Robotic Point-of-Care OCT

项目摘要/摘要 PI以前是在完成杜克大学医学科学家培训时由F30机制资助的 程序。此后，他完成了医学院和实习工作，现在回国从事全职研究工作。 这项职业发展建议是对PI先前指导的培训和研究的有效延续 他拥有丰富的经验，并试图将他培养成一名独立调查员。拟议的项目涉及角色 光学相干断层扫描(OCT)在视网膜疾病筛查中的应用。可预防的视网膜失明影响数十人 数以百万计的美国人和全世界数亿人。它的三大原因是慢性的、渐进性的 在最初的无症状期后导致不可逆转视力丧失的情况。因此，每年一次的筛查 在视力恶化之前发现和治疗这些疾病至关重要。筛查率不是最理想的， 然而，因为由初级保健人员进行适当的眼睛检查是困难的和不准确的 提供商(PCP)。OCT是治疗视网膜疾病的一种基本的成像方式。目前，临床上 OCT被部署为笨重的桌面仪器，需要训练有素的眼科摄影师，专门的成像 套房，以及用于手术的机械头部稳定器，这阻止了基于OCT的眼睛 五氯苯酚筛查。我们最近推出了机器人护理点OCT(RAOCT)，作为一种全新的 基于OCT的眼科检查的范例，克服了OCT仅限于眼科办公室的障碍。 RAOCT提供半自动或全自动非接触式OCT成像，通过将机器人安装的OCT扫描仪 在整个大型成像工作空间中跟踪他们，并对运动伪影进行光学校正。我们的 使用这种方法的实验室原型已经在独立式和座式中证明了足够的OCT质量 分别用于解剖测量和临床相关的受试者，只需最少的操作员培训。 然而，这些原型只有在受控的实验室条件下才能可靠地发挥作用，而且意义重大 为了实现临床应用，必须开发可移植性、跟踪健壮性和运动校正技术。 准备好乐器。因此，该项目寻求将我们安装在工作台上的原型推进到完全成熟 用于非专科诊所的移动成像系统，并对照OCT护理标准对其进行测试。首先，我们 将把我们的原型转换成可以带到诊所的轮式手推车，升级我们的机械臂 扩展覆盖范围，并重新设计我们的机器人安装扫描仪，以改进逼真成像下的跟踪 条件。接下来，我们将通过将图像处理算法转换为专用算法来增强运动衰减 硬件，通过添加对残余运动的数字校正，并通过结合新的自适应扫描 减少成像时间的技术。最后，我们将在眼科临床上进行RAOCT成像比较 对照护理标准和初级保健办公室评估筛查工作流程。完成这项工作 该项目将把机器人OCT开发成一个交钥匙成像平台，承诺增强眼睛 在初级保健环境中进行筛查。

PROJECT SUMMARY/ABSTRACT The PI was previously funded by the F30 mechanism while completing the Duke Medical Scientist Training Program. He has since completed medical school and internship and now returns for a full-time research career. This career development proposal is an effective continuation of the PI’s prior mentored training and research experience and seeks to develop him into an independent investigator. The proposed project concerns the role of optical coherence tomography (OCT) in retinal disease screening. Preventable retinal blindness affects tens of millions of Americans and hundreds of millions worldwide. Its top three causes are chronic, progressive conditions that yield irreversible vision loss after an initial asymptomatic period. Annual screening is therefore essential to detect and treat these diseases before sight deteriorates. Rates of screening are suboptimal, however, because the proper eye examination is difficult for and inaccurate when performed by primary care providers (PCPs). OCT is an essential imaging modality for management of retinal diseases. Currently, clinical OCT is deployed as bulky tabletop instruments that require trained ophthalmic photographers, dedicated imaging suites, and mechanical head stabilization with chinrests for operation, which has prevented OCT-based eye screening by PCPs. We recently introduced robotic point-of-care OCT (RAOCT) as a fundamentally new paradigm for OCT-based eye examination that overcomes the barriers that restrict OCT to ophthalmology offices. RAOCT offers semi- or fully-automated non-contact OCT imaging by bringing a robot-mounted OCT scanner to the patient, tracking them throughout a large imaging workspace, and optically correcting for motion artifact. Our laboratory prototypes using this approach have demonstrated sufficient OCT quality in freestanding and seated subjects for anatomic measurement and clinical correlation, respectively, with only minimal operator training. These prototypes function reliably only under controlled laboratory conditions, however, and significant technology development for portability, tracking robustness, and motion correction is necessary to yield a clinic- ready instrument. This project therefore seeks to advance our bench-mounted prototypes into fully-fledged mobile systems for imaging in non-specialist clinics and to test them against the OCT standard-of-care. First, we will transition our prototype into a wheeled cart that can be brought into clinics, upgrade our robot arm for extended reach, and redesign our robot-mounted scanner for improved tracking under realistic imaging conditions. Next, we will enhance motion attenuation by transitioning image processing algorithms to dedicated hardware, by adding digital correction for residual motion, and by incorporating a novel adaptive scanning technique to reduce imaging time. Finally, we will perform RAOCT imaging in ophthalmology clinics to compare against the standard of care and in primary care offices to evaluate screening workflows. Completion of this project will develop robotic point-of-care OCT into a turnkey imaging platform that promises to enhance eye screening in primary care settings.