Optical imaging of blood perfusion to predict treatment failure

血液灌注光学成像预测治疗失败

• 批准号: 7217250
• 负责人: STEVEN L. JACQUES
• 金额: $ 25.52万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7217250
• 关键词: Acute; Appearance; Area; Blood; Blood Clot; Blood Vessels; Blood Volume; Blood coagulation; Blood flow; Caring; Child; Clinical; Clinical Research; Coagulation Process; Computer software; Data Analyses; Engineering; Equipment Design; Failure; Image; Image Analysis; Laser-Doppler Flowmetry; Lasers; Lesion; Life; Light; Location; Measurement; Medical Surveillance; Optics; Oxygen; Patients; Physiological reperfusion; Predictive Value; Principal Investigator; Procedures; Reperfusion Therapy; Research Personnel; Site; Skin; Spectrum Analysis; Staining method; Stains; Standards of Weights and Measures; Surface; System; Testing; Time; Treatment Efficacy; Treatment Failure; Venous; Week; Work; Wound Healing; base; blood perfusion; computer science; design; experience; follow-up; improved; optical fiber; optical imaging; partial response; programs; prototype; response; software development; spectroscopic imaging; time use

DESCRIPTION (provided by applicant): Laser treatment of vascular abnormalities, such as portwine stain lesions (PWS), target the abnormally large PWS vessels with thermal damage, which yields clot formation in the PWS that elicits a wound healing response that removes the PWS. This treatment has been especially justified in children whose PWS are easily treated and provide a lifetime of normal appearance. However, there are often regions of treatment failure that require repeated treatments. Our working hypothesis is that treatment failure occurs because the treatment fails to induce a clot or the treatment-induced blood clot loosens and local blood flow is re-established thereby rescuing the PWS from the wound healing response. We propose a spectral camera system that can image the blood content and mixed arterio-venous oxygen saturation of the PWS before, immediately after, at 30 min, and at the 6-week follow-up exam, after laser treatment and indicate regions where blood perfusion has re-established. The acute measurements can predict regions of treatment failure and the measurements at follow-up can quantify the efficacy of treatments. No alteration of standard care will be done. The significance of the study is that once the correlation between reperfusion and treatment failure is demonstrated, justification would be established for immediate re-treatment of regions predicted to fail or other strategies for improving the stability of blood clots formed in the PWS by the procedure. The aims of this proposal are to (1) construct a prototype spectral camera for a pilot clinical study, (2) develop the analysis software that can efficiently analyze these images, and (3) conduct a pilot clinical study to establish the predictive value of the optical imaging.

描述（由申请方提供）：血管异常（如Porcelain染色病变（PWS））的激光治疗针对具有热损伤的异常大PWS血管，这会在PWS中形成凝块，促进伤口愈合反应，从而清除PWS。这种治疗在PWS易于治疗并提供终身正常外观的儿童中尤其合理。然而，经常有治疗失败的区域需要重复治疗。我们的工作假设是，治疗失败是因为治疗未能诱导凝块或治疗诱导的血凝块松动，局部血流重新建立，从而将PWS从伤口愈合反应中拯救出来。我们提出了一种光谱相机系统，可以成像的血液含量和混合动静脉血氧饱和度的PWS之前，之后立即，在30分钟，并在6周的后续检查，激光治疗后，并指出血液灌注已重新建立的区域。急性测量可以预测治疗失败的区域，随访时的测量可以量化治疗的疗效。不会改变标准治疗。该研究的意义在于，一旦证明了再灌注和治疗失败之间的相关性，就可以为预测失败的区域的立即再治疗或其他改善PWS中形成的血栓稳定性的策略提供依据。该提案的目的是（1）构建用于初步临床研究的原型光谱相机，（2）开发可以有效分析这些图像的分析软件，以及（3）进行初步临床研究以确定光学成像的预测价值。