Absolute Measurement of Cerebral Blood Flow Using Diffuse Optics

描述（由申请人提供）：中枢神经系统（CNS）疾病管理的临床干预主要基于各种次要信息的推断和临床医生的个人或集体经验，而不是直接测量脑功能，特别是脑血流量（CBF）。事实上，一种用于测量微血管CBF的无创、连续、床边仪器对于各种中枢神经系统疾病（如中风、出血和头部创伤）的治疗是非常理想的。当前使用的诊断有局限性。例如，现有的模式要么提供的信息不足（如经颅多普勒超声测量选定动脉内的速度），要么相对难以接近（氙气吸入CT、动脉自旋标记MRI、PET）。这一建议的前提是一种新开发的光学技术可以用来测量绝对CBF。漫射相关光谱（DCS）提供了新的、非侵入性的医疗诊断工具，其相对测量的能力最近在完整人脑的功能激活研究中得到了证明。预计DCS的进一步发展将产生临床影响。为此，本建议以系统的方式解决DCS的缺点。问题如；“信号的生物学起源是什么？”“正在探查哪个组织体积？”和“皮质脑卒中的绝对脑卒中能被估计出来吗？”通过计算机模拟、组织模拟幻影实验和体内研究来解决这些问题。如果成功，该仪器将进行临床试验和进一步开发。我们期望在短时间内，该技术的临床应用将得到建立。这个项目的另一个好处是，在其他疾病和器官的其他临床应用将是可行的。中枢神经系统（CNS）疾病管理的临床干预主要基于临床医生的各种次要信息和经验的推断，而不是直接测量脑血流量（CBF）。一种非侵入性、连续的床边仪器，用于测量微血管中的脑血流，对于各种中枢神经系统疾病（如中风、出血和头部创伤）的治疗是非常理想的。提出的光学技术将在填补这一空白方面迈出一大步。

DESCRIPTION (provided by applicant): Clinical interventions in central nervous system (CNS) disease management base decisions on primarily deductions from a variety of secondary information and on the individual or collective experience of clinicians rather than direct measurements of brain function, and in particular cerebral blood flow (CBF). A non-invasive, continuous, bed-side instrument for measurement of CBF in the micro-vasculature would, in fact, be highly desirable for management of a variety of CNS disorders such as stroke, hemorrhage, and head trauma. Diagnostics in current use have limitations. For example, available modalities deliver either insufficient information (e.g. transcranial Doppler Ultrasound measurement of velocity within selected arteries) or are relatively inaccessible (Xenon inhalation CT, arterial spin labeling MRI, PET). The premise of this proposal is that a newly developed optical technique can be used to measure absolute CBF. Diffuse correlation spectroscopy (DCS) offers new, non-invasive medical diagnostic tools whose capabilities for relative measurements have recently been demonstrated in functional activation studies of intact human brain. Further developments in DCS are expected to have a clinical impact. To that end, this proposal addresses the shortcomings of DCS in a systematic way. Questions such as; ``What is the biological origin of the signal?'', ``Which tissue volume is being probed?'' and ``Can the absolute, cortical CBF be estimated?'' are addressed via computer simulations, experiments on tissue simulating phantoms and via in vivo studies. If successful, pilot clinical trials and further development of the instrumentation will follow. We expect that in a short time period, the clinical utility of this technology will be established. Another side-benefit of this project will be that other clinical applications in other diseases and organs will be feasible. Clinical interventions in central nervous system (CNS) disease management base decisions on primarily deductions from a variety of secondary information and experience of clinicians rather than direct measurements of cerebral blood flow (CBF). A non-invasive, continuous, bed-side instrument for measurement of CBF in the micro-vasculature would be highly desirable for management of a variety of CNS disorders such as stroke, hemorrhage, and head trauma. The proposed optical technique will take a big step towards fullfiling this void.