Clinical diagnosis of potentially treatable early articular cartilage degeneration using optical coherence tomography
Clinical diagnosis of potentially treatable early articular cartilage degeneration using optical coherence tomography
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DOI：
10.1117/1.2789674
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发表时间：
2007-09-01
影响因子：
3.5
通讯作者：
Studer, Rebecca K.
中科院分区：
文献类型：
--
作者：
Chu, Constance R.;Izzo, Nicholas J.;Studer, Rebecca K.
进行了一系列从实验室到手术室的研究，以确定在临床上使用光学相干断层扫描（OCT）诊断潜在可逆的早期软骨退变是否可行。进行了一项人体尸体研究，以确认OCT成像和分级的再现性，该研究基于使用获批用于临床的偏振OCT系统识别软骨OCT形式双折射的变化。基于OCT形式双折射的存在或不存在，将外观大体正常的人关节软骨分为两组，表明没有OCT形式双折射的软骨响应于合成代谢生长因子IGF-1增加蛋白聚糖合成活性的能力降低。实验室数据进一步表明，没有OCT形式双折射的软骨中的IGF-1不敏感性是可逆的。为了证明临床可行性，随后在19名人类受试者中使用OCT进行关节镜检查。临床结果证实，在关节镜手术期间可检测到离体研究中观察到的OCT形式双折射的差异。在更可能具有软骨变性的组中的人类受试者的软骨中观察到软骨OCT形式双折射的更普遍的损失。这一系列综合实验室到床旁研究证明了将OCT用于临床研究的转化可行性，该临床研究旨在确定是否可以足够早地诊断出人类软骨退化，以进行干预，从而延迟或预防骨关节炎的发作。(c)2007年，由光学仪器工程师协会（Society of Photo-Optical Instrumentation Engineers）主办。
A series of bench to operating room studies was conducted to determine whether it is feasible to use optical coherence tomography (OCT) clinically to diagnose potentially reversible early cartilage degeneration. A human cadaver study was performed to confirm the reproducibility of OCT imaging and grading based on identification of changes to cartilage OCT form birefringence using a polarized OCT system approved for clinical use. Segregation of grossly normal appearing human articular cartilage into two groups based on the presence or absence of OCT form birefringence showed that cartilage without OCT form birefringence had reduced ability to increase proteoglycan synthetic activity in response to the anabolic growth factor IGF-1. The bench data further show that IGF-1 insensitivity in cartilage without OCT form birefringence was reversible. To show clinical feasibility, OCT was then used arthroscopically in 19 human subjects. Clinical results confirmed that differences to OCT form birefringence observed in ex vivo study were detectable during arthroscopic surgery. More prevalent loss of cartilage OCT form birefringence was observed in cartilage of human subjects in groups more likely to have cartilage degeneration. This series of integrated bench to bedside studies demonstrates translational feasibility to use OCT for clinical studies on whether human cartilage degeneration can be diagnosed early enough for intervention that may delay or prevent the onset of osteoarthritis. (c) 2007 Society of Photo-Optical Instrumentation Engineers.