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    • 专利摘要:
    The invention is a method of estimating the amount of analyte in a liquid sample, and in particular in a body fluid. The sample is mixed with a reagent capable of forming a colored indicator in the presence of the analyte. The sample is then illuminated by a light beam produced by a light source; a matrix photodetector forms an image of the beam transmitted by the sample, from which a concentration of the analyte in the liquid is estimated. The method is intended to be implemented on compact analysis systems. One intended application is the determination of glucose concentration in blood.
    公开号:FR3038723A1
    申请号:FR1556445
    申请日:2015-07-07
    公开日:2017-01-13
    发明作者:Jean-Guillaume Coutard；Patrick Pouteau；Myriam Laure Cubizolles
    申请人:Avalun；Commissariat a lEnergie Atomique CEA；Commissariat a lEnergie Atomique et aux Energies Alternatives CEA；
    IPC主号:
    专利说明:

    Method for estimating an amount of analgesic in a liquid
    Description
    TECHNICAL AREA
    The technical field of the invention is the analysis of body fluids, in particular blood, in order to determine an amount of an analyte, and this by an optical method. An application is the measurement of blood glucose in the blood.
    PRIOR ART
    Measurement of blood glucose is a measure commonly performed using portable, home-use measurement devices in applications referred to as "Point of Care", meaning at the bedside of the patient, or in the patient.
    The measurement of blood glucose can be performed by an optical method. This is for example the case of the device described in patent US5866349. In this patent, an optical method is described for determining the concentration of glucose in whole blood. After a haemolysis step, the method implements an enzymatic reaction resulting in the formation of a colored indicator from a tetrazolium salt.
    A photodetector measures the intensity of a light radiation transmitted by a blood sample, the latter being successively illuminated by two light-emitting diodes. A first light-emitting diode emits a first light beam in a wavelength of 660 nm, this wavelength being included in the absorption spectral band of the color indicator. A second light emitting diode emits a second light beam in a wavelength between 740nm and 940 nm, a spectral band in which the blood has a high transmission. A comparison of the intensity transmitted, at these two wavelengths, makes it possible to estimate a quantity of color indicator formed in the sample, from which a glucose concentration can be determined.
    But this method involves the use of successive illumination of the blood sample analyzed by two different light sources. It is therefore necessary to have two light sources in the analysis device. On the other hand, the patent EP1875203 describes a device for estimating a quantity of glucose in a blood sample, without implementing a hemolysis step. The measurement principle is also based on the formation of a colored indicator resulting from the reduction of a tetrazolium salt. The blood sample is coupled to the photodetector by two lenses arranged successively between the sample and the photodetector. These lenses make it possible to increase the signal collected by the photodetector. The photodetector may be a matrix photodetector, of the CCD type. As in US Pat. No. 5,066,349, two light sources are used, one emitting in a spectral absorption band of the colored indicator, the other emitting in the near infrared. The detection of the light radiation transmitted by the sample, illuminated in the infrared, makes it possible to estimate a hematocrit level; the detection of the light radiation transmitted by the sample in the absorption spectral band of the indicator makes it possible to estimate a quantity of glucose, this estimate being corrected for the hematocrit content previously determined.
    But the implementation of a complex optical system, based on two hemispherical lenses, harms the compactness of the device, as well as its cost. The proposed invention solves these problems by providing a simple method for obtaining quantification of glucose, or other analyte, through an enzymatic reaction resulting in the formation of a colored indicator. This method does not require the illumination of the sample by two light beams in two different spectral bands. In addition, it can be implemented using a simple and compact optical device.
    SUMMARY OF THE INVENTION
    An object of the invention is a method of estimating an amount of an analyte in a liquid sample, the process comprising the following steps: a) mixing said sample with a first reagent capable of forming a colored indicator in the presence of said analyte in the sample, b) following this mixing, illumination of said sample with the aid of a light source, able to emit light radiation towards the sample, c) acquisition, using a photodetector matrix, an image of a light radiation transmitted or reflected by the sample, d) estimating a quantity of said analyte according to said image.
    The method may comprise the characteristics listed below, taken separately or according to the technically feasible combinations: Step d) may comprise the following substeps: i) selection of a measurement zone, in said image, said zone of measurement comprising a plurality of pixels, ii) determining, within the measurement zone, a region of interest and at least one exclusion region, iii) estimating said amount of analyte from a magnitude representative of the intensity of the pixels in said area of interest, without taking into account the intensity of the pixels of each exclusion region.
    This makes it possible not to take into account, during step d), portions of the image which are not representative of the formation of the colored indicator. On the other hand, making an image-based estimate allows for possible spatial variations in the amount of analyte or color indicator formation.
    Sub-step ii) may comprise the determination of at least one exclusion region, said region of interest corresponding to a part of said measurement zone not comprising each exclusion region thus determined.
    In particular, the region of interest is, in the measurement zone, complementary to each determined exclusion region. This makes it possible to estimate the amount of analyte over the entire measurement area, with the exception of the exclusion zone or specific exclusion zones. The area of interest is then maximized on the basis of which the estimate is made.
    The exclusion region may be determined by thresholding the image, or by segmentation of said image.
    The sub-step ii) can in particular comprise the determination of a plurality of exclusion regions, distinct and distant from each other, the region of interest extending between these exclusion regions. Each exclusion region may in particular be delimited by a closed, annular or polygonal contour. The sample comprising particles, for example red blood cells, the method may comprise mixing the sample with a second reagent, called lysis reagent, capable of lysing said particles. This mixture is especially carried out prior to steps c) and d), and for example during step a). Each exclusion zone can then correspond to the trace of an air bubble, said air bubble being formed following the lysis of said particles. Thus, the estimate of the amount of analyte does not take into account the presence of these air bubbles.
