Robotic Point-of-Care OCT

项目总结/摘要 PI之前在完成杜克医学科学家培训时由F30机制资助 程序.此后，他完成了医学院和实习，现在返回全职研究生涯。 该职业发展建议是PI先前指导培训和研究的有效延续 他希望能把自己培养成一名独立的调查员。拟议项目涉及的作用 光学相干断层扫描（OCT）在视网膜疾病筛查中的应用。可摘性视网膜盲影响数十人 数以百万计的美国人和全世界数以亿计的人。它的三大原因是慢性的，渐进的 在最初的无症状期后产生不可逆视力丧失的病症。因此，年度筛查 在视力恶化之前发现和治疗这些疾病至关重要。筛查率不理想， 然而，由于适当的眼睛检查是困难的和不准确的，当进行初级保健 供应商（PCP）。OCT是用于视网膜疾病管理的基本成像模式。目前，临床 OCT作为笨重的台式仪器部署，需要经过培训的眼科摄影师、专用成像 套房，以及手术用下巴托的机械头部稳定，这阻止了基于OCT的眼睛 通过PCP筛选。我们最近推出了机器人床旁OCT（RAOCT），作为一种全新的 这是基于OCT的眼科检查的范例，克服了限制OCT进入眼科诊所的障碍。 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 患者，在整个大的成像工作空间中跟踪他们，并光学校正运动伪影。我们 使用这种方法的实验室原型已经证明在独立式和坐式中具有足够的OCT质量 分别用于解剖测量和临床相关性的受试者，仅接受最低限度的操作员培训。 然而，这些原型仅在受控的实验室条件下可靠地运行， 便携性、跟踪鲁棒性和运动校正的技术开发是必要的， 准备好的仪器因此，该项目旨在将我们的台式原型推进到成熟的 用于非专科诊所成像的移动的系统，并根据OCT护理标准对其进行测试。一是 我们将把我们的原型转变成一个可以带进诊所的轮式推车，升级我们的机器人手臂， 扩展范围，并重新设计我们的机器人安装扫描仪，以改善逼真成像下的跟踪 条件接下来，我们将通过将图像处理算法过渡到专用的 硬件，通过增加残余运动的数字校正，并通过结合一种新的自适应扫描 减少成像时间的技术。最后，我们将在眼科诊所进行RAOCT成像， 对照护理标准和初级保健办公室评估筛查工作流程。完成本 该项目将把机器人床旁OCT开发成一个交钥匙成像平台，有望增强视力 在初级保健机构进行筛查。

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.