             
               
                 Tumor comprehensive RGB value, tumor-side comprehensive RGB value and therapeutic evaluation coefficient of sick children before and after treatment: 
               
               
                 Treatment time period 
                 0 month of treatment 
                 1 month of treatment 
                 2 months of treatment 
                 End of treatment 
               
             
            
               
                 Tumor comprehensive RGB value 
                 90.14=29.35 
                 103.40±31.77 
                 112.68±31.98 
                 131.42±33.93 
               
               
                 Tumor-side comprehensive RGB value 
                 146.93±39.57 
                 143.66±35.92 
                 141.07±34.22 
                 144.93±36.40 
               
               
                 Therapeutic evaluation coefficient 
                 -56.79±22.07 
                 -40.21±14.94 
                 -28.70±12.72 
                 -13.17±6.44 
               
            
           
         
       
     
     The results in Table 2 were analyzed by variance, where F=438.847, p&lt;0.01. The variance results showed that there were significant differences in the therapeutic evaluation coefficients at different treatment times of sick children. The quantitative evaluation system for color of hemangioma in the present disclosure can objectively analyze the tumor color of infant patients to prompt the state of an illness of infant patients. Clinicians grouped the tumors of sick children according to growth states, and analyzed and found that there were significant differences in the therapeutic evaluation coefficients between the proliferation phase and the plateau phase, the proliferation phase and the remission phase, and the plateau phase and the remission phase of sick children. 
     The preferred embodiments of the present disclosure are described in detail with reference to the accompanying drawings and embodiments, but the present disclosure is not limited thereto. Within the scope of the technical concept of the present disclosure, a variety of simple modifications can be made to the technical solution of the present disclosure, including the combination of each specific technical feature in any suitable manner. In order to avoid unnecessary repetition, the present disclosure will not describe various possible combinations. However, these simple modifications and combinations should also be regarded as the contents disclosed in the present disclosure, and all belong to the protection scope of the present disclosure.