    The method may include, after mixing the sample with said second reagent, and in step d), determining a lysis indicator from the image acquired in step c); the estimate of the amount of analyte being made when the lysis indicator satisfies a predetermined lysis criterion.
    The method may be such that when the lysis indicator does not satisfy said lysis criterion, step c) is repeated, so that a plurality of lysis indicators are determined, from images acquired at different moments. In particular, each lysis indicator can be determined by forming a comparison image, representing a comparison between two images acquired at different times (t ,, t, -i), in particular in the form of a difference. The lysis indicator can then be obtained by a statistical magnitude of each image, or each comparison image, the statistical quantity being for example an average, a median or a dispersion factor of variance or standard deviation type.
    This makes it possible to follow the evolution of the lysis using the image, and to detect the moment from which the estimate of the amount of analyte can be made.
    The method may include a step of introducing the sample into a fluid chamber, steps c) and d) being performed at a predetermined time after said introduction.
    The method may comprise forming a plurality of successive images of the light radiation transmitted or reflected by the sample, the amount of analyte being determined, in step d), according to the evolution of the intensity of the each image as a function of time.
    During step d), the magnitude representative of the intensity of the pixels in said region of interest can comprise the integral or the average of the pixels in said region of interest.
    The photodetector may be located at a distance from the sample of less than 1 cm, which allows the implementation of the method by a compact device.
    According to one embodiment, there is no magnification optics between the sample and the photodetector, which allows the implementation of the method by a compact and inexpensive device. The analyte can be glucose. The sample comprises a body fluid, for example blood. The sample may be disposed between said light source and the photodetector, so that the photodetector detects radiation transmitted by the sample, the image acquired by the photodetector then being a so-called transmission image. The sample may be arranged facing the light source and the photodetector, so that the photodetector detects radiation reflected or backscattered by the sample, the image acquired by the photodetector then being a so-called reflection image. This is more particularly for thick samples, for which a transmission configuration would lead to excessive attenuation of the light radiation transmitted by the sample.
    Another object of the invention is a device for estimating the amount of an analyte, in a liquid sample, the device comprising: a light source capable of emitting light radiation, towards said sample, a support, to maintain the a sample between said light source and a matrix photodetector, the matrix photodetector being arranged to acquire an image of the radiation transmitted or reflected by the sample, when the latter is exposed to said light radiation, a processor capable of estimating an amount of analyte in the sample, said processor being able to implement step d) of the method defined according to the characteristics described above or in the following description.
    The photodetector may be located at a distance from the sample of less than 1 cm, which makes it possible to obtain a compact device.
    According to one embodiment, there is no magnification optics between the sample and the photodetector. The device is then of simple and inexpensive design.
    FIGURES
    Figure 1 shows a device for implementing the invention.
    Figure 2 shows three measurements of the absorption spectrum of a color indicator, in this case Formazan, used in one embodiment.
    Figures 3A and 3B show images obtained in an exemplary embodiment, on a sample comprising whole blood, for two different concentrations of glucose in the sample.
    Figures 4A and 4B show comparative results of measurements.
    FIG. 5 represents the steps of an embodiment of a method according to the invention.
    Figure 6 shows the steps of a variation of this embodiment.
    FIGS. 7A, 7B, 7C, 7D and 7E show images of the sample at different times, respectively 10s, 20s, 30s, 60s, 120s following the introduction of the sample into a microfluidic chamber, the sample with a glucose concentration of 4.8 mM.
    Figure 7F shows the image of a sample 120 s after its introduction into a microfluidic chamber, the sample having a glucose concentration of 19 mM.
    FIGS. 8A, 8B and 8C represent, from images obtained using a sample having a glucose concentration of 4.8 mM, the evolution of an indicator, called lysis indicator, as a function of time. This lysis indicator is respectively the standard deviation of the intensity in each image, the average intensity of a comparison image, formed by the difference between two successive images, and the standard deviation of the image. intensity in said comparison image.
    FIGS. 9A, 9B and 9C show figures respectively analogous to FIGS. 8A, 8B and 8C for a sample having a glucose concentration of 19 mM.
    DESCRIPTION OF PARTICULAR EMBODIMENTS
    FIG. 1 represents an exemplary device that is the subject of the invention. A light source 11 is able to produce a light radiation 12, or incident light radiation, in an illumination spectral band, in the direction of a sample 10, along an axis of propagation Z. The sample 10 comprises a liquid and that particles bathed in this liquid. The liquid may especially be a body fluid, for example blood. It can especially be whole blood. The particles may be blood particles, and more particularly red blood cells.
    The distance Δ between the light source and the sample is preferably greater than 1 cm. It is preferably between 1 and 30 cm, typically 5 cm.
    The light source 11 may be a light emitting diode or a laser light source, for example a laser diode.
    Preferably, the light source, as seen by the sample, is considered point, but this is not necessary. The term punctual means that its diameter (or diagonal) must be less than one-fifth, better one-tenth of the distance between the sample and the light source. Thus, the light radiation 12 reaches the sample in the form of plane waves, or can be considered as such.
    The light source 11 may be associated with a diaphragm 18, not shown in Figure 1 so as to appear punctual. The opening of the diaphragm is typically between 50 μm and 1 mm, preferably 50 μm and 500 μm. The presence of a diaphragm is not necessary.
