Keshen Mathura, M.D., PhD, founder, developer and chief science officer of MicroVision Scan, Inc, a device that uses Side-stream Dark Field Imaging (SDF) to view, in real time, the capillary bed and flow through the microcirculation.
Sublingual Sidestream Dark Field (SDF) Imaging: Innovations and Insights by Keshen Mathura, MD, PhD
Sublingual Sidestream Dark Field (SDF) imaging represents a significant advancement in visualizing and analyzing the microcirculation of the human body. Keshen Mathura, MD, PhD, has played a pivotal role in advancing this technology, providing a deeper understanding of its capabilities and applications in clinical settings. This imaging technique is particularly valuable for its ability to offer real-time, direct observations of the microvascular network under the tongue, which is reflective of systemic microvascular health.
The journey to the development of SDF imaging began with the need for a more effective method to observe the microcirculation without invasive procedures. Traditional methods involved the use of large microscopes that could only capture the microcirculation in the nail fold of the finger. These methods, while useful, were limited by their bulkiness and the invasive nature of the procedures required for observation.
Dr. Mathura highlighted the historical context in which microscopes were once cumbersome and limited to specific settings such as major hospitals. The evolution of these microscopes, from their inception to the development of the portable and less invasive SDF technology, marks a significant transformation in the field of microvascular imaging. This new technology, inspired by advancements from an American company, Cytometrics, was designed to be portable, allowing for bedside application with minimal discomfort to the patient.
Sidestream Dark Field imaging utilizes green light, which is absorbed by hemoglobin in the red blood cells, thus allowing for enhanced visualization of blood flow through capillaries, arterioles, and post-capillary venules. The shift from traditional to SDF imaging involved not only a change in the technology used but also a paradigm shift in how microcirculation is studied at the bedside.
In his presentation, Dr. Mathura elaborated on how SDF imaging is particularly adept at providing insights into the sublingual area, which is a reliable indicator of systemic microcirculation due to its close proximity to the aortic arch. This aspect is crucial in critical care settings, especially for monitoring patients with conditions like sepsis or undergoing major surgeries, where microcirculatory dysfunction can predict clinical outcomes.
Through various studies and clinical trials, SDF imaging has been shown to correlate well with systemic microcirculatory health. Dr. Mathura discussed several case studies and research findings that demonstrate the effectiveness of SDF imaging in predicting patient outcomes, particularly in critical care and emergency settings. For example, in cases of septic patients, the sublingual microcirculation provided by SDF imaging could mirror the microcirculation in other critical areas such as the gut.
Looking forward, Dr. Mathura emphasized the potential of SDF imaging to become a standard tool in clinical practice, especially for rapid assessment and intervention in acute and critical care settings. The development of algorithms and software that can translate SDF images into actionable clinical data is a key area of focus, potentially leading to better patient management and outcomes.
Sublingual Sidestream Dark Field imaging is a transformative technology that has significantly enhanced our ability to visualize and understand the microcirculation in real time. Dr. Keshen Mathura’s contributions to this field, through both research and clinical application, highlight the importance of innovation in medical technology. As SDF imaging continues to evolve, its integration into clinical practice promises to advance our capabilities in diagnosing and treating patients with critical microcirculatory conditions.
Graduated with degree in medicine at the University of Amsterdam. PhD research with prof. Can Ince at the department of Clinical Physiology of the University of Amsterdam Academic Medical Center
