Development of photoacoustic tomography for non-invasive, label-free imaging of tissue perfusion in chronic wounds

开发用于慢性伤口组织灌注非侵入性、无标记成像的光声断层扫描技术

• 批准号: 10404566
• 负责人: Jun Xia
• 金额: $ 42.4万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10404566
• 关键词: 3-Dimensional; Acoustics; Address; Affect; Ambulatory Care Facilities; American; Amputation; Angiography; Ankle; Biometry; Blood; Blood Circulation; Blood Vessels; Buffaloes; Chronic; Clinic; Clinical; Clinical Trials; Clinical and Translational Science Awards; Contrast Media; Control Groups; County; Data; Decision Making; Detection; Development; Diffusion; Disease; Doppler Ultrasound; Ensure; Evaluation; Generations; Geometry; Goals; Guidelines; Hemoglobin; Hospitals; Hybrids; Image; Intervention; Label; Lasers; Leg Ulcer; Light; Lighting; Location; Medical center; Microcirculation; Modality; Monitor; Neuropathy; Operative Surgical Procedures; Optics; Outcome; Oxygen; Patients; Penetration; Performance; Perfusion; Photoplethysmography; Physiologic pulse; Positioning Attribute; Quality of life; Resolution; Scheme; Secure; Signal Transduction; Skin; Stasis Ulcer; Surgeon; Surgical wound; System; Systems Development; Techniques; Testing; Three-Dimensional Imaging; Time; Tissue imaging; Tissues; Toes; Transducers; Treatment Cost; Ulcer; United States National Institutes of Health; Universities; Venous; Visit; Visual; Visualization; Work; X-Ray Computed Tomography; absorption; base; blood perfusion; chronic ulcer; chronic wound; clinical risk; clinical translation; computer science; decubitus ulcer; design; diabetic; diabetic patient; effectiveness analysis; feasibility testing; follow-up; foot; hemodynamics; high resolution imaging; image processing; imaging capabilities; imaging modality; imaging platform; imaging system; improved; indexing; innovation; mortality; multidisciplinary; nephrotoxicity; optoacoustic tomography; photoacoustic imaging; portability; pressure; prevent; programs; reconstruction; revascularization surgery; systems research; tool; treatment group; treatment planning; two-dimensional; ultrasound; wound; wound care; wound healing; wound treatment

Project summary Chronic leg ulcers are affecting approximately 6.5 million Americans and the disease includes venous stasis ulcers, arterial ulcers, pressure ulcers, and diabetic (neuropathic) ulcers. They are associated with significant mortality (28% over two years), reduced quality of life (nonambulatory), and high treatment costs (>$25 billion/yr in the U.S.). Since many chronic ulcers have underlying vascular insufficiency, accurate assessment of blood perfusion to the wound is critical to treatment planning and monitoring. However, existing clinical tests fail to meet this need in practice. Without timely information on circulation, a patient may need to wait months after the revascularization surgery before any additional intervention can be planned. An accurate, noninvasive tool for circulation assessment would greatly improve post-surgical decision making and clinical outcomes of wound patients. This project aims to develop a three-dimensional (3D) wound assessment system using photoacoustic tomography (PAT), a hybrid modality that detects optical absorption in tissue through the photoacoustic effect. The conversion of optical absorption into acoustic waves breaks through the optical diffusion limit, allowing for high-resolution imaging in three dimensions. Since hemoglobin serves as the major endogenous contrast at near-infrared wavelengths, PAT provides label-free, three-dimensional imaging of hemoglobin distribution, which is closely related to circulation. While PAT has shown promising results in vascular imaging, various hurdles have prevented its application in wound evaluation. Capitalizing on the recent innovations in photoacoustic system development and image processing, the team will address these hurdles and develop a PAT-based wound imaging system with unique advantages in terms of spatial resolution, penetration depth, and portability. To ensure successful implementation of the project, the PI has gathered a multidisciplinary team with expertise in photoacoustic imaging, wound healing, vascular surgery, biostatistics, and computer science. The project has also secured support from the region’s busiest vascular clinic located at Buffalo Generation Hospital and Erie County Medical Center and their outpatient clinics. More importantly, the team has already worked together and acquired preliminary data through support from the University at Buffalo’s NIH Clinical and Translational Science Awards (CTSA) Program. Through the four-year project, the team will achieve the following aims: Aim 1: Develop a versatile, high-resolution 3D photoacoustic imaging system that can be easily rotated and positioned to image any regions on the foot; Aim 2: Validate the system at vascular clinics and identify photoacoustic features of tissue perfusion; and Aim 3: Test the feasibility of using PAT to monitor tissue perfusion and guide post-surgical assessment and treatment planning.

项目概要 慢性腿部溃疡影响着大约 650 万美国人，这种疾病包括静脉淤滞 溃疡、动脉溃疡、压疮和糖尿病（神经性）溃疡。它们与重要的 死亡率（两年内 28%）、生活质量下降（不能行走）以及高昂的治疗费用（每年超过 250 亿美元） 在美国）。由于许多慢性溃疡都有潜在的血管功能不全，因此准确评估血液 伤口灌注对于治疗计划和监测至关重要。然而现有的临床试验未能 在实践中满足这一需要。如果没有及时的循环信息，患者可能需要在治疗后等待数月 在计划任何额外的干预之前进行血运重建手术。一种准确的、非侵入性的工具 循环评估将极大地改善术后决策和伤口的临床结果 患者。该项目旨在开发一种利用光声技术的三维（3D）伤口评估系统 断层扫描 (PAT) 是一种通过光声效应检测组织中光吸收的混合模式。 光吸收转化为声波突破了光扩散极限，使得 三维高分辨率成像。由于血红蛋白是主要的内源性对比 近红外波长，PAT 提供血红蛋白分布的无标记三维成像， 与循环密切相关。虽然 PAT 在血管成像方面显示出有希望的结果，但仍存在各种障碍 阻碍了其在伤口评估中的应用。利用光声领域的最新创新 系统开发和图像处理，该团队将解决这些障碍并开发基于 PAT 的 伤口成像系统在空间分辨率、穿透深度和便携性方面具有独特的优势。 为了确保项目的成功实施，PI聚集了一支具有专业知识的多学科团队 光声成像、伤口愈合、血管外科、生物统计学和计算机科学。该项目有 还获得了位于布法罗一代医院和伊利的该地区最繁忙的血管诊所的支持 县医疗中心及其门诊部。更重要的是，团队已经齐心协力， 在布法罗大学 NIH 临床和转化科学的支持下获得了初步数据 奖项 (CTSA) 计划。通过为期四年的项目，团队将实现以下目标： 目标 1：发展 多功能、高分辨率 3D 光声成像系统，可轻松旋转和定位以成像 脚上的任何区域；目标 2：在血管诊所验证该系统并识别血管的光声特征 组织灌注；目标 3：测试使用 PAT 监测组织灌注并指导术后的可行性 评估和治疗计划。