    The light source 11 can also be fiberized. In this case, an optical fiber extends between a first end, disposed facing a light source, and collecting the light thereof, and a second end, emitting light to the sample. In this case, this second end is considered to be the light source 11.
    The light source 11 may comprise an optical filter 19, in particular a band-pass filter, making it possible to adjust the spectral band of illumination of the light radiation 12 of the light source 11. The spectral band of illumination of the light radiation emitted by the light source 11 is adapted to an absorption spectrum of a color indicator 24 described in the following description. The sample 10 is contained in a fluid chamber 13. The side walls of the chamber are not shown. The fluidic chamber 13 is for example a microcuvette, commonly used in point of care type devices, in which the sample 10 penetrates by capillarity. In Figure 1, there is shown two longitudinal walls 15, transparent and 150 pm apart. The distance between these two longitudinal walls 15 along the axis of propagation Z corresponds to the thickness ε of the sample. The latter typically varies between 20 μm and 1 cm, and is preferably between 50 μm and 500 μm, for example 150 μm. The sample 10 is arranged between the light source 11 and a matrix photodetector 16, able to establish an image I, called the transmission image, of a light beam 14 transmitted by the sample 10. The matrix photodetector extends according to a detection plane P, preferably parallel to, or substantially parallel to, the longitudinal walls 15 of the fluid chamber 13. The term substantially parallel means that the two elements may not be strictly parallel, an angular tolerance of a few degrees, less than 10 ° being admitted.
    The matrix photodetector 16 comprises a matrix of pixels, of the CCD type (of the English Charge Coupled Device) or a CMOS (of the English Complementary Metal-Oxide Semiconductor). The photodetectors whose inter pixel pitch is less than 3 μm are preferred because they make it possible to obtain images with a satisfactory spatial resolution.
    Preferably, the photodetector comprises a matrix of pixels, above which is disposed a transparent protection window. The distance between the pixel matrix and the protection window is generally between a few tens of pm to 150 to 200 pm. Preferably, the detection plane P along which the photodetector extends is perpendicular to the propagation axis Z of the incident light wave 12.
    Note in this example, the absence of magnification optics between the matrix photodetector 16 and the sample 10. This does not prevent the possible presence of microlenses focusing at each pixel of the photodetector 16. This allows forming a transmission image of the beam 14 transmitted by the sample by minimizing the distance between the sample and the photodetector. This makes it possible to use a particularly simple and compact analysis device. Thus, in the absence of magnification optics, the distance d between the sample and the pixels of the photodetector is preferably less than 2 cm, or even 1 cm, and preferably between 50 pm and 2 cm, preferably between between 100 μm and 2 mm.
    A processor 40, for example a microprocessor, is able to process the images I acquired by the matrix photodetector 16. In particular, the processor is a microprocessor connected to a programmable memory 42 in which is stored a sequence of instructions for performing the operations image processing and calculation described in this description. This programmable memory 42 may also include calibration information of the device, as will be discussed later. Sample 10 has an analyte 30 of which it is desired to determine a quantity or concentration in the sample. In this example, the analyte is glucose. The principles of detecting glucose in a blood sample by carrying out enzymatic reactions resulting in the formation of a colored indicator are described in US3964974 and US5866349. In general, this colorimetric method is based on: the oxidation of glucose by NAD (acronym for nicotinamide adenine dinucleotide), in the presence of GDH (acronym for glucose dehydrogenase), resulting in the formation of NADH + H + (acronym dihydronicotinic acid amide adenine dinucleotide). the reduction of a tetrazolium salt by NADH + H +, in the presence of diaphorase (dihydrolipoyl dehydrogenase), resulting in the formation of a color indicator 24, the concentration of which is representative of the glucose concentration in the sample.
    The tetrazolium salt used may be MTT, an acronym for 3- (4,5-dimethylthiazolyl-2-yl) -2,5-diphenyltetrazolium bromide, in which case the colored indicator is Formazan, which is violet in color.
    The term color indicator denotes a chemical species having a particular color, and whose formation in the sample is able to modify the absorption spectrum or the transmission spectrum of the sample.
    Also, the method comprises a step of mixing the sample with a first reagent 22, allowing the formation of a color indicator 24 by reacting with the analyte present in the sample, in this case glucose. The first reagent 22 may comprise GDH, NAD, Diaphorase and MTT.
    In a sample with whole blood, glucose is present in the plasma as well as in the red blood cells 20, suspended in the plasma. In order to take into account the amount of glucose present in the red blood cells, the method may comprise a step of hemolysis, by adding a second reagent 26, called lysis reagent, capable of lysing the red blood cells. For example, this second reagent 26 is saponin.
    But lysis of red blood cells 20 can result in the formation of air bubbles 27 in the sample. As a result, after mixing with the first reagent and the second reagent, the sample stains progressively due to the formation of the colored indicator 24. However, this coloration is not spatially homogeneous, in particular because of the presence of air bubbles. As a result, the optical transmission T of the sample is not homogeneous.
    By optical transmission is meant a comparison of the intensity of a light beam incident to the sample with the intensity of a light beam transmitted by the sample. The ix comparison can in particular take the form of a ratio, in which case Τλ = -, where: Τλ denotes the optical transmission at the wavelength λ; 7o denotes the intensity of the light beam 12 incident on the sample at the wavelength λ; Ιλ denotes the intensity of the light beam 14 transmitted by the sample at the wavelength λ;
    The formation of the color indicator 24 representative of the analyte 30 results in a decrease in optical transmission in an absorption spectral band (or spectral color band) of the indicator.
