Quantitative Estimation of Periodontal Inflammation and Tissue Destruction with High-Resolution Ultrasound-Based Imaging - Admin Supp

摘要(来自家长资助申请) 牙周炎，由细菌感染引发，并由宿主炎症反应复合而成，是一种主要的 影响6500万美国成年人福利的牙齿脱落原因。越来越多的证据表明牙周炎也是 与全身健康有关，主要通过一个共同的联系，炎症。因此，诊断和 牙周炎的治疗可能会改善整体健康状况。目前的临床治疗措施 牙周炎是目测和“探诊出血(BOP)”。不幸的是，他们是 主观的，对检测疾病活动不敏感的。对亚临床炎症征象的靶向成像，例如 血管增多、间质积液、组织丢失等，有助于准确诊断和及时诊断。 在主席身边非侵入性地治疗这种深思熟虑的疾病。一些定量超声生物标记物， 例如，后向散射、弹性、彩色血流和能量多普勒在医学上得到了广泛的研究 近年来，已被公认为是评估特定身体器官炎症的有效方法。他们 可能是客观测量牙周炎症的潜在候选者。一个微型尺寸(16.2毫米)， 高成像分辨率(~60微米)超声探头样机是由我们团队专门开发的 在受限的口腔中，并已被验证为准确成像牙周组织。它已经准备好了 用于收集上述定量超声的商用超声系统 参数。支持这一提议的假设是，可以使用非侵入性和定量超声 评估最终可能导致早期发现的牙周炎的程度/程度 牙周附着和骨丢失。这一建议的目的有两个方面：(1)建立量化 基于超声的成像生物标志物，即B型(定量超声，QUS)、组织应变以及 使用具有已知属性的模体的分数血容量以及(2)执行相关性测试 确定非侵入性超声成像生物标志物和 侵袭性组织学/分子生物学，使用已建立的临床前猪模型。取得的成功成果 这项研究将带来新的、客观的和精确的超声生物标志物，可以估计 牙周炎的严重程度/程度。随后，检测疾病活动的可预测性 个人和集体将通过纵向的临床前和人体研究进行评估。最终， 我们打算为常规口腔护理制定临床指南和临床成像方案，以缓解 影响数百万美国成年人的牙周炎的巨大负担。

ABSTRACT (from parent grant application) Periodontitis, initiated by bacterial infection and compounded by host inflammatory response, is a leading cause of tooth loss affecting welfare of 65 million US adults. Mounting evidence suggests periodontitis is also associated with systemic health, mostly through a common link, inflammation. Therefore, diagnosis and treatment of periodontal inflammation would potentially improve general health. Current clinical measures of periodontal inflammation are visual inspection and “bleeding on probing (BOP)”. Unfortunately, they are subjective and insensitive to detect disease activity. Targeted imaging of subclinical signs of inflammation, e.g. increased vascularity, interstitial fluid and tissue loss, etc., would shed light on precise diagnosis and timely treatment of this deliberating disease non-invasively at chairside. Some quantitative ultrasound biomarkers, e.g. backscatter, elasticity, color flow, and power Doppler have been investigated extensively in medicine in recent years and have been recognized as validated for evaluating inflammation of specific body organs. They would be potential candidates to measure periodontal inflammation objectively. A miniature sized (16.2 mm), high-imaging resolution (~60 µm) ultrasound probe prototype was developed by our group specifically for use in the constrainted oral cavity and has been validated for accurately imaging periodontal tissues. It is ready for use on a commercially available ultrasound system for collecting the above-mentioned quantitative ultrasound parameters. The hypothesis driving this proposal is that non-invasive and quantitative ultrasound can be used to estimate degree/extent of periodontal inflammation that could eventually lead to early detection of periodontal attachment and bone loss. The aims of this proposal are two folds: (1) Establish quantitative ultrasound based imaging biomarkers, i.e., B-mode (Quantitative Ultrasound, QUS), tissue strain as well as fractional blood volume using phantoms with known properties and (2) Perform correlation testing for determining inflammation extent/severity between the non-invasive ultrasound imaging biomarkers and the invasive histology/molecular biology, using an established preclinical porcine model. Successful outcomes of this investigation will lead to novel, objective and precise ultrasound biomarkers that can estimate severity/extent of periodontal inflammation. Subsequently, the predictability of detecting disease activity individually and collectively will be evaluated through longitudinal preclinical and human studies. Ultimately, we intend to develop clinical guidelines and a clinical imaging protocol for routine oral care to alleviate the tremendous burden of periodontitis affecting millions of US adults.