Clinical translation of an early-photon imaging system for safe placement of feeding tubes

Placement of nasogastric tubes (NGTs) is a routine medical procedure, yet the consequences of
misplacement are dire (e.g. food entering the lungs, leading to death and/or disability from
pulmonary complications). Current practice for NGT localisation relies on X-rays. This introduces delays to initiation of feeding (associated with worse patient outcomes) and increases burden on healthcare system resources and exposes patients and staff to ionising radiation. We have developed a compact bedside system with off-the-shelf componentry, capable of providing real-time guidance when placing NGTs. This device utilises an imaging implementation of time-correlated single-photon counting (TCSPC): early photons with a near direct path from a point source of light placed inside an NGT are detected by a time-resolved single-photon sensitive camera positioned outside of the patient. To date, we have validated device functionality, specifically differentiation between stomach and non-stomach NGT localisation, in porcine and human cadaver models. We shall shortly be commencing a first in-human clinical study at Edinburgh’s Royal Infirmary.