    Figure 2 shows the absorption spectrum of Formazan. It was obtained experimentally by reacting MTT and NADH in the presence of diaphorase in PBS (acronym for Phosphate Buffered Saline meaning phosphate buffered saline) buffer at pH 7.4 at 30 ° C. The total reaction volume is equal to 300 microliters and the reaction is carried out in a 96-well microplate. After 15 minutes of reaction, a measurement of the absorbance OD is performed using a microplate reader marketed by Tecan in order to determine the spectrum of the absorbance of Formazan produced. Thus, when the color indicator 24 used in the process is Formazan, the absorption spectral band extends between 370 and 670 nm, with an absorption maximum towards λ = 565 nm. FIG. 2 represents three realized spectra, referenced # 1, # 2 and # 3, these three spectra being superimposed on each other.
    A device similar to FIG. 1 was tested using: a laser diode manufactured by Thorlabs, emitting at a wavelength of 650 nm, serving as excitation source 11, a monochrome CMOS sensor 12bits, from the manufacturer Mightex under reference BTN-B050-U, serving as a matrix photodetector 16, a microcuvette provided by Hemocue, under the reference HE114701, acting as microfluidic chamber 13, containing the various reagents necessary for the determination of glucose as well as the sample.
    The microcuvette was placed between the laser diode and the CMOS sensor at a distance of Δ = 5 cm from the laser source and at a distance of d = 1 mm from the CMOS sensor. The sample is venous human whole blood collected from EDTA (Ethylene Diamine Tetraacetic), the latter acting as an anticoagulant.
    Various attempts were made by mixing the whole blood with a calibrated amount of glucose using a glucose solution from Sigma Aldrich and G8644.
    The blood is used to fill the aforementioned microcuvette, acting as a microfluidic chamber 13, by capillarity. This microcuvette contains, in embedded form, on the one hand a first reagent 22, allowing the formation of Formazan as a function of the glucose concentration in the sample, this first reagent 22 comprising GDH, NAD, MIT, and the diaphorase. The microcuvette contains, on the other hand, a second reagent 26, in this case saponin, for lysing the red blood cells.
    FIGS. 3A and 3B represent images obtained by the CMOS sensor while the glucose concentration in the sample is equal to 9.4 and 2.3 mM, respectively. Each image is obtained 120 seconds after the introduction of blood into the microcuvette, the exposure time being 0.3 ms
    In each figure, one can observe the contours C13 of the microcuvette 13, in which the sample extends. Circular arcs generated by the manufacturing process of the microcuvette are also observed.
    Glucose quantification is performed on a measurement zone ZM of each transmission image I, encompassing 640 x 460 pixels. This measurement zone ZM is represented by a rectangle in FIGS. 3A and 3B. The intensity of the light collected by the photodetector depends on the optical transmission of the analyzed sample. The higher the concentration of glucose in the sample, the higher the concentration of Formazan formed in the sample, the lower the optical transmission of the sample, thus reducing the intensity of the light detected by the photodetector 16.
    Thus, the higher the glucose concentration, the darker the image formed by the photodetector. This evolution of the optical transmission can be quantified by using a quantity k representative of the intensity of the pixels in the measurement zone ZM. This quantity k can be established from the integral or the average of the pixels in this measurement zone. A calibration performed on calibration solutions, in which the glucose concentration is known, makes it possible to relate the measured quantity κ to the glucose concentration in the sample. The data obtained during this calibration are stored in the memory 42.
    However, the lysis of red blood cells is accompanied by the formation of air bubbles 27 in the sample, the latter appearing in the form of dark traces 28, disc-shaped, on each image. Their quantity and their position in the measurement zone ZM are random, as shown in FIGS. 3A and 3B, and change with time. Also, the optical transmission in the sample is not spatially homogeneous. This inhomogeneity can give rise to significant measurement errors.
    Also, it is proposed to establish a magnitude representing the intensity of the pixels in the measurement zone ZM, while avoiding the impact of air bubbles. For this purpose, before the calculation of the quantity k, a region of interest ROI comprising the pixels situated in the measurement zone is defined inside the measurement zone, excluding the pixels corresponding to the traces 28 formed by the air bubbles 27. In other words, a region of interest ROI and at least one exclusion region REX are determined inside the measurement zone ZM, the latter being considered as representative of a trace 28. A measurement zone may comprise several exclusion regions, each corresponding to a trace 28. The region of interest therefore corresponds to a region, in the measurement zone, complementary to each exclusion region. Most often, the measurement zone ZM comprises a plurality of exclusion regions REX, these regions being distinct from one another and isolated from each other, so that the region of interest extends between these different exclusion zones. Each exclusion zone is defined in particular by a closed contour, in particular of annular, circular or polygonal shape.
    The quantity is then calculated as a function of the pixels of the region of interest thus defined, without taking into account the pixels of the exclusion region REX or the exclusion regions REX present in the measurement zone ZM.
    In connection with FIGS. 3A and 3B, on each measurement zone ZM, it is possible to delimit a region of interest ROI corresponding to said measurement zone, excluding exclusion regions REX, each exclusion zone corresponding to a dark disc. Note that the average intensity of the pixels of the region of interest associated with FIG. 3A is significantly lower than the average intensity of the pixels of the region of interest associated with FIG. 3B, because of the strongest glucose concentration on the sample shown in Figure 3A, resulting in a lower optical transmission.
    Comparative tests were carried out on samples A, B, C, D and E whose glucose concentration is respectively 0.4 mM; 2.3 mM; 4.8 mM; 9.4 mM and 19 mM.
