June 9, 2019
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Article

Non-invasive detection of severe neutropenia in chemotherapy patients by optical imaging of nailfold microcirculation

Publicated to: Scientific Reports. 8 (5301): 5301- - 2018-12-01 8(5301), DOI: 10.1038/s41598-018-23591-0

Authors:

Bourquard, Aurelien; Pablo-Trinidad, Alberto; Butterworth, Ian; Sanchez-Ferro, Alvaro; Cerrato, Carolina; Humala, Karem; Urdiola, Marta Fabra; Del Rio, Candice; Valles, Betsy; Tucker-Schwartz, Jason M; Lee, Elizabeth S; Vakoc, Benjamin J; Padera, Timothy P; Ledesma-Carbayo, Maria J; Chen, Yi-Bin; Hochberg, Ephraim P; Gray, Martha L; Castro-Gonzalez, Carlos
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Affiliations

CIBER BBN, Madrid, Spain - Author
Harvard Med Sch, Boston, MA USA - Author
Harvard Med Sch, Massachusetts Gen Hosp, Ctr Canc, Boston, MA USA - Author
Harvard Med Sch, Wellman Ctr Photomed, Boston, MA USA - Author
HM Hosp, Ctr Integral Neurociencias HM CINAC, Madrid, Spain - Author
Hosp Univ La Paz, Dept Hematol, Madrid, Spain - Author
Massachusetts Gen Hosp, Boston, MA 02114 USA - Author
Massachusetts Gen Hosp, Dept Radiat Oncol, Edwin L Steele Labs, Boston, MA 02114 USA - Author
MIT, Elect Res Lab, Cambridge, MA 02139 USA - Author
MIT, Inst Med Engn & Sci, 77 Massachusetts Ave, Cambridge, MA 02139 USA - Author
Univ Politecn Madrid, Biomed Image Technol, Madrid, Spain - Author
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Abstract

White-blood-cell (WBC) assessment is employed for innumerable clinical procedures as one indicator of immune status. Currently, WBC determinations are obtained by clinical laboratory analysis of whole blood samples. Both the extraction of blood and its analysis limit the accessibility and frequency of the measurement. In this study, we demonstrate the feasibility of a non-invasive device to perform point-of-care WBC analysis without the need for blood draws, focusing on a chemotherapy setting where patients' neutrophils-the most common type of WBC-become very low. In particular, we built a portable optical prototype, and used it to collect 22 microcirculatory-video datasets from 11 chemotherapy patients. Based on these videos, we identified moving optical absorption gaps in the flow of red cells, using them as proxies to WBC movement through nailfold capillaries. We then showed that counting these gaps allows discriminating cases of severe neutropenia (<500 neutrophils per mu L), associated with increased risks of life-threatening infections, from non-neutropenic cases (>1,500 neutrophils per mu L). This result suggests that the integration of optical imaging, consumer electronics, and data analysis can make non-invasive screening for severe neutropenia accessible to patients. More generally, this work provides a first step towards a long-term objective of non-invasive WBC counting.
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Keywords

AdultBloodCapillariesCapillaryCell-tracking algorithmsCisplatinConnective-tissue diseaseFeasibility studiesFemaleHumansLeukocyte countLeukocytesMaleManagementMicrocirculationNeutropeniaNeutrophilsOptical imagingReliabilitySpectroscopyVelocityVideocapillaroscopy

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Scientific Reports due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2018, it was in position 15/69, thus managing to position itself as a Q1 (Primer Cuartil), in the category Multidisciplinary Sciences.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2025-12-21:

  • Google Scholar: 30
  • WoS: 22
  • Scopus: 25
  • Europe PMC: 10
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-12-21:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 88.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 88 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 149.
  • The number of mentions on the social network X (formerly Twitter): 13 (Altmetric).
  • The number of mentions in news outlets: 15 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: https://oa.upm.es/54988/

As a result of the publication of the work in the institutional repository, statistical usage data has been obtained that reflects its impact. In terms of dissemination, we can state that, as of

  • Views: 450
  • Downloads: 247
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (BOURQUARD, AURÉLIEN) and Last Author (Castro-Gonzalez, Carlos).

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Awards linked to the item

The authors thank Tom Vettenburg for his involvement in the event-rating process and Arrate Munoz Barrutia for providing advice and mentoring. We thank the Madrid-MIT M + Vision Consortium faculty for their guidance in developing this project. This work was supported by the Comunidad de Madrid through the Madrid-MIT M + Vision Consortium; the Center For Future Technologies in Cancer Care through grant NIH U54 (award no. 4U54EB015403-05); the Wallace H. Coulter Foundation at BU; the Deshpande Center for Technology Innovation; the MIT Sandbox Innovation Fund and the EU FP7-PEOPLE-2011-COFUND Program within the M + Vision Project of Fundacion Madri + d (Comunidad de Madrid); Fundacion Ramon Areces; and the MIT Undergraduate Research Opportunities Program (UROP).
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