USE OF THERMAL AND 3D IMAGING TO QUANTIFY ARTHRITIS

使用热成像和 3D 成像来量化关节炎

• 批准号: 7567325
• 负责人: Raphael Hirsch
• 金额: $ 17.87万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7567325
• 关键词: 3-Dimensional; Adrenal Cortex Hormones; Anti-Tumor Necrosis Factor Therapy; Arthralgia; Arthritis; Childhood; Chronic Childhood Arthritis; Clinic Visits; Clinical; Clinical Research; Clinical assessments; Devices; Disease; Disease remission; Dose; Drug Delivery Systems; Evaluation; Goals; Hand functions; Health; Heating; Image; Inflammation; Inflammation Mediators; Inflammatory; Injection of therapeutic agent; Interobserver Variability; Intervention; Joints; Lasers; Magnetic Resonance Imaging; Measurement; Measures; Metacarpophalangeal joint structure; Methodology; Oral; Outcome Assessment; Patient Care; Patient Monitoring; Patients; Pattern; Peripheral; Pharmaceutical Preparations; Physicians; Questionnaires; Recording of previous events; Reporting; Reproducibility; Research Design; Rheumatoid Arthritis; Rheumatology; Self Assessment; Surface; Swelling; Synovitis; Testing; Therapeutic Intervention; Time; Variant; Wrist; clinical remission; cohort; cost; functional status; improved; prototype; public health relevance; response; sensor; tool

DESCRIPTION (provided by applicant): One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. It can even be difficult to determine whether inflammation is present or absent. Carefully designed studies have repeatedly shown poor We have built a prototype device using well-established sensors-specifically 3-dimensional (3D) laser line triangulation digitizer cameras and thermal infrared cameras-to rapidly quantify surface swelling and heat in arthritic joints. This Arthritis Surface Imager produces results within minutes. Thus it could become a routine component of the rheumatology clinic visit, allowing for the replacement of the current subjective and unreliable joint assessment with a quantitative and highly-reproducible measure that can be used to monitor patients over time. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis. The first Specific Aim is to test the hypothesis that surface imaging will provide an earlier and more sensitive measure of change in active arthritis and functional status than do physician's assessment and patient's self-assessment A cohort of patients with JRA and RA will be followed longitudinally before and during the course of a therapeutic intervention. Change in arthritis, as measured by the Arthritis Surface Imager will be compared to well-established and validated clinical measures, including 1) physician's assessment of joint tenderness and swelling and 2) patient's self-assessment of joint pain. Correlation will also be made with changes in functional status, as assessed by components of the Childhood Health Assessment Questionnaire (CHAQ) and Health Assessment Questionnaire (HAQ) that pertain to hand function. We will also examine predictors of change in functional status. The second Specific Aim will test the hypothesis that surface imaging can improve the accuracy of remission measurement. It has recently been reported that patients in clinical remission often have MRI evidence of continued synovitis, demonstrating that current clinical measures of inactivity do not correlate well with true remission. Our Preliminary Studies suggest that many patients with a history of arthritis have abnormal joint thermal patterns even when asymptomatic. Patients with clinically-inactive disease will be imaged by MRI to determine whether patients with subclinical arthritis can be identified by the Arthritis Surface Imager. Low-cost, time-efficient tools that produce a set of reliable, reproducible and objective measures of the inflammatory state of the joint would improve the assessment of outcome in arthritis clinical studies, and ultimately will improve patient care. This proposal focuses on the wrist and metacarpophalangeal (MCP) joints, which make up 22 of the 28 joints in the Disease Activity Score (DAS) 28. Methodologies developed here could be readily applied to other peripheral joints. reproducibility of physician assessment of the number of swollen and/or tender joints. PUBLIC HEALTH RELEVANCE: One of the biggest challenges in caring for patients with Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA) is quantifying the degree of disease activity in any given joint. We have built a prototype device using well-established sensors to rapidly quantify surface swelling and heat in arthritic joints. The goal of our studies is to test the hypothesis that this Imager can improve the clinical assessment of arthritis.

描述(申请人提供)：护理类风湿性关节炎(RA)和青少年类风湿性关节炎(JRA)患者的最大挑战之一是量化任何给定关节的疾病活动程度。甚至很难确定炎症是否存在。精心设计的研究一再表明糟糕我们已经建造了一个原型设备，使用成熟的传感器-特别是三维(3D)激光直线三角数字化相机和热红外相机-来快速量化关节炎关节的表面肿胀和热量。这款关节炎表面成像仪在几分钟内就能产生结果。因此，它可能成为风湿病诊所就诊的常规组成部分，允许用一种可用于随着时间的推移监测患者的定量和高度重复性的衡量标准来取代目前主观和不可靠的联合评估。我们研究的目的是验证这种成像仪可以改善关节炎的临床评估这一假设。第一个具体目的是验证这样一个假设，即表面成像将提供比医生评估和患者自我评估更早、更敏感地衡量活动期关节炎和功能状态变化的指标。在治疗干预之前和过程中，将对JRA和RA患者队列进行纵向跟踪。由关节炎表面成像仪测量的关节炎的变化将与公认和有效的临床测量相比较，包括1)医生对关节压痛和肿胀的评估以及2)患者对关节疼痛的自我评估。儿童健康评估问卷(CHAQ)和健康评估问卷(HAQ)中与手功能有关的部分也将与功能状态的变化相关联。我们还将检查功能状态变化的预测因素。第二个具体目标将检验表面成像可以提高缓解测量精度的假设。最近有报道称，临床缓解的患者通常有持续滑膜炎的MRI证据，这表明目前临床上不活动的测量与真正的缓解没有很好的相关性。我们的初步研究表明，许多有关节炎病史的患者即使在没有症状的情况下也有异常的关节热模式。临床非活动性疾病的患者将通过核磁共振成像，以确定是否可以通过关节炎表面成像仪识别亚临床关节炎患者。低成本、省时的工具能够产生一套可靠的、可重复的和客观的关节炎症状态测量方法，将改善对关节炎临床研究结果的评估，最终将改善患者的护理。这项建议将重点放在腕关节和掌指关节(MCP)上，在疾病活动评分(DAS)28的28个关节中，它们占22个关节。所开发的方法可以很容易地应用于其他外周关节。医生对肿胀和/或压痛关节数量的评估的重复性。 公共卫生相关性：护理类风湿性关节炎(RA)和青少年类风湿性关节炎(JRA)患者的最大挑战之一是量化任何给定关节的疾病活动程度。我们已经建立了一个原型设备，使用成熟的传感器来快速量化关节炎关节的表面肿胀和热量。我们研究的目的是验证这种成像仪可以改善关节炎的临床评估这一假设。