    On each sample, the protocol described in connection with FIGS. 3A and 3B was reproduced. A magnitude representing the intensity of the radiation transmitted by the sample is determined from an initial moment when the sample enters the fluid chamber, which corresponds to the initial moment t = to = 0. The magnitude is calculated during a period of 170 s after the initial moment. FIGS. 4A and 4B show the evolution of the quantity as a function of time, knowing that: the magnitude k, whose temporal evolution is represented in FIG. 4A, corresponds to the average intensity on region of interest ROI corresponding to the measurement zone ZM, after exclusion of each exclusion zone REX, representative of the traces 28. This average intensity is normalized by the average intensity, over the measurement zone ZM, of a reference image 10 obtained without sample between the light source and the photodetector. Because of this normalization, the magnitude k corresponds to the average of the optical transmission, as previously defined, in the region of interest ROI.
    The magnitude k ', whose time evolution is shown in FIG. 4B, corresponds to the average intensity on the measurement zone ZM. This average intensity is normalized by the average intensity, on the measurement zone ZM, of a reference image lo obtained without sample between the light source and the photodetector. Due to this normalization, the magnitude k 'corresponds to the average of the optical transmission, as previously defined, in the measurement zone region ZM.
    In this example, the region of interest is obtained by applying an intensity thresholding of the pixels of the measurement zone. Pixels whose intensity exceeds a certain threshold P are considered to belong to the zone of interest ROI, the others being considered as belonging to an exclusion zone.
    In other words, the quantity represented in FIG. 4A can be expressed in the form:
    where: r denotes the position of a pixel in the image I; l (r) denotes the intensity of the pixel r of the image I; / 0 (r) designating the intensity of the pixel r of the reference image 10;
    NreRoi is the number of pixels in the ROI region of interest.
    The quantity represented in FIG. 4B may be expressed in the form:
    Nr e zm denotes the number of pixels contained in the ZM measurement zone.
    The comparison of FIGS. 4A and 4B shows that the quantity k is preferable to the size k '. Indeed, the magnitude k ', whose temporal evolution is shown in FIG. 4B, changes constantly with time, and can take substantially different values for the same amount of analyte. This is particularly the case for samples A, B and E respectively having a glucose concentration of 0.4 mM, 4.8 mM and 19 mM. Conversely, the magnitude k, whose temporal evolution is represented in FIG. 4A, appears more reliable: its evolution as a function of time is less pronounced, beyond a duration of 60 s after the initial moment. . In addition, the measurements corresponding to the same glucose concentration are more repetitive.
    It is understood that the fact of acquiring an image, and not a one-dimensional optical signal, non-spatially resolved, as in the prior art, makes it possible to identify traces 28, and to exclude them when estimating the concentration. of glucose. This makes it possible to obtain a more reliable estimate of the amount of glucose in the blood, because of the fact that the traces 28 which are not representative of the coloration observed are not taken into account in the portion of the image analyzed.
    Moreover, beyond the traces linked to the air bubbles produced by the hemolysis, the fact of having an image I makes it possible to exclude any other disturbance, for example a manufacturing defect on a fluidic chamber 13, or some dust inside or outside this room.
    It is also noted that the use of a second light source, illuminating the sample in a wavelength of 880 nm, is not necessary.
    Thus, on the basis of an image acquired by the photodetector, and with the aid of a single light source, it is possible to estimate the glucose content of a blood sample, and, more generally, to assay an analyte present in a liquid sample, by observing a coloration of the sample resulting from the transformation of this analyte.
    In this example, the determination of the region of interest ROI is performed by image thresholding, the pixels belonging to the region of interest when their intensity is greater than a threshold. The value of this threshold was taken as 50 for samples A, B, C, 30 for sample D and 20 for sample E.
    This threshold P can be predetermined; it can also be defined, case by case, on the basis of each image, for example by a histogram analysis in the measurement zone ZM. Indeed, the pixels corresponding to an exclusion region form a peak in the histogram; the threshold P can be determined based on an intensity determined from this peak, for example a terminal of this peak, in particular the upper bound when an exclusion region appears in the form of a dark trace. Other methods for determining the ROI region of interest are conceivable, based on known techniques of morphological analysis and image segmentation. We then take advantage of the fact that each exclusion region REX corresponds to a closed, substantially circular form. Shape or contour recognition algorithms can therefore be implemented to identify and delimit each exclusion region.
    Figure 5 summarizes the main steps of a method for estimating a glucose concentration according to the invention.
    During a step 100, the body fluid is introduced into a fluid chamber 13. The liquid introduced into the chamber forms the sample to be analyzed 10.
    During a step 200, the liquid is mixed with a first reagent 22 capable of forming a color indicator 24 in the presence of glucose 30, and a second reagent 26 capable of lysing the red blood cells present in the sample. The first and second reagents may in particular be present in said fluidic chamber in the dry state, for example in freeze-dried form.
    During a step 300, the fluidic chamber is illuminated by a light source 11 and the light radiation 14 transmitted by the sample is collected by a matrix photodetector so as to form a transmission image I. This transmission image can be formed after a predetermined time period T following the introduction of the sample into the fluid chamber.
    During a step 400, the transmission image I is analyzed, so as to determine, in a measurement zone ZM of said image, a region of interest ROI and one or more region (s) of exclusion ( REX).
    During a step 500, a quantity k, representative of the intensity of the pixels in the region of interest at the instant T, is calculated from the transmission image I, the pixels of each exclusion zone not being taken into account in the calculation of size k.
    In a step 600, the quantity k is compared with standard quantities, obtained on standard solutions, under similar experimental conditions, so as to estimate the quantity or concentration of the analyte 30. The standard quantities are stored in a memory 42 is connected to the processor 40. The step 500 may require the acquisition of an image lo, called initial image, formed by the photodetector in the absence of liquid in the fluid chamber, or in the absence of fluidic chamber. This reference image lo can be established during a step 100 ', without a fluidic chamber between the light source 11 and the photodetector 16, before or after the formation of the image I. It can also be established by arranging a fluid chamber without sample between the light source 11 and the photodetector 16.
    Steps 100 and 200 can be inverted or performed simultaneously.
    Alternatively, steps 300 to 600 are repeated at different times so that in step 600 a plurality of quantities k is determined as a function of time t, the amount or concentration of analyte being estimated from the time evolution k (t) of said magnitude.
    According to another embodiment, the light source 11 and the photodetector 16 are arranged on the same side with respect to the sample 10. The photodetector then detects an image Γ of the radiation 14 'reflected, and possibly backscattered by the sample. The formation of a colored indicator 24 modifies the optical absorption properties Αχ of the sample, especially in the spectral absorption band of the color indicator 24. It should be noted that the optical absorption, at a wavelength λ given, can be defined by the expression: Αλ = 1 - Τλ, Τλ being the previously defined optical transmission. The advantage of this embodiment is that it can be applied to thicker samples, for example whose thickness exceeds 5 mm or even 1 cm.
    According to a variant of the embodiment previously described, prior to the implementation of step 400, it is sought to ensure that the lysis of the red blood cells is sufficiently advanced so that the image analyzed in the following steps is not influenced by the diffusion of light radiation 12 by these red blood cells. In other words, we wait a moment You say instant lysis, beyond which the lysis is considered to be performed.
    Indeed, until the lysis has reached a sufficiently advanced stage, the measurement of the transmitted radiation 14 is influenced by the diffusion by the red blood cells in the sample. This can cause a measurement error. To guard against this, it is preferable to wait for the lysis to be complete, or sufficiently advanced for the transmission of light through the sample to be representative of the optical absorption of the sample, the influence of the diffusion is negligible because of the small residual amount of red blood cells.
    This variant is shown in FIG. 6. During a step 300, the fluidic chamber is illuminated by the light source 11 and the light radiation 14 transmitted by the sample is collected by a matrix photodetector so as to form an image transmission l (t,) acquired at time t ,. The variable t, is a temporal variable, representing a sampled time.
    During a step 320, a lysis control zone ZC is determined in the image l (tj). This control zone corresponds to all or part of the liquid sample analyzed in the fluidic chamber.
    During a step 340, a lysis indicator Ind (t,) determined using the intensity of the pixels of the lysis control zone is established. This lysis indicator is for example the variance or the standard deviation of the intensity distribution of these pixels.
    During a step 360, a lysis level is determined from the value of the indicator Ind (ti). Depending on its value, it is estimated that the lysis is sufficiently advanced or repeats steps 300 to 360, considering an image l (ti + i), acquired at a time ti + i later than time t ,. When the value of the lysis indicator reaches a certain criterion, called lysis criterion, it is considered that a lysis end time has been reached and the next steps 400 to 600 are taken, either by acquiring another image or based on the image 1 (1 = 7 ^) acquired at the instant Τι- The lysis indicator can be established image by image, with each image l (tj) being associated a lysis indicator Ind (ti) .
    It can also be representative of a correlation or a difference between two successive images l (t |) and l (tn), an indicator Ind (ti) attributed to the image pair l (t |), l (ti) -i). In this case, during step 340, for example, an image difference A (t,) such that A (t,) = l (ti) - l (ti-i) is determined. This image A (t,) is called comparison image at time t ,. The lysis indicator Ind (ti) may correspond to the mean or the standard deviation, or the variance of said comparison image A (t,).
    The end-of-lysis criterion is determined as a function of the temporal evolution of the lysis indicator Ind (ti). In particular, it is considered that the end of lysis criterion is reached when the lysis indicator no longer changes significantly. The end of lysis criterion may also be a predetermined threshold value, the lysis end time Γ; being considered reached when the lysis flag Ind (ti) crosses such a threshold.
    The other steps 100, 200, 400, 500, 600 are analogous to the steps described in connection with FIG. 5. The control zone ZC defined in step 320 may be similar to the measurement zone ZM described in connection with FIG. step 400.
    Experimental tests were carried out in order to determine, by image analysis, an end of lysis time Tt, under different conditions.
    The images of FIGS. 7A, 7B, 7C, 7D and 7E represent a sample similar to that described in FIGS. 3A and 3B, the glucose concentration being 4.8 mM. A control zone ZC of 640 x 480 pixels has been selected. This zone is represented by a white frame on the image 7A, knowing that this zone is identical for each of the images 7A to 7E. If to denote the introduction of the sample into the microcuvette, these images were respectively acquired at + 10 s, to + 20 s, to + 30 s, to + 60 s, to + 120 s.
    It can be seen that at t0 + 10 s (Figure 7 A), the image appears noisy, especially in comparison with the other images, this noise being due to the scattering of the light radiation incident by the red blood cells. It is understood that the signal measured by the photodetector is greatly influenced by the diffusion. As the time elapsing since the introduction increases, the images are less and less noisy, and this is particularly clear between t0 + 10 s (Figure 7A) and t0 + 30 s (Figure 7C). Beyond to + 30 s, we observe the formation of bubbles, appearing in the form of black disks, whose surface increases over time. This increase of the surface can in particular be appreciated by comparing FIGS. 7C to 7E. The inventors consider that the lysis can be considered as complete, or no longer evolving significantly, after to + 30 s.
    Figure 7F shows a sample whose glucose concentration is 19 mM, the image being acquired at t0 + 120 s. It is observed that the gray level is much darker than in the image 7E, carried out under the same conditions, with a lower glucose content. This is due to the fact that the intensity of the transmitted light beam is very largely governed by the absorption due to the colored indicator, the concentration of the latter being greater in FIG. 7F than in FIG. 7E because of the difference amount of glucose.
    FIG. 8A shows the evolution of the standard deviation of the intensity of the pixels in the lysis control zone ZC as a function of time. More precisely, the abscissa axis represents the increment number of each image analyzed, the time interval between each image being 5 seconds. The image 1 corresponds to to + 10s, the image 2 corresponds to t0 + 15s, etc. The lysis control zone ZC is the same for each image, and corresponds to that represented in FIG. 7A. The standard deviation fluctuates in the first images, then stabilizes after the image i = 5, corresponding to a duration of 30 seconds after the introduction of the sample in the microcuvette 30. From this moment, it is considered that the lysis is complete, or at least sufficiently advanced so that the measurements are not significantly disturbed by the diffusion. Also, the standard deviation of each image can be an indicator of lysis.
    FIG. 8B represents the evolution of the average, in the lysis control zone, made from comparison images Δ (ΐ,), each comparison image being obtained, in this example, by a subtraction of a image Ι (ΐ,) acquired at a time t, at an image l (ti-i) acquired at a time tj_i. As in the example described with reference to FIG. 8A, this figure is made from images successively acquired at a time interval of 5s, the image 1 corresponding to to + 10s. The abscissa axis represents the number i of each comparison image Δ (ΐ,) analyzed, the time interval between each image being 5 seconds. The ordinate axis represents the average value of pixel intensity in the lysis control zone ZC of each comparison image Δ (ΐί). There is a stabilization of the average value from the comparison image corresponding to the index i = 4, ie t0 + 25s. Also, the average intensity of the comparison image pixels A (t,), acquired at different times t, can constitute a lysis indicator.
    FIG. 8C represents the evolution of the standard deviation, in the lysis control zone ZC, produced from the comparison images A (t,) described with reference to FIG. 8B. There is a stabilization of the standard deviation from the image corresponding to the index i = 4, ie to + 25s. Also, the standard deviation of the intensity of the comparison image pixels A (tj), acquired at different times t, may constitute a lysis indicator.
    Figs. 9A, 9B and 9C show respectively results obtained in the same way as those shown in Figs. 8A, 8B and 8C. These figures were obtained using a sample whose glucose concentration was 19 mM.
    As in FIGS. 8A, 8B and 8C, and in a general manner, the lysis indicator makes it possible to determine an end-of-lysis moment, from which the lysis of the particles of the sample is sufficiently advanced of such so that the image acquired by the photodetector is little or not influenced by the diffusion, by the particles, of the light radiation 12. From this moment, the image is mainly influenced by the absorption of the light radiation 12 by the sample. In this case, in the examples previously exposed, this moment is of the order of 25 to 30 seconds after the introduction of the sample into the microcuvette.
    This instant, called instant lysis, is reached when the lysis indicator respects a certain criterion, called lysis criterion. The lysis criterion may be a threshold value of the indicator. It may also be a value representing a stabilization of the temporal evolution of the indicator, based on a comparison between indicators established according to several consecutive images. The term comparison can mean a subtraction or a ratio.
    Thus, in general, an object of the invention is a method for determining a lysis indicator in a liquid sample, the sample comprising particles, the method comprising mixing the sample with a reagent of lysis, capable of lysing said particles, the method comprising the steps of: illuminating said sample 10 with the aid of a light source 11, able to emit light radiation 12 towards the sample, acquisition, with the aid of a matrix photodetector 16, an image I of light radiation transmitted or reflected by the sample, determination of a lysis indicator from said image.
    This lysis indicator represents a state of progress of the lysis of the particles in the sample, under the effect of the lysis reagent. When this lysis indicator reaches a certain criterion, called lysis criterion, it is considered that most of the particles have been lysed. The scattering effect of the light radiation by the sample is then negligible. The image acquired by the detector then represents the absorption of the light radiation transmitted or reflected by the sample. The lysis indicator may comprise: a term representing the dispersion of the intensity of the pixels of an image acquired by the photodetector around an average value, for example a variance or a standard deviation of this image; establishing a comparison, for example in the form of a difference, or a correlation factor, between two images acquired at different times t, and tj_i a term, representing a mean value of an image of comparison A (t,) resulting from such a comparison, or representing a dispersion around this average value, for example a variance or a standard deviation of this comparison image.
    The method described above, applied to the determination of a concentration of glucose in whole blood, can be generalized to any analyte present in a liquid sample, particularly a body sample.
    权利要求:
    Claims (19)
    [1" id="c-fr-0001]
    A method for estimating an amount of an analyte (30) in a liquid sample (10), the method comprising the following steps: a) mixing said sample (10) with a first reagent (22) capable of forming a colored indicator (24) in the presence of said analyte, in the sample, b) following this mixing, illumination of said sample (10) with the aid of a light source (11), able to emit light radiation ( 12) to the sample, c) acquisition, with the aid of a matrix photodetector (16), of an image (I, Γ) of a light radiation (14, 14 ') transmitted or reflected by the sample, d) estimating a quantity of said analyte (30) according to said image, the method being characterized in that step d) comprises the following substeps: i) selection of a measurement zone (ZM ), in said image, said measuring zone comprising a plurality of pixels, ii) determining, within the measurement zone (ZM), a region of interest (ROI) and at least one exclusion region (REX), iii) estimating said amount of analyte (30) from a quantity (k) representative of the intensity of the pixels in said area of interest, without taking into account the pixel intensity of each exclusion region.
    [2" id="c-fr-0002]
    The method of claim 1, wherein the substep ii) comprises determining at least one exclusion region (REX) said region of interest (ROI) corresponding to a portion of said measurement area (ZM ) not including each exclusion region so determined.
    [3" id="c-fr-0003]
    3. The method of claim 1 or claim 2, wherein the sample comprises particles (20), the method comprising mixing the sample with a second reagent (26), said lysis reagent, capable of lysing said particles.
    [4" id="c-fr-0004]
    4. The method of claim 3, wherein each exclusion zone corresponds to the trace (28) of an air bubble (27), said air bubble being formed following the lysis of said particles.
    [5" id="c-fr-0005]
    5. Method according to one of claims 3 or 4, also comprising, during step d), - the determination of a lysis indicator (lnd (t,)) from the image acquired during the step c). the estimation of the amount of analyte being carried out when this lysis indicator satisfies a predetermined lysis criterion.
    [6" id="c-fr-0006]
    The method according to claim 5, wherein when the lysis indicator does not satisfy said lysis criterion, step c) is reiterated, so that a plurality of lysis indicators (Ind (tj)) are determined from images (Ind (ti), (Ind (ti-i)) acquired at different times (t ,, ti-i),
    [7" id="c-fr-0007]
    The method of claim 6, wherein each lysis indicator is determined by forming a comparison image (Δϊ), representing a comparison between two images (Ind (ti), (Ind (ti-i)) acquired at different times (t, you)
    [8" id="c-fr-0008]
    The method of any of the preceding claims including a step of introducing the sample into a fluid chamber (13), wherein steps c) and d) are performed from a predetermined time (T) after said introduction.
    [9" id="c-fr-0009]
    9. A method according to any one of the preceding claims, comprising acquiring a plurality of successive images (I, Γ) of the light radiation transmitted or reflected by the sample, the amount of analyte being determined, when step d), according to the evolution of the intensity of each image as a function of time.
    [10" id="c-fr-0010]
    The method as claimed in any one of the preceding claims, wherein, in step d), said magnitude (k) representative of the intensity of the pixels in said region of interest (ROI) comprises the integral or the pixel average in said region of interest.
    [11" id="c-fr-0011]
    11. Method according to any one of the preceding claims, wherein the exclusion region (REX) is determined by thresholding said image (I, Γ), or by segmentation of said image (I, I ').
    [12" id="c-fr-0012]
    The method of any one of claims 3 to 11, wherein said particles (20) are red blood cells.
    [13" id="c-fr-0013]
    The method of any one of the preceding claims, wherein the analyte is glucose.
    [14" id="c-fr-0014]
    The method of any of the preceding claims, wherein the photodetector (16) is located at a distance (d) from the sample of less than 1 cm.
    [15" id="c-fr-0015]
    The method of any of the preceding claims, wherein there is no magnification optics between the sample (10) and the photodetector (16).
    [16" id="c-fr-0016]
    A method according to any one of the preceding claims, wherein the sample (10) is disposed between said light source (11) and said photodetector (16), so that the photodetector detects a transmitted radiation (14). by the sample (10), the image acquired by the photodetector then being a so-called transmission image (I).
    [17" id="c-fr-0017]
    The method according to any one of claims 1 to 15, wherein the sample is disposed facing the light source (11) and the photodetector (16), so that the photodetector detects radiation (14 '). reflected or backscattered by the sample (10), the image acquired by the photodetector then being a reflection image (Γ).
    [18" id="c-fr-0018]
    A device for estimating the amount of an analyte (30) in a liquid sample (10), the device comprising: a light source (11) adapted to emit light radiation (12), toward said sample (10); ), a support, for holding the sample (10) between said light source (11) and a matrix photodetector (16), the matrix photodetector (16) being arranged to acquire an image (Ι, Γ) of the transmitted radiation or reflected (22, 22 ') by the sample, when the latter is exposed to said light radiation (12), a processor, able to estimate an amount of analyte in the sample (10), said processor being able to implementing step d) of the method that is the subject of the claims therein 13.
    [19" id="c-fr-0019]
    19. Device according to claim 18, wherein the photodetector (16) is located at a distance (d) of the sample less than 1 cm, and / or in which there is no magnification optics between the sample (10) and the photodetector (16).
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    同族专利:
    公开号 | 公开日
    FR3038723B1|2019-06-14|
    EP3115770A1|2017-01-11|
    US20170011517A1|2017-01-12|
    US10346983B2|2019-07-09|
    US20190012788A1|2019-01-10|
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    优先权:
    申请号 | 申请日 | 专利标题
    FR1556445A|FR3038723B1|2015-07-07|2015-07-07|METHOD OF ESTIMATING A QUANTITY OF ANALYTE IN A LIQUID|
    FR1556445|2015-07-07|FR1556445A| FR3038723B1|2015-07-07|2015-07-07|METHOD OF ESTIMATING A QUANTITY OF ANALYTE IN A LIQUID|
    EP16178062.2A| EP3115770A1|2015-07-07|2016-07-05|Method for estimating an amount of analyte in a liquid|
    US15/204,300| US10049453B2|2015-07-07|2016-07-07|Method for estimating an amount of analyte in a fluid|
    US16/031,485| US10346983B2|2015-07-07|2018-07-10|Method for estimating an amount of analyte in a fluid|
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